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HomeMy WebLinkAbout007-360-019Ermit#61 nson; Jr. Teton Way, lot 19, North Par o fi 33-79B,P,E,M( / new single LAU `007-360-019 02-19 I ALE BECKER,DAVE •., " 716 GRAND TETON, CHICO CONT: AIR-ART HEATING C REPLACE HVAC . } r -007-3 60-019.. �+ .'04=2789, ~ BECKER, DAVID 716 GRAND TETON"WY; CHICO' y ;` Cont- SCHUKELCONST RE-ROOF 36'SQ t r r BUTTE COUNTY ' 0�vTT�0 DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT 024 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) o • o OFFICE #: (530) 538-7541 FAM(530)538-2140 _J WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042789 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: 09/22/2004 APN: 007-360-019-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number,Site Address: 716 GRAND TETON WAY CHI gyp_ Date: T Contractor Map Index: Description: REROOF(36 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: BECKER DAVID B 8r CHRISTINE C permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 716 GRAND TETON WAY 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 CHICO, CAS she is exempt therefrom and the basis for the alleged exemption. Any 95973-0419 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 -" Code: The Contractors' State License Law does not apply to an Applicant: SCHUKEI CONSTRUCTION, GLENN owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, EDWARD provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 25 AMBER WAY proving that he or she did not build or improve for the purpose of CHICO, CA 95926 sale.). 530-343-6020 ❑ 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 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.). Contractor: SCHUKEI CONSTRUCTION, GLENN L3 am Exempt under Article 3 of the Business and Professions Code EDWARD Date: Owner: 25 AMBER WAY CHICO, CA 95926 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 530-343-6020 ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the License #• 606543 Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance carrier apo policy number are: Engineer: Carrier: Policy #: ❑ I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, 1 shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: `'j— Applicant: / \ � � �In 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. CONSTRUCTION LENDING AGENCY i— This permit is hereby issued under the applicable provisions of the Butte County C A and/or I hereby affirm that there is a construction lending agency for the Resoluti o Oo work in ' ed a f which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: Date: � PERMIT EXPIRES ON: ate Address: - ❑ 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 & 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 a above eelmmeentioned property for inspection purposes. / n r <`�'�`r t� Print Name: � �� \ � Signature: � Date: 0 Owner Contractor 0 Agent for Owner ❑ 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 REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY* APP /CAN SIGNATURE X For office use only: OWNER Last Nameh N� irst Name Address '�� �N City c i Co State QA-- Zp 9s Phone z, 73 Fax E-mail Lic. # �' ,,� c APP /CAN SIGNATURE X For office use only: CONTRACTOR Name N� Address g— AV,- City J'C d State Zip Phone Phone Fax E-mail E-mail Lic. # �' ,,� c Class APP /CAN SIGNATURE X For office use only: ARCHITECT/ENGINEER Name C-- �iw\ _ L,/ . Address g— AV,- City No State Zip Phone Phone Fax E-mail E-mail State License Number APP /CAN SIGNATURE X For office use only: APPLICANT NAME Name C-- �iw\ _ L,/ . Address g— AV,- I Yes No ct State Zip C' Phone —C Fax E-mail Date Approved: APP /CAN SIGNATURE X For office use only: Zoning Property Address 71 g' lR'� Flood Zone Cross Street Co q SRA I Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. I:1 BIN # LOCATION 0 2 AP# 0-7 —' Ulr� (f OI LJ�/ Property Address 71 g' lR'� City` G- W dca Cross Street Co q WORKER'S COMPENSATION Policy Number.. Carrier S+A4,i-�- F& r< -AJ 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 Descri n or Scepf Work: Sq. Footage ❑ Structure Built Wthout 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 required. 