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HomeMy WebLinkAbout021-131-004LjT .21-131-04 .„4005-90B. . y WEATHERFORD, W. 2330B HODGES; 'Weston --- _ 1787P' fs 6.31 `Little Ave,, Gridley . r •� 3�- }` 2 Contr.: AMRE • (vinyl 'siding/sO `` s/s`Little Ave. 1100' west of French, Gridl (new' single -family) r CONTk: Joe Wright, Rt. 2., Box 54A, Gridley 021431--004'""—. '”' �` • 06-1619 ff' HODGES 631`LITTLE AVE, GRIDLEY 'Cont: ROGERS ROOFING ,r RE ROOF w c i j rt r i i' j c • . r \ o T 021-131-004 06-1619. HODGESttKcrtn+vCat�rts�avt*>e. WO T E S 631rLITTLE AVE; GRIDL-EYu� ' ;s Cont ,,ROGERS ROOFING RE ROOF RESIDENTIAL APN: Permit No. Owner. j Site Address: Contractor. •4 - r --------------- • '. Type of Permit: t SPECIAL COMMONS � - • a CHECKED BY Q SRA Q FLOOD CERTIFICATE EQUIRED 0 FIRE SPRINKLERS REQUIRED - ❑ SPECIAL INSPECTION ITEMS Q VERIFY Q USE PERMIT CONDITIONS Q SUBSTANDARD HOUSING LETTER ` Q ENCROACHMENT PERMIT t Q REINSPECTION FEE PAID , Q ENV HLTH CLEARANCE - EJ DATE JOB FINALED• . SIGNATURE: © S +=OK •nv M-ANUFACTURE'D HOMES MISCELLANEOUS - DATE Lj PERMANENT FOUNDATION Lj SOFTSET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn Test; FaII/C/O-Concrete 4 Wtr; Loctn-Test-Easeinent Needed -Regulator 5 Elec Loctri-DImcs-.Grnd 'Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LPO Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Llne 8 Gas; MH Test-Demand-Valve-Dnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-DImcs 10 Drain; MH Test -Fail -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie. Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Labelflnsignia Numbers Serial Numbers '.--DATE 10 E C K S -C O V E R S -C A R P O R T S -G A R A G E S 1 ZoningSetbacks-Easements 2 Figs; SoilsSz DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-0cking-Brcing - Stairs-Guard/Handralls 4 Wood Awn; Posts-Beams4btrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-DnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs Trusses 9 Siding; Nailing VengerStucco-Lath . 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wail pnis DATE 1POOL5 1 Setbacks -Easements 2 Soils; CompactionStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men-Llning 4 Elec Rcptcls/Lting; Distance -GR 5 Elec Pool Lting; 15 volts-GFi 6 Elec.Enclsrs; Conduit Entries Terminals -Listed 7'Elec Bonding; Metal w/5-Crckng Egp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Encisrs-pnlboards4nsultn.to Main Conduit 9 Health Dept App' M 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche , 12 Encisr, Fencing -Alarms 13 Bonding, Diving board or Slide dA 0`� � - �,6y • Pool Drawing S RESIDENTIAL DATE UNDERFLOOR 1 Zoning-Setbacks-Easements-Flood-Slope2 Ftg Main; Soils-Elec Grnd Ftp Dpth 3 Ftg Garage; SoilsSteel-Elec Grnd Ftg Dpth 4 Ftg Porches/Decks; Soils-SteelFtg Dpth ' 5 Stemwalls Main; Steel-Blockouts Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frple Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgitrService Test 12. Elec Undrgmd 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 14 GirdersSills-SillsBolts-Joists-Vnts-Cripples 15 Ace & VnUtn 16 Insulation d.P DATE FRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces-Plates-Sound 19 Bearing Walls over Girders A flr Nailing 20 Draft Stop In Wails (rat Proof) 21 Fire Stops; Furred CeilingsStairs�hasers Tubs 22 Headers & BeamsSi &" Bearing" 23 Hangers-Posf Caps Anchrs'-Citnctns 24 Ceiling JOist4Vw Ties-Purlirt-Roof Brac-Truss 25 Frplc Ties or Type A Flue=Frpic Throat Clrnc 26 Attic Acc; Sz &'Rutz'0AcI;n-Draft Stop -Ins Baffles 27 Bdrrn Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtcth Framing -RC Channel 29 Prprty Line Firewall & Opngs' 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run4-anding-Fire Prtctn 32 Plywd on Roof Ovrhng Attic Vnts4ft ()utrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Ace 35 Glazing Area -Glass PrtetnSkyLts-Plastic . 