HomeMy WebLinkAbout017-170-035w C 20�3� �-92=176 + , .
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JONES , "John' �.-
► v S/S Honey Run Rd, 1 mi.E Cover ridge 2T34' HoneyRun;Rd .Chico . ' Trk'1 !'
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STAMMER, • Carol`
0/7-/70r
2134*Honey Run;Rd.', Chicoy `E'•
•Cont -,Chico Electric '
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COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT �A x'Mr22
ASSESSOR PARCEL NUMBER
ZONING
BUILDirGPERMIT
OWNER �490L STAUN MER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILI2 4E 4ONEYRUN RD. CHICO CA
CONTRACTOR'SOffCO EMIC
Hjj EL
-') ONE
' f
J
CONTRACTORSTAILIV ADORES N RD.
6 wW CHICO CA 93'
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan CheckingFee
$
BUILDING ADDRESS 2134 HOt�L�lilUl� RD.
� �p��}��
Energy Plan Checking Fee
$
CHICO
$
PERMIT FEE
$
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING 'PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 5 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities Y1 Installation ❑ Other ❑
Describe Work: REPLACE ELECTRICAL SERVICE
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service iooAoass
23.0023*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.
License Class G 10 Lic. No. `iS"13"1 S
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 I000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. S.
SO
3.,45
T.
NEW CONST. MULTI -OUTLET
NON-RESID. I
97.50
POWER APPARATUS
d SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FDcrURES
s
A0 @ 'Z.OWNER-BUILDER
Ex. Occup. ouTELErs RESI6.DFea
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$ •00
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.
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' compensation insurance carrier and policy number are:
Carrier F,4. _-A-, s ';-,r,J
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
Policy Number w7..?
(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
forthwith comply -with those provisions.
X_4-, Date _ I '_q�__
Signature of Applicant - ❑ Owner ❑ Contractor XAgent
An OSHA permit is required for e� avations over 5'0" deep and demolition or construction
of structures over 3 stories in heic�jllTTt.
Mobile Home Installation Fee
$
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 43 .00
HAZ.
D. FEES
IMP
I FLOOD
I COF
I PARCEL PD
HD
UE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for hick fees have
%�
�y !.'�-t"
PERMIT EXPIRES OND.S.-B.D.
the applicable provisions
Resolutions to do work
been paid.
8 l
Dat r r
ate
rR7eceo. 224918 •UU
CANARY•ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATI OM AND PERMIT
ASS ESSOR PARCEL NUMBER
011-250-035
ZONING
BUILINNG PERMIT
OWNER CAROL STAINER
TE
SO. FT. - OCC. BUILDING VALUATION
owNERSMA1LI2134EHONEYRUN RD. CHICO CA
CONTRACTOR'S NAME
CHICO ELECTRIC
TELEPHONE '
91-1933
CONTRACTOR'S MAILING ADDRESS
36 W. EATON RD. CHICO CA 95973
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
2134 HONEYRUN RD.
Energy Plan Checking Fee
$
CHICO
$
PERMIT FEE
S
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF F3 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
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 ❑ Utilities X] Installation ❑ Other ❑
Describe Work: REPLACE ELECTRICAL SERVICE
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
Main Service zoo, OOa LEss
23.00 23-00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 commencin with Section 7000 of Division 3 of the Business and Professions Code,
( g )
and my license is in full force and effect.
License Class C_ to Lic. No. LAS`' S"A 5
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
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.
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' compensation insurance carrier and policy number are:
Carrier ''1rll, „�I,o J3 's _
Main Service 200A TO L000A
46.00
NEW CONST. DWELLING OCCUR
OR ADDNS. ( s Acc. BLOB.
SO
3.5QFT;
NEW CONST. MULTI -OUTLET
NON-RESID. ANC C
@7.50
PowER AppARArus
&SINGLE OUTLET CIR.
Ex. Occup. CUTLET OR FIXTURES
.00
2UQ x .50
BAL 9 .SO
Ex. Occup. OUTLETS (a SE p,DEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
$ 43.00
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
Policy Number W -z—? q5ex-IS-4%lon
(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
forthwith complythose provisions.
X _ �, �_ _____ Date _1 " Q0=90
Signature of Applicant - ❑ 0�n:vr ❑Contractor AgentAn OSHA permit is required forations over 5'0" deep and demolition or constructionof structures over 3 stories in hht.