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. I I Received b)r Amount: 0`° -D - v" Bldg 1 I OVER FOR SUBMITTAL REQUIREMENTS K TORMSWILDING FORMS\BldgApolSubRgmts.doc Page 1 of 2 Receipt #: Date: Sheriff SMIP Total REV 7-27-04 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 1N INK. O 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 A/C 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). ❑ 13. Sanitation and site plan approval from the Environmental Health Department. 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 KAFORMSWILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 ,:� Q � ...�.............. ..—�c... • ...... R .. .: '�rr•a.� i +h _ _'. T'^C w*sa:a. a .�.,.T,.,��r�v2�•aY;�' �, ._. :rr e fir 007,360=0198 02-1074 ` `BECKER; DAVE i. 716 GRAND,TETON; CHICO Rr ,CONT:; AIR -ART HEATING & A/C-:. F REPLACE HVAC' ' • z Hl � - t - j COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION ' 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P RMT (Rev. 12/96) APPLICATION AND PERMIT «/� ASSESSOR PARCEL NUMBERO r 300 J ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERS (LING ADDRES ..�� COM CTOR'S ME t SOL R N it %v% 4 TELEPHONE CONTRACTORS MAID ADDRESS W, .� SZ. co A. CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ BUILDING ADDRESS / � `Dn GEnergy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other " SPECIFY Solar or heat um water heater 23.00 Water piping 15.00 Each gas water heater or vent 1 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ublities ❑ Installation ❑ Other ❑ Describe Work: �I(, .(� . VAC ' Gas piping stem 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 LESS Main Service zo.A OR LESS 23.00 f LICENSED CONTRACTOR'S 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 the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO T000A 46.00 NEW CONST. DWELLING Occup.DS. So OR ADDNS. ( e ACC. BL3.5a FT. fNON.gESID. MULTI.OUTLET 97,50 PSOWEINR APPARATUS 8 GLE OUTLET CR. ourLEroRFornnTEs Ex. Occup. BAL ° ': o OR Ex. Occup. OUTLETS Aa ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 LA. PERMIT FEE $ 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 is issued. ,6 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier SIA FU N0 1 L` Policy Number X11 • 0000114-7-0?_ (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify4hat 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 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 comp h those provisions. 2 X Date Z 7 �0 Signature of Applicant - ❑Owner Contractor U0 Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories yin height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling�4( Hood 6.50 Ventilation PERMIT FEE $ ' Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE� TOTAL FEE $ HA2. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code,arld/or Resolutions to do work indicated above for which fees have been paid. By - Date �- JIt -7-13 - 03 PERMIT EXPIRES ON Date Receipt No. �% V77-3 71k� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P R T (Rev. 12/96) APPLICATION AND PERMIT 2a 1 NUMB , ^ r © ASSESSGRP 0.il 1 1VI ZONING BUILDING PERMIT OWNS elU TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER UNG ADDRE ,__V/C7//vA 4 `G/),/ CONI CT S E n. 1 A_-+ TELEPHONE CONTRACTORSADDRESS Nb 6\, ChicoCA, `ice CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER UCENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS n Energy Plan Checking Fee $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ulilities ❑ Installation ❑ Other ❑ Describe Work: re- gi%1 ul Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 OV OR LE Main Service . oR LESS 23.00 