HomeMy WebLinkAbout007-360-014v
a E. Johnson,
r IYWa'terford Dr., lotNorth Park
Sub, Chico
Permit #3658-79B PE M(new single
family) 'd�® ��
.007-360-014 04-2802.•
SHAUGHNESSY, EDWARD
717- WATERFORD DR;- CHICO
Cont: GREENE & SON R O�ING
007-360 014 1;;' 05-1305
SHAUGHNESSY,- EDWARD
717 WATERFORD DR`CHICO,:
Co'nCPF REILLY & CO ,
REP (8) WNDWS.,
o
P
+
' r
im, cr;F� 7.
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.
BPO51305
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
Issued Date: 05/17/2005 APN: 007-360-014-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect. �(-�-n ����2
License Class : f�l� License Number: �!1ia 3LZ
Site Address: 717 WATERFORD DR CHI
y
Date: -.5116&5 Contractor:
.
Map Index:
Description: REPLACE EX WINDOWS (8)
OWNER -BUILDER DECLARAT N
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: SHAUGHNESSY EDWARD A
permit to construct, alter, improve, demolish, or repair any structure, prior
717 WATERFORD
to its issuance, also requires the applicant for such permit to file a
DR
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
95973-0451
7000) of Division 3 of the Business and Professions Code) or that he or
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 penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: P F REILLY & COMPANY INC
Code: The Contractors' State License Law does not apply to an
owner of property who builds or -improves thereon, and who does
such work himself or herself or through his or her own employees,
3028 ESPLANADE
provided that such improvements are not intended or offered for
SUITE F 95973
sale. If however, the building or improvements are sold within one
530-898-0833
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' State License Law does
Contractor: P F REILLY & COMPANY INC
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.).
3028 ESPLANADE
SUITE F 95973530-898-0833
O I am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
License #: 711037
WORKERS' COMPENSATION 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
Architect:
Labor Code, for the performance of the work for which this permit
/ is issued.
Its' 1 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 carder and policy number are:
Carrier: t5i Roe_ T `^"'4
Total Square Ft: 0 S. F.
Policy #: 15 x-35 5 CZ -;Zc 5
Valuation: $0.00
Census Code:
❑ 1 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'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith c mply with those provisions.
Date: __Jr �t� D•5
Applicant:_
WARNING: Failure 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.,
�� O
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
This permit Is hereby iss ed under the applicable provisions of the Butte County Code 7d/ or
Resolutions to do rk dicated a ove• for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
S
Name:g.
By: Dat
Address:
PERMIT EXPIRES ON: l/O
(date)i
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534.0f the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ , Notification in accordance with Section 1'9827.5 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 state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
'authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: r(�J D/I Signature: �i"�A //au~
�
/
f'
Owner 0 Contractor Agent t for Owner V Agent for Contractor
.❑
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAtL 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
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
Sly e55 OWNER
Last Name S
first Nae r_ _ _ _
�.
Address ?Z 1 v
City Ckcc-0
State LA
ZipgSg73
Phone53o_ �Tz23
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name"��,
City C4, co
Address 3a2$ Fp
Zip�s� 3
City W�Z>
Fax
State G/t
Zipcp5q7 3
Phone 0 - ge6_b133
Fax 5-3,D, jc[` I Sqq
E-mail
E-mail
Lic. #.7 11637
CI sVIc
1
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City C4, co
Address
Zip�s� 3
City
Fax
State
Zip
Phone
Address
Fax
E-mail
Lot #
State License Number
APPLICANT NAME
Name C�c l 5-a5.501'e
Address 3a�g E6P[
City C4, co
State
Zip�s� 3
PhoneS�-
Fax
E-mail
APPLICANT SIGNATURE
X
For office use ly:
LOCATION
AP# 007---560—C)/
D7---560`C)/
Zoning
Cit
14 CGp
Flood Zone
SRA I Yes
I No
Occ.
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
Type Const.
Subdivision Name
Address
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
6!57— 1365
BIN #
Description or Scope of Work*
'Re�/
��� e5ct5�CG r,Ut a�1S tvtl4 11�cJ
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
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.