Mobile Home Installation Fee
$
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL po
HD
I UE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for ich fees have
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Dates
�L
Date
Receipt No. 22491$/$43.00
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
(Rev
COUNTY OF BUTTE- DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
q✓� 7 County Center Drive - Oroville California 95965 - Telephone (916) 538-7541
12/96) APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBERD ` I ��O — 0 �
f
ZONINOF� 9
BUILDING PERMIT
OWNER �� M ^ r
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 4 t1 �
^a(g
CONTRACTOR'S NAME
`/^t`o�ec+((`J
TELEP E
291—k -Z,
�U
CONTRACTORS MAILING ADDRESS w
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS ' I
on run
Energy Plan Checking Fee
S
$
PERMIT FEE
_
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
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 ❑ Utilities Y Installation ❑ Other ❑
Describe Work:���� �C-al S�.ryfl�_
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
600V OR LESS
Main Service 200AORLESS
23.00 3�
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.
DECLARATION
1 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.
❑ 1, 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
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 is issued.
❑ 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
Policy Number
(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
forthwith comply with those provisions.
X _ Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mein Service TO 46.00so
CCU000A
NEW CONST. DWELLING OCCUP. SO
DWE200ALLING
OR ADONS. a ACC. Blas. 3.5QFT:
No RESD. MULTFOIRCUT 97,50
8PSINowGLEER APPARArus
OUTLET CIR.
20 (VI 00OWNER-BUILDER
Ex. Occup.OUTLET OR FIXTURES BAL o .yo
Ex. Occup. OFIX�EDS i , 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PERMIT FEE $
MECHANICAL'PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEL: $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ J
HA2.
O FEES IMP
I FLOOD
I COF
PARCEL PD
HD
LSSUE
This permit is hereby Issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date _
Date
ReceiptNo.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
-,. - ,.. .. �Y1.,-►.,rtyp•: p v .. � yy.•a.'v•.yy Y.. a.y. ._.r m:rs•,"'--^.��[ �" i .. .a +.�Y, s -v.. .. �r i,� !e.•v- _ _ ,-,y,
e% Oma'
2d
i I ro,
G'AS,.
i Mete ,
ELECT,RI
1t_,Meter By Date Y 11 Fti4
!k> Fciy�
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS T Y' PERMIT NO. J
7 County Center Drive - Oroville, California 95965 - Telephone 916/34-4541• !
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
'S c ,. ;
COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS
` 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICAT60N AND PERMIT
PERMIT NO.
/Y/
ASSESSOR PARCEL NUMBER ZONING
S�—
BUILDING PERMIT
OWNERn ��� Ey,EPH NE
J dmm
O�ADD N
SQ. FT. OCC. BUILDING VALUATION
ACI LI N G
OWNER'S MO9; , V
Yft
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS ,Fi
51,5 O -
PLUMBING PERMIT
lin 9 Fee 10.00
Each Trap
2.00
_
D i-
Solar Water Heater
20.00
L LD ��
Water piping
5.00
LOT NO. SUBDIVISION NAME
PARCEL MAP
Each qas waterheater or .vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF ❑ Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile Home JSJGJWJ
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work: F 4!722(e— S&lW/e4r: 0A64t)6E
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
Main service 100 AOR S
MP ORLESS
10.00 10,9e>
Main service EA. ADD'L 100 AMP
2.50 -Z, 157-0
NEW CONST.(DWELLING OCCUP.&`
OR ADDNS. ACC. BLDGS. I
1
2/20sgft
CONTRACTORS LICENSE LAW
I'declare under penalty of perjury (Check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and m license is in full force and effect.
%�
License No. Classification
❑ 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 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 CONSTR. ULTI-OUTLET 2,50 ea
NON-RESID BRANCH CIRC ITS.
NEW CONSTR. (POWER APPARATUS &'�
NON-RESID. SINGLE OUTLET CIR.
Ex. Occup(o OR FIXTURES 9AL®3o
BAL@30
FIXED APP LNS, OR
FIXED
Ex. OCCUp. OUTLETS (RESID•) E 2.00 2,00
Temporary service 10.00
Mobile Home Facilities
15.00
Misc. Wiring 15.00 S1 C9C
Permit Fee $ ,
Contractor
MECHANICAL PERMIT
FilingFee 10.00
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.
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.
Heating
Cooling
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
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
agai st said County in co sequence of the granting of this permit.
X Yli Date
Signature of Ap IiCanr — Ownerrvr Contractor E]Agentwork
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ S�f.0-0
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
HD
IseuE
This permit is hereby issued under
sions of the Butte County Code and/or
indicated above for which
DIRECTO PUBLIC
By `�
PER EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. �7�T
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE, - DEPARTMENT OF 0UBLIC.WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541
PERMIT APPL_ KATION DATA SHEET
�/n� Permit No.
OWNER (f�0� 5'r� �`hiiil�✓� A. P. No.
Proposed Building Use-5E,e_4)1ec C'%Ig-10 6om,
Permit Fee Based Upon: Complete Contract Price DPW Valuation
Other (Explain)
Building Inspectors 1I�_l�'L� Date
...,,..
v
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or issuance: DATE RECEIVED APPROVED
1. All items have been submitted. . . . . . . . . . . .
2. Plot plans in duplicate./triplicate. . . . . . . . . .
3. Complete plans in duplicate. /triplicate. . . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . .. . . .
6. State Energy Forms No.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
9. Letter of signature authorization.
10. Sanitation approval from 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 owner ❑ )
15. Improvements may be required. . . . . . . . . . . .
6. Mobilehome Installation Data.
,� .�( •'�-
�`- Pre -Inspection for �.� C�l�. g� U/wPre-Inspec. request to
ired. Building Inspector
18. Other
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other x. "
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.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by --L—'Telephone
i
By
Plans checked by,
Plansapproved by
Other
Copy—DPW
Date
Date
—Mail Other
Date
r
COUNTY OF BUTTE - teriartment•of Public Works
1 7 County Center -Drive, Oroville, CA. 95965 Phone: 916-534-4541
OWNER -BUILDER VERIFICATION
1 '
i Attention Property Owner:
An "owner -builder" building permit has been applied for in your nameand bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing permit. No building permit will be issued until this.verification is received.
1. I personally plan to provide the major labor and materials for construction
of the -proposed property improvement (yes or no)
2., 'I (have/have not) 1J`e- signed an application for a building
permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction: 06✓V
Name t, Aa(f_ t A
Address.' City
Phone Contractors License No.
t
4. I plan to provide portions of this work, but I•have hired the following
person to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License -No.
5. I will*provide some ofthe work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
r
S igned : '
Property. Owner
Social Se it' umber
Date
NOTE: This Owner -Builder Verification is sent to you'as required by Sections 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.
COUNTY OF BUTTE - DEPART SENT. OF PUBLIC WORKS
- Telephone 916/534-4541
7 County Center Drive - Oroville, Californ 959tRMIT
APPLICATION A D P
OWNE�j L^ ES,eaH N
, �-
4SSESSOR PARCEL NUMBER ZONINGrFireplce
LDING PERMIT
BUILDING VALUATION '
OWNER'SMAILING /A�DDR�E—SSb
-
CONTRACTORSNAME TELEPHONE
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
UNKNOWN
aluation $
Fee $ 10.00
LENDER'S MAILING ADDRESS
Fee $
ARCHITECT OR ENGINEER
LI ENSE NO.
Pian Checking Fee $
Penalty $
ARCHITECT OR ENGI,NEER'S MAILING ADDRESS
Permit fee $
BUILDING ADDRESS
S
PLUMBING PERMIT Filing Fee 10.00
Each Trap 2.00
_ D D d
Solar Water Heater 20,00
._- L i
Water piping 5.00
Each qas water heater or vent 5.00
LOT NO.
SUBDIVISION NAME
I-ARCEL
Gas piping system 1 - 5 outlets 5.00
USE OF STRUCTUREU.
SF ❑ Duplex ❑ Mobi lehome ❑ Other 1 Fv -
ilding sewer 5.00
obile Home S G W 10.00e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ ' OtherContractor
Describe work: �' F' ��L�/FF �'f�i2��F
^`z
�.J S'^
Permit Fee $
ELECTRICAL "PERMIT Filing Fee 10.00
600V OR LESS 10 �(]
Main service 100 AMP OR LESS to,6
Main service EA. ADD'L 100 AMP 2.50 'Z, 5-C)
NEW CONST. / DWELLING OCCUP.&) 2y2QSgft
OR ADDNS. l ACC. BLDGS.
CONTRACTORS LICENSE LAW
I'declare under penalty of perjury (check one):
❑ 1 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. Classificationy
❑Temporary
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-4S,
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NE w NIS ULT(.OUTLET 2,50 ea
NON-RESID 'BRANCH CIR TS
NEw CONSTR OWER APPARATUS &)
/P
NON.RESID. (SINGLE OUTLET CIR.
EX. OCCUp OUTLETS OR FIXTURES eA m20 90
FIXED APPLNS, OR c
EX. OCCUp. OUTLETS (RESID.) E 2.00 S,OC)
service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00 /S
Ci i c
Permit Fee $
Contractor
MECHANICAL PERMIT JFilingFeel 10.00
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.
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.
Heating
Cooling
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
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
agai,pst said County in consequence of the granting of this permit.
X !, i P �' rte)<. Z %'t- %' L"�' Date
SignatUre of liCant - Owner Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
- ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ Sy. S0
OCCUP. GROUP
I TYPE Or CONST,
PARCEL
PD
NO
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
PERMIT EXPIRES Date
.."- �7iT
Receipt No. 7
WNITE-D.P.W.-, YELLOW-AS<GSSOR. PINK-INSPECTOR. GOLDENROO-APPLICANT
BUILDING DIVISION
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: (916) 538-7541
AGRICULTURAL BUILDING EXEMPTION PERMIT �
,(1► \ R�TN
VVVV r
Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm
implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human
habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a
place used by the public.
ASSESSOR PARCEL NO.
T-� j 3-5ZONING
PARC,��
OWNER �/
_,PHONE
NO�/}
OWNER'S ADDRESS ��
D ' /� A _ H l C O ^ ,
N
LOCATION OF BUILDING l�
e
pPka k a D'
/7'-dU S
USE OF BUILDING 0 76
�D
SIZE OF STRUCTURE
'
SL
X -� _ SQ. FT.
TYPE OF CONSTRUCTION:
WOOD FRAME STEEL
CONCRETE OTHER (Specify) �
TYPE OF, SIDING
L vj
ROOF COVERING
Ga
FLOO TYPE
a d�tJ
E TIM %YE COST OF-CONSTRU CTION
AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances
as follows:
FRONT
SIDES REAR l a
AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a
mobilehome, and 23 feet from a commercial building.
AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a
mobilehome, and 40 feet from a commercial building.
AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation
USGS Datum.
I declare under penalty of perjury that the building will be used as stated above and the purposed use conforms with the AG
Building definition. If any change in use or occupancy of the building is m e, I will contact the Building Division and obtain
any necessary permits, inspections, and approvals to comply with th qu' ments in effect at that time and before occupancy.
Date �197i Signature of Owner
Permit Fee - $50.00 The above descri AG Building is pt from a building permit.
Receipt No. a%-2-7
Manager Building Divisi
By Date
White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant
FLOOD
PARC,��
P.D,
ROOFING
ISSUE
df?
V"',
Manager Building Divisi
By Date
White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant
a
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORN1 55965 - TELEPHONE (916) 538-7541
,F,
PERMIT APPLICATION DAJO, SHEET
,*�o /1/0 W
OWNER
Proposed Building Use
A. o-/
Building Inspector Date
% 3S�
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ........................................
2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3. Complete plans, 3/4 sets, signed by preparer of plans . ......................
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ...........................................
6. Energy Design Compliance and supporting documentation . ................. .
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of$ ..........................................
11. Impact fees as shown on attached schedule. ............................. .
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ..................
14. Sanitation and plot plan approval Health Department . .............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: I . ........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. ... ..
Pre-Inspection.req.uesf-
20. Pre -inspection for required. .. to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ............. .
22. Certificate of Workmans Compensation Insurance . ......................... .
23. Owner -Builder Verification (Given to owner t , Mail to owner ). . .
24. Recorded copy of Agricultural Acknowledge em nt Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... r
27. Letter of intent on building use . ........................................ .
28. Mobilehome utility clearance . ......................................... .
29. Documentation of legal access . ........................................
30. Documentation of 50% subdivision developed or (A) Road improvements completed t
and (B) Parcel meets zoning area and frontage requirements . ............... t
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33. f '"
34.
When you issue the permit, process as follows: (,,e' -Mail to owner. Mail to contractor.
Telephone and hold for pickup at A office. Deliver with inspector.
Other
Parcel Creation��'� /
Acreage Applicant "'/ Date 7
Copy of Haz-Mat form sent Health Dept. Fire Dep . Air P I ion Date
Copy of plans sent Health Dept. Fire Dept. Cher Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works