HomeMy WebLinkAbout007-250-055%'4 45 55
Jim Clark
3122 Johnny Lane, Chico ij`f o
Permit #6865-79B(new pri.garage)
contra Holiday Pools, Chico
"Permit #5682-79B,P,E( ew privat
swimming pool & spa) ;woo
contr : Earl G. ';lark, Campbell, CA.
Permit #6866-79B(addition/SF)
7-4.S -SS 214
Permit#6102--0B(17sta11 wood
3tove)SF fin3 ,
7-25-55
Contr: Sunshine. Pools�j-�
Permit #1584-8.6B;E(new swimmin pool
007-250-055 OS -0239
KIM.BERLING, LARRY
3122 JOANNA LN, CHICO
Cont: OWNER
DINING&LIVING ADDITIONS Z'7 1*
NOTES RESIDENTIAL
' PERMIT NO.
z OS -0239 ti
KIMBERLI -6, LARRY
n-
`, 3122. LN FCHICO 06f
Cont: OWNER
CQ ( � fql - ao1 5 '� DINING&LIVING iWDITION
L
�2 •
i irI
` SPECIAL CONDITIONSY w '
F
• CHECKED
BY
SRA
FLOOD CERTIFICATE REQ: '
FIRE SPRINKLERS REQ. -
SPECIAL INSPECTION ITEMS y
VERIFY
USE PERMIT CONDITIONS
SUB 'STANDARD HOUSING LETTER
i
D_q
JOB FINALED (Date)-
Signature
Date) Signature
J=OK
0 = Not OK
. = NotReadyable MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ P' L'ft.
- / P Nat. or / P' L "ft./ P LPG
7.'Well Clearance &Disconnect
8. Utilitv Clearance
Date Card B-1 Date Card B-1
Date
Card B=1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs-Type-Installation.Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
Date
9.
Card B-1 Date
Card B-1
Date
Card B-1 Date Card B-1
Card B-1 Date
Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Setbacks -Easements
Enclosure; Fencing -Alarms
1.
Zoning Requirements -Setbacks -Easements
3.
2.
Footings; Size -Spacing -Marriage Line
4.
Elec.; Receptacles and Lighting, Distance-GFI
3.
Blocking
Elec.; Pool Lighting; 15 Volts-GFI
Card B-1 Date Card B-1
4.
Gas; MH Test -Demand -Valve
7.
5.
Electricity; MH Test
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
Date
Card B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails.
4. Wood Awn.; Posts- Beams- Rftrs-Connectors.
Shthg-Frg-Bracing ,
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels •
Date
9.
Card B-1 Date Card B-1
Date
10.
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
Light Niche
1.
Setbacks -Easements
Enclosure; Fencing -Alarms
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
'
5.
Elec.; Pool Lighting; 15 Volts-GFI
Card B-1 Date Card B-1
'6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
k'.
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9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
k'.
j'•r. • ,iY•4y ,.. f"�'.O:ba.a•..ix•o�.wr'yJwrtr:-3K�.w�.b.y„Fw .�4::3!�.�.
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDUAFLOOR (Plans) OK except #'s
V Ftg., Main; Soils-Elec. Grnd.-/ ' " Ftg. Depth
3-Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4- Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5 -Stemwalls, Main; Steel- Bloc kouts-Wrapped _
&_ remwalls, Garage; Steel- Bloc kouts-Wra ed
}gold Downs and Special Anchors
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except #'s
17. Water Htr.: Vent -Access -Combustion Air Baffle
19. D.W.V.; Test Fittings Anchor -Nail Protection
20. Shower Pan; Test, Orst Floor -Tub Access
22. Gas Pipe; Six! Anchors
23. Fire Sprinkle Test
Date
QDiShe ails; Nailing -Bolts
Card B-1 Date Card B-1
Date
race Interior/Exterior Wall Panels
Card B-4 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Date
24.
F' ure & Transformer Cle ncq4ns. ProteVon
Date
-r!;_-O(o Card B-1 Date Card B-1
Elec. 5pceptacles Sp ng -L' hts & Swi es at Doors
FINAL (Plans) OK except #'s
26.
S' Boxes & No. of Conductors Stapled
Ext. Steps -Door & Sidelight Protection -Landings
Romex Installed Close to Edge of Studs & C.J.
Smoke Detector
28.
ers- Bond Gas & Water
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
29.
30.
2 ADolianConductor Size GFI
W' u or AI-A.C. Wire Size/ /ga Cu or Al
Bedroom Exiting
31
/ga Cu -Oven Circ. / /ga Cu or Al
Insulated Neutral ❑ Yes ❑ No
G.F.I. & Bath Fixtures & Tub Access -Spa
3
tser Conductors & Ground Main Disconnect
Elec. Trim & Subpanel, Breaker Sizes & Labels
33.
ors-Mech. Equip.
Stairs & Rails
34.
-GkAhasOlnset Lioht Shnwer'Cight-Spa Light
Fireplace or Stove, Clearance -Hearth
3
Smoke Detector
Elec. Outlets at Wood Panel, Int. & Ext.
73.
Date -
Date
FQ
I
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
ECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
75.
37.
Vent Fan, Exhaust above insulation
76.
38.
Condensate Drain & Overflow, Size & Grade
77.
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
78.
40.
Attic Access & Platform if Furnace in Attic
Date
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
Card B-1 Date Card B-1
Date
Insulation -Foam -Looked in Attic
Card B-1 Date Card B-1
Date
FRA G (Permit K except #'s
4
Sills o.p aterials & An rs-
42.
a Nailing Spacing & Braces -Plates -Sound
_
43.
Bearing Walls over Girders & Floor Nailing
44.
Draft Stop in Walls (rat proof)
45.
Fire Stops Furred Ceilings -Stair -Chasers-Tubs
46.
a Beams -Size & t
87.
Water Well, Disconnect, Electrical, Plumbing
Date FRAMINIP (Continued) /
47. naers-Post CaDs-Anchors-Connectors
ftr. Ties- Purlin-Roll Brac.-Truss-Shtin F
or Type A Flu 54jbiggCfearan
Size & Romex Protection -D ft Stop -Ins.
54 RA. Doorsits
55. room- ise- un- an ing- ire ection
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
(n Siding -Nailing Veneer
58. Stdc. �t+Aosh brie SereAd f d �i neR6 n�
QDiShe ails; Nailing -Bolts
6
race Interior/Exterior Wall Panels
2.
Insulation -Walls -Ceilings
Date
3.
Infiltration -Walls -Windows
Card B-1 Date Card B-1
Date
-r!;_-O(o Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64.
Ext. Steps -Door & Sidelight Protection -Landings
65.
Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68.
G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70.
Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72.
Elec. Outlets at Wood Panel, Int. & Ext.
73.
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74.
Elec. Outlets & Receptacles at Kit. Counter
75.
Garage Fire Door; Swing -Landing -Closure
76.
A.C. Duct in Garage -Damper
77.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83.
Following Instld./Drive ❑ Yes ❑ NoMalks ❑ Yes ❑ No/Planters O Yes ❑ No
84.
Stucco Brown -Finish
85.
A.C. Unit Disconnect, Electrical -Plumbing
86.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87.
Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89.
Ventilation Throughout House
90.
Glass Protection
91.
Corrections from Previous Inspections
92.
Gas Test -Meters Tagged, Gas -Electric
93.
Water & Sewer Connected -C/O to Grade -HD Approval
94.
Energy Compliance Certificate -Other Certificates
95.
Address Posted
96.
Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
CORRECTION NOTICE
!Lt
OWNER J PERMIT NO.
A routine inspection indicates that the following violations of Butte Count Ordinances exist at '
p 9 Y .x 3_
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional ""41
explanation, please contact the Building Inspector as indicated below. per.
n a. j 1w;'\e'011 V-0 a"'-, We
COUNTY OF BUTTE
BUILDING DIVISION
jr
DEPARTMENT OF DEVELOPMENT SERVICES.
'
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
!Lt
OWNER J PERMIT NO.
A routine inspection indicates that the following violations of Butte Count Ordinances exist at '
p 9 Y .x 3_
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional ""41
explanation, please contact the Building Inspector as indicated below. per.
n a. j 1w;'\e'011 V-0 a"'-, We
7r
'Yti V
l
i u
"A
_tf
Vln
Date ) Inspector
�
•,
REV 4/05 Phone #
a
t4:
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
yaj
r.
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive - Oroville, CA - (530) 538-7541 -
1A
CORRECTION NOTICE
P
OWNER v PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below. .