36 Shear Walls; Nailing -Bolts 37 Brace IntiExt Wall pals 38 tnsultn-Walls-Ceilings 39 Infiltration -Walls -W ndws DATE ELECTRICAL 40 Fxtr & Tmsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Gmd made up w/Mech Fstnrs 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz , [:ICU or El AL AC Wire Sz , El CU or DAL 48 Range Circ y� Q CU or Q AL Oven Circ ❑ CU or 0 AL Insulated Neutral QYes ❑No 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Clrncs pnts-Motors-Mech Eqp 51 Clothes Closet LtShwr Lt -Spa Lt 52 Smoke Detector Single & Duplex) DATE PLUMBING 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr. Nail Prtctn 56 Shwr Pan; Test, First flr-Tub Ace 57 Test Tutt & Shwr, 2nd flr - Tub Ace 58 Gas Pipe; Sz & Anchrs ' 59 Fire Sprinkler; Test 60 Yard Gas Piping DATE MECHANICAL 61 AC Ducts Insultn & Support " 62 Vent Fan, Exhaust abv Insuitn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air RtrnfVent 115 Outlet 65 Attic Ace & Pitfrm if Furnace in attic Ole o�d DATE FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cimc-Comb, Air-Dnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Ace -Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frpic or Stove, Clmc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking Clmc 77 Elec Outlets & Rcptcls ai Ktchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct In Garage -Damper. 80 Wtr Htr, Vnts-CimcCom Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Pimb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcis in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstretn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Cimc Dmge Planters 0 Yes Q No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Pimb 89 Vnts abv Roof, Plmb. Appinc-Frpic-Cimc to Opngs 90 Wtr Well, Dscnnct, Elea Plmb 91 Ext Elec Trim, GFI RcptcWndrgmd 92 Vntitn thru House 93 Glass Prtctn 94 Corrections from previous ltispctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-D/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler 4 bu I l t l.VU1V l i DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 BP061619: 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 penally 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: _ LI rise Number:15-3- Date:2- Contractor: C! C OWNER -BUILDER DECLARATION I hereby affirm under penally 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 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 the Contractor's Slate License Law (Chapter 9 commencing with Section 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 penally of not more than five hundred dollars ($500).): .Issued Date: 07/06/2006 APN: 021-131-004-000 Site Address: 631 LITTLE AVE GRI Map Index: Description: RE -ROOF (28 SQ) Owner: HODGES WESTON & WANDA W 631 LITTLE AVE GRIDLEY, CA 95948 ❑ 1, 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, Buslness .and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or Improves thereon, and who does Applicant: ROGER'S ROOFING such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for (ROGER GRAHAM) sate. If however, the building or Improvements are sold within one 435 HASKELL STREET 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 GRIDLEY CA 95948 sale.). (530) 846-4560 ❑ I, as owner. of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Stale 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 Contractor: ROGER'S.ROOFING pursuant to the Contractors' Slate License Law.). (ROGER GRAHAM) ❑ I am Exempt under Article 3 of the Business and Professions Code '435 HASKELL STREET GRIDLEY CA 95948 Date: Owner. (530) 846-4560 ✓WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penally of perjury one of the following declarations: License #: 853159 O I 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 Architect: required by Section 3700 the Labor Code, for the performance of Engineer: g the work for which this permit Is Issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy N: Total Square Ft: 0 S. F. �erlify that In the performance of the work for which this permit Is Valuation: $0.00 Issued, I shall not employ any person in any manner so as to Census Code: 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: 4 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 This permit Is hereby Issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the Resol tlo s to do worIt Indicate abov for which fees have been paid. r-+ COperformance of the work for which this permit Is Issued (Sec 3097 CIV.) BY: Date: I ' +l1 (0 Name: _-ll / PERMIT EXPIRES ON: / f (' � Address: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health & Safely 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 authorize agent of the owner. I agree to comply with all county and stale laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official formor d cument of Butte County. I hereby authorize rep✓ nlalives of Butte Counlyle�enler upon the above mentioned property for Inspection pur ses. Print Na.