447 a y: Amount: Bldg
SRA
Receipt #: Sheriff
(.Q SMIP
Other
Dater '� o_5 21ZC1
CR.1.1 Total
Page 1 of 2
RCv L-LY-VJ
LOCATION
AP# 007---560—C)/
D7---560`C)/
Property Address
-7i'7 2r tz
Cit
14 CGp
Cross Street
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
Name
Address
Description or Scope of Work*
'Re�/
��� e5ct5�CG r,Ut a�1S tvtl4 11�cJ
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
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.
447 a y: Amount: Bldg
SRA
Receipt #: Sheriff
(.Q SMIP
Other
Dater '� o_5 21ZC1
CR.1.1 Total
Page 1 of 2
RCv L-LY-VJ
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN 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 faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) 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).
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.
❑ 12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
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\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION tt: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.netldds
PERMIT NO.
AP042802
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: 09/23/2004 APN: 007-360-014-000
the Business and Professions Code, and my license is in full force and
effect. y
License Class : t/:./-3 0f License Number: 22;/ E�
Site Address:.717 WATERFORD DR CHI
Date:—Z 3 Contractor.
Map Index:
Description: RE -ROOF (28 SQ)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' Stale License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: SHAUGHNESSY EDWARD A
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
717 WATERFORD DR
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
A 95973-0451
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 penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
_ -
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: GREENE & SON ROOFING
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
PO BOX 2467
provided that such improvements are not intended or offered for
PARADISE, CA 95967-2467
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
530-873-3940
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' State License Law does
Contractor' GREENS &SON ROOFING
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.).
PO BOX 2467
❑
PARADISE, CA 95967-2467
I am Exempt under Article 3 of the Business and Professions Code
530-873-3940
Date: Owner:
License #: 275057
WORKERS' COMPENSATION DECLARATION
1 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:
is issued.
, Engineer:
01-4 have and will maintain workers' compensation insurance, as
,
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: -S rA_ fp_ Ex
Total, Square Ft: 0 S. F.
I Valuation: $0.00
r
Census Code: �:n
Policy M. J753G yy
❑ I certify that in the performance of the work for which this permit is
(v l
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'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant: L
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
,f _ / r'g�
`T l ' Z 3 ' d¢
hundred thousand dollars ($100,000), in addition to the cost of
/
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereb is! ued under the applicable provisions of the Butte County Code enrVor
I hereby affirm that there is a construction lending agency for the
Resolutions to do coo indicated above for which fee$ have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
�� G
Name:
BY ate:
PERMIT EXPI EON: Q ' Z3 'C 57
Address:
Date
❑ 1 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 19827.5 of California Health 8 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 state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives ofButte County to enter upon the above mentioned property for inspection purposes.
Print Name:_` l y✓ PPy�� Signature: -.
Date:
❑ Owner �r ❑ Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP042802
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: 09/23/2004 APN: 007-360-014-000
the Business and Professions Code, and my license is in full force and
effect. r
License Class: ��-3 Cf License Number: 229�2%e5-07
Site Address: 717 WATERFORD DR CHI
Date:_ Contractor. t��2'�GQ/./�t;tl �fdr�f"rou�
Map Index:
Description: RE -ROOF (28 SQ)
OWNER43UILDER 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: SHAUGHNESSY EDWARD A
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
717 WATERFORD DR
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
95973-0451
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 penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: GREENE & SON ROOFING
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
PO BOX 2467
provided that such improvements are not intended or offered for
PARADISE, CA 95967-2467
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
530-873-3940
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' State License Law does
Contractor: GREENE & SON ROOFING
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.).
PO BOX 2467
❑
PARADISE, CA 95967-2467
1 am Exempt under Article 3 of the Business and Professions Code
530-873-3940
Date: Owner:
License #: 275057
WORKERS' COMPENSATION 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:
is issued.
Engineer:
0--1 have and will maintain workers' compensation insurance, as
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:
Cartier: �r
Total Square Ft: 0 S. F.
Policy a: /7.536 9 y
Valuation: $0.00
Census Code:
❑ 1 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'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
4-/ 5g4r, �S q
' z 3 ' b4 -
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 hereb issued under the applicable provisions of the Butte County Code ?nrvor
I hereby affirm that there is a construction lending agency for the
Resolutions to do wo ipdicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)q,
��
Name:
By ate:
Q ' Z3 -C�s)
Address:
PERMIT EXPI EON:--
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 19827.5 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 state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives ofButte County to enter upon the above mentioned property for inspection purposes.