1 I L �i� a to , �MI1
Date ICS ^ C � Inspectory--�/ Y VC -x
-'.,t 53�--ll q
REV 4/05 Phone #
j
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834`"
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP050239
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 05/23/2005 APN: 007-250-055-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Site Address: 3122 JOHNNY LN CH -1
Date: • Contractor:
Map Index:
Description: living room addition (450)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: KIMBERLING LARRY W
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
3122 JOHNNY LN
signed statement that he or she is licensed pursuant to the provisions of
CHICO, CA
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
95973-9135
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penally of not more than five hundred dollars ($500).):
00 I, as owner of the property, or my employees with wages as their
1 sole compensation, will do the work, and -the. structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: KIMBERLING LARRY W
Code: The Contractors' Stale License Law does not apply to an
3122 JOHNNY LN
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
CHICO, CA
provided that such improvements are not intended or offered for
95973-9135
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors. to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' Slate License Law does
Contractor:
not apply to an owner of property who builds or Improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the Business
i
�Professie
Date Owner:
License #:
WORKERS' COM PEN ION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
Architect: HEATON, ROBERT
is issued.
❑ I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft: 450 S.F.
Policy #:
Valuation: $29,250.00
Census Code:
I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
�t
compensation provisions of Section 3700 of the Labor Code, I shall
I
forthwith comply with those provisions.
12�
Date: • _0:-
Applicant:
l
WARNING: FdCuW to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is eby issued u e applic a provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutions do work in ate ove fo. hich fe s have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
z.,6 6
Name:
_S___
By: Date:
PERMIT EXPIRES ON: 5. Z G .--0 C7
Address:
Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ % Notification in accordance with Section 18827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and stale laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or docume�t of Butte County. ereby
2uthorize representatives of Butte County to enter pon theme above mentioned property for inspection purposes.
Print Name: [_����nuL7 �c {i%�lJb Signature:
Date: J FT' ' 0Z/
�J77
„)41.Owner 0 Contractor ❑ Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
"PLEASE PRINT CLEARLY"
OWNER
Last Name //l, nLgL�A)�
`'
irst Name /_AdU �
Address •�
a To jj.1V ,A Ln1-
city G N I C-0
State c -A
zip c� S [73
Phone /
Fax
E-mail A 16^& AtjvN CS
CONTRACTOR
Name
Address
City State
Zip
—Phon
E-mail Lic. #
Class
ARCHITECT/ENGINEER
Name 906 -4--Ib2-1 6. Al -,�X%O/L%
Address ya Lc y 64iJT7� ZAA)S/
city CA)y 60
State CA
Zip
Phone 3Ll-Ff 03 7
Fax 3 q3 - 3p
E-mail
State License Number
APPLICANT NAME
Name
Address 1 A A TOk N 4jv �ANi
City C u Go
State CA
zp
Phone 3 5 35�
Fax
E-mail LAJZ6Z-4
For ctfiwuse on
AP# 7
Zoning %L
Flood Zone SRA Yes I No
Occ.
WORKER'S COMPENSATION
Type Const
Subdivision Name
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K
PERMIT
NO.
BP05-OZ
LOCATION
AP# 7
Property AddressLill
31 d j0_ -VV4A
City6,Q I
Cross Street
E4 729-''U f6VP
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
-lam
Address
Description or Scope of Work:
//l// OV" ,,-LJ
l VIA-) 6 JLO0/1-1 e vJ
Sq. Footage � —
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
.\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 otc
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: Amount: V Bldg
,/`���
lSRA
Receipt M Sheriff
SMTther
P
r11% loft
Date: I 6
VU ' Total
RCV /-L/-V9
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
,normit.
INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND /N INK
1.
Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
2.
Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
3.
Engineered truss details and layouts in duplicate (if required). No faxesl
4.
Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to
mobile or modular homes.)
❑
5.
Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑
6.
Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down
or fnd plans, all in duplicate.
❑
7.
Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑
8.
Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑
9.
Site plan and business license approval from the City of Biggs.
❑
10.
Letter of intent for non-residential buildings.
❑
11.
Detached Accessory Building Form filled out by the owner (if required).
❑
12.
Hazardous Material Form (for Commercial Buildings only).
—.:,A 13__Sanitation_and site plan apploYaLftomthe EnkonmentalHealiliDepadment
Remaining
items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if 'no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REI/ 7.27-04
..-ti....r•.,in--:ww,:..�,,,,;,.�,..�vv�,.tr....�'�ti•...r�.:r..rf`.-""-`,�, ��.�.�._..a.--y..--.-o-�.----Y�• � ., �
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive; Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: /' �Gvt qt�LiN% / C_��'/`7�'% ASSESSOR PARCEL NUMBER ,207-
Proposed
//y /-Proposed Building Use: r/ O\j Counter Technician: G�-S Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
CSI! q/ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. .
14 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
f/t/ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Letter from Engineer or Architect for truss design review.
I^/ 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate
❑ 11. Site plan and business license approval from the City of Biggs
❑ 12. Letter of intent for non-residential buildings
❑ 13. Detached Accessory Building Form filled out by the owner
\ ❑ 14. Hazardous Material Form
15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
❑ 16. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 17. Fire Sprinklers...........................................................................
.................
❑ 18. Agricultural Buffer cir and site plan apr from the Ag Commissioner Sent by
❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........
❑ 2 Erosion Control Plan Required........................................................................ ........
j Fees as shown on the attached Schedule of Fees -Due Sheet ..............................
❑ ?2. City of Chico Plumbing permit........................................................................
�\ ❑,. 23. California Department of Forestry plan approval ❑ paid. Sent by. -
24.
y:24. Planning approval (A) Use: 0 IL (B)Parking: (C) Parcel Check:
❑ 25. Contact Land Development about _ Improvements, _ Drainage .........................
26. NPDES Form ................................. :...........................................................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Pre -Inspection for required.......
❑ 29. Contractor's license information. (Number'Name Style, Classification)..._ .............
\ O 30. Worker's Compensation Carrier and Policy Nu ber..........................................
�p I hJ 31. Owner -Builder Verification (_ Given to owner," -Mailed to owner) .....................
0 32. Letter of Signature allthorization..................... :.................. :.........................
....
❑ 33. Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 34. Manufactured home utility clearance.....................'A.....................:................
❑ 35. Existing violations and/or expired permits ..................
❑ 36. Deed Restriction.........................................................:' ..............................
❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from4Legal Owner, ❑ Check to H.C.D. $
❑ 38. Other:
❑ 39. Other:
When issued Telephone and hold for pickup.
_ U
I have been informed of the above items and requirements for obtaining a building permit. )
Applicant: ` /% Date:
1. Index per " a. licatio5j& the above items numbered: Plan Chedl Letter
2. Additional tems requjred
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, o as advised of the above data by ❑ phone, ❑mail, ❑ cou y Date:
Plans reviewed by: Date: Plans approved by: Date
Structural review by:Date:a E Structural approve .� Date:
Note transfer by: Date: �i
Yellow: Building Division
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING'DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541
SCHEDULE OF RECEIPT OF FEES t
OWNER IV6 / Gary `� / A.P. # ' 00 7'—
PROPROSED BU DING USE "DIT7r� G/1//NG20VW DATE
L/ t RECEIPT # DATE REC.
1. UILDING PERMIT FEES
--- Balance Due ..................... $
5=2�
--- Additional Fees Due........... $
<--evised Plan Checking Fee.... $
Vaid
CHOOL DISTRICT FEES
at School District Office) (fo av 'labl after Plan Check)
a/was- .
3. SHERIFF FEES (paid at Building Division)
Residential............ X $360.00 =$
Units
Commercial (sq. ftg.)..... X $0.03 = $
Sq.Ftg.
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit)..... X = $
# Units Amt.
Comm al (Sq. Ftg.).... X = $
Sq. Ftg. Amt. ,
*5. RECREATION DISTRICT FEES
(paid at Recreation District Office) (form available after Plan Check)
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
7. SRA FIRE INSPECTION AND PLAN CHECK FEE
$89.00 (paid at Building Division)
8. WATER TENDER FEES BATTALION #
$200.00 (paid. at Building Division)
9. NORTH CHICO SPECIFIC PLAN (paid at Building Division)
Residential Zone X =$ '
Zone # Units Amt.
Commercial (sq. ftg.) ......... X = $
Sq. Ftg. Amt.
1 LUTHER 667
l '
At time of permit application, I was advised th above fee as required to be paid prior to issuance of the permit. These fees
may be changed during the checkin ess. J
APPLICANT DATE �!
Pursuant to GWmt2
dection 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You
have 90 days from the of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a
protest are specified in Government Code Section 66020(a).
Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003)
QPRTMENT
oo�pos
�TrF0 Depa"rtrnent of Public Works
C o u n to f B u t t e
I 0 , O y
1 0 l O ). Michael Crump, Director LAND DEVELOPMENT DIVISION
\� O O Storm Water Management Program
7 County Center Drive
p (1 N�F 9 / . Oroville. CA 95965
LIC WD (530) 538-7266
(FAX) 538-7171
National Pollutant, Discharge Elimination System (NPDES) Phase 11
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE]
Project Description:
Project Location and/or -Parcel Number:. =-- -
A a '
y By signing below", the=project- ownFf/owrier's`=agent �eei tify that this project WILL NOT DISTURB
lZacre or: more�ofiland and t) at I,;thereiore dojnot`rLeed�t6 apply _f9r:a`-Construction Storm W:ater}Permit=
from the•State`-of California RegioiralktW :Qnality�Control-�Board. Phased projects:ahat'--contain,-
�_._ _ __ ,.multiple site°build=outs-of lessr.than:one_;.acre_but�-whentcombined-with_ subsequent :phases total_rnore•_
than one acre- of disturbed-soil:-will-.requir--e-a-Construction Storm Water Permit from ..the -State of ._.-
California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
a
Signed:
Title:
Date:
Less than 1 Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program
Revised 5/24/04
-",, t V Y �i b; Y14� F�,_`,i 3vi`j�O
$h�.s:�fi�i.t.,,.,,c'""�c.,'siJra,�v,c��
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary
delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
--- 1. I personally plan to provide the in jor labor and material for construction of this proposed E
property implovement: YES [ V ] NO[ ].
2. I HAVE [.Vl HAVE NOTA[ ]signed an application for a building, permit for. the proposed
work.
3. 1 have contracted with the following person (firm) to provide the proposed construction:1 41
NAME: t.. .
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO: `.
4. I plan to provide portions of the work, but I have hired the following'person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: a -
PHONE: + • - '• [ CONTRACTOR'S LICENSE NO
5. I will provide some of the work but I have contracted (hired) the., followingpersons to provide
the work indicated:
NAME . , LADDRES S PHONE , • ; TYPE OF WORK
r r
1
SIGNED:
PROPERTY OWNER:
DATE: 7
NOTE This Owner -Builder verification is required by Section 19831 and.19832 of the California
Health and Safety Code.
-
This verification must be completed and returned to our office before we are permitted to issue the
permit.
" ' 'Rev'd 11/4/2004
Butte County Department of Development Services
ADMINISTRATION • BUILDING' GIS `PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile
i'".t�4`��.�- k'G°i :Rux"st'aLh. � ,�� q..c.�^' c t,*�S r't?•�"...+r�*�h�' ¢r'�-�'�ri^'t,+`.?�?�=7tSEs�x .t '}3'i4r. w,:�.tt4: �...
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their own
work. If your work is being performed by someone other thanyourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the city or county. They are also required by law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government as an employer and you are subject
to several obligations including state and federal income tax withholding, federal social security taxes, workers'
compensation insurance, disability insurance costs, and unemployment compensation contributions.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
i�
Micyael C. Vieir4 C.B.O.
M ager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
05/23/2005 MON 15:56 FAX 530 .891 3267 CUSD BUSINESS OFFICE
May -23 05- 03:28p
School Distrid
A.P. Number
Property Owner
Property LocatiordAdaress
BUTTE COUNTY SCHOOLS IMPACT'FEE CERTIFICATION FORM
(One form per Sullding)
Budding D partrnent No.
City County
Z001/001
p•1
�oS a239
27- J o H -VIA✓ L.,AJ - aft j c-0
Subdivision Lot No.
Res)dential.Development L_� �` i Footage (//
No of Living Mobile Homo I A 1P. 'Supplemental to i Gmaup R)
units Installation : Conversion Permit 0 h
r ;
*(No fourdatbn Mspec tion)
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction end Notice of Limited Use Facility document)
Commerciallindusirial Q Sq. Footage
New (Inidcdhg Exterior
+., Roofed Areas)
- -2
BumMv Department Represents Date
District Identification No. IQ r
C.J-yJ School District certifies that l �-
(Applicant)
U e ,
(Street Address) (Phone Numbed
C, � C- ...
(City) (State) (Zip Code) S
has complied with the requirements of Resolution No. by payment of $ G..'
representing '7 square feet. JAB 2926 $
LULL IAntGATION $
5 b2 OSS
School District Representative Date
Paid by Check 9 Remarks:
Notfea: You may protest this lmp oltion of the leas kloni ied above by submitting s written protist to the District, In compliance wlth
Goverrunent Coda IlsWon 66g20(U: w" 80 days ham tM data loss We paid, Falturs to *Wm* a 111mely W11124h plow wm prob"M
you from choly oing the Impesblon of the fos In any court action - --
V. wbsequout to mu hidroa 0Wrkt Rspcssardamvr, signma thio cum. Cwmy eNroois Impoa Fee comicaum Form mw school mistrla is
w9led by 00 applicable Local Planning Agency thud Oft pro)ad Is bskhg rsir)swod under mhe Cdlfomsa Envfromn-W Que ft Act (CEQAJ
Itrbt projsd may be eulded to additional school boo to fully n*%*a b Mcp d an the school dsbkile sethoots
White (applicant), Yellow (building department), Pink (school district) foefonn.ds Oolmmm
—'2 P/0
0
4
E.H.-USE ONLY
'Plot Ulan Attechad F.7
/ Roos flan Attached iPs
Sent to B.D.
Io
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
_��,- i n 31 Z L So 1. r n �/ L n .• - 7� Z Sd ---- ®s'S
' Owner Location AP# .
Plan Approved for: Sewage Disposal X Water Supply: Public Private Well
Clearance for-daae4litr9. Other r wI 't /"v J"'
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist Date
8/96
SITE PLAN'REVIEW APPLICATION
Date: /U 0 AP#
00 7- 750,015_s
Permit Number (if applicable) 0^'Q 3 I
APPLICANT INFORMATION ,Parcel Size: -23
Owners Name:
Owners Address: ✓�a� n a �' CPe _q 9 73
Telephone Np:�
Situs Address:. t S/Q,
Proposed Use:
Residential
❑ New Single Family Residential
Single Family Addition ❑ Single Family Remodel
❑ Mobile Home ,
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family '
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
❑ Commercial. Remodel
❑ Industrial Remodel
Other
❑ Septic - ❑ Well -
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
DO NOT WRITE BELOW THIS LINE
c DEVELOPMENT SERVICES INFORMATION (For Staff Use)
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
Site Plan Stamped Approved
By Date J� o as
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Snow Load Area:
❑ Land Conservatiori Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
Expansive Soils (Test for expansive soils and if verified proper foundation design required) o�L�IA,tL
SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached)
a Flood Zone: )(
Flood Panel No.: • 66007G- 659 Index Date: l�
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
❑ Minor Variance ❑ Variance
-----------------------------------------------------------------------
❑ Detached Building Use Form ❑ Encroachment -Permit
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning: 5—
G f -LJQRL
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
aZ19 ,
Side
5 -
Side Street
Side
Rear
S
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
a Applicable Development Fees:
Standard Fees Amount
Formula
❑ Fire
,
❑ School*
❑ Parks/Recreation
,
❑ Roads
❑ Sheriff
.. .
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Areas Road
❑ Thermalito Impact
❑ Other
Subdivision Map Special Fees
-----------------------------
❑ Water Tender
❑ Road Improvement
+'
❑ North Oroville Area
❑ Other (per map)
# Check with school district to, verify actual fee if pre -application
review. A final determination will be made at the time of
the building permit
Parcel Created By
II Deeds:
Date of Creation:
Legal Access Provided: - ❑ NO' , ❑ Yes
Deed of Reference:
Legal Access Required ❑ No ❑ Yes
Parcel Frontage on PubliclyMaintained Road:
❑ No ❑Yes, Road Name:
Complies with Co ty Standards for Deed Creation:❑
�
No El Yes
-
Comments: OZt
�D
G Rit Gl.� i�
J
Parcel Deemed to be legal -
❑ Verify Legal Parcel "❑ Verify Legal Access ❑Provide Deed of Creation`
❑ Obtain a Certificate of Compliance -
❑. Obtain a Merger ❑ Obtain a Lot Line Adjustment, '
El Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current_ Environmental Health Department requirements
Page 3 of 5
Subdivision Map/Parcel Map:.
Map Date of Recording:
Lot: Book: Page.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
Parcel Map/Subdivision Map[Use Permit Conditions
❑ Comply with the following Conditions of Approval:
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works.
❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate
Battalion Water Tender Fund may be required.
❑ Measures shall_ be taken to control fugitive dust emissions from .all driveway and other civil
` construction: associated with residential development.. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
❑ Property owners responsible for roa
Ina
Page 4of5
is
J=OK
O = Not OK
Nbt Applicable MOBILEHOMES
= Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements—Setbacks—Easements _
2. Soils; Special MH Support—Sketch
3. Sewer; Location—Test—Fall-C/0—Concrete
2. Footings; Size—Depth—Spacing-Connectors
3. Decks; Girders and/or Joists-Decking—Bracing—Stairs—Rails
4. Water; Location—Test—Easement Needed (Sketch]
4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.-Rfg.—Bracing
5. Electricity; Location—Clearances—Grnd.-/ / Amp—Concrete
5., AlumiAwn.; Columns—Connections—Splice—Decal—Enclosures
6. Gas; Location—Test—Wrap:/ /"L''ft./ /"Nal.or/ /"L" ft./ P. LPG
6. Carports; Windows—Doors
7. Utility Clearance
; 7. Elea
Card -BI
Date Card -BI Date
Card -Bi
Date Card -BI Date
Card -BI
Date
Date CardrBI Date
MOBILEHOME INSTALLATION (Plans) OK except H's
Card -BI
Date
Date' Card -BI Date
PO 1 - (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
etback's—Easements -
2. Footings; Size—Spacing—Marriage Line
oils; Compaction—Structure Stability
3. Gas; MH Test—Demand—Valve—Connector
jPool'Structure; Steel-Connections—Thickness—Dead Men—Lining
4. Electricity; MH Test—Crossovers—Breakers—Clearances
. Elec.; Receptacles and Lighting; Distances—GFI
5. Drain; MH Test—Fall—Flex Connector
ec.; Pool Lighting; 15 volts—GFI
6. Water; MH Test—Regulator—Connector
lec.; Enclosures; Conduit Entries—Terminals—Listed
7. Water and Sewer Connected—C/O to Grade—HD Approval
E c.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas and Electricity Tagged
lec.; Grounding; Equip, w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enclosures—Panel boards—Ins. to Main in Conduit
9. Exits; Insp.—Sketch
10. Cert. of Occupancy
VAealth.Department Approval
Plumb; Cir. Test—Water Supply Test r
Card B -I
Card B -I
Date Card -Bl- Date
Date Card -BI Date
Card -BI
Card -BI
DateCIV % Card -BI Date
cJ� Date Card -BI . Date
V = OK
0 =
Not OK
- =
=
Not Applicable
Not Ready RESIDENTIAL (Sin,gle
and Duplex)
Date
_
--
_
-
____9-
UNDERFLOOR Plans OK except #'s Date
- -_7. Zoning requirements -Setbacks -Easements
2_Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth
4. Ftg., Porches & Deoks; Soils -Steel- / /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
6.Stemwalls,.Garage; Steel-Blockouts-Wrapped-Slab
7_
Piers -Fireplace Ftg.-Steel
8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
Gas Pipe: Size -Anchors
FRAMING (Continued) ^ -
48. Property Line Firewall & Openings
49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection _
51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
52. Siding -Nailing -Veneer -
53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
54. Glazing Area -Glass Protection -Skylights -Plastic
55. Shear Walls; Nailing -Bolts
10. Water Pipe; Test -Anchors -Regulator -Service Test
11. Electric; Underground
-
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. -Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI
Date Card -B I Date
-
-- - _
Card -BI
Date Card -BI Date
Card -BI
Card -BI
----
-_ Date _ Card -BI Date
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
FINAL (Plans) OK except #'s
Date
PLUMBING (Permit) OK except #'s
14. Water Ht.: Vent -Access -Combustion Air
15. Water Pipe; Test & Anchors -Nail Protection
16. D.W.V.: Test-Fttngs & Anchors -Nail Protection59.
17. Shower Pan; Test, First Floor -Tub Access
18. Test Tub & Shower, 2nd Floor -Tub Access
19. Gas Pipe: Size &Anchors
56. Ext. Steps -Door & Sidelight Protection -Landings
57. Smoke Detector
58. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
Bedroom Exiting
60. G.F.I. & Bath Fixtures & Tub Access
61. Elec. Trim & Subpanel; Breaker Sizes -Labels
62. Stairs &Rails
63. Fireplace or Stove; Clearances -Hearth
64. Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Card -BI
_ ___
Date - Card -BI Date
Date Card -BI Date
65. Kit. Fixt. & Appliance; Grnd -Air Gap -Cooking Clearance
66. Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except #'s
67. Garage Fire Door; Swing -Landing -Closer
68. A.C. Duct in Garage -Damper
20. Fixture & Transformer Clearance -Ins_. Protection
21. Elec. Receptacles Spacing -Lights & Switches at Doors
22. Size Boxes & No. of Conductors -Stapled
23. Romex Installed_ Close to Edge of Studs & C.J.
24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water
25. 2 Appliance Circuits in Kitchen & Conductor Size
26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al
27. Range Circ. / / ga. Cu or AI -Oven Circ./ / ga. Cu or Al,
Insulated Neutral _.Yes _j No
28. Service -Riser Conductors & Ground -Main Disconnect
29. Equip. Clearances: Panels-Motors-Mech. Equip. -
69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
70. Plb., Elec. & Mech. Equip. Listed for Location
71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
72. Insulation -Foam -Looked in Attic [] Yes
73. Guard Rails &Deck Construction -Post Caps
74. Fdn. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
75. Following instld.: Drive [j Yes ❑ No: Walks 0 Yes ❑ No;
Planters ❑Yes EJ No
76. Stucco; Brown -Finish
Card B -I
Card g -I
30. Clothes Closet Light -Shower Light -
`- - -
-- -----
Date Card -Bi _ Date
Date Card -BI Date --
_ .
77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
78. Vents Above Rooi; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79. Water Well; Disconnect, Electrical, Plumbing
80. Exterior Elec. Trim; G.F.I. Receptacle -Underground
81. Ventilation throughout House
82. Glass Protection
Date
MECHANICAL (Permit) OK except #'s
83. Corrections from Previous Inspections -
31. A.C. Ducts. Insulation & Support
32. Vent Fan: Exhaust above Insulation - --
84. Gas est -Meters Tagged; Gas -Electric
85. Water & Sewer Connected -C/O to Grade -HD Approval
33. Condensate Drain & Overflow: Size Grade -
86. Energy Compliance Certificate -Other Certificates
_&
34. Furnace -Vent: Access -Comb. Air- Return Air_ Vent -115V outlet
35. Attic Access & Platform if Furnace in Attic -
- -
--
-
Card -BI
Card -BI
DaleCard-BI
Card -BI Date
Date - -
Card -BI Date
Date Card -BI Date
Card -BI
Card -BI-'
D to Card -BI Date
Gate Card -BI Date
Com lents at Final:
Date FRAMING(Plans) OK except #'s
36. Sills, Proper Material & Anchors
37. Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound
38. Bearing Walls over Girders & Floor Nailing
39. Draft Stop in Walls (rat proof)
-
40. Fore Stops:. Furred Ceilings-Stairs=Chases-Tub_-
41 Header & Beam -Size & Bearing
--
---- -
42. Hangers -Post Caps -Anchors -Connectors
43. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnp.-Rfnp.
44. Fireplace Ties or Type A Flue -Fireplace Throat
- --' -- -
- -- -•--- -- ,_
45. Attic Access. Size & Romex Protection -Draft Slop -Ins. Baffles
46. Bdrm. Windows or Exiting Doors -Sill Hgl. & Dimensions
- ---- - --
-- -- - - -
47. Garage Fire Protection Framing
(NOTE Anentry must be made each time you visit job site)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
w
PE I .NO.�
ASSESSOR PARCEL NUMB R
ZCGNI
BUILDING PERM
pWeRo..
m14AT14L
TELEPHONE
SQ. FT. OCC.1 BUILDING VALUATION
��' S—
OWNE MAILING A OR ESS • - I
i+- 5 aje � �-
CONTRACTOR,'S NA
ooA.
Su �,�,e.. -
TELEPHONE
3I/s-v-y
u
-
CONTRACTOR'S MAILING AD�jRESS
,7 05d/I
Fireplace
CONSTRUCTION LENDER
No
UNKNOWN
Total Valuation Is 9-75-
/S
"
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS '-
Permit Fee
$ (p$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
•
Penalty
$
BUILDING ADDRESS
31 t2 -3-0h nn. �n/
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
•
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE,
SF ❑ Duplex❑ Mobilehome❑ Other SWtmcrr+lng T t3OL
SPE I v
Gas piping system 1 - 5 outlets
5.00
Building sewer-
5.00
Mobile Home S G I W
10.00 ea.
TYPE OF WORK
New [% Addition ❑ Remodeller❑ Utilities ❑ Installation❑ Other ❑
Describe work: V c�J� _
Permit Fee
$
Contractor
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 OR LESS
100 OROR LESS
10.00
Main service EA. ADD -L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penaltyof perjury
p I y (Check One):
I am' licensed under provisions of Chapt. 9, Div. 3 of the Business -
and Professions Code and my license is in full force and effect.
a
License No. 357-29r Classification C��J
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ i am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST.. DWELLING'OCCUP.BI\
OR ACDNS. ACC. BLDGS.
'/zQsgft
NEW CONST R., MULTI.OUTLET
NON.RESID BRANCH CIRC ITS
2.50 ea
PowER APPARATUS IN
(SINGLE OUTLET CIR.
Ex. Occu / o
pl UTLETS OR FIXTURES
_ 20 @ 30`
.2AL030
Ex. Occup. OUTLETS FIXED P(RESID IREA.1
2.00
Temporary service
10.00
Mobile Home Facilities
15.00'
-7
!)7itss 'Wiring pOL
15.00 is
Permit Fee
$ d5
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California. I
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating'
-
Cooling
Hood
a
3.00
Ventilation
permit Fee
$
Contractor
I• certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize. representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date to `/0 -86
Signature of Applicant — Owner F1 Contractor M Agent ❑
An OSHA permit is required for excavations over 54' deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
occu P.
CONST.TYPE
I
I PLOD.
PARCEL
PD
I AmoISSUE
This permit is hereby :issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECT91R OF PUBLIC
By
PEF07KT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
R c T'i : t. /: -� ;r► t• F.
w•
COUNTY OF BUTTE - DEPARTMENT OF VAPUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE', CALIFORNIA 95965 - TELEPHONE: 916/534-4541 /
OWNER
PERMIT, APPLICATI.ON DATA SHEET
Permit No.
Proposed Building Use P.--, Po,)/` -
A. P. No. -2 — aS -,5.5
Permit Fee Based Upon: Complete Contract Price DPW Valuation
P Other (Explain)
Building Inspector OV`'V� . Date G // Iii
At time of permit application, I was advised the following data must be submitted prior to permit processing
sand./or issuance: DATE RECEIVED APPROVED
1. All items have been submitted. .
D ✓2., Plot plans in duplicate/U-HM4eate. . . . . . . ... . .
3. Complete plans in duplicate/tri.plicate. . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . .
6. CUSD "Fees Paid" Stamp on Floor Plan . ... . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
9. Letter of signature authorization.
Q/C'r10. Sanitation approval from '.L3 Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14, Owner -Builder Verification (Given to owner, Mail to ownerEl')
15. Improvements may be required. . . . . . . . . . . . A
16. Mobilehome Installation Data. . . . . . . ..
•Pre-Inspec. request to (Date)
17. Pre -Inspection for Required, Building Inspector
18. Recorded copy of Agricultural Acknowledgment Statement.
19. Other Driveway permit (const. approval required nrinr to occupancy)
When ypu issue the permit, process as follows: Mail to, owner. Mail to contractor.
Telephone �1� " �'7S� and hold for pickup atC sLo office. Deliver w/inspector.
Other
Applicant �a'z� %'t •mow' Date ('-1°-4,
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No. tr
2. Additional items required:r
(Contractor, Designer, Owner) was advised of above required data by
Plans checked by
Plans
Other
By
Copy—DPW
, f.
Te le,phone —Mail Other
Date
Date
Date 6
TO: Building Department
FROM:'
Environmental Health, Chico
j 4'
SUBJECT::" Sanitation Clearance
Owner < �R�1—�L ZS-SS�
Locatio APS
Plan approved for: sewage disposal
water supply
Hold final for:. x �—
water ply
,Final clearance O.K. for:
water supply
Clearance for. bedroom mobile. home. Other
Note°°*
-------------
Smnitarian - -�
Date,
------------
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PER T NO.
ASSESSOR PARCEL NUMBER
ZON IN'G
BUILDING PERMIT
OWNER
cp>
TELEPHONE-
SO. FT. OCC. BUILDING VALUATION
R'S MAILI G ADDRESS
�-
O R CTOR'SNAME
ho
•CO
TELEPHONE
0-5
_
Fireplace
—+$
TOR'S M A I LT NG ADDR SS
`7
CONSTRUCTION LENDE
UNKNOWN
Total Valuation
Filing Fee 10.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Pian Checking Fee $
Energy Plan Checking Fee__•_, S
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Permit fee -- $ / ;a,•�
PLUMBING PERMIT Filing Fee 10.00
Each Trap
2.00
G
Solar or heat pump water heater _
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other_ �(��(�����;��
SPCl Fr
Gas piping system 1 - 5 outlets
5.00
Building sewer
—
5.00
Mobile home S 1 G I W 1 10.00
ea
TYPE OF -WORK
New Addition[]. Remodel❑ Utilities[]Installation[]Othe�
Describe work: _
�6
--
Permit Fee $
Contractor _
ELECTRICAL PERMIT Filing Fee 10.00
—
6V OR L
Main service 100 AMP ORSLESS 16•00
Main service EA. ADO•L 100AMP 2.50
CONTRACTORS LICENSE LAW
I declare under pen ty of perjury (check -one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license Is In full force and effect.
License No. Classification
F1I, as the owner, or my employees .with wages as their sole compen-
sation, will do the work,and the structure isnot intended or offered
for sale. (Sec. 7044)
❑ 1, as the owner, am exclusively contracting with licensed contract -
.ors.
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING 0CCUP.& 1 gft
OR ACDNS, t ACC. BLDGS. 2h¢„
NEW CONSTR.MULTI-OUTLET 2.SOea
NON-RESIU• BRANCH. CIRC ITS
(POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. Occ up(our LE l'S OR 1-IXTURE20®90C
S 13AL030
IXED
Ex. OCCup. OL TLETS PIRESID.IAPLNS.REAJ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
�Virin 15.00
9
_
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare and anally of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
I Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor--
MECHANICAL PERMIT FiIingFee 10.00
Heating
Coolin g
Hood 3.00
Ventilation
permit Fee ;
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
i to building construction, and hereby authorize representatives of the Countyot
I Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
%� Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
Ian of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ t
OCCUP•
CONST.TYP!
IFL00DIPARCEL
P11
ND
ISSuE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date L L/ Q
PERMIT EXPIRES Date
Receipt No.
WHIT[-D.P.W.. T[LLOW-ASSESSOR.•PINK-INSPECTOR. GOLDENROD -APPLICANT
'POO
,tPERs�iIT NO. j 5682-79B,P.,8
. , • . �5 c�`` `gam , .
PERMIT EXPIRES
jOWNER
Jim E. Clark
CONTR. Holiday Pools, Chinn
44-45-58
LOCATION (A.P. )
E••/S Johnny Lane-@ end, Chico
•
y
s
k
• r
j
i/ 8C)
` - Temp. Power Pole
Called PG&E
G Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
-Called PG&E
JOB
FINALED
(Date)
(Signature)
1 � ,
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS i
BUILDING INSPECTION RECORD `
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
StemwalI
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Car ort
p
Footings
Prov. for physically
handica ed
Conformance of ex.
structure
Appliances
Gas PI In &Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Relnf. Steel
Final
Fixtures
RINKLERS
Stucco
Motors
s
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES ------------------
Elec. Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
M2MLLE INSTALLATION - - - - - - - - - - • - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you v sit the job site.)
COUNTY OF BUTTE '— DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
Telephone: 534-4x41
APPLICATION AND PERMIT �C
autnorize representatives or the t,ounty or twtte to enter upon the
above-mentioned property for inspection purposes.
X Date
tur of Permitee or Agent
Receipt No. Zz
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOP.,%OF PUBLIC WORKS
BY Date
Building permit expires Date
BUILDING
Owner T 6m E. 4A/3 K
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
� Q' Qf✓i
Contractor P6 J, / p A y LS
Mailing Address F 4/9SS6N A VE
Fireplace
Total Valuation A
f llIc61
Telephone No.
tj3- $g���
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee ,ov
Y 3QX 3122 '-�HNN /V
PLUMBING No. @ FEE
/l
PERMIT FILING FEE $3.00 3 en -
Each Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. W.
IfTJ oning & Planning
Water piping 1.50 15-
Each gas water heater or vent ] 1.50 /,S
F s I
VKC.F*-4U=4,-Fire Dept.
Fire Zone .
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
P Ing
sans
Parcel
Declaration
Parcel Ma 60' R/W
p
Im ro ents
p
Each additional outlet 30
Building sewer 5.00
13J(Plans Plans Recd
Parcel Appilval
Plan Approval
Lawn sprinkler system 2.00
NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑
I I
Permit Fee $
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 3 Gt
Main service 1000' AMP ORV OR LESS5.00
Single Family ❑ Duplex ❑ Mobil Home ❑ Others
Main service EA. ADD'L 100 AMP 2.50
„
Vry ��
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW
OR ADDNST ACC/DWELBLDGS.LING CCUP. 7i) 20sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of: /► /
Ho c l DA y Pa 0ks
NEW CONST R. /MULT I.OUTL T
NON-RESID `BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS 0
NON-RESID. SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTIIRES I BAIL
FIXED APPI-0 OR
Ex. Occup.(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
•
License No. 209- 32 2 ' Classification (2- 5'
Misc. Wiring G 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
®I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
❑I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3:00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$ - r
autnorize representatives or the t,ounty or twtte to enter upon the
above-mentioned property for inspection purposes.
X Date
tur of Permitee or Agent
Receipt No. Zz
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOP.,%OF PUBLIC WORKS
BY Date
Building permit expires Date
• t V'adY �'
OROVILL E, CALIFORN14
GENERAL CLAIM
CLAIMANT: Jim Clark
ADDRESS: Rt. 5, Box 3122
CITY & STATE: Chico, CA. 95926 IMPORTANT:
November 13' 1980 SEE' INSTRUCTIONS
DATE OF CLAIM: ON REVERSE: SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS: OR SERVICES '
DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO -AVOID DELAY) ( AMOUNT
!Owner decided not to build. (Bldg, Permit AppTns. #6865-79B and,.
_._
v6866 -79B - ece pt #3O7 e -
#6865-79 ----- Building permit fee paid -- $36.00
etain 113 of fee ---------
Amount of refund due ------------------ $24.00
#6866-79 ----- Building permit fee paid $84.00
-
Retain 173 of fee
Amount of refund due ----------------- 56.00
TOTAMEFUND DUE --------- -------------- $80.00
$80.00
i
_
f
I ,
I
' TOTAL
$80.00
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered• and that this
claim is true and co e ct as stated.
/. ............. e
Dated this .....0 .................. day of ,/ � 19 W.. at�&J.l..�. .., Calif. ....... ,...........................
........... .............. .................
ature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed•or de-
livered ,and that there is a Budget Appropriation O or Specific Board Approval r_� (Check one) for the same. ,
80 Oroville
Datedthis ........1.3tt1................ day of ••NOVO............... 19....... at .............................. Celif..........._....... .................................................................
Department Heed or Authorized Deputy
Dept. Exp. '
Code............................................ Code ................................................PAYABLE FROM................................................................_........................... FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR DEPT.
CODE , & SUB.
PROD.
SUB.
OBJ.
I CLAIM
NO.
INVOICE
NO.
I INVOICE
DATE
DISC.
GROSS
AMOUNT
ENCUMB.
SUB -DIST.
COUNTY 017,3UTT_F — DEPARTMENT OF PUBLIC WORKS
r 7 County Center Drive Oroville, California 95965 Telephone: 534-4541�
APPLICATION AND PERMIT 6P6�
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date
A A
Si natureof Permitee or Agent
ef
Receipt No.-"19lb-5—
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit expires Date
BUILDING
Owner eJ Z�(Z/,�
SQ. FT. OCC. BUILDING VALUATION
Mailing Address d f2L
L�.
Telephone No.
@ `
Contractor 6 L Nr
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address A/
a �% ` T
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
A
f '� U
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. -/V— A15- S-5—
`
Z
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fe
2 tion I Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
arcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. ns Recd Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family ❑ Duplex ❑ Mobil Home ❑ Others
Main service EA. ADD'L 100 AMP 2.50
n
T
Main service OVER s O 25.00
100 AMP OR LESS
Main service EA. ADD•L 100 AMP 1.00
NEW CONS. DWELING 0
OR ADDNST ( ACCLBL G5. P &J 20sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of: ��
NEW CONSTR OUTL
BRANCH UITS 2.50ea
NON-RESID. BRANCH CIRC
NEW CONSTR. POWER APPARATUS 8
(SINGLE OUTLET CIR.
_NON.RESID.
Ex. OccuD(OUTLETS OR FIXTIiRES IBAL@100
Ex. Occup ( FIXED , OR
OUTLETTSS (RESRESID,) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. 31113 k !eClassification Qs�
Misc. Wiring 6.25
❑ 1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
ISI certify that in the performance of the work for which this
ermit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 1 1 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date
A A
Si natureof Permitee or Agent
ef
Receipt No.-"19lb-5—
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit expires Date
'BOUNTY OF BOTE,� — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive .Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
auttlunce reprebentutives or the county or rsutte to enter upon the
above-mentioned property for inspection purposes.
X Date
11/1/217
Signature of ermitee or Agent
Receipt No. 301 caS
White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By
Building permit expires Date
Date
BUILDING
Owner (���
SQ. FT. OCC. BUILDING VALUATION
% Z VU 0
Mailing Address
Telephone No.
G ��
Contractor X4,
Mailing Address /V /Z iso -1 S,74"
Fireplace p0(�
Total Valuation CT®
ACL /J� Or ��
(� P
Te ph�� No.
Permit Fee
Building Adress
Plan Checking Fee&/or Penalty
Permit Fee
,3 /a2 oI •�/�/
PLUMBING No.1 @ FEE
l•
PERMIT FILING FEE $3.00
Each TraD 1.50
Repair drainage or vent piping 1.50
A. P. No. �— SAr�
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F s
Sa n Fire Dept.
FireZone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
rcelEach
Declaration
I Parcel Map
60' R/W I
Improvements
additional outlet .30
Building sewer 5.00
Bldg. Plans Rec'd Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITIONJO UTILITIES ❑ OTHER ❑
Permit Fee $
$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD•L 100 AMP 2.50
Main service OVER 25.00
100 AMPP OR LESS O
Main service EA. AOD'L 100 AMP 1.00
NEW CONS. I DWELING OR ADDNST % ACCLBLDGS.CCP 4\ 20 sq ft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of: �i
TLET
NEW CONSTR / BRANCH CIRCUITS)
NON-RESID, l BRANCH CIRCUITS) 2.50ea
NEW CONSTPOWER APPARATUS 9
NON -RESID. SINGLE OUTLET CIR,
250
Ex. OCCUD(OUTLETS OR FIXTIIRES) g L @ 1
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID•) EA% 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.��� 3 Classification /
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
l certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEEWORKMEN'S
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws -relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$
auttlunce reprebentutives or the county or rsutte to enter upon the
above-mentioned property for inspection purposes.
X Date
11/1/217
Signature of ermitee or Agent
Receipt No. 301 caS
White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By
Building permit expires Date
Date
• '6102-80B
' PERMIT NO.
PERMIT EXPIRES 12/15/81
OWNER JIM CLARK
CONTR. Owner
ASSESSOR PARCEL 44-45-55
LOCATION '1122 johnny, Chico
f
i
f
t .
4
a
i Temp. Power Pole
Called PG&E
Temp. 'Elec. Service
y Called PG&E
{ Temp. Gas Service
i Called PG&E
1, JOB �rIfIALED (Date
fir
t
Signature
JOK
O = Not OK
— = Not Applicable MOBILEHOMES
* = Not Ready
MISCELLANEOUS,
Date
MOBILEHOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements—Setbacks—Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1.' Zoning Requirements—Setbacks-Easements
2. Soils; Special:MH Support—Sketch
2., Footings; Size—Depth-Spacing—Connectors
3. Sewer; Location—Test—Fall-C/O—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
4. Water; Location—Test—Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing
5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
6. Gas; Location—Test—Wrap:/ /"L" ft./ /"Nat. or/ L"ft./ /"LPG
6. Carports; Windows—Doors
7. Utility Clearance
_
7. Elea
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements—Setbacks—Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except #'s
1, Setbacks—Easements
2. Footings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
3. Gas; MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
4. Electricity; MH Test—Crossovers—Breakers—Clearances
4, Elec.; Receptacles and Lighting; Distances—GFI
5. Drain; MH Test—Fall—Flex Connector
5. Elect; Pool Lighting; 15 volts—GFI
6. Water; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7. Water and Sewer Connected—C/O to Grade—HD Approval
7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes— Enc losures—PaheIboards— Ins. to Main in Conduit
9. Exits; Insp.—Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
J
J = OK
0 = Not OK
- = Not Applicable RESIDENTIAL jSingfe and Duplex)
* = Not Ready ,
Date
UNDERFLOOR Plans OK exce t#'s
Date
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
48.
49.
Property Line Firewall & Openings
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
51.
52.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8.
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
411
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Card -BI
Date Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
57. Smoke Detector
Card -BI Date Card -BI Date
Date PLUMBING (Permit) OK except q's
14.
Water Ht.; Vent -Access -Combustion Air
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
19.
Test Tub & Shower, 2nd Floor -Tub Access
Gas Pipe; Size & Anchors
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date
Date Card -BI Date
ELECTRICAL Permit OK except N's
66.
Elec. Outlets & Receptacles at Kit. Counter
67.
Garage Fire Door; Swing -Landing -Closer
-
68.
69.
A.C. Duct in Garage -Damper
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
20.
21.
Fixture & Transformer Clearance -Ins. Protection
Elec. Receptacles Spacing -Lights &Switches at Doors
70.
Plb., Elec. & Mech. Equip. Listed for Location
22.
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23. Romex Installed Close to Edge of Studs & C.J.
24.
25.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
2 Appliance Circuits in Kitchen & Conductor Size
72.
Insulation -Foam -Looked in Attic ❑Yes
73.
Guard Rails & Deck Construction -Post Caps
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI
74.
75.
Fdn. Vents & Crawl Hole Door -Drainage &Wood -Earth Clearance
Looked under Floor ❑Yes
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes []No
27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes ❑No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77•
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
80.
Water Well; Disconnect, Electrical, Plumbing
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
Ventilation throughout House
Card B -I
Date Card -BI Date
82.
Glass Protection
Date
MECHANICAL (Permit) OK except q's
31. A.C. Ducts; Insulation & Support
83.
84.
Corrections from Previous Inspections
Gas Test -Meters Tagged; Gas -Electric
85.
Water & Sewer Connected -C/O to Grade -HD Approval
32.
33.
34.
Vent Fan; Exhaust above Insulation
Condensate Drain & Overflow; Size & Grade
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
86.
Energy Compliance Certificate -Other Certificates
35.
Attic Access & Platform if Furnace in Attic
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING Plans OK except N's
Comments at Final:
36.
Sills; Proper Material & Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
38.
Bearing Walls over Girders & Floor Nailing
_
_
39.
40.
Draft Stop in Walls (rat proof)
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
41.
Header & Beam -Size & Bearing
42.
Hangers -Post Caps -Anchors -Connectors
43. Ing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Ring.
4.*-" Fireplace Ties or Type A Flue -Fireplace Throat
45.
46.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing
(NOTE: An entry must be made each time youvisit jobsite)
COUNTY OF BUTTE.- DEPARTMENT OF PUBLIC WORKS PERMIT NO
7 County,Center Drive - OroviIIe,,CalifO,rnia 959E5 - Telephone 916/534-45 jO�O
APPLICATION AND PERMIT
ASSESSOR ARC L NUMBER r
T- -5S• i r
ZONING
=Z• ►
�.''' BUILDING PERMIT I o
OWNT LEPHONE
OW 'S MAILING ADDRESS
S Inc
SO. FT.OCC: BUILDING VALUATION
C NTRACTOR'S NWE • TELEPHONE
t
CONTRACTOR'S MAILING ADDRESS
.
CONSTRUCTION LENDER - } - - UNKNOWN
r r
LENDER'S MAILING ADDRESS 4, -
..'Permit
'
Fireplace
Total Valuation $
Fee $
ARCHITECT OR ENGINEER , LICENSENO.
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Plan Checking. Fee
Penalty
Permit fee
$
$
$ C2 f�
BUILDING ADDRESS
2i f h .� •
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
. 2.00
Repair drainage or -vent piping
2.00
-
Water piping •.
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each pas water heater or vent
2.00
'
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ( Duplex❑ ,Mobilehome❑ Other •
Building sewer
Lawn sprinkler system
2.00
t y
SPECIFY
t TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ .Other
Permit Fee-
$
Contractor V
ELECTRICAL PERMIT
Filing Fee 3.00
Describe work:
'
00V OR
Main service 100 AMP ORSLESS
5.00
Main service EA. AOD'L 100 AMP
2.50
NEW CONST. DWELING
OR AODNS. ( ACCLBLDGS.CCUP.&)
20sgft
..
CONTRACTORS LICENSE LAW
I declare under penaltyof perjury )
p i y (check one): -
F1NON-RESID.
I am licensed under provisions of Chapt. 9, Div. 3 of' the' Businesseo@2S4
and Professions Code and my,,license is in full force and effect:
.�
License No. Classification
I, as the owner, or my employees' with wages as their sole-compen-
NEW CONSTR MULTI -OUTLET 2,50 ea
NON-RESID BRANCH clRc ITs
NEW CON ST FL POWER APPARATUS &
(SINGLE OUTLET CIR.
Ex. OCcup(o XTS OR FIXTURES BAL@104
FIXEEDD APP LNS. OR
Ex. Occup.(0UTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities
15.00
.sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044) ''
❑ I, as the owner, am exclusively contracting with licensedycontract-
Misc. Wiring
6.25
,
ors. (Sec. 7044) 1.
Permit Fee
$ '
❑ I `am exempt under Sec. Business and Professions Code
Contractor
for this reason
MECHANICAL PERMIT
FiIingFee 3.00
WORKMEN'S COMPENSATION INSURANCE , •
Heating
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have .placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
shall not employ any person in any manner so as to become subject
-Cooling.
Hood
2.00
Ventilation
to the,W. C. laws of California.
NoyI
6e o Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked. ' +
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
Mobile Home Installation Fee
$
Land Development Fee
$ "
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon ;the above-mentioned property for inspection purposes.
TOTAL. PERMIT FEE
$ a�
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, -and expenses which may in ny way accrue
again lt�aid County in ns uence of the granting of this perm t.
occUP, GROUP
TYPE of CONST.
'
PARCEL
PTH
ssuE
This permiCis hereby issued under the applicable provi-
:sions of the'Butte County Code and/or resolutions to do
°
X = Date S �•
Signature Applicant Owner
g pp � Contractor ❑ Agent ❑
work indicated above for which
fees have been aid.
p
An OSHA permit is required for excavations. over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
IRE TO F ELIC
r
By -
IPE MIT EXPIRES Date/z
WORKS
.
at
Receipt No. !�
WHITED. P. W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT + -
G E REVISIONS:
'-' - - --• ---- -- .-. ---- .--.----_ assessing how a proposed design compares to this package) of features. More detail on �' S �% GENERAL CONSTRUCTION NOTES
each of the requirements follows later in this chapter.
Table 7-2 - sae 0f dNliom
Prescriptive Less than 500 ft' Less than t.000 EXISTING 41M1 L3 - 1C) REMAIN
Tab/e3-1- Summary of'k.akage0Requirements Requirementsroi Component 10oh•,rless(1) (1) it -(1) All Additions (1) 1. Weather-strip all doors leading to unconditioned areas.
Additions CalliWall Ip insulation (3) R-09 2. Caulk all exterior door and window frames. EXISTING 1M1LLS - TO BE REMCNED
^�+ R-13 Package D (2) Packarge D (2) Package D (2) �- -.
BUILDING'ENVELOP T 2 3 d ., 13 14 15. 18 � Well InaWation (3) R-13 R-13 R-13
5 6 7 8 9 10 X11 t2
Floor irut4tlonV(2)PeCkHQe D(2) 3. Caulk and seal all openings in building envelope to prevent infiltration.
Insulation minkrurm�ar . R3B R30 R30 R30 R30 R30 R30 R30 R30 R30 Ria Ria R 13 e D (2) Peckapa D (2) Package D (2) NEW �.$ - TO
Fenestrelwnu.factor(5) g.Ts(to) ) p 4. NEW Windows and glass doors shall be dual pane glazing, with a ma imum BE CONSTRUCTED
Calling aokal0e D (2) Padkape D (2) /� „
ty, } / Rig R21 R21 R21 Glazing csoa'(6) e+Glass Psckalge+Glass Package U -Factor of D• QS and a maximum RHGC of no �Gi
{ry i Walls R21 R73 R73 R73 Rt3 R13 R73 R13 R13 R13 R19 R19 Rig R21 R21 R21 - �A8�) _ Exl$T'1 - _
d (7) Remowed (7) NG OOC)RSR4.76 R2.44 82.44 R2.44 R2.q 82.44 R2,44 8244 R2.44 R2. R4.7 R4.78 R4.78 R4.78 R4.78 R4.76 Solar Heat Galn J''.Ali glazed assemblies shall be labeled with cer}ified U -Factor, SHGC and
6abw-grade wallsF10 Coefficient(SHGC) PeOkp°D12)D (2) Packa{ps0(2) Package D(2). InfiitidtiOn CertiflCatlOn.
i,RO RO RO NR 'RO RO RO RO RO RO RO R0 RO RO RO R13 t,RaisedSlab Roparimeler -NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR R7 Bedlam Genian (4) N/A 6. InsulatlOn Shall meet CaiifOrnla Energy COmmi$$iOn Cluality Standard$ and NEIN DOO1�$
D (2) Pxka®a D (2) Paekega D (2) IRafaada°ora Rt8' Rt9' R19r R79a Ri9r R19r R19r R19r Rt(1' R10 Rt(1' R79a Rtl'r R79r R19x Rt9'- $hail have file fOIIOWing mInIR1Um rat:IngS:
Car [ Sa reread Isers Ra Ra RO RO RO RO RO RO RO RO R6 R4 R8 RB R4 NR Spam Hearing 3 Cooling (a) Mandatory D (2) Pack" D (2) Packep• D (2)Becton/ Gamer NR RED NR REq NR NR NR REQ REO RE REG REO REO REQ REO NR Rel- GLAZING �- 'an' Charge and N/A D (2) package p (2) p�lrags p (2)Exterior WailsAirflow forTXV)(9)MaxsnumU-alaoP 0.85 085 0.T5 0.75 0.75 0.75 0.75 0.75 0.75065 0.65 065 0.65 0.65 0.85 0.60 _ Ei(1STfNG MVINpaw$Duct Seatrp (9) NfA D (2) Packeg)e D -
Maximum Wfel eros 16% 16%" 20%• 20% 16% 20% 20% 20% 20% 20% 16% 16% 16% 16% 16% 16% (2) Package D (2) 1 -
`•F•i Solar Heal Gan CoelFcient• - Water Hearer Replacement N/A- Ceiling$ NEW WINDOWS
�N/A WA N/A - ISOuaNadng glazing NR 0.40 NR 0.40 NR NR 0.40 0.40 0.40 0.40 0.40 0.40 0.q0 0.40 0.40 NR Add Water Heater See Tebla 7-5 7.5 See Tafde 7-5 See Table 7-5 � - ,a
ER5141clng gazing .NR 0.40 NR 0.40 NR NR 0.40 0.40 0.40 0.40 0.40 0.40 0.40 0.40 0.40 NR Notes: p00(S ►I�A L++�/t „_ a r/�' f nt r -
n IY IC J a (9/(iJr ij i � EXISTING
Ent az h ,. Additions
7. Furnace shall be certified b Californila Ener
r -% o TMorriNacrn • P' NR 0.40 NR NR 0.40 0.10 0.40 0.40 0.40 0.40 0.40 0.40 0.40 NR - Y specific sae range column Can also use prescriptive requiremtertre listed In anycolumn to - y Energy Commissio , shall be pilotless,.
rIro glazing NR 0.4 fns Nght ea ion ea all p ,
�N)
9 requirements In the chosen column are met. I NEW
O � ,� 9glazing NR' 0.40 NR 0.40 NR NR 0.40 OAO 0.40 0.40 0.40 e40 0.40 0.40 0.40 NR I shall be gas-fired, and Silai) have a minimum AFUE Of
RMAI MASS 2. Areae shown M grey are the Pae
NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Package D requirements that apply to addnlons M the name manner as may
SPACE HEA SI"STEM° - ` Package Few construction. d (me Table
requirements, either the standard packs n D Or the Alternative to , 8. ; Air conditioner shall be California Energy Commission certified and shall have `
i Package D may be used (tree Table 3-2). g + s a minimum SEER of i '..ar' r 1 CJP'
5 M t r f o0 CI Af /( rryj 1 Y ,n Eleeaic res stent allowed No No No No No No No No No No No No No No No No 3. Heavy Maes and'Llght Mesa walla may meat the Package D requirements ler mess waU Insuhtion ! n
T4 SEpj'lG' /RY�V1i1✓ If gas, gFUE• MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN Instead of R-13(see Table 3-1). 7. �UCtS Shall beC
1�, �^ -T •n. onstructed, insulated, assembled and Installed in conformance
If hem pump. spat system HSPF°.� j,41N MIN MIN MIN MIN MIN MIN MW MIN MIN MIN MIN MIN MIN MIN MIN 4. The radiant barrier requirement only applies to me addition roof area. It b not necessary to retrofit a radiant
with the latest edition of the California Mechanical Code. N
�y Srpk Package systerm HSPF • barrier m me ezlaring attic. N
-MIN MIN MIN MIN MIN MIN MIN MW MIN MIN MIN MIN MIN MIN MIN MIN 5. Due
/ '`
SPACE -COO -LING SYSTEM ireme d greenhouse winrbwa and dual -glazed skylights are assumed to meet me applicable U-tagor 10. - Thermostat shall be programmable type with setback controls. Q(IS"t'i §V Goa., . .
` requirements.
M k
Le%Q4 j uapeaanton �C,sEffR= 6. Thu 11. Water heater shall be gas fired and shall be certified b California(71y iEnergy o v
MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN apfxoeM does not allow credit for glass removed. As described In Nola. t, kcomplfence win all the �V • 1
Refrigerant k requirements for me column for additions d less than 500 square feet isallowed/wed, in which mse ned6 for COmnliSSiOn. i ST 1 N ••. CD
- 1 r ��C�'- -- � 1 aln9a dlerge enol airflow SJR REq' NR NR NR NR NR RED- REq• REO RED- REO' REQ' REO- REQ• NR Z M t
Lr-` < f•�V� IfsinggdrTXY Glazk area is SMOKE DETECTOR NOTES: ry r'
S duple Package ONI G DU MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN MIN �•w'a", 7. Ge addiarea b linked tome Package D fenestration area Plus me area of any gflazing removed bemuse of - ■ ® � Ci•
SPACE CONDITIONING DUCTS � the addition. - - 1"� t MO
8. When heating and/or coding will be extended to an addition from me existng sysrtem(s), the existing A §1'
Dud Sealing R;EO• REQ' REO- REQ- REQ- RED- REQ- RED* REQ* REq REO• REO• RE_Xx
q' REq' RE RE equipment need rwt eomDly wlth TMe 24, Part 8. The heatlng system capacity mtuat be adequate to meet a /'A �'^�••- "'�% If �,
`J e:7. f smoke detectors do not exist on this residence, install smoke detectors
- -
DOMESTIC WATER -HEATING �... .the minimum requirements of UBC Section 310.11. Noelectric resistances space, hsag iii
TMPE(syatemmuslmeetbadge:, er n9 maybe in the following locations: �
flee §151 (b) 1 and M 8 and A"Y Any Any Any Any Any Any Any Any Any Any Any Any Any Any Any - In
9. The requirements for testng refrigerant Marge and airflow for Installing a lhemto,static expansion valve 11711
-
(TXV)) apply on # a naw split stem air - - ops S V iC
Tables 3.14 re 3-17) _ � b P Y conditioner or heat pump a installed as pan of ma addition. Ile � � E - is U. separate air distribution system Is Installed for the addition, men this new system must be tested and sealed =
ach bedroom, on ceiling near door.
fill' HERS rater field verification and dagnmtic testing are requted for tlsa fulure. As an sitemative un er Pa a D, beaer glazing and higher to have a leakage less man or equal to 6% of the fan alrilow. 0 an existing air disthbutfan system is '
g ' rw m
.... I�t ty �extended to serve the addition, moa too must be leafed, but me tested target duct leakage da -
Each hallway leading m s
Tableefficiency
for the
increased
can valud.nsteadvaybyclimate.c testing of av distribution duets, split syst air Itd'loners and hea:,.•.•$.See Y to bedrooms nM
Tale 3.2 forme Inoefaeed veltres ivIHM vary by climate: � size d the addition and other tactors discussed in Section 72 .3, Determining the Target Percenlmleekege. - g , O � � � C �
00
R t t� N At high point of ceilin where height a � co
�§ NR=Not Required REq=Re cored - - In Neu of testing duct leakage and refriddyam Marge end airflow(Or installing and vedfyirg aTXV), me _ _ g e ght Changes, all rooms..
9 MIN •Minimum builder can clwose t0 meet tree Alternative to Package D requirements. See Table 3-2. - -
Lj 10• When the Alternative 10 Package D is used for additions of 500 ft' or lose, the fenestration U -tactor and M
SHGC criteria of the Alternative to package D must be met. See Table 3-2 for a summary of the N
- U ^ C
requirements. LU C4 ` M N
_ t 1. When reptacing s central air wndilkmer that serves both the addalnn and exfefing twlldmg, the reptammen: - O A
fs an aheretldn and must meet me requirements described in 7.5.2, New S am l:aMltionin Equipment VX v S
Ce
0 027 �3 (�WBatt t t`t W A PWA, c a
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