� A Signature: Name: t -, � Date.. Nl 66 ~ ❑ Owner 6 -Co__ ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16.04 pg 1 `q'° BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT . 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE LICENSED CONTRACTORS DECLARATION I hereby affirm under 'penally 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 :=LLN umber: ��Dale: 7— - C3 GContrC OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires 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 signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 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 properly, 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 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 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 proving that he or she did not build or Improve for the purpose of sale.). ❑ I, as owner. of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Slate License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ i am Exempt under Article 3 of the Business and Professions Code Dale: Owner: WORKERS' COMPENSATION DECLARATION ' I hereby affirm under penally 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 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: Policy p: I11--t-c'erlify 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. Dale: C, 6 — 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,atlorney's fees. r CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is issued (Sec 3097 Civ.) Name: PERMIT*NO. BP061619: OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. Issued Date: 07/06/2006 APN: 021-131-004-000 Site Address: 631 LITTLE AVE GRI Map Index: Description: RE -ROOF (28 SQ) Owner: HODGES WESTON & WANDA W 631 LITTLE AVE GRIDLEY, CA 95948 Applicant: ROGER'S ROOFING (ROGER GRAHAM) 435 HASKELL STREET GRIDLEY CA 95948 (530) 846-4560 Contractor: ROGER'S ROOFING (ROGER GRAHAM) 435 HASKELL STREET GRIDLEY CA 95948 (530) 846-4560 License #: 853159 Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: �10Q S' r o-oci This permit Is hereby issued under the applicable provisions of the Butte County Code and/or Resol tlo s to do wogs indicate abov for which fees have been paid. By. //' / Date: t -6-06 PERMIT EXPIRES ON: /' r-� I 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 & Safely Code Is not applicable to the scheduled construction of this project. Cl 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 authorize agent of the owner. I agree to comply with all county and stale laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official form or d cument of Butte County. I hereby authorize repr�e,►ss�nntttaatives of Butte CounV_� enter upon the above mentioned property for Inspection pur ses. -Print Name: ►l� v,.Q t EA k � Signature: Dale:Ff/�� ' ~v�66 O Owner ontractor ❑ Agent for Owner ❑ Agent for Contractor o r o„u.t b.., Permit (11.19.04 nn 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES ;.o BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** CONTRACTOR OWNER INFORMATION Last Name 440V City Firs1t_ rName C- 6 Address / f . City '_ State State Zip Phone 3 Fax E-mail State License Number CONTRACTOR Name Name City Address Address Z" f . City l/�T ? E ` / State Stat Cs/el Zip .5 Lc Ph ^ 4r d Fax ffEmail State License Number Lic. 9'5-315-7 Clas�-.n APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Date Approved: Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLIC T SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BIN # PROJECT LOCATION AP# 02-1-131-0 Property Address Z' City / + r Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scoe of Work: 6 L i Sq FT -.Living Garage Open Cov ❑ 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 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 Received by: K6 , Amount a.00 Bldg I I Receipt #: I �6 %(3 (N -do SRA Sheriff SMIP I I Date: `�_ (0-0 G/ I 11JCJ OD Other I I Total Page 1 of 3 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS. The following drawings and specifications must be submitted to the Building Division Korder"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 AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (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. Building Permit Application Without Required Clearances Form ❑ 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). ❑ 0 4. 