Print Name: ,Z), A- ��P�'�— Signature:
Date:
❑ Owner �r 0 Agent for Owner ❑ Agent for Contractor
PERMIT NO. 3658-79R.P,F -M
PERMIT EXPIRES
,;OWNER RaycE,.Johnson, Jr
owner
CONTR.
4
LOCATION (A.P.4-38-102 pxt.
North Park Sub,
46ft Waterford Dr., lot
Chico
�t
Temp. Power Pole
Called PG&E
-7 7". Elec. Serv.
t
Called PG&E
Temp. Gas Serv.
C a I I e d
JOB
FINALED
(Date)
(Signature)
r 4
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Forms
Main Bldg.
Footings
Stemwal l
lab
' 1C
iers
/14—'rage
Footings
Stemwa I I
P9
Slab
`r
Carport
Footings
Slab
Patio
Footinas
Stucco
Firewall
Parapets ._.------
Restroom Finish
Windows
Siding
_Roof Sheathing
Roofing
Fdn. Vents
Garage Vents
Insulation 4
Prov. forph' sicall_v__,�---
handicaD&
Conformance of
FIREPLACE
Soil Piping
1st Floor Z
2nd Floor
3rd Floor
To out
Water Piping
Sewer
Fixtures
Water Htr.
Heaters
Appliances
Gas Piping & Test ,
Temp. Gas
Sanitation ^�
Final / Q "�
ELECTRICAL
Final V F/ Fixtures L ----
FIRE SPRINKLERS Motors
Test Water Htr. -�—
Final Subpanels
CHANIC Grd. Fault Prot.
Heating Service
R
Brown G / Cooling Temp. Pole %06 -
Finish Ducts Underground
Interior Lath �� Ventilation Permanent
Door Closer Final �f ✓ Final Z-5/0
MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal
Water Piping Sewer Gas Piping
MOSILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE % REMARKS OR CORRECTIONS i 7
sjc
(NOTE: An entry must be made on this form each time you visit the job site.)
ERSET
COMPANY
® LICHNBBD CONTRACTOR
Phone: 342-4764
P.O. Box 628 — Durham, California 95938
INSULATION (Batted or Blown)
Date— 19 _
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25,
STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
Street Lot Number Tract No.
EXTERIOR WALLS
ManufacturerThickness/Type R Value
CEILINGS
Batts: Manufacturer Thickness' R Value
Blown: Manufacturer, Thic nes % No. Bags Wt./Bag
Sq. Ft. Covered LR Value
FLOORS
Manufacturer
SLAB ON GRADE
Thickness/Type R Value
Manufacturer Thickness/Type R Value
Width of Insulation Inches
FOUNDATION WALLS
Manufacturer Thickness/Type R Value
GENERAL CONTRACTOR LICENSE NUMBER
BY T E DATE
IN ION NTR11— A AA
TOR ( LCENSE NUMB§9
B TLE "A69/�� DATE/ t
SAVE ENERGY - INSULATE!
(DATE)
ACCEPTED ETH" COMPANY
(Authorized Representativ )
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS
ATGu 47-i
Gocati n)
BUILDING PERMIT NO. ` ��' — 7% A.P. NO. -_3S
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROA/M 1-)T.ANC
(Check each item or write N/A if,'not.applicable)
INSULATION:
Slab Edge. _
Fdn. Walls
Floors—
Walls '
loorsWalls_
Ceiling/Roof
Ducts_ ✓
Circulating Pipes
APPROVED HEATER
APPROVED WTR.HTR;
GLAZING:
Single Glazed V/
Special (Insulated)_
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS.
BACK DAMPERED FANS
INTERMITTENT IGNITION DEVICES
CERT. APPLIANCES
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name
Signature of, (please -print)
Insulation Applicator
State Contractors
License No.
General Contractor/Owner Name_
Signature of (please print)
General Contractor/Owner Date
are Contractors
License No. I((,.C(-
.
THIS CERTIFICATE MUST BE ON FILE WITI{ THE BUILDING DEPARTMENT PRIOR T'O
REQUESTING FINAL INSPECTION.AND SMALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
log
COtiNT"V OF BUTTE — DEPARTMENT OF PUBLIC WO
7 County Center Drive - Oroville, California 95965
Telephone: 534-4541 5APPLICATION AND PERMITe,.,A6
SI to ee of ermDateitee Agent r,,
Receipt No. Vt
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date
BUILDING
OwnerSQ.
is /U tShl'
FT. OCC. BUILDING VALUATION
/ 4
Mailing Address o1700
p -�
iot
c
Tel h one No.