LICENSED CONTRACTOR'S 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 the Business and Professions Code, and my license is in full force and effect.PSING License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service zooA TO ,000A 46.00 NEW CONST. DWEWNO OCCUP. SO OR ADDNS. ( a ACC. BLDS. 3.50, NON-RESID MULTI -OUTLET @7,50 a R A OURET CIR. OWELEPPARATUS Q ,.00 Ex. Occup. OUTLET OR FIXzo TURES fi20 .50 NS Ex. Occup. ourLEEDTSA PL.16.oEl 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 3,01.1 Misc. Wirina 23.00 `Z PERMIT FEE $ 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 is issued. ,lb I have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' qpm e sationn i su ante carrier and policy number are: Carrier SA N Policy Number �,la - 0000Ci-1 -C7 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 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 forthw'th coy it / �h those provisions. X Date 23 -0 Signature of Applicarif - ❑ Owner V. Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating , Coolingf Hood 6.50 Ventilation PERMIT FEE $ ° Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD CDF PARCEL I PO I HD I ISSUE This permit is hereby issued under the applicable provisions of the Bu unty Code d/or Resolutions to do work indicate abov for which ee have been paid. -71215 By Date PERMIT EXPIRES ON C �� Date Receipt No. 3773 - WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT a PERMIT NO. 6133-79B�E,P,M PERMIT EXPIRES OWNER Ray E. Johnson, Jr. owner --CONTR. 44-38-102 port. LOCATION (A.P. ) 716 Grand Tton Way, lomat__ 111 North Park Sub, Chico e .s Temp. Power Pole Called PG&E 1 1! iEI ec.- Serv. Vol Called PG&E . Gas Serv.�. �- Called PG&E f• tl JOB FINALED (Date) P i , (Sig ature) r- EPSET �ppnn- 1 COMPANY Iiia LICENe6D CONTRACTOR Phone: 342-4764 P.O. Box 628 = Durham, California 95938 INSULATI,4N(Batted or Blown) Date 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: �q Street Lot Number Tract No. EXTERIOR WALLS Manufacturer Thickness/Type l_ t R Value CEILINGS Batts: Manufcturer Thick ss R Value( ^ T Blown: Manufacturer TicJS ks�esL FLOORS - Manufacturer.- Thickness/Type R Value SLAB ON GRADE v a Manufacturer Thickness/Type R Value ^' t^ w Width of Insulation Inches FOUNDATION WALLS Manufacturer Thickness/Type R Value GENERAL CONTRACTOR LICENSE NUMBER t BY TI LE DATE INSULAT ON NTRAC LICENSE NUMBER D TITLE DATE SAVE ENERGY -INSULATE! ( DATE) ACCEPTED r� r ETH. OMPANT (Aufhorlsed Represenfafive) TN IS PS TO CERTIFY THAT INSULATION HITS BEEN 1NST4LEO IN CONFORMANCE' WITH THE CURRENT ENERGY REGULATIONS;, CALIFORNIA ADMINISTRATIVE CODE; TITLE PS. STATE OF CALIFORNIA. IN THE BUILDING LOCARD AT: Godman Ave. 19 Chico Street o um er City EXTERIOR MALLS Manufacturer Thickness/Type e R Value ' CEILINGS Batts: Manufacturer Thickness' R Value C " Blown: Manufacturer T Thickness 6' 2 No. Bags 27 Mt,/Bag 24 Sq. Ft. Covered 1367 R Value 19 FLOORS Manufacturer Thickness/Type R Value Manufacturer Thickness/Type ti•, R Value FOUNDATION MALLS Manufacturer Thickness/Type R value GENERAL CONTRACTOR LICENSE NUMBER By TITLE DATE INSULATION CONTRACTORN T C. Hnl , S O N I N SU LA T I O N LICENSE NUMBER 212461 BY TITLE Vice Pres . DATE 2-20-80 RESIDENTIAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS'TQ CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS RAVE BEEN 1," THE FOLLOWING HAVE BEEN INSTALLED AS PER APVRn1/vn UT AMC. (Check each item or write NIA if not applicable) INSULAT ION; GLAZING: Slab, Edge. 6*Pf Single Glazed Fdn. W� FlooraA4X Special Insulated) ZE CERT. & LABELED WDS. Walls & SLIDING DRS. Ceiling/Roof- WEATHERSTRIPPED DRS. Ducts"' '-. I - :21, BACK DAMPERED FANS Circulating Pipes INTERMITTENT IGNITION DEVICES APPROVEDHEATE CERT. APPLIANCES APPROVE Vol - WT R o HT R�.' 