5. NPDES Form. 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 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. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees -for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 3 REV 8-12-05 „'tap a-fl•,.z;,f •Fief* f{ y �/' ;'�'"a "'�`�xr+`•+� "t'"+' « E } ir:'�w.,u,d'*ryc•sv+�a;`k"s�t-i'b�a�i`x;'::s1; k'a: . �„ -r.��, ,.,,.. .. ', ;i;.-.�;. ;:r�•'i}.:�"`�C+�}"�� 21-131-04 4005-90B r��4c'iy HODGES, Weston 631 Little Ave, Gridley .Contr: AMRE } (vinyl siding/sf) ice, � Ari COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. C Iifornia 95965 - Telephone: 916/538-7541 APPLICATION A'I D PERMIT PERMIT NO. In ASSESSOR PARCEL NUMBER/ ZONI G BUILDING PERMIT OWNER i TELE NE FT. OCC. BUILDING VALUATION �S)Q. �, Q)A OWNER'S AILING ADDRESS CO RAC OR'S NAM TELEPHONE CO TRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ to - ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS ) Permit fee PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF)k Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition ❑ ,,--Re��modddel ❑ Utilities ❑ Installation❑ Other Describe work: _ Permit Fee $ Contractor Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): rr�7 I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No.n bl(% Classification El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUR.d OR ADDNS. ( ACC. BLDGS. 2/22sgIt NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS tr) SINGLE OUTLET CIR. E Ex. Occu p OUTLETS OR FIXTURES eL0 zALO 30 Ex. Occup. OUED R TLETS ((RESID,)EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ 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 becomesubject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating 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 again t id County inCA sequ ce oft ranting of this permit. %� Date Signature of Applicant — Yri er Contractor❑ Agent An OSHA permit is required fexcavations over 5'0" deep and emolition or construct- ion of structures over33 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST TYPE TOTAL FEE $ (� i O HAZ CUA PARK SCHL FLD PAR I PD Hb ISSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC B (els �'V V y PERMIT EXPIRES Date1112 c.)�� the appiicabie provi- resolutions to do have been paid. WORKS Date �� ? U Receipt No. S!,_7J WHITE-D.P.W., YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT t, -7 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Caliir3 95965 -Telephone: 916/538-7541 APPLICAYION AND PERMIT ASSESSOR PARCEL NUMBER/ ZONI G BUILDING PERMIT OWNER TELE NE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS �- uE CO RAC OR'S NAME TELEPHONE CO TRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ ! .�— Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 19 - ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS I ` Permit fee PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 LOT NO.SUBDIVISION NAME PARCEL MAP Solar or heat pump water heater 20.00 Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home TSTG W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work:�v. _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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 my license is in full force and effect. License No. gTL(Z 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, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ACDNS. ACC. BLDGS. , 2/zQs q it NEW CONSTR ULT' -OUTLET NON•R ESID BRANCH CIRC ITS 2.50 ea ea POWER APPARATUS tr SINGLE OUTLET CIR. )' ( Ex. Occup( OR FIXTURES 20®50Q SAL930 Ex. Occup. OUTLETS FIXED P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 9 15.00 Permit Fee $ 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot 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 again t id County in sequ ce of ranting of this permit. X Date Signature of Applicant — 0 ner g pp Contractor ❑ Agent' An OSHA permit is required f r excavations over 5'0" deep and emolition or construct- ion of structures stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE �/ o TOTAL FEE $ HAz CUA PARK SCHL FID PAR PD H ISSUE This permit is nereby issued under the applicable provi- sions or the Butte County Code and/or resolutions to do work indicated abo a for which fees have been aid. p D E ORVUBLIC WORKS By / ate it Z Z) PERMIT EXPIRES Date y*over �3 Receipt No. 0-f _7J WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT