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HomeMy WebLinkAbout021-160-120BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP041386 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/14/2004 APN' 021-160-120-000 the Business and Professions Code, and my license is in full force and effect. ! License Class: License Number: Site Address: 1054 LEWIS OAK RD GRI Date: Contractor: Map Index: OWNER49UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW ELECTRICAL SERVICE 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 ' • Owner• STEWART ALVIN R & LOU ANN to its issuance, also requires the applicant for such permit to file a p O BOX 386 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law. (Chapter 9 commencing with Section GRIDLEY, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95948-0386 she is exempt therefrom and the basis for the alleged exemption. Any ! violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law 'does not apply to an Applicant: STEWART ALVIN R & LOU ANN 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' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a cofitractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: I WORKERS' COMPENSATION DECLARATION License #: I hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: ca`rier Total Square Ft: 0 S.F. Policy #: Valuation: $0.00%/ C I certify that in the performance of the work for which this permit is Census Code: + �r �" T issued. I shall not employ any person in any manner so as to I - become subject to, the workers' compensation laws of California, and agree that if I should become subject to the workers' IV/ compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �(/ v �O l Date: — / Zf-�i L/' �Ud L$ <'c� Applicant: i s 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—it is reby issued under t applicable provisions of the Bette County Coda anrVor I hereby affirm that there is a construction lending agency for the Res lutions do work indicated ove or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) BY , Date: Q Name: PERMIT EXPIRES ON: I —!7 ^ C)S Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge itis unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte Coun/t/tyy�to enter upon the above mentioned property for inspection purposes. �-- Print Name: /,(� ) f �%�'r 42t'•� Signature: ,w,.,,-- oe. Date: 38 Owner ❑ Contractor ❑ Agent for Owner 0 Agent for Contractor �tR, �'�{,y ��'a`K+`'4.�`6'4'M1�+i�,Y{}'�+-wv�1y��.�.:�,.,�lti+Wl'�fR._'�t�l1�.r•^.'nreFl�` 1 KR' e! a r' COUNTY OF BUTTE 'BU ILDING DIVISION , ` ' ` ' ` ` ° ' = = • = _ :. ; E 1 DEPARTMENT OF DEVELOPMENT SERVICES I, 411 Main Street • Chico, CA • (530) 891-2751 �_- 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. }' A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, A please contact this office immediately. f , k 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.netWds PERMIT NO. BP041386 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/14/2004 APN: 021-160-120-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1054 LEWIS OAK RD GRI Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW ELECTRICAL SERVICE 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 Owner: STEWART ALVIN R & LOU ANN to its issuance, also requires the applicant for such permit to file a p O BOX 386 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section GRIDLEY, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95948-0386 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: STEWART ALVIN R & LOU ANN 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' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: - and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: Cl 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 Architect: is issued. ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier. Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: k7 I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the 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:�i�Jr 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 _ .- _ _ -,,,Y compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY mit is reby issued under t applicable provisions of the Butte County Code and/or Thiflutions I hereby affirm that there is a construction lending agency for the Redo work indicated ove or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: Date: S ^- &-64 '47 - as Address: PERMIT EXPIRES ON: / Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Jle,� Print Name: ��1 till 7 E�lp�fSignature: Date: ��'�i�j Lr 1O ner 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor �" --✓times^^ ' "�.; 34r=rs a.�`=i � , COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: 41 1/ / n �hf UJIJ(� ASSESSOR PARCEL NUMBER Proposed Building Use: I�p7 _�:P/t/. Counter Technician: 1P. Date: �� G Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. O 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. . ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and.signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ...............•......... ❑ 26. NPDES Form...................................................................................•......... ❑ ; 27. Encroachment Permit for driveway from the Public Works Dept ........................... ��,"�'J' 28. Pre -Inspection for ,L►�P - required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ,0 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification (_j_Aiven to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance.......................................................•....... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant:12 _ 4e Y Date: Ol 1. Index permit application f r t�e en m ered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division O.B.-1 OWNER -BUILDER 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. I personally plan to provide the ajor labor and materials for construction of the proposed property improvement: YES NO ❑ 2. I HAVE _HAVE NOT ❑ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: may: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: Com: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME • ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: SOCIAL SECURITY NUMBER: DATE:—, NOTE. This Owner -Builder Verification 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 OB. -1 I OWNER BUILDER INFORMATION 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. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to seveial 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, if you 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, Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE: This Owner-Builderinformation is required by Section 19830 of the California Health and Safety Code OVER BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION CONTRACTOR OWNER Name l W & ' Address Phone Fax Ci t Class Sta Z' Phone Fax E-mail Planner CONTRACTOR Name Address City Zip Phone Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use onI Zoning Property Address Cu Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. a�q BP BIN # LOCATION AP# •� r Property Address Cu Cross Street WORKER'S COMPENSATION Policy Number Carrier Nhiring 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: Sq. Footage 0 Structure Built without Permits O Proposed Change of Occupancy '(Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: ' P Receipt #: Amount: C515• �0 Bldg Sheriff Alb �0t 9 SMIP t" % Date- U %Id Other Q '7 �S• Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 4-30-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division ip order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to mobile or modular homes.) ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. ❑ 10. Metal Buildings: (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 b t�gineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (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 b the he en ig_neer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant.at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 ..... .. . .. ... . ...... PRE -INSPECTION -REPORT DATE TO INSPECTOR: `1 -, Building Description: Electric: Commercial/Usage: Residential/# of Units - Currently Occupied AbandonedIVadant PERMIT HISTORY:( )NONE t)-ASIO-LLOWS: BUILDING INSPECTOR'S REPORT Yes No Electric currently On Off Condition of Electric Gas: Natural Propane None Currently On / Off Obvious Problems: Sanitatlons Plumbing Working Well Working Potable Water— Obvious SewageProblemsm- ACTION RECOMMENDED: ISSUE: HOLD FOR. Inspector: Date Z/--- Com/ --6 � Sketch buildings on reverse and indicate location on property. —A GOUH T Y OF BUTTE -DEPARTMENT OF DEVELOPMERT SERVICES - BUILDING DIVIIS1ON 1 7 County Center Drive & Oroville, Ce.lifornia 9598; ► Telephone (530) 538-1541 P w1u9� APFUCATION AND PERMIT BUILDiNG PERMIT SQ. FT. 0= st 243 VALUMON oQ� Ft=9= Da In M MM aanF s r ■ ■ . "li,- ■_ ■ ■ :?MkAIT FEE ?Alb �i�Yn 1 �GTi►�ii � G� Firm Fee S 20.00 Permit Fes s - Pben Chemo Fes S Mr.:. 14� E%wffy Pkm Chemidng Fee S BECHAhDCAL ?ERMT s• PmmrT FF'c s PL[b6tiBm a 'PERtaT F mg Fee 20.DD East Trap 7.0 D Sobs or host p=p wrier hamw 28.DD 1Nei p' ' g 15.00 CC:b1pm water heir or vard 1 S.DD Gs 1 -5= 1S.DD -%Umg sawer 15.DD �bbg ! bm9 5 G WAsb 0.DD Pmr F4 S pmtw F�mg F� 2o.Do r = OA LmS 2�D 2 3, `o mna so upon 45AD ,r� & • U== d$ FOLMO BOL B 'z FCS APPiJPi Op Tem Ssrv�s MOD NbbBe Home Fseifiiies 2100 . Mr.:. 14� 4 2hh3DD BECHAhDCAL ?ERMT Fdng Fes 20. D0 6.50 P=-RBAPT FE -a I S tJbb6e Hams bnsabftn Fes Is / 1 �argy hsspe_-bon Fee s rm TOTAL FEE $ So __ � � COd FMI P27D CDF PAi =9 PC 1,07 ii 7WM permit is heresy issued unlet the apprr_sble prz,4 � s of the Buffe aunty Code endlor Resohae= b do work b6ms ed above for w}fr--h fees have been paid. 3y . Dete PERMIT c'7-iR=13 ON Ra I � FIRE DAMAGE REPORT OWNER: �.� t DATE: LOCATION: A 0 9A i,ta i S own 6Ld,! V 6 Z1 Ly r CONTRACTOR: ZONING: DATE TO INSPECTOR: IV- 6 q PERMIT HISTORY ( ) NONE () AS FOLLOWS: BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: _ Residential # of Units: Currently Occupied Abandoned/Vacant: Electric: ( ) Yes ( ) No Electric Currently () On ( ) Off Condition of Electric Gas: Currently () On ( ) Off Condition Sanitation: Plumbing Worldng ( ) Yes ( ) No Obvious Sewage Problems ( ) Yes ( ) No Mobile Home Condition of Utilities: ( ) Damaged -Requires Permit ( ) Undamaged —No Permit Required Description of Damaged Area: Estimate Cost of Repairs: Condition of Foundation: ( ) Good ( ) Poor Explain if repairs needed: Inspector: Sketch building on reverse and indicate area of damage. Date: - a f4ft'lCI)PBOTTE COUNTY FIRE INCIDENT-LOG DATE 12/28/2003 INCIDENT NUMBER 15192 LOGGED BY JLKD REPORT_ TIME 7:50 LOCAL FIRE NUMBER 11276 RO BANNER STATE FIRE NUMBER Fwarswainmf BI , CASE NUMBER _j rioa+Cnc.e MEDICS LOCATION 102 -LEWIS OAK RD I PRA IY10 r ECC ❑ RP JOHN DAILEY I PHONE NUMBER 530-864-0189 - I REPORT METHO ISEVEN DIGIT EME WILDLAND FIRES ❑ ESTIMATED ACRES FIRE INFORMATION STRUCTURE FIRE RESIDENTIAL I FIRE INFO SENT HOW EMAIL BY LKD TO STA 74 OTHER FIRE I 7 -DAY LOGGED © INITIALS CJS MEDICAL AIDS INCIDENT NAME LEWIS OAK PSAIOTHER START DATE 12128=03 START TIME HAZ MAT DIAMOND # 5 0 COMMENTS CAUSE SMOKING SINGLE WIDE MOBIL WITH LAND USE FARMIRANCH ' EXP. " ACRES0� TYPE OF ACRES DIAMOND 5 ONLY $ DAMAGE TYPE ALL OTHER �. DOLLAR DAMAGE, 10000.00) SAVE 5000.00 INJURIESIFATALITIES ❑ # CIVILIAN INJURIES " 0 # CIVILIAN FATALITIES EMD ❑ OES ❑ _OJ # FF INJURIES # FF FATALITIES 0� ♦ New Incident FC -40 INFORMATION FC -40 ❑ DATE OF FC -40 INC AGENCY INC # INC P# _ FC40 COMP DATEFC-40 COMP BY County Notifications © EARS Hard Copy Recieved ❑ EARS Checked Agenst EARS Computer ❑ .< sr,,.....�„►�, ,D tl ! "�"�"'�YJ t :4�' • F T rc , ;4 I, y t , 1 v t I . k r � 5 • n t[ y - k}t� .o r j 5 ..rw _- ` v .•. . __ _ a•i.. �,vn.r'Lia_S.-. {.%i•"too-^- COUNTY OF BUTTE - DEPARTMENT.OF DEVELOPMENT SERVICES - w ILDING DIVISION , 7 County Center Drive • Oroville, California 95965 • Telephone 30) 538-754EsM1T (Rev. 12/96) APPLICATION AND PERMIT " ,�:T ASSESSOR PARCEL NUMBER 021-160-120 ZONING BUILDING PERMIT OWNER stgwWrt alvin TELEPHONE SO, FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1059 _ Oak Rd Gridley.QS4 R 7!. _ _ CONTRACTOR'S NAME Owner / TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER [Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ 35.00 Plan Checkin Fee $ BUILDING ADDRESS 1054 Lewis Rd Gridley Energy Plan Checking Fee $ $ PERMIT FEE $ 55„00 LAT No. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFJD; Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other QC Describe Work: RerOOf & HVAC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service ao2o0ov R. OR tESS 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.P License Class Lic. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46,00 NEW CONST. DWELLING OCCUP. OR ADONIS. 6 ACC. BUDS. SO 3.50FT: NO CONS ' MULTI -OUTLET NON REBID. 97.50 OWER APPARATUS a SINGLE OUTLET C1 R. Ex. OCCU OUTLET OR FIXTURES BEL @ 1.00 Ex. Occup. ouTleis RID.OE ESA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a'certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 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 MECHANICAL PERMIT Fling Fee 20.00 Heating 1 15.001 Cooling 15_00 Hood 6.50 Ventilation PERMIT FEE $ C11171,1711 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.) certifythat 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 �X Date Of Signature of Applicant'- ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavatio over 5'0" deep.and demolition or constructionof structures over3 s�ories i�heigl�t,bBy Mobile Home Installation Fee $ Energy Inspection Fee $ Gcc C�TTYPEI TOTALFEE$ (A W HAIMPFLOOD CDF PARCEL Po HD ISSUF� Thilpermit is hereby issued under the applicable of a Butte County Code and/or Resolutions indi ` ted a v f r whi h fees have been /Receipt PERMIT EXPIRES ON ( I 0e) provisions to do work paid. "��6 No. J' / //' JA U ' Jtl._J — WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT yr . COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 pE IT (Rev.12/96) APPLICATION AND PERMIT 3_ )My ASSESSOR PARCEL NUMBER 021-160-120 ZONING BUILDING PERMIT OWNER stewart. alvi TELEPHONE SO. FT, OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS 1059 Lewis Oak R 24 ` ` o. - ' ' CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ Q5.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 1054 Levzis Oak Rd, Gricilpy Energy Plan Checking Fee $ $ PERMIT FEE $ 55-00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF;fk Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other W. Describe Work: Rer00f & HVAC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G 1W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 "OOVMain Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. & ACC. BWS. SO 3.S¢Fr. 1pµROSIID. MULTI.OUTLET @7.50 POWER APPARATus & SINGLE OUTLET CTR. Ex. OCCU OUTLET OR FIXTURES BAL Ex. Occup. DirnFrsPR=.DEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 MECHANICAL PERMIT Fling Fee 20.00 Heating 15.00 Cooling15.0 Hood 6.50 Ventilation PERMIT FEIE $ 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 _ Date Iindi Signature of Applica - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavatio over 5'0" deepand demolition or construction of structures o r ores i 1 1 119 ad. .._� Receipt No. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAz. D FEES IMP FD cDF PARCEL PD HD LOO ISSU Thii permit is hereby issued under the applicable of a Butte County Code and/or Resolutions ted v f r whi h fees have been y ate B161 PERMIT EXPIRES ON provisions to do work paid. to WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT v +Mw++..6'Rh..:°�A...�✓�..-w�''�"`^�f+-^�'✓►*+"\,!�'�.:��r�'?".��h t�ll`�1!`f,�'St�'-..�.i`CY,�t'rt'�e�r"MS=i�r'M>!+�.i3E`,4,"�, 021;160 120' ` �'-,cii�t; 03 099�8';�s # P-STEWART yALVIN11��`�a.N +1054 °LEWIS OAK RD GRIDLEY Cont: NORTH VALLEY ELECT xADD 2ND IvIETER;WA�TE'R PUMP r ,x.i$'+N tiyt.�Y�Y?.si9lrfi OFFICE COPY ' Address ' Meter By e ELECTRIC, Daf9 Meter.By - oe� r fl t f. t• t t , r ' 1 1� OFFICE COPY ' Address ' Meter By e ELECTRIC, Daf9 Meter.By - oe� r fl t f. COUNTY OF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES - BgILDING DIVISION g 7 County Center Drive - Oroville, California 95965 - Telephone (5:3.0) 538-741 (Rev. 12/96) APPLICATION AND PERMIT _63-6 ASSESSOR PARCEL NUMBER 021-160-120 ZONING a BUILDING PERMIT OWNER stewart aloin TELEPHONE SQ. FT OCC. "BUILDING VALUATION OWNERS MAILING ADDRESS 1054 Lewis Oak Rd.'• Grid1gy, C4 9594 ' CONTRACTOR'S NAME Nor'th Valley Electrci TELEPHONE 846-208 - CONTRACTORS MAILING ADDRESS PO Box 911 Gridley, CA 95948-0911 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS - Fireplace Total Valuation $ ARCHITECT OR ENGINEER - LICENSE NO. i - Fills Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1054 Lewis Oak ltd. Gridley Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF WC Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent LIAO, _ TYPE OF WORK flVew ❑R Alit, on ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describ6*,*Nork: �` ci I [ ,i C, i 7 �"� r , !, �, ." i tl 1I y < a ) r" G ci C l( rI ri Gas piping system 1 - 5 outlets i's -Do ' Building sewer 1 00 Mobile Home S G W PERMIT FEE $ }•�� �� �> ELECTRICAL PERMIT Filing Fee 20.00 600VORLESS Main Service zo.A OR LESS 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. --, t/��' G /'> </. r :" �- LiceQ a .waSS I LIC. NO. 7 +'• OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for thejpllowing reason: ❑ I, as pWner 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. i O I am exempt under Sec. Business and Professions ode for this reason WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarationsf ❑ 1 have and will maintain a c'ertificate of consent to self -insure for workers' compensation, asprovided fore�action 3700 of the Labor Code, for the performance of the work for which thtsl a rnit is issued. ❑ 1 have and will maintain worket� ation insurance, as requirgd by Section 3700 of the Labor Code, for the perfor a of work for which this permit is issued. My workers' compensation insurance, carrier and policy number are: Carrier ' ' i'/t� ciN D Policy Number I I, .l j :- ; — ' ' �. (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the pe rmance of the work for which this permit is issued, I shall not employ any : so in any manner so's to become subject to workers' compensation laws o a' rniaitnd agree tha'tif I should become subject to the workers' compensation v X* Je i ri`4*�700 of the Labor Code, I shall fotthwit comply with those prpv stons. r i X;'tfr /% ' %�/ .-'• '' Date ' �� Signature of Applicant - 0 Owner C tfac r ❑ Agent An OSHA permit is required for iccavati ov 5'0 deep an emkU olition or co str n of structures o i sin t rReceiptNo. Main Service 200A TO 1000A 46.00NEW CONST. DWELLING OCCUP. OR ADDNS. a ACC. S. SO =.ES1D. ' MULTI -OUTLET O�],50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. OCCU OUTLET OR FIXTURES EL FlXED APPLNS. OR Ex. Occup. DUTLETS RL. D• 5>A0 Temporary Service3.a0 ` Mobile Home Facilities +20.00 Misc. Wirina 23.00 Pre -Inspection 123.00 PERMIT FEE $ 66400 MECHANICAL PERMIT Filing Fee 2'0.00 Heating Coolir Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under the of the a my Code and/or indicated b ' e for hich ees have �( By ERMIT EXPIRES ONITE-D.D.S.-B.D. applicable provisions Resolutions to do work been paid. G ,� ate Date CANARY -ASSESSOR PINK-INSPECTOA GOLDENROD -APPLICANT M COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION j 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-7541 (Rev.12/96) APPLICATION AND PERMIT 63-offlf., ASSESSOR PARCEL NUMBER 02.1-1 ZONING BUILDING PERMIT OWNER TELEPHONE SO, Fr, OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 1054 Lewis Oak Ed, GricilpV, CA 91;c)A.R CONTRACTOR'S NAME TELEPHONE Horth Valle eCtrC CONTRACTORS MAILING AD RESS PO z t ,z, CA 99948-0911 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filina Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ Plan Checking Fee $ BUILDING ADDRESS 1094 Lewis 1Ed Gri r11 elz Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE Each Trap 7.00 Solar or heat pump water heater 23.00 SF %X Duplex ❑ Mobilehome ❑ Other Water piping 15.00 SPECIFY Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: SIO � 2 (,,J 0-+4e�0-+4er p 4 o �Q 164 Ch Building sewer 15.00 Mobile Home S G W @20.00 JM� _D✓L,� rh 0 i, SP Y U i C � I OQ a CC( [�a S'PC6NdQ /u PERMIT FEE S }-n,o ELECTRICAL PERMIT Fling Feel 20.00 R LESS Main Service 2o0A OR LESS 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the B ( g ) on Business and Professions Code, and my license is in full force and effect. / 3 License Class C -I O G -10 1 Lic. No. (� gQ % OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. Main Service 200A TO 1000A 46.00 OCCUP. NEW CONST. DW8 ACC. S. OR AD DNS. ( 3.5QELLING SO FT. NEW CONST. NON•RESID. MOLT 0.OLmtT @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @ I000 B .5 FixI Ex. Occu . OfLETSRLNS oR� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ❑ 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 ire-InsDeCtion 2 3.00 PERMIT FEE $ rr, on WORKERS' COMPENSATION DECLARATION MECHANICAL PERMIT Filing Fee 20.00 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 Heating Cooling Hood 6.50 performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section Ventilation 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: PERMIT FEE $ Carrier E O M P E'Aj S T - p 4F UAI V. Policy Number b $ '7 7 2:3, — O Mobile Home Installation Fee Is (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. I D. FEES I IMP I FLOOD CDF PARCEL pD HD ISSU workers' compensation provisions 0 section 3700 of the Labor Code, I shall f w' comp ith o vi ' This permit is hereby issued under the applicable provisions X Date �� Oz e the C my Code and/or Resolutions to do work of indicated o e or ich ees have been paid. Signa ure of AppliW Owner actor ❑ Agent An OSHA permit is 9quired for excavati over 60" deep andjoemolition or construClibn of structures PAW. By ate Receipt No. -PERMIT EXPIRES ON WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECT GOLDEN ROD-APPLI ANT Date COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 l RMIT APPLICATION DATA SHEET OWNER: ASSESSOR PARCEL NUMB Proposed Building Use: Counter Technician: Date: M - Items required in order to apply fora permit. All boxes MUST be checked O arked NA in order to apply. ❑ 1.. Plot plans, 3 or 4 sets, signed,ty the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. f. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the en ig neer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. f Date Received By . ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form ....................:. . ......................................................... _ ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet ........................................ ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit......................................................................... ❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 19. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage... ............................ ❑%L 1. Encroachment Permit or i eway t ubl' o k n v approval prior to occupancy). 22. Pre -Inspection for �// �l �e .............. O 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ...... ........:................... .......... . ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone and hold for pickup. I have been informed of the above items and "require ients for obtaining a building permit. Applicant: Date: 1. Index permit application for iZabove items numbered: Plan Check Letter 2. Additional items required Contractor, designer, `,owner, was advised cfthe above data by ❑ phone, ❑ mail, ❑ counter, ey Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: -~ , Date: Structural reviewed by: Date: Structural approved by: Date_ Note transfer by: Date: Yellow: Buildine Division-- ._ . .iado.id uo uojjnaoj ajnaipui pun �slaAa.l uo sBuipjjnq,ga1a31S x03 Q'IOH :aassl :a3cLK3wwoo3x Nowt' 1700 4" :S-;aawwo, ,-/"rzep0// (7v Gk3rv-?v Yl?,(Y suralgotpBe&--,S snotngp SEM olgno l _... UAM!ri IIZM s �M 8mg=ld k r v ` 1\: ✓ _ a C, ,n f .� 'S'=jgq. 3a snoUg0 :rsJ otIz133o uoptpc O tip /Cpm= 0 13 ON :oopd}txoQ 291pOnS ivoi 7i S.ZIoiozdsta waavnS OI RLVa Y4\ 70 'ate - �-xoioYXIxoo Noiidooz JLNOCIHH MOUPENISNU-2mci >, COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street - Chico, CA - (530) 891-2751 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE ER i inn - / PE-RM-T"NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 9 •pti.r a Date L J Inspector REV 10/92 1a-s0100hVQAmmor Name STEWART ALVIN R &LOU ANN Asmt # ) Fee # 021.160-120.000 Status ACTIVE Status Date 04/04/2001 Addr1 P 0 BOX 386 – — Tax 000 NORMAL OWNERSHIP TRA 075 018 Addr2 I GRIDLEY CA 95948-0386 Situs 1054 LEWIS OAK RD GRIDLEY Addr3 –_ _ _ Base Dt 04!04/2001 Addr4 Land Timber Preserve 659, Ag Structure "Pres- t44,705' Comments IWAS 021-160714' PTN. -112 BLM BY Fixtures jJ Etal – 0 ._& _ Creating Doc# 2001 R001 3271 Date 04!04!2001 ❑Notes Growing p r Bonds Total L&I _ - - Current Doc# 200180013272 Date 04/04/2001 - 77,364, --�� J Multi Situs Fix. R Killing Doc# Date MH PP 0 Asmt Desc LEWIS OAK & PETERSEN SuplCnt FIag2 PP 9r---jj 0 Zoning Dwell " J 910 MH Exempt 0 Acres/Sq Ft 2.44 WCF6-21 Asmt PP Pen 411 Net 77,364; Tax PP Pen R!C# r Appeal Pending 'T/R Dt iSplit Pending R/C Stat PHY OWN EXP - TAX ' ` ;" H0N ATT Si .: APR:.., - ••.,.PCL �F ind Mail � 2u RGj2jIsa,, 07J23J2002 6:02:00 PM . �.t rF, Z i4 } , L u ,� k :- �:Ad .. 'x: .. - '� n ^'. a �`. • . ` 'd •, ..;,,�J,',..fir��T A.'Y}.�¢i.-�.�r'ri+�+-���"ILM1C?,7f.Y��'rC`��'��ja-��v.�swl Jw _ +.tW.� - .. M Cuts �.PRPE Lr* s*�', � �•��c� ��� t� �c,a ;tea PP gt6 W, T P4 • ��hM SL!! ilr�J�,'�[.•-ti7�~9iU�r•Jl.) �'�-i 7` .. �'` �1. }•. y t 't': • - i ty �f,YS!.:+� {�: _ .0 r ♦ «. w #.f-}•"�'M.-'�.'i or' :_o"'f'^. `> *., .3"'.T '.' "�''P'4'' ..�','i�'t'!1' 1'� " �+ iZ�►^''� '? ... . - +. _• ��.... f."-- T _.� .. .� u.- 'S �,� t• �i}}_Gj� 4?� - �.ti���." ;r: � _ s.i:--s a .c a • . `.K- +. 1+ar.. k r,.�.:-•. rb;- '4c+. Sawa- t / .4r• i• 6- . `. -' h.:��;c�_z3.r;..:y+�t• `?tart + + '