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021-160-062
21-16-62 Don Cummings 'tea/� � 14 Cotter of French & Petersen Ave., Gridle contr: Quist Const., Gridley Permit #4319-77B,P,E,(new single-w/,att. _garage & covered'•patio/SF) c626=89B,E,M- CUNINIINS; Don' '594 Peterson+Avenue; Gridley, ContR:Quality, const•. �':V; , i (repair. °fire, damage)SF `i•,': t r. ., r tFINALED : �_ �:•. 021-160-062 " ; y� ,' : 03-1999 CUMMINS, DONALD>` 594 PETERSON AVE:, G Cont.' , EDOWNER,' .''.' �', . REROOF/SF r a l0 4 R . 4 _ . '021'160-062 • B07 1021 � � • MISCELLANEOUS L:.Ag'Exempt AG BUILDING1_-LAWN AND YARD Ef , { 594 PETERSON AVENUE _'a" 't CUMMINS DONALD & MADELIENE Ff v BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT . 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 594 PETERSON AVENUE Owner: Permit NO: B07-1021 APN: 021-160-062 CUMMINS DONALD & MADEL Issued Date: 06/08/2007 By TMP Permit type: MISCELLANEOUS 594 PETERSON AVE Subtype: Ag Exempt GRIDLEY, CA 95948. Expiration Date: 06/07/2008 Description: AG BUILDING - LAWN AND YARD (530) 846-2062 Occupancy:.•U-3 Zoning: A5 Contractor Applicant: Square Footage: CUMMINS DONALD & MADI Building Garage Remdl/Addn 594 PETERSON AVE GRIDLEY, CA 95948 Other Porch/Patio-. Total (530) 846-2062 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $109.98 Total Charged: $185.68 Fees Paid: $185.68 Balance Due: $0.00 Receipt No: B3024 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that 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 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 pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 06/08/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Ple a pheck one of the following: Contractors Signature Date S OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE WCOPMPENSATION,WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued, rm rove for the purpose of sale.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permit is or once Hun r�llars ($100) or Tess.) ) I AM EXEMPT under Section B. & P.C. for this reason: El ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' . Compensation laws of California, and agree that if I should become subject to the workers' 6/08/2007 *04,44 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those O vers Signature Date provisions. X 06/08/2007 1 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the 7T own r or authorized to act on the property owners pehalf. (/J� nS 06/08/2007 CONSTRUCTION LENDING AGENCY IHEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) F1?1Owner ` Contractor . OR; Agent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip ' BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net/dds AGRICULTURAL BUILDING EXEMPTION STATEMENT 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 aplace of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials4�AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. InitialsYA�� Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, / 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings InitiaAG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 594 PETERSON AVENUE Permit No: B07-1021 APN: 021-160-062 Square Footage: Permit Type: MISCELLANEOUS Occupancy: U-3 Permit Subtype: Ag Exempt Zoning: A5 Description: AG BUILDING - LAWN AND YARD EQUIP Required Setbacks: Applicant: CUMMINS DONALD & MADELIENE FAM Front: 20' Side: 20' Rear: 20' 594 PETERSON AVE Type of Construction: GRIDLEYCA95948 (530) 846-2062 Type of Siding: T-111 Owner: CUMMINS DONALD & MADELIENE FAM Est. Const. Cost: $ 5,000.00 594 PETERSON AVE Roof Covering: Compostion GRIDLEY, CA 95948 (530) 846-2062 Floor Type: Other I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effect at that time and prior to occupancy. Signature of owner: Date: 05/10/2007 FILE COPY Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B07-1021 Location: 594 PETERSON AVENUE GLB Parcel Number: 021-160-062 /Dya5/10/2007 Ae Exempt Owner Name: CUM IINS DONALD & MADELIENE FAM(530)'846-2062 Description: AG BUILDING - LAWN AND YARD EQUIPMENT The above permit application has the following Clearances required prior to ermit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit plication. Yes No DRAINAGE DISTRICT/S/ ❑ ❑ Thermalito Irrigation District, 410 Grand Avenue, Orovi le CA 95965 - (530) 533-0740 ❑ ❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (53 33-2000 ❑ ❑ City of Chico, 545 Vallombrosa, Chico CA 