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 Na.1ie- Signature of: (please print) Insulation Applicator State contractors "License No.. General Cqptractor/owner Name Signature of (please print) XN.,CONED RW CE WITH CJJRRENT E ERGY CONSERVATION REGULATIONS 10 ( cgtion BU ILD SIT NO,�;3 ?q, A.P. No. License No. 1," THE FOLLOWING HAVE BEEN INSTALLED AS PER APVRn1/vn UT AMC. (Check each item or write NIA if not applicable) INSULAT ION; GLAZING: Slab, Edge. 6*Pf Single Glazed Fdn. W� FlooraA4X Special Insulated) ZE CERT. & LABELED WDS. Walls & SLIDING DRS. Ceiling/Roof- WEATHERSTRIPPED DRS. Ducts"' '-. I - :21, BACK DAMPERED FANS Circulating Pipes INTERMITTENT IGNITION DEVICES APPROVEDHEATE CERT. APPLIANCES APPROVE Vol - WT R o HT R�.' 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 Na.1ie- Signature of: (please print) Insulation Applicator State contractors "License No.. General Cqptractor/owner Name Signature of (please print) t THIS CERTIFICATE MUST .BE ON FILE WITH THE BUILD TING 'DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHAM%BE �QSTED INA CONSPICUOUS -LOCATION WITHIN THE 'DWELLING. General-Contr4ctor/owner I -Date ate Contractors License No. t THIS CERTIFICATE MUST .BE ON FILE WITH THE BUILD TING 'DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHAM%BE �QSTED INA CONSPICUOUS -LOCATION WITHIN THE 'DWELLING. FINAL Permit No�j�� 3� 1. Plans 2. EntrapzdrSto Sideli rotection 3. Smoke ler6ctor 4. FMpKce--V4n Clea IM5 s Combu Ai n o Gara a is ht & Mech, ction 5. Bedroeff tgitjM- 6. GK.I. & Bz6 Fixtures 7. Elect Trim & Sub--Panrt--La s 8. Sia=r 9. Fir ace o e --Clea ances Heart 00 Fixtures & Appliances in Kitchen- round •-Air Gap --Cooking Clearance 12.cLL 13. -Garage F' Door --S g & Lan-' , Clo 14. 15. Wate Bate a s, Clea ces, Combu 'on Air, P. ., Conn r -jn Garage-Hei Mech.P ction ' 16. Fbketialls & in s --A aratz.on a s 17. 18. Ins ion--Foam--Looked in Attic Yes 20. G and on 21. Foundation Vents &.Crawl hole Door--Dra' ge & Wood-EaER trearances— Looked Under -Floor -r-7- Yes S 22. Following Installed: Drive es I _/ No; Walks es 1_j No; Planters or Wing Walls M Ye No --- Creating Drainage, -Problems -1'--7 Yes No 23. A.C. Unit--Dis nect Clea s Bre er ondu r S' - 15V et 24. Vents AbQyoof--Plum Appli es Fire e--Clearanc" o Openings 25. Water Well -Disc ct, Electrical, Plumbjng ------------------- 26. Exterior Ele r' Trim & G.F.I. a tacle 207. V�entilatio roughout House 28. nV1�JJ 11VLG\. {..1 VLl JZ. LL1CL-ry--GL)LLLPlldL1CC I+CLL111CcLLC 33. Sign Job Card ALL OF ABOVE COMPLETED / / EXCEPT _ Si ned: Date:2 tD ABOVE LISTED CORRECTIONS COMPLETED I -0a SIGN JOB CARD Si ed•' Date 1r -4- PLUMBING --Above Floor Permit No. 1. Water Heater--Vent--Access--Combustion Air 2. Water Pipe --Test & Anchors --Nail Protection 3 Drain Pipe--Test--Fittings & Anchors --Nail Protection 42" Test 4. Shower Pan --Test, First floor --Tub Access 5 Test Tub & Shower, second floor --Tub Access 6. Gas Pipe --Size & Anchors 7 Sign Job Card ............................. ALL OF ABOVE COMPLETED U EXCEPT Signed: Date: ABOVE -LISTED CORRECTIONS COMPLETED Date: ELECTRICAL --Above Floor Permit No. 1 Clearance & Insulation Protection at Flush Light Fixtures 2 Elec. Receptacles Spacing --Lights & Switches at Doors 3 Size Boxes & No. of Conductors --Stapled 4 Romex Installed Close to Edge of Studs & C.J. 5. Equip. Ground made up w/Mech. Fasteners 6. 2 Appliance Circuits in Kitchen & Conductor Size 7. Sub Feeders --Wire size ga. Cu or Al, Breaker Size Q Amp. -- Insulated Neutral, Yes No Q - 8. Range Circuit Q ga. Cu or Al, Breaker Size Q Amp. --Oven Circuit ga. Cu or Al, Breaker"Size Amp. ' 9. Service --Riser Conductors & Ground 10 Bond Gas & Water Pipes 11. Clothes Closet Light --Shower Light 12 Sign Job Card ALL OF ABOVE COMPLETED Z__J EXCEPT - Signed: Date: ABOVE LISTED CORRECTIONS COMPLETED Date: ... .... . .. ......................................... MECHANICAL --Above Floor Permit No. 1. A C Ducts --Insulation & Support 2. Vent Fan --Exhaust Above Insulation 3. Condensate Drain & Overflow --Size & Grade 4. Furnace--Vent--Access-Comb.Air--Return Air Vent --115V Outlet 5. Attic Access & Platform if Furnace in Attic 6 Sign Job Card ALL OF ABOVE COMPLETED EXCEPT Signed: Date: ABOVE LISTED CORRECTIONS COMPLETED Date: -3- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS i • BUILDING INSPECTION RECORD Setback Forms Mai Bldg. Footings Stemwal I Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footings Masonry Walls Relnf. Steel Bond Beam Framing Stucco Mesh Scratch —tA 117"M M11 2nd Floor ping & Test Gas Door Closer Final -��j —�t Final MOBILEHOME UTILITIES - - - - - - - - - - - - - - - - - - Elec- Service Elec. Pedestal Water Piping OBILEH0 Water Piping Drainage Gas Piping DATE - REM KS OR CAjt�NS. Sewer Gas Piping ME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBL ORKS 7 County Center Drive. - Oroville, California 959 5 Telephone: 534-4541 / /S3 —2 APPLICATION AND PERMIT (/�/�'// authorize representatives of the County of Butte to enter upon the above-mentioned p Lforpection purposes. Dat at re of itee or A nt Receipt No. 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 ftBLIC WORKS By Date /'— �� 7 B ilding permit expires Date BUILDING Owner S .l `�� 'v SQ. FT. OCC. BUILDING VALUATION Mailing AddressPh gu nbo �b ZQ CA ` 4 Contractor ®UA) Mai I i ng Address Fireplace �N Total Valuation 1031,15-2119 Telephone No. Permit Fee 133,00 Building Address Plan Checking Fee&/or Penalty Permit Fee .00 , / PLUMBING No.1 @ I FEE PERMIT FILING FEE $3.00 ypp Each Trap 1.50 i{Z,,pe> wzro PW So& LQ "L-/ cmlez Repair drainage or vent piping 1.50 A. P. No."q -J&Z, C 7 (0 /I - v Zoning & P nning Water piping 1.50 Each gas water heater or vent 1.50 1.-50 FW' W. &OW1 Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 L5 d EQA Parking I Plans Parcel Declaration Parcel p 60' R/W Improvemen Each additional outlet .30 Building sewer 5.00 1 g. ons R ±'('d 1 Parcel A royal Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ , 60 .$ 14 r7a ELECTRICAL No. @ FEE moi. PERMIT FILING FEE $3.00V OR LE Main service 100 AMP ORSLESS 5.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD -L 100 AMP 2.50 Main service OVER 600v 25.00 100 AMP OR LESS Main service EA. ADD•L 100 AMP 1.00 NEW OR ADDNST L LN GSCCUP, S) 20sgft r V 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 RESID. / BRANCH CIR T NEW CO I T \ BRANCH CIRCUITS( 12.50ea NEW CONSTR (POWER APPARATUS 6 NON RES D. (SINGLE OUTLET CIR, 250 Ex. OCCUD(OUTLETS OR FIXT11RES) �B L i m FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 91 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ fw7th $ �Cf 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. jjg�^ I certify that in the performance of the work for which this 1L-J'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 '3 ,00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ RICO m-1 $ 1-37m- 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 $ O authorize representatives of the County of Butte to enter upon the above-mentioned p Lforpection purposes. Dat at re of itee or A nt Receipt No. 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 ftBLIC WORKS By Date /'— �� 7 B ilding permit expires Date ,,�7'AII' Materials & Wor 46n.ce with.; Recognized kya�ity prescribed for the Ccrr Buildins Plumbing & N ,i #lienal Electrical Code-. 0) fru. . Y, .CS�X�� , .� .� . a E F ,t jp' .j. 0 .� -C c o m o OA LID N•4oN d IM aim°o m C }gym C3 Y•`'� Septic system and location of build+ inq* drok stub -out to be as poP Butte C Lin y FMh Dept. Ka- f i n (orfiCANP -re- "ON WAY of plans and spiecificd.fions MUST -,be iob at all times and if unlawful to. hanqes or alterations on scime without.. nission from the Department of !,.#ie Linty of Butte. t I'1�f •,i1 �, � s7 � ( ,•s At, I ' .. 71. LLL . . • 'Bi�TrE' courts � „..� RIM ' P',�. %�.,�'rti'. ,.kms' �R � 07 See Master Plan on file for building •' '' wL+' / plans. � S •�r� ;