I i
Cpt,�, �g
Contractor
Mailing Address
Fireplace 5Z_10
Total Valuation
Telephone No.
Permit Fee
Building Address
P I an Checki ng Fee &/or Penalty
Permit Fee or.)
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 , cnri�)
Each TraD 1.50
„�Tjf t f G p
Repair drainage or vent piping 1.50
A. P. No'.•�-38 �4T,
Zoning & P ng
Water piping 1.50 ,5z>
Each gas water heater or vent 1.50
Fees
V a
Fire Dept. Fire Zone
Use ermit
Gas piping system 1 - 5 outlets 1.50 n -7t)
EQA
Pa ing
Plans
Parcel
Declaration
el
60' R/W
Improveme s
Each additional outlet .30
Building sewer 5.00
Par A22rovoll
p,14—s Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$ LciZ
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 .lea
00V OR L
Main service 10000 AMP ORSLESS 5.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADO'L 100 AMP 2.50
'
Main service R 600V
1100EAMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONS
OR ADDNST AC L D P S) 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 ULTI-OUTLET
NON-RESID BRANCH CIRCUITS) 2.50ea
1�
NEW CONSTR POWER APPARATUS &
NON-RESID. SINGLE OUTLET CIR.
Ex. QccuD{OUTLETS OR FIXTIIRES BAL@1
FIXED APLNS
Ex. Occup. ( OUTLETS P(RESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ Z
$ ZZ
MECHANICAL No. @ 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.
I certify that in the performance of the work for which this
permit is issued 1 shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00oc�
Heating /*,.k (��
_J& -
Cooling
Ventilation
Hood 2.00 Cly
Permit Fee $ (jp
$
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 represents 'ves of the County of Butte to enter upon the
above-mentioned o erty for inspection purposes.
Date . J C
Land Development Fee
$ Qf
TOTAL PERMIT FEE
$
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
abov or which fees have been paid.
R OF P BLIC WORKS
SI to ee of ermDateitee Agent r,,
Receipt No. Vt
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date
the f;ug. Setback shall be 5 ft, from the
tide property line and 50 ft, from the
centerline of the road, permitting a maxi-
mum of a 2 ft. eave overhang but entirely
Ot* of all easem1b.fz
Thf s set of plans and specifications MUST be
kept on the job at all times and it is unlawful to
make any changes or alterations on same without
wrifftn, permission from the Department of Pub,
lic Wrks, County of Butte-
09
;Oil�.
e
Aro, A
ri V
14 TO !Y44
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163,77 p
All
004k
o-6v�/fin
9
d
(
o
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Seg
ing
ti "syste
d,6 in
nd location of build-.
b -out
But
to. be: as
;.:� ..P_,.
av � CUuly 17
BUILDIN �DEPARTMENI
APP
OVPD
'Sr✓An d=-� / V. I S � J _. -
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.G'�1 Y x . _1 c7 ,-/N_5ON .../Ae,
t> /-W V4,4 1C' Z" Az-- s
'
This set of plans and specifications MUST 6e
'
kept* on the job at all times and it is unlawful to
' NOTE:—i411 Materials &Workmanship Shall Be in
make any changes or alterations on same without
written permission from the Department of Public
Accordance with Re;ognixed Good Practices and
'
Works, County of Butte. -- --
mof a quality prescrib d for the Specified use in the
Uniform Building, Plur Bing & Mechanical Codes and -
the National Electric Code.
Septic system and location of build-
ing drain stub -out to be as per
Butte County Health Dept. Re-
--
h = � ' � 1 �►.%
quirements.
ei, 0 9 �
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,off
19
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.. G8. 27' •
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'
See Master Plan on _file for building
plans.
i?�y �nh n s •�.
I
4 from We
BUTTE CO1i"�
The Bldg. Setback s
11-5
_
Ode property line nd 50 ft. frein--the
BUILDING DE?ARTMN
centerline of the road, permitting a n1lixi-
mum of a 2 ft. eave overhang but entirely
APPROVED
out of all easements.
at P �-?gz ' 79 —
,5 u ,CS O / V ♦ T' / a Ae"
G v//�G o Y oCVffepr �' f
G/U/G O
e– A,