95926 (530) 895-4711 F: R PARKS & RECREATION DISTRICTS Chico Area Recreation District, 545 Vallogi6rosa, Chico CA 95926 - (530) 895-4711 Durham Park & Recreation District, 9 7 Midway, Durham CA 95938 - (530) 345-1921 Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 Paradise Parks & Recreation, 66/Skyway, Paradise CA 95969 - (530) 872-6393 SCHOOL DISTRICTS Biggs Unified School Distriicc , 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School Dis"t/ict, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School �District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School Distr4ct, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 Marysville Scho/o�rDistrict, 1919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elem/efitary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 /rded fon High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105 ified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER opy of Agricultural Acknowledgment Statement- See Attached Instructions s Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: Other: Other: Signature of Property Owner: Date: 5/10/2007 PY FILE BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 95965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: B07-1021 Job Address: 594 PETERSON AVENUE Contractor: Printed: 5/10/2007 1:56 pm Fee Description Account Number Fee Amount Paid Date Pmt Amt DBOMSCF Ag Exemption Permit 0010-440001-4210500-1010 $109.98 5/10/2007 $109.98 DBEH Building Review Fee 0021-540013-4614901-1010 $75.70 5/10/2007 $75.70 Printed By: Gwyn Benedict 185.68 $185.68 Balance Due: $0.00 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fees may change during the plan checking process. Signature: Date: 5/10/2007 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds V 1� National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B07-1021 Location: 594 PETERSON AVENUE Parcel Number Owner Name Description: 021-160-062 CUMMINS DONALD & MADELIENE FAM AG BUILDING - LAWN AND YARD EQUIPMENT Date: 5/10/2007 By: GLB Sub Type: A2 Exempt Phone: (530) 846-2062 By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB f acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of .California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: 1 Title: FILE Date: 5/10/2007 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at hqp://municiDalcodes.lexisnexis.com/codesibutteco/ Reference Number: B07-1021 Location: 594 PETERSON AVENUE Parcel Number: 021-160-062 Date: 5/10/2007 Owner Name: CUMMINS DONALD & MADELIENE FAM Phone: (530) 846-2062 Description: AG BUILDING - LAWN AND YARD EQUIPMENT Signature of Property Owner: Date: 5/10/2007 FILE N. 1/2 SEC. 11, T.17N. R.2E. M.D.B.&M. mom 13 v 21-16 1-400' 17 10 9 28 9.40 AC 633x3 31 1 1.46 Aft 117 4.584c. 2 118 4.584c. PM144 96/97 AVP Butte County Assessor's Map Book 21, Page 16 NOTE Ii,ese porus are fa ossessrneM 0ny and may not cwfM uta legal par DATED Of DB 1 CREATED ON 7-9-2001 REV= Of SDT REVISED ON 10-17-2= EFTECTNE 20011-011 MOLL ft"o u took forum, 0l Par CoapW 61 The Butte Cmmb, Assessor's Wbe 8.70 AC 8.31 AC 6.00 AC S. 27.90 AC 1 2 1.17 AC 8.50 AC 20.00 AC- 9.92 AC 103 98 99 408 101 41 42 !s / 13\O� 14 I 22 r.n Ac G 1s R1.08 Ac PM 79-12 102 32350 x'00 49 111 610.00 1 00 S89'58'51 "E 19 GRIDLEY COLONY J4, 6 M.D.R. 8 GRIDLEY COLONY J7 6 M.D.R. 7 GRIDLEY COLONY 19 6 M.O.R. 58 51 a.12 actO I O7 I O 27 5126 &75 AC 9.25 AC I 24 19.36 AC O 49 .1A 41ACt 19.20 AC 8 2� - GO l is tot,, 32 13.13 AC i 31 30 32 I 1 C�\�� PM 103-6 `1 I G 38 2.12 Act Soo.ao 9 1114 1.10 �` � J 610.0D 321,15 310.00 AC S89'59'06'E ACS _ - 1 1 5 M4,00 2 i92 116 - '3.31 ac 64 6.06±Ac 94 W O 8.01 AC 35 - 119 6.19Ac W'0 12 . 122 11 PM 75-73 440.006.77 SILVA LANE AC 63 v 6.28±Ac GG 92 O O ,9aao Ot 1.53 AL 93 O = 120 ac 91 7 a 6W-00 Z - - - 100 .67 - v 21-16 1-400' 17 10 9 28 9.40 AC 633x3 31 1 1.46 Aft 117 4.584c. 2 118 4.584c. PM144 96/97 AVP Butte County Assessor's Map Book 21, Page 16 NOTE Ii,ese porus are fa ossessrneM 0ny and may not cwfM uta legal par DATED Of DB 1 CREATED ON 7-9-2001 REV= Of SDT REVISED ON 10-17-2= EFTECTNE 20011-011 MOLL ft"o u took forum, 0l Par CoapW 61 The Butte Cmmb, Assessor's Wbe 8.70 AC 8.31 AC 6.00 AC S. 27.90 AC 1 2 1.17 AC 8.50 AC 20.00 AC- 9.92 AC 103 98 99 408 101 41 42 !s / 13\O� 14 I 22 r.n Ac G 1s R1.08 Ac PM 79-12 102 32350 x'00 49 111 610.00 1 00 S89'58'51 "E 19 GRIDLEY COLONY J4, 6 M.D.R. 8 GRIDLEY COLONY J7 6 M.D.R. 7 GRIDLEY COLONY 19 6 M.O.R. 58 BUTTE COUNT' DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION . OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name n1 i ,First a e �t/AZ D Mailing ddres fizc7 � iq A/ pl of City 21 t� -`/ State Zip 4 Y� Phone.30 g f1° Fax .3(9 gq 7 E-mail JC Ayo r» 1� ®w C t S P Cbly1 APPLICANT SIGN TURE As L lt�_ Z, tiff; i' ►tb Z ECT LOCATION Property Address �_2,i PERMIT NO. b,1 . 100A BIN # I City /_'_ _ . i /l. - I WORKER'S COMPENSATION Policy Number Carrier ; ' Ztn e If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY 'Name Address DESCRIPTION OR SCOPE OF WORK: ARCHITECT/ENGINEER CONTRACTOR Name "Address SRA City Address State Zip Phone CityNO& Fax E-mail i State License Number State C�A Zipg5& t-) Phone _ L3� ` ,g$3 Fax E-mail tic. # Class APPLICANT SIGN TURE As L lt�_ Z, tiff; i' ►tb Z ECT LOCATION Property Address �_2,i PERMIT NO. b,1 . 100A BIN # I City /_'_ _ . i /l. - I WORKER'S COMPENSATION Policy Number Carrier ; ' Ztn e If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY 'Name Address DESCRIPTION OR SCOPE OF WORK: ARCHITECT/ENGINEER Name - tv�g HS "d W N Com, "Address SRA City ,a State Zip Phone Open Cov Fax E-mail State License Number APPLICANT SIGN TURE As L lt�_ Z, tiff; i' ►tb Z ECT LOCATION Property Address �_2,i PERMIT NO. b,1 . 100A BIN # I City /_'_ _ . i /l. - I WORKER'S COMPENSATION Policy Number Carrier ; ' Ztn e If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY 'Name Address DESCRIPTION OR SCOPE OF WORK: APPLICANT INFORMATION Name - tv�g HS "d W N Com, Address SRA City ,a State Zip Phone Open Cov Fax E-mail APPLICANT SIGN TURE As L lt�_ Z, tiff; i' ►tb Z ECT LOCATION Property Address �_2,i PERMIT NO. b,1 . 100A BIN # I City /_'_ _ . i /l. - I WORKER'S COMPENSATION Policy Number Carrier ; ' Ztn e If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY 'Name Address DESCRIPTION OR SCOPE OF WORK: e C0(,J.-T9\_AC--T A4, Flood Zone SRA Yes ,a Occ. Type Const. Sq FT- Living - Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): �- ' For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. I i �..ty;-,.�; r.,s�_.ae�9rs:;m1•.airr:�.nlr+"Y•^:c'v�.�.'�;,Sa►:'�7#3".•`�.;-F+:«.�wr"r..xh :!�`k�euam w,e,.v�y'. V.••�o..:a: •....aan,: i � 1 • ,fir.. .� 021-160-062 • CUMMINS DONALD x594 PETERSON AVE ; GR'DLEY ` "Cont: OWNER' e..a �' F -REROOF/SF 3 " k ' 12 1 , e y . r 1 � f t 021-160-062 • CUMMINS DONALD x594 PETERSON AVE ; GR'DLEY ` "Cont: OWNER' e..a �' F -REROOF/SF 3 " k ' 12 1 , e y . r 1 � f 021-160-062 • CUMMINS DONALD x594 PETERSON AVE ; GR'DLEY ` "Cont: OWNER' e..a �' F -REROOF/SF 3 " k ' 12 1 , e y . r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 03-1999 ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER Cummins Donald and Madeline TELEPHONE 846-2%2 SO. FT. OCC. BUILDING VALUATION OWNER'S MAIUNG ADDRESS 594 Peterson Ave Gridley 95948 14 sq caM 84.00 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation Is 840.00 ARCHITECT OR ENGINEER UCENJE NO. Flim Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ 23.00 Plan Checking Fee $ BUILDING ADDRESS 594 Peterson Ave Gridle Energy Plan Checking Fee $ 1 $ PERMIT FEE $ 43.00 LOT NO. SUBDIVISIONS NAME PAROL MAP I PLUMBING PERMIT Fling Fee 20.00 SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each ach 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 ❑ Installation O Other ❑ 1 Describe Work: COWtear off Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W 920.00 PERMIT FEE. $ ELECTRICAL PERMIT Fling Fee 20.00 Main Serviceeoov GR LEss zoOA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingwith Section 7000 of Division 3 of the Business and Professions Code, ) and my license is in full force and effect. License Class Lic. No. I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: Off, 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. ❑ 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.) Oaf I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 1 Signature of �Applicar(t - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO I000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( 6 ACC. BLDS. 3.5QF: NEW CONS . MULTI -OUTLET NON-RESID. 97.50 POWER APPARATUS & SINGLE OUTLET CIR. zo p I o0 EX. OCCU OUTLET OR FIXTURES BAL 0 .50 Ex. Occup. DFixEEDTS galp,OEA_ 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 FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE 643.00 HAZ. D. FEES IMP v FLOOD CDF PARCEL PD HD ISS E 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. By /' Date ! y PERMIT EXPIRES ON Date Receipt No. 39 2 WHITE-D.D.S.-�B.D C NARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I COUNTY OF BUTTE - DEPARTMENT OF DFVELORMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATI ., AND PERMIT 03-1999 ASSESSOR PARCEL NUMBER 021-160-062 ZONING A-5 BUILDING PERMIT OWNER Cummins Donald and Madeline TELEPHON 846-2062 SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS 594 Peterson Ave Gridley 95948 14 sq domp840.00 CONTRACTOR'S NAME owner TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ 840.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 594 Peterson Ave GridleyCA Energy Plan Checking Fee $ $ PERMIT FEE $ 43.00 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 um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: comp tear off Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I WT__ @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service '..A OR IES: 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 Lic. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law fo the following reason: 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. ❑ 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.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 � Ao Date r- Signa ure of licant ❑ Owner 0 Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO +000A 46.00 NEW CONST. DWELLING OCCUR s0 OR ADDNS. & ACC. BIDS. 3.50FT. NEW CONS . MULTI -OUTLET NON-RESID. @7.50 POWER APPARATus 8 SINGLE OUTLET CIR. EX. OCCU OUTLET OR FIXTUREs �,0 Ex. Occup. OUTUTLEEDTSA P) OR 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 FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $43.00 HAZ. D. FEES IMP FLOOD CDF pggCd pp HD 63 E 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. �f , By ,/ Date % PERMIT EXPIRES ON to rReceiptNo. 226 -e ITE-D.D.S.- .D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT O.B.-1 OWNER-BUII.,DER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit' will be issued until this verification is received. 1. personally plan to provide the major labor and materials for construction of the proposed property im rovement :YES J NO 132. I HAVE HAVE NOT 13 signed an application for a building permit for thero osed work. P P I have contracted with the following person (firm) to provide the proposed construction: NAME: ti,,,,nG��• CITY: P NE: CONTRACTOR'S Ll"CEN 4. I plan to Ovide portions of this work, but I hay ' ed the following person to coordinate, supervise, an ovide the major work: NAME: ADDRESS: CITY: PHONE: NTRACTOR'S LICENSE NO. 5. I will provide so e of the work but I ha ntracted (hired) the following persons to provide the work indicated: NAME/ ADDRESS P NE TYPE OF WORK SIGNED: PROPERTYOWNER: DATE: 1Z r�f� NOTE: This Owner -Builder Yerifwation is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER I OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner builder" you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, ifyou wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned rely, Mc 1 C. Vi ira, C.B.O. M ger, Building Inspection NOTE. 77z is Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER r 21-16-62 626-89B,E,M CUMMINS, Don ' 594 Peterson Avenue, Gridley ContR: Quality const. (repair fire damage)SF PI X' FINALED : PERMIT EXPIRES .���`� OWNER CONTR. ASSESSOR PARCEL LOCATION r a r 4 Temp. Power Pole Called I Temp. Elec Called } Temp. Gas Called JOB FINAL Signatu =-OK AU 0 = Not OK = Not Readyable MOBILE HOMES MISCELLANEOUS, Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -131 Date 10. Roof; Shthg-Roofing Card -B1 Date Card -B1 Date 11. Ext.; Steps -Doors -Landings - Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -B1 Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line Card -1211 Date Card -131 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures;,Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-lns.'to Main in Conduit Card -B1 Date Card -B1 Date Card -B1 Date 'Card -131 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test, Card -81 Date Card -131 Date. Card -B1 Date Card -B1 Date 0 = VK 0 = Not - =Not Applicable RESIDENTIAL (Single and Duplex) ' = Not Ready I' - Date UNDERFLOOR (Plans) OK except #'s 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. De 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Del 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -131 Date Card -131 Date Card -B1 Date Card -B1 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mach. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -131 Date Card -131 Date Card -131 Date Card -B1 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing _ Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 48, Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd story, 2 exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card -B1 Date Card -131 Date Card -81 Date Card -81 Date it Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 64. Bedroom Exiting 85. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation throughout House 87. Glass Protection 88. Corrections from Previous Inpections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval Of. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -81 Date Card -131 Date Card -131 Date Card -131 Date Card -61 Date Card -B1 Date Comments at Final: COUNTY OF BUTTE - REPARTMENT OF PUBLIC 7 County Center Drive - Oroville, California 9965 - Telephone: APPLICATION AND PERMIT WORKS PER N 916/538-7541 ASS R PARCE- NjJtER /�/C1% ZVING -'' BUILDING PERMIT ow ` TELEPHONE S,9. FT. OCC. BUILDING VALUATION O790( w CnACTO 'S AME Ua T EPHON E CONT AC R'S M LING AD ESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 1000 LENDER'S MAILING ADDRESS Permit Fee $ 12 Q AD 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 74P Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W O.00ea TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑tallation❑ Other Desc 'be work: ` � 7 r pp Vi,r L<; Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 T7pM� I' I V V� Main service 600 AMP 00V OR LOR ESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I de��r```///JJJa��re under penalty of perjury (check one): Hyl /DCII I am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$ and Professions �Cjode and my license is in full to a and effect. 3' / / S License No. ��� Classification ❑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) E]I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.61 S. , TLET h¢sgft New DCONSTR� A MULTI -OUTLET NON."ESID .BRA CH CIRC ITS 2.50 ea /POWER APPARATUS e (SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 200606 eAL930 FIXED A Ex. OCCup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 9 Misc. Wiring 15.00 QQ ' 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 PE MIT Filing Fee 1 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 liabili 'es, judgments, s, and expenses which may in any we accrue against s d Cou ty po ence of the granting of this permi X Date Signature of Applicant — Owner Contractor Agent An OSHA permit is required for excavations over 5'e p lition or construct- ion of structures oyer 3 sto ies in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE OCCUP. CONST.TYP! JSCII00LJ FLOOD PARClL PO I ND' Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated abov to which PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 3 Receipt No. / WNIT[-D.P.W., YELLOW-ASS9330R. PINK-IN9P CCTOR. G ! RO P L.eW �,; ,. .�. ;'•1.-.�'..•�Il .', 1!3'.•i�"Iu".:(y; M'!1 :r+Y. #J�V .r Wit... '.` i�l'�'.,y--/f ry .-�-t.. ,. .., .l. r -:f"• -* �.1 ..:,n: .. at .'..... .. .,. •y tel.' ... _,.... � COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE.- OROVILLE-CAMFO4,11A 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICAT16-N DATA SHEET nIPermit No. OWNER Proposed Building Use At time of permit application, I was advised the Bui lding�lnspector 6�„� Date owing data must be submitted prior to permit processing and/or issuance: r DATE RECEIVED APPROVED 1. All items have been submitted . .............. i ..................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ - 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing. permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: 17,.Im ovements may be required. riveway permit (construction app val required prior to occupancy) ... Pre-Inspec. request to Pre -Inspection for — �' required ...... Building Inspector 20. Contractor's license information (No., Na Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner o) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ...................................... 25. 26. Date) When ou issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone C —� and hold for pickup atQoffice. Deliver w/inspector. Other A Applicant Copy of plans sent Health Dept., Fire Dept., Other Date Date 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: I I Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by' date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by Sets of plans on hold in File Jabine- AP folder Copy—DPW C) Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 93965 - Telephone: 916/538-7541 APPLICATION. AND PERMIT ASS R -PAR E= ZONING BUILDING PERMIT . Ow ` h TELEPHONE SO. FT. OCC. BUILDING VALUATION OWN N'S MAI LI G DD ES id k CG CTG. 'S NAME T EPHONE CONTIRAC7.^.R's ri LING AO RESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ 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 P Water piping 5.00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other -Building SPECIFYMobile Gas piping system 1 - 5 outlets 5.00 sewer -Fs-TG] 5.00 Home W I 10.00ea TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ tallation❑ Other Desc 'be work:na ` r, F ` en Rpp Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 1Main I L9 VF service jp0 1 01 AMP LISS OR 10.00 CONTRACTORS LICENSE L .� (n/ , /���/�/v I decd are under penalty of perjury upry (check �'PaTp I am licensed under rovlslor , DIV. 3 of the Buslnes and Professions Code and mycense is in full fo a 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) F1I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADO'L 100 AMP 2.50 NEW CONST. DWELLING occuP.e , OR ADDNS. ACC. BLDGS. h2sgft NEW CONSTR.MULTI-OUTLET, NON -ROE D BRANCH CIRC TS 2.50 ea /POWER APPARATUS e\ (SINGLE OUTLET CIR. I EX. OCCUp(OUTLETS OR FIXTURES eAL030 FIXED APPLNS. OR Ex. f�CCUp. OUTLETS (RESID.)EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 0 c Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): Lj i he permit is for $100.00 (vaivationj or less. 1 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 PE MIT Filing Fee 10.00 Heating Conlin 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, s, and expenses which may in any way accrue against s d Cou ty in o once of the granting of this perm1 l %� Date Signature of Applicant — Owner ❑ Contractors Agent An OSHA permit is required for excavations over 5' eep and demolition or construct- ion of structures over 3 stn ies in height. Mobile Home Installation Fee $ Energy Inspection Fee g TOTAL PERMIT FEE $ OCCUP. CONST.TYPEJ JSCNOOLJ FLOOD PARCEL PD No i This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. C WHITE-D.P.W.. YELLOW-ASDE330'. PINK -INSPECTOR. GOLDENROD -APPLICANT FIRE REPOR7 FC -18 13/861 ORIGIN LOCATION SEC. TOWNSHIP® N RANGE ME NATIONAL FOREST, FIRE DST CITY & STREET NO., ETC* I I 1 5 'g -f q 4`7c�,� I MILES DIRECTION 0 FROM 12 IN, NATIONAL FOREST, FIRE DST CITY & STREET NO., ETC* I I 1 5 'g -f q 4`7c�,� OE3IDENT TYPEE ❑ FALSE ALARM -00 TO BLOCK 10 RESPONSIBILITY STATE ZONE STATUTORY O0 WILDLAND BURNED OR THREATENED RESPONSIBILITY 30 A O0 CDF LOCAL GOVT. CONTRACT AT ORIGIN) 1 0 UNPROTECTED 0 STATE ASSIST, OTHER AGENCY (Not City) 0 U.S.F.S. LOCAL ZONE 0 B.L.M. ©CDFJ4:21 OCAL GOVT. CONTRACT 0 B.I.A. S AS'SIST,QTHER AGENCY (Not City) 0 OTHER FEDERAL TE61ER � ZONE A, 0 OTHER ASSI,STi*IFED. AGENCY (Noi*Mil.)' O 0 CDF LOCAL . GOVT. CONTRACT MISC. AND OTHER 0 ASSIST CITY, CONTRACT CO., AIL, OTHER �F&USSE (,STARTS IN' 0 OR ONLY) 0 LIGHTNING DEBRIS, 0 PLAY W/FIRE GHTNI 0 CAMPFIRE 0 ARSON OTHER/MISC. SMOKING' EQUIPMENT 6 P USE (STARTS IN 2OR ONLY) DOMdTIC FOREST INDUSTRY r RAkCWFARM RECREATION !' C] DUMP C3 OTHER- IN6USTRY'-COMRCL. F],.ROAD WILDLAND Fl UTILITY, RAILROAD'; F1 NON-WILDLAND' '0 UTILITY, ELECTRIC, ❑ OTHER DAMAGE (Al 26" 65O08 - 0R NLYI. ACRES - 9F VEGETATION BURNED OWARRIVAL (O VEGETATION FIRES ONLY) SIZE DISTANCE (Origin to head) WEATHER (ESTIMATE AT S . ENE) WIND SPEED (M.P.H.) DIRECTION (FROM) TEMPERATURE (°F) OVER "PtlL'E`A'SE CDF 7340.1 30-011 a 86 39852 k. I , S DAMAGE and IR" W off to pud Sl r7" &/or sj w4aF &/OR K* -x WILDLAND VEGETATION (Other than T & Y G) AGRICULTURAL PROD (Other than T & Y G) DWELLINGS 'I VOR CONTENTS' OTHER STRUCTURES 4 &/OR CON7ENTSt VEHICLES & CONTENTS I 6THERA� 3., ro ,;TOTAL ACRES - 9F VEGETATION BURNED OWARRIVAL (O VEGETATION FIRES ONLY) SIZE DISTANCE (Origin to head) WEATHER (ESTIMATE AT S . ENE) WIND SPEED (M.P.H.) DIRECTION (FROM) TEMPERATURE (°F) OVER "PtlL'E`A'SE CDF 7340.1 30-011 a 86 39852 10 URDER NUMBER " REG. R.U. INCIDENT JNO. YEAR /1' FIQF emrnQn AA^ TIME FIRE STARTED OUTSIDE 1 OR Eller 1ST. CD Dis 8 PERSON HOURS AIRCRAFT FLT. HRS. CDF STATE' 8 LOCAL GOVT. CONTRACT CREW NAME �- INSIDE 0 0 OR 8 2, 5 1860 FIRE DISCOVERED co D FIRST REPORT 0661 SECOND REPORT FIRST ATTACK, BY CDF Q 5o(o FIRE CONTAINED 06 111 I r1 CREW /OVERHEAD RECORD GO TO 1© + LOOKOUT: (If 1 ST. or 2ND. report made by lookout SITE ' NAME: SITE, NAME: + IL CDF STATE & LOCAL GOVT. CONTRACT CREW NAME ORGAN- IZATION PERSON HOURS AIRCRAFT FLT. HRS. CDF STATE' 8 LOCAL GOVT. CONTRACT CREW NAME �- ORGAN- IZATION PERSON HOURS AIRCRAFT FLT. HRS. 1 ST. ATK CDF CREW ^/ f ,{ i i CDF OVERHEAD TOTAL ON FIRES, ENTER TOTALS BELOW, : • %:,: .;ps „ 3s; r# U.S.F.S. (incl. Overhead) TOTAL OTHER FEDERAL'(Incl. Overhead) TOTAL l „i FIRE DIST. 3 OTHER LOCM TOTAL , PAID HOURLY (E.F.F.) TOTAL VOLUNTEERS (Unpaid) TOTAL • ❑ FC -188 (Additional crew activity) ATTACHED* ti ,o—% ORIGINAL REPORT RV! /1 COMMENTS sts MAP IS: XONE SECTION ❑FOUR SECTIONS ❑ M .� 1 ) I ( e y • DDDnvcn RV. 14 SIGNATURE _ , T i� �� TITLE DATE yo INTI. DATE �!"k ^/ JOB: 16365 MAT THIS DESIGN HAS BEEN PREPARED FROM COMPUTER INPUT, SUBMITTED BY TRUSS FABRICATOR TOP CHORD 2X4 FIR -LARCH *1 TC X -LOC L -R: 6.29 7.41 14.99-20.59 27.71 c7 BOT CHORD 2X4 FIR -LARCH *1 TYPE --ALPINE SEON--156558 FURNISH R COPY OF THIS DESIGN TO ERECTFON CONTRACTOR WEBS 2X4 FIR -LARCH STANDARD SC X -LOC L -R: 0.29 9.94 18.06 27.71 SCALE - 0.2503 O O O O O O OAUS FiPINE ENGINEEkEO PRODUCTS, INC. **IMPORTANT** SHALL NOT BE RESPONSIBLE FOR ANY DEVIATION FROM THESE SPECIFICATIONS OR ANY DEVIATION FROM TRUSSES REOU1kE EXTR Me' CARE WRRNING IN HANDLING., FRt•_vT[ON AND BRAC)NG.SEE -BWT-76-, (BRACING WOCi1•fRUSSES:1TC CONNECTOR PLATES MUST BE INSTALLED IN ACCORDANCE WITH SINGLE CUT WEB *-TC:1,4 N REQUIREMENTS OF I.C.B.O. RESEARCH REPORT ,2949. v DATE TOP CHORD SHALL BE LATERALLY BRACED WITH PROPERLY CONNECTED ALL PLATES ARE TO BE CENTERED ON THE JOINT, LEFT TO RIGHT AND PURLINS SPACED AT A MAXIMUM OF 24" O.C. m TOP TO BOTTOM, EXCEPT WHEN LOCATED BY CIRCLE OR DIMENSION. �,`,: Ej SEE DRAWING 136 FOR "PLATE LOCATIONS ON TYPICAL JOINTS." IT IS THE RESPONSIBILITY OF THE BUILDING..DESIGNER AND TRUSS p� FABRICATOR TO REVIEW THIS DRAWING PRIOR TO CUTTING LUMBER TO CD 1 t7/y?. VERIFY THAT ALL DATA, INCLUDING.DIMENSIONS AND LOADS, CONFORM C:) CR-ENGAPPLY TO THE ARCHITECTURAL PLANS/SPECIFICATIONS AND FABRICA_TOR'S OUR. FRC. 1.25 [SPACING PITCH 4.0/12 - TRUSS LAYOUT. TYPE C O M N - - + Bottom chord checked for 10 PSF live load. 3, 4X4 14-0-0 (14-0-.0 Q t� RlBSD 4!- 3.50^ 28-0-0 OVER 2 SUPPORTS �, R -BSD 77 11� 3.50' PLATE TYPE --ALPINE SEON--156558 FURNISH R COPY OF THIS DESIGN TO ERECTFON CONTRACTOR REV 13.Is . SCALE - 0.2503 O O O O O O OAUS FiPINE ENGINEEkEO PRODUCTS, INC. **IMPORTANT** SHALL NOT BE RESPONSIBLE FOR ANY DEVIATION FROM THESE SPECIFICATIONS OR ANY DEVIATION FROM TRUSSES REOU1kE EXTR Me' CARE WRRNING IN HANDLING., FRt•_vT[ON AND BRAC)NG.SEE -BWT-76-, (BRACING WOCi1•fRUSSES:1TC °^"' "`'. �� pESIGN CRIT REFR427--1484 LL 16. 0 PSF DATE 12/22/87 THIS DESIGN DR ANY FAILURE TO BUILD THE TRUSS 1N CONFORrFINCE WITH THE -DUALITY CONTROL MFNURL' BY TPI. ALPINE CONNECTORS CDMMENTRRT FIND RECOMMENDATIONS-•TPI)SEE THIS DESIGN FDR ADDITIONAL SPECIAL PERMR- �,`,: TC OL � 10 . O'PSF DRWG CAUSR427 87356001 o C= RRE MFNUFACTIAEO FROM ZO GAUGE GALVANIZED STEEL UN_ESS SHDWN, MEETING REDUIREMENIS OF RSTM A446 GRACE R. CONNECTORS TO BOTH FACES RT EACH .(DINT APD LOCATE AS BEfiR)NG WIDTHS ARE 4' NOMINAL UNLESS OTHERWISE SHOWN. DESIGN STHP40WOS CONFORM WITH APPLICABLE PROYISIONS OF ANDS RNO sTPI (PCT). NENT BRACING REOUItiEMENTS. UNLESS DTHERYISF. SHOWN, TOP CHORD SHALL BE LRTFHALLT BRFiCED WIIH PROPERLY RTTRCHED PLYWOODSHERIHSHOWN. BOTTOM CHORD WITH RIGID CEILING'OR BRACING" AS SPECIFIED ON DESIGN. OD NOT USE THIS UES14N WITH FINE kE)RRGRNT TREHTED LUMBER.. 1 t7/y?. D• 47 IOTHERWISE �- �IBC : ,;TOT. - C ' •'�`� `- ` � ' DL. + 5. 0 PSF LD. 31. 0 PSF CR-ENGAPPLY O/R LEN. 2B-0-0 OUR. FRC. 1.25 [SPACING PITCH 4.0/12 - 24.07. TYPE C O M N - - TRUSS PLRIE INSTITUTE, NDS • WTIDNRL DESIGN SFECIFTCF.TIDN rDR WOOD CONSTRUCTION '. "' ' J' f t ' PERMIT NO. 4319-77B,P,E,M f PERMIT EXPIRES OWNER Don Cummings ?CONTR. (est Const., Gridley. LOCATION (A.P. 21-16-62 Ye(Corner of French & Peteesen Ave., Gridley F ha . �sl � I �f 8 yYs l II Lig l' I'. (% l Temp. P�wer Pole Calved PG&E Y ,� oZ Temp Elec. Serv. Failed PG&E • Te p. Gas Serv. Called PG&E 11 0 B INALED f (Dat ( ? (Signature) E THIS IS TO CERTIFY THAT, INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Street Lot Number Tract No. EXTERIOR WALLS -3k « Manufacturer �� Thickness/Type— R Value j CEILINGS e- f.12 Batts: Manufacturers Thickness R Value/ Blown: Manufacturer Thickness. No. Bags Wt./Bag Sq. Ft. Covered R Value . FLOORS G Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation inches FOUNDATION WALLS Manufacturer Thickness/Type R Valu,- GENERAL alueGENERAL CONTRACTOR LICENSE No. BY. TITLE — DATE INSULATIO CONTR TOR: 'H KINS INSULATION CO., INC. LICENSE N 215.925 BY C`'�BA L % /� r. Interior Lath I Ventilation Permanent Z Door Closer Final Final 51Z MOBILEHOMEUTILITIES------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOSI�LEHOME (INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS 14 11 00, ex (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPAR;'MENT OF PUBLIC WORKS BUILDING INSPECTION RECORD U LDI G BUILDING (Con 'd) PLUMBING Setback / Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows a.2 f 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer All Garage Fdn. Vents Fixtures Footings i Garage Vents Water Htr. Stemwall Insulation 2-'ZL Heaters Slab Carport Footin s Prov. for phd slcall handicae Conformance of ex. structure % A Iiances Gas Piping & Test Temp. Gas OZ 3 Slab Final -`iZ SanitationA =�d- Patio FI REP L.ArE Final �p Footincis Footin Y LECTRICA Masonry Walls Throat avvZ Rouc3h Reinf. Steel Final % Fixtures Bond Beam FIRE SPRINKLERS Motors , Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL--Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish .3 f Ducts P''77 Underaround 1, Interior Lath I Ventilation Permanent Z Door Closer Final Final 51Z MOBILEHOMEUTILITIES------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOSI�LEHOME (INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS 14 11 00, ex (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE a — DffPART.MENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT =%. tte tU enter upon. the above -me 'o ed proes. XSignature of Pe 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 OFT-11BLIC WORKS By Date C�—Z 7� B Iding permit expires Date Z%pq BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address A(67 X Q' -- T lephone No. Fireplace v Contractor Total Valuation Mai I i ng Address Permit Fee P I an Checking Fee &/or Penalty v ,e ne 17 Permit Fee �Q Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 0D .1"C04 Ct Each Trap 1.50 00 rc / Repair drainage or vent piping 1.50 7aning Verification Unl19 Water piping 1.50 Each gas water heater or vent 1.50_ A. P. No. �° J— — 6 2 Aon. Gas piping system 1 - 5 outlets X 1.50 /1,11-0 Each additional outlet .30 S ire Dept. Fire Zone - Use Permit Building sewer 5.00 EQA Parking Plans Parcel I Declaration I Parcel Ma 1 60' R/W I Improvem s Lawn sprinkler system 2.00 Id . Plans Recd Parcel pproval PIa pproval Permit Fee $ -0 NEWADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE V $3.00 4L Main service 100 AMP SLESS 5.00 OR Main service EA. ADD'L 100 AMP 2,50 1 Single Family Duplex ❑ Others Mobil Home ❑ ❑ Main service OVER 600V 100 AMP OR LESS 21.00 Main service EA, ADDIL 100 AMP 1.00 - NEW CONST. DWELLING OCCUP. & OR ADDNS. ( ACC. BLDGS. ) 20 sq ft t NEW CONSTR. (MULTI -OUTLET BRANCH CIRCUITS) 2.50ea NEW CONSTSL POWER APPARATUS & NON.RESID. (SINGLE OUTLET CIR. 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: Ex. Occup(OUTLETS OR FIXTURES) BAL@ 09 FIXED APPLNF. Ex. Occup. (OUTLETS ((RESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section 3700 of the California Labor Code w ich requires every employer to be insured against liability for W men's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner ❑ so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 17, IftHeating G v—& ✓ d0 Cooling Oy, Od Ventilation � � �.O� Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby a„thnrleor,....- -- ----- __ .. 0 Q_ ®a TOTAL PERMIT FEE CIZ =%. tte tU enter upon. the above -me 'o ed proes. XSignature of Pe 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 OFT-11BLIC WORKS By Date C�—Z 7� B Iding permit expires Date Z%pq I I� PLAN . IT A j Aq .......... ...------......----...._..... .--- ..... _........... - Assess&s Parcel Number 0� u [D e 0 u©® 0 9 0 Scale: 1°' _ O F e Name �),Ooo1,^4 PF4)61ydf r4,;1y S . Address I Phone No. Siie Locator! af9z/ Pr'7�i�Sav Ave 60041 D� LZf Co Contact Nar�e'�� C 4M Al �s Phone tom- 0 $'/` Via' FOR OFFICE U8E ONLY Zoning: General Plan ®esig: Size, Acres PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: