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021-230-064
L. C. McKEE SE corner of Dews. p & Evans Reim . Gridley �l IK Permit# 690-75B(reroof) 7 21-23-64 khan Ahmad Khan c��j� SIS Evans Reimer Rd. intersgf' Dewnup Ave., Grid le contra Quist Const., Gridley Permit #3666-80B,P(repair bath interio 021-23-0-064 93-1894 P,E K ASRAR 403 W NS REIMER, GRID i 1HU (AG WORKER MH, LEC GAS COMPACTION TEST REQ SUPPORT STRUCT REQ 021-230-064 PERMIT#98-1193 KHAN., Asmar Ahmad 405'West:Evans Reimer Rd., Gridley Cont: Twim City Electric Ele Ser Ch/SF -iU19e- � 02 1- 4 0 L36 KHAN, ASM MAD .p 405 WEST EVANS REI ►Z[ y 1 CONTR:NA REMODEL & REPAIR FIRE DAMA E �� NOTES RESIDENTIAL .A r 021-230-04:" 'P 01-0136 KHAN, ASMAR AHMAD 405 WEST ,VANS REIMER RD GRIDLEY CONTR: NA ' REMODEL & REPAIR FIRE DAMAGE t t� 4 L } 4 t +I . x 7'f SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB—STANDARD HOUSING LETTER JOB FINALED (Date)':, Signature ` ./ = OK 0 = Not OK - = Not Applicable = Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Footings; Soils -Size -Depth -Spacing -Connectors -Steel 1. Zoning Requirements -Setbacks -Easements 4. 2. Soils; Special MH Support Sketch Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 3. Sewer; Location -Test -Fall -C/O -Concrete 7. 4. Water; Location -Test -Easement Needed (Sketch) Frmg.; Sills-Anchors-Studs-Rhrs-Trusses 5. Electricity; location-Clearances-Grnd-/ /Amp -Concrete 10. 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /"L"ft./ PLPG Ext.; Steps -Doors -Landings 7. Well Clearance & Disconnect 10. Plumb.; Cir. Test -Water Supply Test 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 12. Permanent Foundation Only; License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s . 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rhrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 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-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓ = OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (; Date derfloor (Plans) OK except #'s Z zonin - etbacks-Easements-Flood-Slope --Mg ., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. 4. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists- Vent s-Crippies 15. Access & Ventilation 16. Insulation 69. Stairs & Rails Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date KUMBING (Permit) OK except #'s 1 Water Htr.; Vent -Access -Combustion Air Baffle Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance Water Pipe; Test & Anchor -Nail Protection 1go-eW.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 76. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 23�ture & Transformer Clearance -Ins. Protection 4. Elec. Receptacles Spacing -Lights & Switches at Doors . ySieE Boxes & No. of Conductors Stapled 29.- Ro x Installed Close to Edge of Studs & C.J. 81. quip. Ground made up w/Mech Fasteners -Bond Gas & Water 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI 2 feed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or At 30. Range Circle/ / ga Cu or AI -Oven Circ. / / ga Cu or At Insulated Neutral O Yes U No 31 ervice-Riser Conductors & Ground Main Disconnect M. Equip. Clearances Panels-Motors-Mech. Equip. 33 othes Closet Light -Shower Light -Spa Light 34. Smoke Detector Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 35. A.C.Ducts Insulation & Support 36 ent Fan, Exhaust above insulation 7. C_94ensate Drain & Overflow, Size & Grade 90. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s FIs Proper Materials & Anchors 41. ptills Studs -Nailing Spacing & Braces -Plates -Sound . Bearing Walls over Girders & Floor Nailing !?,"Draft Stop in Walls (rat proof) 44. ire Stops, Furred Ceilings -Stairs -Chasers -Tubs Headers & Beams -Size & Bearing 'ingle & Duplex) Date FRAMING (Continued) 4 angers -Post Caps -Anchors -Connectors 47. . Joist-Rftr. Ties- Purlin-Roff Brac.-Truss -Shting.-Rfng. 4T Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. c Access; Size & Romex Protection -Draft Stop -fns. Baffles Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51 arage Fire Protection Framing 52. Pr9petfy Line Firewall & Openings 54Axt. Doors -One T -Check Garage 3rd Story, 2 Exits 54. Stair dth-Headroom-Rise-Run-Landing-Fire Protection 5 lywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. 57 Sidi ailing Veneer tucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. 59. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 60. Bra Interior/Exterior Wall Panels " I ` 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 - Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Ramex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Look under Floor O Yes 82. Following Inst) rive J Yes J o/Walks :),Yes J No/Planters J Yes J No 83. Stucco %An -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: �. } T� �... w ..r ��. ...- �F ....-r . K« S.. „1 ti. . ti. .+^ti--. -.a �- ♦ -.-1. --..-+- Y�: '--.. � -,y� •- •• iK -• •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 0/`Y4' ASSESSOR PARCEL NUMBER N 021-230-064 ZONING 40 BUILDING PERMIT OWNER KIWI, A�S�MAM A�H+Arff?p�/�+p� TELEPHONE �- ►206 SO. FT. OCC. BUILDING VALUATION �1Q�. R 2t5.+57t�.c>�t �j}� .OWNERS MAIUND-�A,'DDWzS EVANS REIMS RD., GRIDM CA 95948 CONTRACTOR'S ,,. NA�AM/E TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ 16.676, Ili ARCHITECT OR ENGINEER LICENSE NO. Filen Fee $ 20.00 Permit Fee $ 26.5.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 177 _9% BUILDING ADDRESS 4U. -)'W= EVANS REINI W RD. , GRIDI" CA 95948 Energy Plan Checking Fee $ 'J'� $ PERMIT FEE $ bAO,z5 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF 1& Duplex ❑ Mobilehome ❑ Other nI► SPECIFY Each Trap 4 7.00 9,ti.(110 Solar or heat pump water heater 23.00 Water piping 15.00 1 S Each aas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other QX i Describe Work: REMODEL & REPAIRS DUE TO FIRE DJ414WE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 111; M Mobile Home S G w @20.00 PERMIT FEE t 7-8. 0 ELECTRICAL PERMIT Filing Fee 20.00 800OR LE Main Service zo.A V0.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.POWER 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. 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason . WORKERS' COMPENSATION DECLARATION 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.) certify that in the performance of the work for which this permit is issued, I shall knot employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. /�l X Wi Date Signature df Applicant - ❑ Ownir ❑ 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 TO 46.00 W 0CU000A NEW CONST. DWELLING OCCUP. SO i jtJ� OR ADDNS. ( a ACC. Blas. 3.50SO • NONgEOSID MU ' LTI.OUTLET 97.50 APPARATUS 8 SINGLE OUTLET.IR. .00 EX. Occup. OUTLET OR FIXTURES BAL p I. 0 Ex. Occup. OUTLEEDTSA R=.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 3i.SO MECHANICAL PERMIT Filing Fee 20.00 Heating Edi IIifC`I"5 ��•t1U Cooling Hood 6.50 Ventilation 1 4.50 4.50 PERMIT FET: $ 39.50 Mobile Home Installation Fee $ Energy Inspection Fee $ 46.00 OCC CONST. TYPE TOTAL FEE $ M1.05 HAz. D. FEES IMP x FLOOD CDF w PARCEL pp HD JVJ,/ r(BSUE 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 !`l w { Date •c( 1 U 7/0 PERMIT EXPIRES ON ate Receipt No. :1144911=I . V3 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT s � Willamette Induttries, Inc, Engineered Wood Products WEYERHAEUSER E -Z CalcJOB, NAME: MITCHELL'S BUILDING SUPPLY (v6.0.3 RG} LOCATION: + 01123/2001 JOB NO: First Job DESIGNER: TOM SHEET:. MARK New Mark Floor Beam Input reflects horizontal center to center spans W1= 376 plf LL = 180 plf DL = 196 plf 'Duration = 100% CEILING/ ROOF LOADS Member Weight = 11.4 plf wf 07.21') LOA®S . 1121• f 3333# SHEAR 4340'07 MOMENT 33330 Maximum Reaction's Support 1 Support 21 ; Critical Live Load: (DOL) 1549 (100) 1549 (1 00y ' Dead Load: 1,784 .1784 % Allover. Maximum Allow. ' , DOL - Control Shear: (lbs) 38% 2849 7500 • 100'0 -All Loads Positive Moment: (ft -lbs) 96% 14340 14926 100% -All Loads Deflection LL Ratio TL Ratio Span: 0.224 11920 0:483 1/427 El =1582 x 106 ««« USE 3.125 x 15 INCH Willamette OLB(24F-N4 DF) Min end bearing = 1.64 incites. Support bearing length requirements must be checked separately. Laterad support required at bearings for top edge and bottom edge. f A The products noted ate intended for interior use, normal temperatures, untreated; applications and must be installed in accordance with local building code requirements and Willamette Industries; Inc. recommendations. This Calculation reflects the specific design information and product determination for engineered wood products manufactured by Willamette industries, Inc. The loads, opens and spacings have been provided by others and all information noted shou d be carefully examined and verified for the accuracy and suitability of all design parameters and product selections. 1 z0' d 06t709t7.60ES I 01_ 6169 1 LE: 916 DUS- 63SIl3UH63,�3M �J3 WU 9 1 : L 1002 CE Nd( R COUNTY OF BUTTE BUILDING DIVISION 10 DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE i tel- 013 PERMIT NO. A routine inspection indica that the following violations of butte county Ordinances exist at the above address and sh d be corrected. Please notice this office when correction of work is completed. If you a any questions pertaining to this matter, or need additional explanation, please contact- s office immediately. .1 C. Date 4�-2 ! Inspector REV 10/92 :� M� COUNTIr'a1``eUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PRMIT NO. (Rev. 121/96) APPLICATION AND PERMIT I D/-Of`jl� ASSESSOR PARCELNUMBER 021-230-064 ZONING 40 a BUILDING PERMIT SO. FT. OCC. BUILDING VALUATION OWNER KHAN ASMAR AHAMD TH46 4206 DWNERsILI4nD�WEST EVANS REIMERS RD., GRIDIEY CA 95948 CONTRACTOR'SNAME N TELEPHONE E. . CONTRACTORS ' MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS —Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 20.00 Permit Fee $ 00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee 5 avILDINGAD405 WEST EVANS REIMS RD. GRIDIEY CA 95948 Energy Plan Checking Fee b 911 a PERMIT FEE $ 1480-25 LOT NO. SUBONISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF II_ Duplex ❑ Mobilehome ❑ Other 1CX 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 [AX Describe work: REMODEL & REPAIRS DUE TO FIRE DAMAGE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 G Mobile Home S W Q20.00 PERMIT FEE = 78.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service ppA pp LEgg 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby. affirm under penalty of perjury that 1 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 regson :.' Main Service YOGA t000A 48.00 NEW CONST. DWELLINGNGNOOCCUP. OR ADONS. & ACC. BLD.. 3.SQFso T. 1 7.30 NONAEOSID. BRANCHMULTI-C= Qu 7,50 POWER APPARATUS 8 SINGLE OUTLET CIR. EX. Occup. OUTLET OR FIXTURES .00 BAL ®I.SG Ex. Occup. oLInET. Rein°ERA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE = 37 .30 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 permitis 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 th se provisions. ,�/ lr X Date / v Signature f Applicant - ❑ OwnAr ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories In height. MECHANICAL PERMIT Filing Fee 20.00 Heating EX DUCTS 15.00 Cooling Hood 6.50 Ventilation 1 4.50 1 4.50 PERMIT FES S39, 0 Mobile Home Installation Fee $ Energy Inspection Fee $ 46.00 occ CONST. TYPE TOTAL FEE $ 05 HA2. D. PE IMP FLGOD c� COF PARCEL X PO .� This permit is hereby Issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable Resolutions been D Z provisions to do work paid. e to Receipt No. 314492 /$681.05 WHITE-O.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ' COUNTY'OF WTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P RMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 021-230-064 ZONING 40 BUILDING PERMIT OWNER KHAN ASMAR AHAMD TELEPHONE 846-4206 SO. FT. OCC. BUILDING VALUATION 11,94 R 26,676.00 OWNERS MAULI4�DWEST EVANS REIMERS RD. GRIDLEY CA 95948 CONTRACTOR'S NANAME TELEPHONE CONTRACTOR'S MAULING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total valuation $ 26 76, 00 ARCHITECT OR ENGINEER LICENSE NO. $ 20.00 -FilingFee Permit Fee $ 265.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 179 99 BUILDING ADDRESS 405 WEST EVANS REIMERS RD. GRIDLEY CA 95948 Energy Plan Checking Fee $ 91-00 $ PERMIT FEE $ 480-29 LOT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF fi Duplex ❑ Mobilehome ❑ Other SPECIFY XX Each Trap z, 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 INX Describe work: REMODEL & REPAIRS DUE TO FIRE DAMAGE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 15 00 Mobile Home I s I G I w 920.00 PERMIT FEE $ 78.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service '.OA 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.POWER License Class LIC. NO. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for 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 regson ,A Main Service sow TO 46.00 NEW CONST. DWELLING oCCUccuP. ( ORNEW BLDSEt 3.5 ¢F°� 17.30 cDNS.ONSMUALCTC. NON-RESID. 97.50 APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAS @ I .50 Ex. Occup. ounFis po .OFRA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ 37 .30 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.) R" 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 f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forth with comply with those provisions. X' _ Date O Signature cf Applicant - ❑ Own r ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating EX DUCTS 15.00 Cooling Hood 6.50 Ventilation 1 4.50 4.50 PERMIT FEt $ 39.50 Mobile Home Installation Fee $ Energy Inspection Fee $ 46 .00 occ CONST. TYPE TOTAL FEE $ 68 1 09 HAz. IMP ✓ FLOOD �� CDF PARCEL X PO D s This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By D PERMIT EXPIRES ON -Z/ provisions to do work paid. e t �I efe ReceiptNo. 314492 681.05 WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive a Oroville, CAlifornia 95965 • Telephone (530) 538-7541 PERMIT NO. �(Rav,2/ga) APPUC TIONANDPERMIT bl -or�� :....:. fftK�_17'A BUILDINGPERMIT /V)SAda. FT. I O BUILDING VALUATION R Awm ;" 04, 1 ht' I _"� /'n / " -7 / I CONSINX >oM0000E Fireplace `DOOM MMJW ADOPMS Total Valuation s AACWMCfgrpuMM Most @a Film Fee E 20.00 Permit Fee = � AAICKMM on CH McMs HAW4 ADOW" Plan Checking Fee E A Oy7-- ADONMS C Energy Plan Checking Fee'— J i _ PERMIT FEE _ (� Trp sueavecwsrwe ►"^Ca MAP PLUMBING PERMIT Fling e• 20.00 Each Trap7.00 USEOFSTRUCTURE23.00 Solar or heat um water heater SF plex O Mobilehome O Other Water piping 15.00 SP'WVV Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.0 New ❑ Addition ❑ Remodel ❑ Utilities visitation ❑ Other O Building sewer 15.00 � Mobile Home I S I G I W @20.00 Describeork: g.% PERMIT FEE _ ELECTRICAL PERMIT I Filing Fee 20.00 Main Service ao�oA o°Rn LSM. s 23.00 Main Service Zea► To 1~ 46.00 cDraT.owFu+a occuv. 3.StSC c ON ADOW. t AGC. OLDS. @7.50 ►a=.Mutnovrttr MANCH CIRCUM ( ( Poww AIPAAATIX ,' 9MOLO O d0. Ex. Occup. ounar os FMTaAro ao a x. 00 MLML•x90 Ex. Occup. ovnt°s rs�o. FA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ~ PERMIT FEE MECHANICAL PERMIT Fling Fee 20.00 *PERMIT FEE PAID $ Heatin i— Lives %� SRA- - ! P Coolin Hood e.50 _ SHERIFF $ ventilation y� d OTHER.. PERMIT FEt3 ti. Mobile Home Installation Fee $ Energy Inspection Fee = occ CONST. TTft TOTAL FEES AMOUNT RECEIVED $ o5- K&L °• �a W PLOOO j CDP I I'M PC ov< This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutkme to do work *RECEIPT / Indicated above for which lees have been pad. NUMBER * TO BE PVT INTO COMPUTER By Date _ PERMIT EXPIRES ON Pat*) T4-1, .i::i=ham ;,u• ;� .J� .,a. a COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PE"IT APPLICA TION DA TA SHEET OWNER: ASSESSOR PARCEL ER: Oc5�— ( — --_� © 0 Co f� Proposed Buil mg OsJ Building Inspector. Date: — 2 Z — p At time of permit application, I was advised the following data must be submitted prior to permit proce processing and/ r issuance: Date Received By ❑ . All items have been submitted----------------------------------------------------------------------------- lot.plans, 3/4 sets, signed by the preparer of plans. ---------------------------------------------------- Kn mpleteplans, 3/4 sets, signed by the preparer of plans. --------------------------------------------- gineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. 05. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- 06. Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------ El 8. Hazardous Material Form. --------------------------------------------------------------------------------- ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ----------- 0 10. Fees of $---------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ❑ 12. California Department of Forestry plan approval/fees--------------- Vb13.odelevation certificate. --------------------------------------------- nitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit. ------- =------------------------------ ❑ 16. Plot plan and business license approval from the City of Biggs. --- ❑ 17. Planning approval for (A) Use: (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---. 020. Pre -inspection for required. Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 0 22. Workers' Compensation carrier and policy number. ----------------------------------------------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- ❑24. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑ 26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- E130. -------------- ❑30. Other: ------- —7— _ :Date) WWhen%u issue t, /,Z as follows ❑ Mail to owner, ❑Mail to contractor. telephoneO `� C �Q and hold for pickup at� office. ❑ Deliver with inspector. Applicant: A��P�e W-41 Date: _0 Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Di ision counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buill1i 1Avision counter, by D te: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: VAIM11 On— - n—It—f ,fTlo,.el ..,e .c ......:...... n ... t_J.__^' _• - E.H. USE ONLY Rot Plan Attached _ Floe► Ran Attached Sent to G.O. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Lt Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Cleace for dwelling. Other �� ;A -P �c..� C a loAk ra Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date 8/96 Insulation Certificate BUILDING OWNER: BUILDING LOCATION: Description of Installation ROOF Material Thickness (inches) Brand Name Thermal Resistance (R -Value) CEILING �.#_ G, �Q Brand Name ��,,te�S-drl��`� Batt or Blanket Type . ._.T-- Thiclrness(inches) �D Thermal Resistance.(R-Value) 30 Loose Fill Type Brand Name -' Contractor's minimum installed weight/ lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) EXTERIOR WALL dy Material 6Gi'�/SL5 3 Brand Name z Thick�tess (inches) —� 3 2, Thermal Resistance (R -Value) L ,' RAISED FLOOR Material Thickness (inches) SLAB FLOOR Material Thickness (inches) Width (inches) _ FOUNDATION WALL Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) Material Brand Name Thickness (inches) "rmal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efciency Standards for new residential buildings contained in Title 24 of the California Administrative Code. General Contractor (Builder) I� n c Signature and Tide Sub -Contractor (Insulation Installer) Signature and Title License Number Date License Number DaLe THIS CERTIFICATE MUST .BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. JANUARY 1993 0 m 'I j4p 't,0rj,,js & gotL.anshIP Sb&11 W� u Lt LL) 05 1p C) Y This of plans and 6',0 -7 ba 0 ecif!catloas Wit -,F 8 An all t'r "dI f � L 60 kap r, cn, 1 a j c jb a t -r-C-3- -3J 1 �-Ikl : !jv XuL Oil Q I wriLtafl!orm1.ss - : tori.,,ii frLieDep.a-rl%lmentofPubllo P. Works, gaunt of Butte. ALL STRLICTUESAND INCLUDING 6YERHANGS AL.L BE LEAH. OF ALL EASEMENTS. A SEL "I A:_'d-• 075 F -T. '-;:',HE SIDE MIN) 1w FT. UNE SHALL. 60 u5k� OF sr UCTUE-Z, A :!:! ECCE; FOR A 2 FT. `/E OVER-HA",'0-. �'6FI- 15,6 HUTTE GOUNT4 -Ap AVE. �N/3i/o/ co Lb 33 o-yialv NT 0 47 L. C. McKEE SE corner of Dews?p��& EvanysReip4 d Gridley 4 ��Z,-7 / 7 Perrait# 690-75B(reroof) 21-2,3-64 1 Idian Ahmad Khan 41, ( 1 1, SIS Evans Reimer Rd. inters.l J - f" Dewnup Ave., Gridle contr- Quist Const., Gridley Permit #366.6-80B,P(repair bath interiol —&-ins,t -.,shoXpr_&_ lavy/5F).___ ,� 021-23-0-064 93-1894 P,E KHAN ASRAR x4003 �-EVANS REIMER, GRID,�j (AG WORKER MH., ELEC GAS COMPACTION TEST REQ — SUPPORT STRUCT REQ 021-230-064 PERMIT#98-1193 KHAN, Asmar Ahmad 405 West Evans Reimer Rd., Gridley Cont: Twim City Electric Ele Ser Ch/SF r -ll,)& 4W -74W7 021-230-064 01-0136 KHAN, ASMAR AHMAD 405 WEST EVANS REIMER RD GRIDLEY CONTR: NA REMODEL & REPAIR FIRE DAMAGE 02.,/--- Z-30-, CDF BUTTE COUNTY FIRE INCIDENT LOG DATE 11/03/2000 + INCIDENT NUMBER r 12317 LOGGED BY SJD REPORT TIME 21:54 LOCAL FIRE NUMBERffII24 ast �'ra� Ftm ; RO GARBER STATE FIRE NUMBER i aat cmta cya nrrrureBICASE NUMBERacf(aisns MEDICS LOCATION 405 WEST EN NIS REIMER RD - �. PRA Y10 ECC ❑ RP RAY PHONE NUMBER 8465090 I REPORT,METHOD 911 WILDLAND FIRES ❑ ESTIMATED ACRES OJ FIRE INFORMATION STRUCTURE FIRE RESIDENTIAL I FIRE INFO SENT HOW EMAIL BY SJD TO 74 OTHER FIRE I 7-DAY LOGGED © INITIALS MAA MEDICAL AIDS INCIDENT NAME EVANS PSA/OTHER START DATE 11/03/2000) START TIME r 21:45 HAZ MAT I DIAMOND # 5.0 t COMMENTS CAUSE ELECTRICAL POWER ATTIC LAND USE DOMESTIC FIRE ACRES r 00 'TYPE OF ACRES DIAMOND 5 ONLY $ DAMAGE TYPE ALL OTHER DOLLAR DAMAGE r SAVE 150000.00+ INJURIES/FATALITIES ❑ # CIVILIAN INJURIES 01 # CIVILIAN FATALITIES0� EMD ❑ OES ❑ # FF INJURIES 0 # FF FATALITIES 0 FC-40 INFORMATION ♦` _♦ New Incident J FC-4'0 ❑ _ DATE OF FC-46 INC AGENCY INC # INC P# FC-40 COMP DATE I FC-40 COMP BY M I County. Notifications EARS Hard Copy Recieved ❑ EARS Checked Agenst EARS Computer ��---❑----�� y 1 .r .. . r r.5• � S r � Vis• �0s•�- q�n••wr+c.F►+.•Saklr�"^y`C•r`f'r' ••'*r.•.i .. ,�.'L,r+_+��'y^.`Cryr.-.�;,��v=w-•�...camw'r+•ieis-.cv;,'.'t^�•-+4"•...e..yr.r-..— u. e. . i 021-230-064 "'PERMIT#98-1193 KHAN, Asmar Ahmad l r` '405 West Evans Reimer Rd:, Gridley Cont- Twim City Electric Ele Ser Ch/SF • •OFFICE COPY Address - f �. GAS e Meter By `ELECTRIC p% .Meter By 4e , 4 ;' Ia 7 1 I ;COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION •� it - ' 7 County Center Drive - Orovdle, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT qq- I l ASSES$,Oj,�Pf1RCMBFi" t1t�i 20NIN0 BUILDING PERMIT OWNER ASW ATRW KHAN TELEPHONE 846-4206 SO. FT. OCC. BUILDING VALUATION OWNER'S MAIuNG ADDRESS 405 W. EVANS REIMER RD., GRIDLEY CA 95948 CONTRACTOR'S NAME TELEPHONE TWIN CITY ELECTRIC LIC. #64468 CONTRACTOR'S MAILING ADDRESS 1749 BAY CT., YUBA CM CA 95993 CONSTRUCTION LENDER NONE LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER NONE LICENSE NO. -FilingFee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS ` 405 W EVANS REIN RD I:Y Energy Plan Checking Fee $ r� $ PERMIT FEE $ LOT NO. SUBDNISION'SN1ME e• PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Muplex ❑ 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 OXInstallation ❑ Other ❑ Describe Work: ELECTRIC SERVICE CH&NGE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W ' 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service A OR LESS 23.00 Z3.00 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.b 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. 10 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 To 46.00 WEE200A CCU000A NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. BUDS.3.50; NON-.ESN.T M�uLTI-OUTLET @7,50 PSINGLE OUTLET CIR.OWER APPARATUS sc � Ex. Occup. OUTLET ORFocruREs sAl 50 Ex. Occup. DuxxLEErs p SESE ID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 1 PERMIT FEE $ 66.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declaration ❑ 1 have and will maintain a certificate of consent to self -insure or workers' compensation, as provided for by section 3700 of the Labor , tde, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as r quired by Section 3700 of the Labor Code, for the performance of work�f6r which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if theFdrmit is for work of a valuation (The of one hundred dollars ($100) or less.) D 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agfee that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X : - �`"'! v Date �� ySi 'nature of Applicant - ❑ Owner ❑ Contraptor ❑ Agent An OSHA permit is required for excavations over' ' dee and demolition or construction of structures over 3 stories in height. ''1� Mobile Home Installation Fee 77$— Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 66.00 HAZ. D. FEES IMP I FLOOD =M I HO ISS 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. 01 BY Date `44-1 1 PERMIT EXPIRES'ON � %11T'T (Da to) Receipt No. '. ' WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT cCOUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DI ION r 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538- 41 PERMIT NO. (RevJ2/96) APPLICATION AND PERMIT �g ^ 1 1 1? 3 ASSESSOR popCf�LI�MgER64 2Y11_ LL �Uf 7UV1 ZONING 40 B LDING PERMIT OWNER ASMAR AHMAD KHAN TELEPHONE 846-4206 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS 405 W. EVANS REIMER RD., GRIDLEY CA 95948 CONTRACTOR'S NAME TELEPHONE TWIN CITY ELECTRIC LIC. #64468 CONTRACTOR'S MAILING ADDRESS 1749 BAY CT., YUBA CITY CA 95993 CONSTRUCTION LENDER NONE [Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEERLICENSE NONE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 4 W V I I EY Energy Plan Checking Fee $ $ PERMIT FEE i LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF EXXDuplex ❑ 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 1XXInstallation ❑ Other ❑ Describe Work: ELECTRIC SERVICE CHANGE Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 LE Main Service '..A OR ss 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. 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. J9 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 ADONS. ( 8 ACC. BLDS. SO 3.5¢FT. NON-RESID. ANC1 CI'CUT @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. OCCu OUTLET OR FDRURES 20 @ 1.00 BAL @ .50 Ex. Occup. ouiLEEDTs REBID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirinci 23.00 PRE—INSP A 23.00 PERMIT FEE $ 66.00 00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 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 Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ 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.) 19 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X �© ��/ Date 16 �l/ ' -/ n S' nature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 66.00 HAZ. 0. FEES IMP I FLOOD I CDF PARCEL PD HD ISS This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. ate l / ate Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT -"COUNTY OF BUTTE DEPARTMENT OF DEVE �MENT SERVICES - BUILDIN IVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFO 95965 - TELEPHONE (916) 53. 1541 PERMIT APPLICATIONI)ATA SHEET `,, I (Da(-a3o-(P`s I OWNER: 1' G V1 ASSESSOR PARC ER: Proposed Building Use: Building Inspector. Date: At time of permit application, I was advisell the following data must be submitted prior to permit processing and/or issuance: Date Received By All items have been submitted.------------------------------------------------------------------------------------- r 1! ❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. 114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- ❑ 6. Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ----------------------------------------------- ❑ 8. Hazardous Material Form.--------------------------------------------------------------------------------- ,-09-Manufactured o /me data and installation instructions including Tie Down Specifications.--------- . Fees of $ 1p 02) ---------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule.------------------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees. Ell 3 . Flood elevation certificate. ------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ------------------- ❑ 15. City of Chico plumbing permit. ----------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: Ell 8. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑J 9. Encroachment Permit for Riveway (construction approval prior to occupancy).---------------------------%�- Pre -inspection for AI A-1 required. Request to Building Inspector on L/L �� (Date) ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 0 22. -----------------------------------❑22. Workers' Compensation carrier and policy number. ----------------------------------------------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- ❑ 24. Letter of signature authorization.-------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ❑26. Letter of intent on building use. ---------------------------------- 027. Manufactured Home utility clearance. -------------------------- 1128. ------------------------- ❑28. Existing violations and/or expired permits. --------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ ❑ 3 0. Other: Wh you issue Dthe ' /permit, rocess as follows ❑Mail to owner, ❑Mail to contractor. l�►Telephone 0 7 a r c�� and hold for pickup at Dr 0 A_ off5p. ❑ Deliver with inspector. Applicant: Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Polluti n Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER y-� V :��N,a(//�� J/' BUILDING PERMIT OWNERTEIEP s 6 NE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING APORESS co CTOR•S NAME _ /! TELEPrNE RACTOR'S ADDRES �i� C l/� CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation S ARCHITECT OR ENGINEER LICENSE NO. Filina Fee Z 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ SUILOLNGAODRESs qcis bJ bams Uw",o Energy Plan Checking Fee 5 - ? Q `E PERMIT FEE i LOT NO. SUBDNISIONSNAME PARL MAP PLUMBING PERMIT Fling Fee 20:00 USEOFSTRUCTURE SF ) Duplex ❑ Mobilehome ❑ Other svEciFv 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 ❑ Re mod ❑ Utirlties ❑ Installa' ❑ Other Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home 181 GI W (920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 800V ORESOMain Service ao.AOR LESS 23.00 , LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 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 Main Service zooA TO I000A 46.00 NEW CONST, OWEWNG OCCUP. OR ADONS. ( a Ate, sLDs. SO 3.52FT. NON•REOSID. MULTMOUTLET 97,50 POWER APPARATUS a SINGLE OUTLET CI Ex. Occup. ovr ET OR FIXTURESSAL® "o .50 Ex. Occup. .,E' R=.°EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 )O 3 PERMIT FEE MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEN= S Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers'.DFEES laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60' deep and demolition or construction of structures over 3 stories in height Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE $ ETOTALL�EE cDF PARCEL Po Ho ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date 0816) [ReceiptNo. WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER: LOCATION: CONTRACTOR: qWLv--------------------- PRE-INSPECTSON DATE /o 1 �6� A. P. #_g2 � � - ZONING °- Ll 0 PRE -INSPECTION FOR: ae-&- -,P- DATE TO INSPECTOR e PERMIT HISTORY: NONE al-lAS FOLLOWS: TYPE OF OCCUPANCY BUILDING USAGE: TENN T: CUPIED F-] HEATED -COOLED OTHER COMMENTS: FIELD - INFORMATION HAS ELEC IC 4S GAS UHAS SANITATION 'FACILITIES )N CONTACTED A ON RECOMMENDED: s ISSUE [_] HOLD FOR OTHER: III w, r. . C. MCKEE- corner of Des' & Evans Rei—M4 . D�! ?j►3� �� ^idley ' 17� jrmit# 690-75B(reroof) _ �A-1 -- 21-2 -64 _-- ?an Ahmad Khan pI ;IS Evans Reimer Rd. inter'sli J )emup Ave., Gridle :ontr: Quist Const., Gridley 'ermit #3666-80B,P(repair bath interio i.afit—.shower & layy-/_SF) _ 021-23-0-064 93-1894 P,E ASRAR 03 W NS REIMER, GRID�,�y HU AG WORKER MMS 1 _ EC S MPACTION TEST REQ PPORT STRUCT REQ (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER _ �30 ` zoN,No BUILDING PERMIT ' OWNER - As L— � TE Ne $aD SO. FT. OCC. BUILDING VALUATION OWNER'S MAIUNO Aj}ORESs .lJt LT r �TELEIr =R NAMENe TOR ADORES //�'� r CONSTRUCTION LENDER LENDER'S MNUNO ADDRESS Fire lace Total Valuation $ ARCHRECT OR ENOINEEA LICENSE NO. Filing Fee S 20.00 ARCHTECT OR ENGINEERS MAUNO ADDRESS Permit Fee E Plan Checking Fee $ SULOwo ADDRESSC J J Energy Plan Checking Fee S -. `e s PERMIT FEE S LOT NO. steONNBIONS NAME PARCiEL MAP PLUMBING PERMIT Fling Fee 20:00 USEOFSTRUCTURE SF )J Duplex ❑ Mobilehome O Other sPEc�v 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 O Remod O Utilities ❑ InstallaO Other Describe Work: L \ Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI G1 W1 020.00 PERMIT FEE S ELECTRICAL PERMIT Filing Feel 20.00 Main Service zooA oa LLESs 23.00 a3. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: O 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 O 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: 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 is issued. O 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 6 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' laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60• deep and demolition or construction of structures over 3 stories in height Main Service 200A TO 1000" 48.00 NEW CONST. OWEILMXi OCCUP. SO OR ADONS. a ACC. BLOB. 3.50FT. aweT N ON.R OES4ID ' M QOUT ET Q7,50 PS0 APPARATu9 6 SWOIE OUILET G0. Ex. Occup. OUTLET OR FIXTURES 800'.000 Ex. Occup. LmETs"PPE,DES .I EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 _ 3. PERMIT FEE MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 8.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee S occ CONST. TYPE TOTAL FEE $ MAL D FEES ,MP FLOOo eoF vARCEL PD NO ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. Receip—Tc-n .0V �.rr. Inter-Depart ; e emorandum To 14 Auditor ;. FROM: _ Development Services, Building Division ..SUBJECT: Errors on Refunds for Sheriff Development Fees t .. a ..DATE a . }z .'..ks 9 `l 7}c } 'F •r' 71, Z r ! fi�� 5/24/95 - ,..� Y 4M�i ~T1 L .i #'y.,1. Jtl 'n�'Y' �. y`Y �';•i 1, r 1 ^.4- } +:r + � £, � � � iy � ,,.� `J'•ya. � F �• �-� Y'; .?3�,L;p s�.Z 7^��:+ � � . N� 7 ^w� -moi �' � j't.,,; ` � k...`, •ria.- '�:. _ _ x .'_ '.S 'f '7.s' 1'` .:A 1 i ..J_••+�I'r+',,.•�r"Ir- .{ The following refunds for Sheriff Deveiopmentifees were processed...* The general f ti-�•% `� w* 'claim forms were: processed*showing Exp:,Cod #4210500 (they:, should hav shown 1011811). Please transfer $360.00 for each transaction'from 1011811to 4210500. >y ..Y ..-- 3 - ♦ .. t ...w.•:V.F .JI I r,F�w-l.i -.#!- '°.{'+r^.f. S`= w�4 �}t �y,, `. .+•w l`� s r�- �j,'••.. fit .M d M�ry �`a i• •-�. •- �t • •�il�lT +.�'S{ � ; h r�{ '^y: '^ .. .. 1 • r � 9.. � k �'•♦ .` ✓w*' I T' '!,- 'Lt i+.1 � sC .�j� 1 i..I s s 1 '� -{. ,f!' s- .� t r -�}K ai'i • i..ht_.+ ...C'. ...y Y4; NAME . DATE ;sA P. # ` , , =ur AMT'OF TRANSFER :..!ti.•f . --5;i,S13., 9r .. # "��� •-r 4�„tse' +�•"k '+ 5`•` ,r �• 1 1.+=71 Asrar Khan _. ,'7/25%94 , �:� A P.#021-230 064, { E t w (Total refund involved only sheriff fees):'r' Judith Pape nburg 3/2/95 A.P.#062-500-090 $360.00 (Total refund involved building permit fees of $244.00 and sheriff fees'of $360.00) MICHAEL C. VIEIRA, C.B.O. Manager, Building Inspection eount* 4 J'Bufte OROVILLE, CALIFORNIA GENERAL CLAIM .. CLAIMANT: ASRAR KHAN ADDRESS: CITY 8 STATE: GRIDLEY, CA 95948 IMPORTANT: DATE OF CLAIM: 7/11194 SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY, TO AVOID DELAY) AMOUNT B.P.#93-1895, A.P.#021-230-064, RECEIPT#143344 DATED 6/17/94, OWNER: ASRAR KHAN SHERIFF'S FEES REFUND DUE.. ........ .........$360.00 ............... .. - ---- _ afar/4 /law y eo' Aud; for- 6" l k wk S re� rticc S i nco✓�rc�c-f- lv� �� ctl� o Ma; l +6k Y.0 - - TOTAL $360. 00 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Q ` /Piz Dated this r���.........dey of ll�'........... 19 1 et �]� IL1�.t,(I.......... Calif. .......... l ` .......... ........j ..... Signature of Claimant I, the undersigngd, hereby certify that, to the beat of my knowledge, the services or articlesecifted above ve been performed or de- livered and that there is a Budget Appropriation 0 or Specific Hoard Approval E] (Check one) fo a .3 Dated this 25TH de of .....JULY . 19 94at OROVILLE caur. ........... ...................... Y ................................... .. ............ ...... ..,.. ............................. department ead or Authorized Deputy coag 440-002 Exp'CONSTRUCTION PERMITS Code.:................4210500.............................. PAYABLE.FROM............................................................................................ FUND DO NOT WRITE BELOW THIS LINE — AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. I -V. eoutd* q J' u te- OROVILLE, CALIFORNIA GENERAL CLAIM ASRAR KHAN CLAIMANT: 405 EVANS REIMER RD ADDRESS: CITY & STATE: GLUEY, CA 95948 IMPORTANT: 6/8/9'4 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT OWNER HAS SOLD MOBILE HOME (B.P.#93-1894 & B..P.#93-1895, RECEIPT #143344, DATED 6/17/94, OWNER: ASRAR KHAN) TOTAL AMOUNT PAID 218.50 RETAIN REFUND PROCESSING FEE............................$25.00 RETAIN PLAN CHECK FEES (MHU)......... .......... $20.00- RETAIN PLUMBING PERMIT FILING FEES MHU ........ 15:00 RETAIN ELECTRIC PERMIT FILING FEES(MHU)........ $15.'00 RETAIN B.P. FILING FEES MHI 15.00 TOTAL AMOUNT TO BE RETAINED.. .$90.00 .......................... TOTAL AMOUNT TO BE REFUNDED ...................... $128.50 TOTAL $128 50 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been pe;formed or delivered, and that this claim is true and correct as stated. `. '' / �i �.�� '/I .'� j•f r' Dated this V.....71 ..(.. ` s.. day of 11_l_.i� Y� ..,..•. , 19 „I -; et �... k i�l' �1 ,•Calif. ,.,,_ ! ....... ....... .. �. ..................... ....................... .................................................... .......................... Signature of Cia ant I, the undersigned, hereby certify that, to the best of my knowledge, the services or ertq1e cpa v een crfortned or de- livered and that trh�erre is a Budget Appropriations or Specific Board Approvals (Checkor Dated this........5.111................... day or ..JUNE.............. 19...9.4at...DRl7.V.ILLE.... callf......................................................... d or Authorized Deputy Dept. Exp. Code 440,r002 .................. Code ...... 4a14��.....................PAYABLE FROM .. STRUCTI N. ... PERMITS ................... ............. FUND DO NOT WRITE BELOW THIS LINE — AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCU MB. GROSS AMT. i i ASRAR AHMAD KHAN 405 W. EVANS REIMER ROAD GRIDLEY, CA 95948 (916) 846-4206 TO: Butte County Department of Development Services Building Division RE: Refund of Permit Fee AP# 021-23-064 FROM: Asrar A, Khan I am writing'to ask for a refund for a Mobile Home Permi't,,, I have s-ld the mobile home, therefore I have no need for the permit that I filed for in June of 1993. I am sorry for any.inconv(e-ince that this may cause. I would appreciate it if the amount of $578.50 minus any filing fees be refunded to me as soon as possible. THANK YOU ASRAR A. KHAN J11� i IGS► Jk .COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. r 7 County Center Drive - Oroville; California 95965 - Telephone: 916.'538-7541 7/� (Z APPLICATION AND PERMIT l ASSESSOR PARCEL NUMBER 021-230-064 ZONING A40 BUILDING PERMIT OWNER ASRAR KHAN TELEPHONE 846-4206 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 405 EVANS REIMER RD., GRIDLEY CA 95948 CONTRACTOR'SNAME UNKNOIM TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is F i 1 i n Fee g $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 20.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 403 W. EVANS REIMER RD., GRIDLEY Permit fee $ 9 nn PLUMBING PERMIT FiIingFee 15.00 Each Trap 5.00 fl Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome'M Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JWJ 615.001 TYPE OF WORK New a Addition r_I Remodel ❑ Utilities ❑ InstallationF ther ❑ Describe work: MHU � T Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200ATO1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License .Jo. 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) 11 as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ADONS. ( AGC. BLDGS. 3.64sq.ft. NEW CONSTFL ULT' -OUTLET _NO ESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS 6 (SINGLE OUTLET CIR. UTLETS OR FIXTURES Ex. Occup( OFIXED A20 76d 20 APPLNS. Ex. Occup. OUTLETS (RE SID )KEA./ I 3.00 Temporary service j 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ - WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 1 15.00 Heating Cooling g Hood 6.50 Ventilation permlt Fee $ LContractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agains said County in co sequence of the granting of this permit. Date J" i r7 93 Signature of Applicant — Owner EZ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S ' Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 105.00 HAz DFEES IMP FLOOD CDF PARCEL PD HD ISSUE i This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 143344 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF;•DEVPLOPMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET OWNER ! >�Z �i i2- f< / I/`C A A. P. % –� 3 – 61 Cl Proposed Building Use �%/�i Z Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ....................................... . 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... A. Engineered plans and calcs, 3/4 sets, with wet signature on plans. 5. Hazardous Material Form . ............................................. 6. Energy Design Compliance and supporting documentation. 7. Statement of Intent for Non -Heated and A/C Buildings . ........:............ . 8 Engineered truss details and layout in duplicate (required prior to plan check). . 9.. Mobilehome data and manufacturer's installation instructions, 2 sets. .......... . 10. Fees of $ .......................................... 1~I -&,, fees as shown on attached schedule. .............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit ............................... 0 ......... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development. about ,* (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy). . . 20. Pre -inspection forP`Bu"�eGt1O" regUlred. . to Building Inspectect or (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . .............................. 0 ........ . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... Letter of intent on building use . ......................................... 28; Mobilehome utility clearance . .......................................... 29.. Documentation of legal access . ..................... :................. . 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation �L Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution ;Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (�j rcle new item n t checked above). 1. Index permit .for above items No. /T�/�j 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone —mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _,phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541 OWNER A.P. NO . �! -(:VC �C/ Z� PROPOSED BUILDING USE DATE REC. # DATE REC 1. School District Fees c C� (paid at District Office) Sheriff Fees (paid at Building Department) Residential .......... _x $ unit amt. Commercial(per sq.ft.) X =$ sq.ft. amt. 3. Urban Area Fees (paid at Building Department Residential (per unit) X _$ # units amt. Commerical(per sq.ft.) X 4 sq.ft. amt. 4. Recreation District Fees (paid at District Office) 5. Drainage District Fees (Contact Land Development) 6. Other 7. Other 1�f33H�F � 9 At time of permit application, I was advised the above fees are required to be paid prior to issuance of the,permit. APPLICANT DATE COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville., California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 021-230-064 ZONING A-40 BUILDING PERMIT OWNER Asrar Khan TELEPHONE 846-4206 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 405 Evans Reimer Rd., Gridley 95948 CONTRACTOR('SNAME TELEPHONE 1 CONTRACTOR'S M71ILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $.�� LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS I Penalty $ BUILDING ADDRESS Permit fee $ 20.00 PLUMBING PERMIT Filing Fee 15.00' 403 W. Evans Reimer Rd. GridleyEach Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF [:1Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK Newl' AdditionE] Remodel ❑ Utilities g Installation❑ Other ❑ Describe work: MHU (2 Bedroom) _ Permit Fee $ 45.UU Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service SS 200AORLESS 1 18.50 18.50 Main service 20( 5A IOOOA, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessPOWER and Professions Code and my license IS In full force and effect. License No. Classification ❑ 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUPM OR ACDNS. ACC. BLDGS. I _37.50 3.64sq.ft. NEW CONSTRULTI.OUT LET NON-RESID BRANCH CIRC ITS @ 5.00 APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 64 A. 70 1g)464 Ex. Occup. OUTLETS P(RESID )REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 1 15.00 15.00 Misc. 1Yirin g 15.00 Permit Fee $48.50 - 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 dof Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 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 Countyoi Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County i onsequence of the granting of this permit. n X Date Iq q3 Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA ion of structures tover 3gstories oin height ons over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Ener Inspection Fee $ Energy p OCC CONST TYPE I TOTAL FEE $113.50 I I IIAZ, DFEES I IMP f I FLOOD I CDF I PA;CPe I PD I HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date 143344 Receipt No. WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT I COUNTYOF BUTTE - DEPARTMENTOFDEVELOPMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET A iZ k.H X N W AD ti., Building Inspector a-__3 -a6 a At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: �+ DATE RECEIVED + BY All items hAe been submitted . ........................................ Plot plans, /4 sets, signed by preparer of plans. . 3, Complete plans, sets, signed by preparer of plans. ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ......................................... . . 6. Energy Design Corr pl ance and supporting documentation . .... ......... . 7. Statement of Intent for Non -Heated and A/C Buildings . ..................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........ :. . 10. Fees of $ 1 . ......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . Flood elevation letter (100 year flo d)� by C,gli ---H Engineer. m ............... . 4. Sanitation and plot plan approva 1''D0i //��Health Department.. ......... . 15. City of Chico plumbing permit . ......................................... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 1 Driveway permit (construction approval required prior to occupancy). . . Prea;spedion requ�— re -inspection for required. . to Btiid n9 Inspector (Date) 2f.. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23 Owner -Builder Verification (Given to owner Mail to owner . ......... . Zi24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired , permits ......................::::::::: : : : :Pheck list. ...................... :::: l When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for p4 ku at office. Deliver with inspector. Other Parcel Creation Acreage Applicant �Date r Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following' data must be submitted prior to permit iss 1. Index permit for above items No. 2. Additional items required: le new item not checked above). Contractor, designer, owner, was advised of above required data bey v phone _ mail Counter by,� Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Co ter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in M_ File cabinet AP folder Copy - Department of Public Works 3&71 A�- 1057.4 793.1 o o _ 69.00 AC. 48.041: AC za 105ift Ar 1T94.6 RS 120-2/ '40 20.00AC. Z Z � ... 19.22 A C. 7593.2 2- O "RA IVS Cm b. DO , RS 120- V 0 /0 jROAq 17 20" 5.00AC O 1057.4 793.1 o o _ 69.00 AC. 48.041: AC za 105ift Ar 1T94.6 RS 120-2/ '40 20.00AC. Z Z � ... 19.22 A C. 7593.2 2- O 464.8 lio 39.5 Ac Lc� R ------------ OA D 0.37AC 9 9 ,o .69 RSIOI-96. S-99 1-0 9.60AC 1326 Work, �jo #7-AfW IVS Cm b. 464.8 lio 39.5 Ac Lc� R ------------ OA D 0.37AC 9 9 ,o .69 RSIOI-96. S-99 1-0 9.60AC 1326 Work, �jo #7-AfW 7— sbou IqOTE. All Materials & workmansrAP 6 �jith ruecogT,.Lzed. Good. -Prt'0110ea t -cordanc cifte - ,c x1c) ape Use 0 it-, e d to qwanty Prescl� ding, P1111n:uing & use-or.aform CID LA -�j "�- EUZ �21 1-224 -------------- - 33 ON - kept on aka ati written] L of plans.and spectacatiom M76T bd ejob at all times and it is ullawfUl to changes or alterations or- same withLyat irmission, from.the Depaxt1n6nt of Pu= antjy of Butte. ALL STRUCT-UES AND EQUIPMENT INCLUDING OVERHANGS S ALL BE CLEAR OF ALL P-ASEMENT§-.- A SEI r FR&J' THE SIDE AND' g2 QEAS� PROPERTY LINES AND' ,!re) T -T. F8 M THE ROAD CENTERLINE SHAUL 6' CLEAR OF ST UCTURES AND EQUIPMENT EXCEL FOR A 2 -'FT. VE OVERHANG. OU I -V6 C U NTY : jUILONG DEPART INT a TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance miW Ws- fihyw\,Jh Ii.H. IIsi: OSI Hot Ilan Attached _ 1'la r flan At •ichor _ BUTTE COBU I of O OF j0%. 24 1993 as kl �vo-,,,r Owner Plan Approved for: Sewa-c Disposal Clearance for :?— bedroom' mobile home. Other a 14(-)I l final for Location 'vVatcr Supply Public Final clearance O.K. for: _ NOTE: 4 x I j % /19, e-G�— �V Environmental Health Specialist 8/92 AP# Private Well � Date AGRICULTURAL AFFIDAVIT EMPLOYER/EMPLOYEE Please read the following carefully before signing: Section 24-21.020 Agriculture Employer/Employee (Applicable only in zones A-5, A-110, A-15, A-20, A-40 and A-160) An individual who verified, by personal affidavit and by affidavit of his employer, that he is, or will be, employed at least thirty-two (32) hours per week for at least sixteen (16) weeks per year, or that his primary source of annual income is, or is anticipated to be, derived from any of the following described occupations: (a) The preparation, care and a treatment of farm land, pipelines or ditches, including leveling for agriculture purposes, plowing, discing and fertilizing the soil; (b) The sowing and planting of any agricultural or horticultural commodity; (c) The care of any agricultural or horticultural commodity. As used in this subdivision, "care" includes, but is not limited to, cultivation, irrigation, weed control, thinning, heating, pruning or tieing, fumigating, spraying and dusting; (d) The harvesting of any agricultural or horticultural commodity including, but not limited to, picking, cutting, threshing, field -packing and placing in field containers or in the vehicle in which the commodity will be hauled on the farm or to the place of first processing; (e) The assembly and storage of any agricultural or horticultural commodity including but not limited to, loading, roadsiding, banking, stacking, binning and piling; (f) The raising, feeding and management of livestock, fur -bearing animals, bees, fish, frogs and other aquatic animals, including but not limited to, herding, housing, hatching, milking, shearing, handling eggs and extracting honey; (g) The operation, conservation, improvement or maintenance of such farm and its tools and equipment. This affidavit is valid only for the named employee. Any change of employee requires a new affidavit to be filed. Employer tax records may be requested as proof of employment status. Signed: 4-�-o,4 kovw Dated: �U/� it AGRICULTURAL. AFFIDAVIT EMPLOYEE Employee Q /„�+ /` ,(� �) Phone 7�� — 850 Employee's Address (Present)�� 5/,4//9 9 1/G'. /A6��iS�/•11�' �iC� ,��' J'� Name of Property Owner Property Owner's Addressoj¢415 v Owner's Assessor's Parcel Number 02 -1 -2 -SO- 31o%0615 Parcel Size L48 Ac. I, 54 RAJA R A ) do declare, subject to the penalty of perjury, that I am the employee ofS address (present) &4 51,411 4Uc /1!)A����.1 L -,t' �� • and that I will be employee under Section 24-21.020 A P - for at least thirty-two (32) hours per (a) to (g) week for at least sixteen (16) weeks per year on AP# Signed: Dated: Environmental Health Approval: Permit Description and Number Date Issued 16 O% � ,r s� �► r By Planning Approval: Date Zone Q ® Dwelling on AP# Q 2.1- 2*S®-- O t 9 By� - Crop/Commodity Produced PGAGH E 5 9 PaZVAJ&5 PC --Si M o,NS v AGRICULTURAL AFFIDAVIT EMPLOYER Employer Ls &Y )�.w/1 Phone ND 4 -MI Q Employer's Address Name of Property Owner -�-s my &-k-C'n Property Owner's Address S-(a'u a's G -.V")- . Owner's Assessor's Parcel Number 0?L1-'Z`3Q-0(o9 06!� Parcel Size L/6 Ac. do declare, subject to the penalty of perjury, that I am the employer of address (present) A2 and that I will be �� L �j employer under Section 24-21.020 P6-7 - for at least thirty-twol��fidursper � (a) to (g) week for at least sixteen (16) weeks per year on AP# 544;� PPA�Z Signed: dy Dated: Environmental Health Approval: Q l Permit Description and Number Date Issued By Planning Approval: Date (o -/ 7 - `j Zone A - LJ 0 Dwelling on AP# 0 2) -- 213 0 - Q & V Lo Crop/Commodity Produced 1�GI=� G1��5 P2 UNG S �G251o�v r FL -OT PLAt, l �� o • - ' 1. Hovse i Z. ,PUMF Sr)ed +� 3, Vrv,p Shed}1"ti 4-- S1nop ? . � t J m }-22.4—pr !4 APPROVED Butte County EnvironmentalHealth 6- -2 y_ %�_ :. M Date i _-- --- Signature ---_ j s FLOUR PIAN MASTER. J F3ATN �R coO J � 6 F3DW ,5o ? ROVED Butte County - Wjv'ironmentai Health - LIVINCiROOM - Date - Fr. DOOR 'gmV ,_ _ Signature stove N � I � K1TC�E•1�1 � _ l' Y 1 t i RDER O—MBER fj0. f7 IYp. jev STAR!MO._ -XT5/// El e { FIRE NUMi FIRE NAME: 0. thru 1/80)FC-18 ` — — 2 ORIGIN LOCATION �...�. SEC. TOWNS H N RANGE �E MIL IRE 10 ROM •❑IN NATIONAL FORES FIRE DIST., !CITY A STREET NO., ,r JE,TC 3 INCIDENT TYPE IR ❑FALSE ALARM O 10 5 4A RESPONSIBILITY (AT ORIGIN) RE T. PROT• RESP.(•D.P.R°) �B STATUTORY Ref. ✓✓ STATE ZONE I - RESPONSIBILITY 10 ❑ WILDLAND BURNED OR THREATENED ©❑ SCHEDULE A D.P.R. ❑ STATE �❑ 0 ❑ UNPROTECTED _ DISTRICT 4G❑ OTHER AGENCY D.P.R. ❑CITY LOCAL ZONE 0 SCHEDULE A D.P.R. ❑COUNTY OTHER AGENCY D.P.R. (Uni orp FEDERAL ZONE FEDERAL except Military). KOTHE SCHEDULE A D.P. ERAL ❑MISCJOTHER( 0 •) A—, U Did not start 2 or 8, "OKING" pUIPMENT ❑ LIC31 TNING DEB 8 PLAY W/FIRE ❑ CAMPFIRE ❑ AR OTHER/MISC. 6 LAND US TS I 1 R ONLY) Did not start in 1 2 8 BOX FOREST INDUSTRY DOMESTIC [-]RECREATION ❑ RANCH -FARM ❑OTHER INDUSTRY-COMRCL. ❑ DUMP ❑WILDLAND ❑ ROAD ❑NON-WILDLAND ❑ UTILITY, RAILROAD ❑OTHER ❑ UTILITY, ELECTRIC DAMAGE (1 8 OR 8 ONLY)�'� ❑NO DAMAGE IN Nuoter eare tsio1 1 2 8/or 8 2 6 8 rTIMBER Voh/Owta b/ORsr,'sr.'>';•.'::> '? YOUNG GROWTH WILDLAND VEGETATION (Other than T8 Y0) AGRICULTURAL PROD (Other than TtiYG) DWELLINGS if _ a/OR CONTENTS OTHER STRUCTURES 8/OR CONTENTS VEHICLES 8 CONTENTS OTHER , o TOTAL ^y� `7 ... �..,. F... .1 ,j oiy��c Sy�p� �� 3 t/ = OX D =Not OK t r� Not Applicable G2F5i®�ia�ti�►� (Singsla acid Duplex) _.,nc�r !_.._. -- - o Not Ready )ate UNDERFLOOR (Plans) OK excepul's Date FRAMING Continued 1. Zoning requlrements-�etbacks-Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Sol Is-Steel-Elec. Grnd.-1 / /" Ftg. Depth 49. Ext. Doors -Ons 3' -Check Garage -3(d story, 2 exits •: 3. Fig., Garage; Solis -Steel- / /" Ftg. Depth 50. Stairs; Width-Headroom-Rise-•Run-Landing-FIre Protection 4. Ftg., Porches & Decks; Soils -Steal- / /" Ftg. Depth S. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Virapped-Slab 53. Stuc ash -Drip S -Fdn. s-Underfir. Access 7. Piers -Fireplace Fig. -Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test-Anchors-Regulator-Seryice Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 55. Shear Walls; Nailing -Bolts 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date :ard-81 Date Card -BI Date Card -BI Data Date Card -BI Date FINAL (Plans) OK except N's 58. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 59. Bedroom Exiting ;ard-BI Date Card -BI Date )ate PLUMBING (Permit) OK except N's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 19. Gas Pipe; Size & Anchors 61. Elec. Trim & Subpanel; Breaker Sizes --Labels 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Ga Cooking Clearance Card -BI Date Card -BI Date Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except N's 67. Garage Fire Door; Swin-Landing-Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Mach. Protection 70. Pitt Elec. & Meth. Equip. Listed for Location 21. Elec. Receptacles Spacing -Lights & Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 23. Romex Installed Close to Edge of Studs & C.J. , 71. Elec. Receptacles in Garage; (G-F.1.)-Romex Protec. 72. Insulation -Foam -Looked in Attic ❑Yes 73. Guard Rails & Deck Construction -Post Caps 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 24. Equip. Ground made up w/Mach. Fasteners -Bond Gas.& Water 25. 2 Appliance Circuits in Kitchen & Conductor Size 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑Yes ❑No 75. Following Instld.: Drive ❑ Yes ❑ No; Walks .❑ Yes :❑ No; Planters ❑Yes ' ❑No 76. Stucco; Brown -Finish 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 78. Vents Above Roof; Pibg.-Appliance-Fire 1. -Clearance to Opngs. 28. Service -Riser Conductors & Ground -Main Disconnect 29. Equip. Clearances; Panels-Motors-Mech. Equip. 30. Clothes Closet Light -Shower Light 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card t3-1 Date Card BI Date 81. Ventilation throughout House 82. Glass Protection 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged: Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 86. Energy Compliance Certificate -Other Certificates 0 ward B-1 Date Card -BI Date )ate MECHANICAL (Parmit) OK except N's ' 31. A.C. Ducts; Insulation & Support 32. Vent Fan; Exhaust above Insulation 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic ;ab -BI Date Card -BI Date Card -BI Date Card -BI Data Card -SI Date Card -BI Date ;ard-BI Date Card -BI Date Card -BI Date Card -BI Date )ate FRAMING(Plans) OK except N's Comments at Final: 36. Sills; Proper Material & Anchors ' 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in 'Valls (rat proof) 40. Fire Stops; Furred Cellings-Stairs-Chases-Tu5 _ 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps-Anchors-Connemes _ 43. Cing. Joist-Ritr. Ties -Purling -Roof Brac.-Truss-Sh_thng.-Ring. 44. Fireplace Ties or Type A Flue -Fireplace Throat ; 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles _ 48. Bdrm. Window3 or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrvmust be made each time vouvisit iohsiml Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) CK except Q's 1. Zoning Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—.Easements 2. Soils; Special MH Support—Sketch 2; Footings; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/O—Concrets 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs--Rails 4. Water; Location—Test—Easament Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connac.—Shthg.—Rfg -Bracing " 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosuras 8. Gas; Location—Test—ylrap: / /" l ft. / /" Nat. or/ /1 ft. / /"LPG S. Carports: Windows—Doors 7. Utility Clearance 7. Elec. Card -81 Date Card -BI Date Card -BI Date Card -BI Date Card -81 Date Card -81 Date Card -BI Data Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's Date POOLS (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Ater—Lining. 4. Elec.; Receptacles and Lighting; Distances—GFI 4. Electricity; MH Test—Crossovers—Breakers—Clearances 5. Drain; MH Test—Fall—Flex Connector S. Elec.; Pool Lighting; 15 volts—GFI S. Water; MH Test—Regulator—Connector 8. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/O to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater S. Gas and Electricity Tagged _ 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghrg. Boxes—Enclosures—Panelboards—Ins. to Main In Conduit 9. Exits: Insp.—Sketch _ 10. Cert. of Occupancy 9. Health Department Approval Card B -I Date Card -BI Datr Card -BI Date Card -BI Date Card B-1 Date Card -BI Dat( Card -81 Date Card -81 Date V COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 959E5 - Telephone 916/534-4541 APPLICATION A'NIJ PERMIT PERMIT NO62. ASS SSOR PARCEL N MBI -R I—Z�—(o r ZOy'1NG /-t "qj) BUILDING PE IT OWNER QJ /� I i G1A�/t'D J/_ 14 /4 f"t' TELEPHONE SO. FT. OCC. BUILD VALUATION 0 OWNER'S MAILING ADDRESS /- V "Q0 CONT CT;R'�fyQMECc �"••" /WO/vLEpF — CONTRSCTOR55'S y�1 q�ILING �pD`j//�_�P�J^(, CONSTRUCTION KEN� UNKNOWN N NK OWN LENDER'S MAILING'ADDRESS Fireplace Total Valuation $ Permit Fee $ SLA 00 ARCHITECT OR ENGINE LICENSE NO. Plan Checking Fee Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS • Permit fee $ $ 2-q-, 00 BUIL �AD y3$ L�C/� 5 '•V/ K /i/j � � % j S� PLUMBING PERMIT /.� Each Trap Repair drainage or vent piping Z)&C—y Water piping Filing Fee 3.00 2.00 2.00 . 00 LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ ❑ MobilehomeOther SPECIFY Building sewer Lawn sprinkler system 2.00 ' TYPE OF WORK New ❑ Addition ❑ ReemodeI ❑ U ' ities Installation 0Other Describe work: �� Permit Fee $ e0($ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 1000 AMP ORV OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC• BLDGS. 20sgft CONTRACTORS LICENSE LAW I decVIunder penalty of perjury (check one): am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full rce and effect. License No. �� ��r� Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. ULTI.OUTLET NON.R ESID BRANCH CIRC ITS 2,50 ea NEW CONSTFL ( POWER APPARATUS &1 NON-RESID. SINGLE OUTLET CIR. Ex. Occu / SO@� P\o XEDTS OR FIXTURES BAL@10¢ FIXED Ex. Occup.(OUT ETS P(RESID,)REA./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): �❑ The permit is for $100.00 (valuation) or less. LJ 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. MECHANICAL PERMIT Filing Fee 3.00 Heating Cooling Hood 2.00 Ventilation Permit Fee $ Contractor 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 authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also acuee to save, indemnify and k p harmless the County of Butte against all Iia ' ies, jud ent sts xpens s which may in any way accrue agains id Coun in op e u c o f e gr nting of this permit. X G/ D Signature of Applicant — Owner Contractor ❑i�Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct-D ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEEco 30, OCCUP. GROUP TYPE OF CONST. PARCEL PD I ND I ISSUE This ermit is hereby issued under si s f the Butte County Code and/or for which WrkndieLECTIOR OF PUBLIC PERMIT EXPIRES Date the applicable proVi- resolutions to do fees have been paid. WORKS DaO ae Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT M ' 'c€sc PERMIT NO. 690-75B P a E M ., )MH UTIL. PERMIT NO. -r PERMIT EXPIRES 3--,7-76 " `DOWNER L. C. McKee / #CON TR. iLOCATION (A.P. 21-23-19 sSE corner of Dewsnup Rd., & Evans Reimer Rd., Gridley. c } Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED a (Date) (Signature) COUNTY OF BUTTE — DEPARTME.NT`OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback % Firewall Soil Piping Forms. Parapets 1st loor Main Bldg. Restroom Finish 2nd loor Footings Windows 3rd F or Stemwall Sidinci To out Slab Roof Sheathin Water Pii Piers Roofing `, Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & est Temp. Gas Slab Final /, Sanitation Patio FIREPLACA Final Footings Footing LECTRICAL Masonry Walls Throat A Rough Reinf. Steel Final Fixtures % Bond Beam FIRES R KLERS Motors i Frami ng Test Water Htr. Stucco Final Subpanels Mesh ME H ICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS 1 �� V COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR 7 County Center Drive ;19.OrNiIIe, California 95965 O — Tel ephone: 534-4541 APPLICATION AND PERMIT auuwn ze represenTaT ryes ui the Guuniy aT Buiie to enter upon the above-mentioned property for inspection purposes. X Dat Signature of; ermi a or Agen Receipt No. 11.2- 9 Af9 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. �1 DIRECTOR OF P LIC WORKS BY IV Dateildin_ g permit expires Date ........................ .. BUIL NG Owner e SQ. FT. OCC. BUILDING ALUATION CIO Mailing Address G • ('. / C14 l C0 Telephone No. 64-57 _12 Fireplace Contractor ® Total Valuation Mailing Address Permit Fee b Plan Checking Fee&/or Penalty Telephone No. Permit Fee $ D Building Address te C©%�E 0T PLUMBING No. @ FEE PERMIT FILING FEE $2.00 Each Trap 1.50 K 7 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 e-� A. P. No. pC �-� L Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 s . S&"ke+rorr Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma p 60' R/W Im rovements P Lawn sprinkler system 2.00 c'd Parcel A Plans Approval Permit Fee - $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER,N ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 r-- RoPr" WITH FlG,=4k.s5 S144k�F_ Main service incl. 1 meter o irk 5/yAkle L' Additional meters, each 1.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven 1.00 ( P/�br..t Water Heater or Space Heater 1.00 Light fixturesbal�iio G' Receps., switches & fix outlets b20 P 25 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole �. 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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. 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 MECHANICAL No. @ FEEPERMIT FILING FEE $3.00 Heating Cooling , Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE $ ©� auuwn ze represenTaT ryes ui the Guuniy aT Buiie to enter upon the above-mentioned property for inspection purposes. X Dat Signature of; ermi a or Agen Receipt No. 11.2- 9 Af9 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. �1 DIRECTOR OF P LIC WORKS BY IV Dateildin_ g permit expires Date ........................ .. COUNTY OF BUTTE - DEPA \=NT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Califo la 965 - Telephone: 916.'538-7541 _ APPLICATION A ERMIT ASSESSOR PARCEL NUMBER - ZONING BUILDING PERMIT - 021-230-064 A-40 WNER TELEPHONE SO. FT. OCC. BUILDING VALUATION O Asrar Khan 846-4206 ER'S MAILING ADDRESS 405 Evans Reimer Rd., Gridley 95948 CONTRACTOR'S/NAME TELEPHONE 'A M _ .�! CONSTRUCTION LEND LENDER'S MAILING A RC HITECT OR ENGINEER'S MAILING ADDRESS DING ADDRESS NO. SUBDIVISION NAME UNKNOWN N ARCEL MAP USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY TYPE OF WORK New AdditionLJ Remodel ❑ Utilities g InstallationC Other ❑ Describe work: WU (2 Bedroom) Fireplace Total Valuation $ Filing Fee _ Permit Fee Plan Checking Fee Energy Plan Checking Fee Permit fee PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping Each qas water heater or vent Gas piping system 1 - 5 outlets Building sewer Mob le Home I S 1 G 1 W Permit Fee Contractor ELECTRICAL PERMIT Main service 10.0VORLEOR SS 200A LESS Main service 20GATO1000A1' u The permit Is for $1 . (va u ion I have placed on file with the County of Butte Building Department CONTRACTORS LICENSE LAW NEw coNST. I DWELLING OCCUP.6\ T. OR ACC. SLOGS. II declare under penalty of perjury (check one): WA NEW CONST R. ULT I.OUTLET NON.RESID BRANCH CIRCUITS) ❑ I am licensed under provisions of Chapt. 9. Div. 3 of the Business SINGLE OUTLET APPARATUSh) Notice to Applicant: If after making this statement, should you become subject and Professions Code and my license is in full force and effect. Ex. Occup( OUTLETS OR FIXTURES Contractor License No. Classification FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA. El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure Is not intended or offered Temporary service for sale. (Sec. 7044) Mobile Home Facilities I, as the owner, am exclusively contracting with licensed contract-. Misc. Wiring ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code Permit Fee for this reason — Contractor WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT I declare under penalty of perjury (check one): 00 00 I at' ) or less Heating u The permit Is for $1 . (va u ion I have placed on file with the County of Butte Building Department ❑ a Certificate of Workmen's Compensation Insurance or a Certificate Cooling of Consent to Self -Insure. ,/of I shall not employ any person in any manner so as to become subject Hood to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you become subject Permit Fee to the W. C. provisions of the Labor Code, you must forthwith comply with such Contractor provisions or this permit shall be deemed revoked. $ S $ $ Fi I i ng Fee $ 40.UU Fi ling Fee 1 18.50 37.50 3.64 sq.tt. @ 5.00 20 761 13.00 15.00 1 15.00 15.00 $48.50 15.00 Filim Fee 1 15.00 $ 6.50 I certify that I have read this application and state that the above information Mobile Home Installation Fee S is correct. I agree to comply to all County Ordinances and State Laws relating Ener Inspection Fee $ to building construction, and hereby authorize representatives of the County of Energy p Butte to enter upon the above-mentioned property for inspection purposes. occ coNs""' TOTAL FEE $113.50 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue HAZ. DFEES IMP FLOOD CDF PARC PD HD ISSUE against said County i consequence of the granting of this permit. i� n�j � /X Date T vI` This permit is hereby issued under the applicable provi Bions of the Butte County Code and/or resolutions to do Signature of Applicant — Owner Contractor ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA u mit is Srequired height. over 5'0" deep and demolition or construct- DIRECTOR OF PUBLIC WORKS ion of 1 3 BY Date Receipt No. PERMIT EXPIRES Date .....�._.. .0 vrn....•a.►..no PIN11-INSPECTOR. GOLDENROD -APPLICANT v NOTE: All Materials &Woramansr p ed Good 2— nictic:�= 'Ar Accordance with Recog� � F ��r�.'r � " = �- --• . Accordance Prescribed for tr_e SJPE�'iEed -1`'e _ - of a Quali ti� the Uniform. Building, i%unbing .. I in e ;`5� 60 Thie; het of plates and specifications MUST be �( l mntslma'wlui toleano the job at altimes ad changes or ltera;.�ons On same without k 12-Awrit permission from, she Department of 1 -0 Works Crn FT. FROManty of Butte. ING tNCWD f:- ALL STRl1CTUH LL BE CLEAR O LASAND EQUIPMENT EIIRENTs: OVERHANGS S . A S� Rp.C,,ifr..I• a�L TI -9E SIDE ANG' 60 aZ5 Fi'.. -T'ic REAM PROPERTY LINES ANb FT. FROP THE ROAD CENTERLINE SHALL SF N CLEAR OF STR CTURES AND EQUIPMENT EXC& ► . FOR A 2 FT. EAV OVERHANG. �� o 3� �v2i N 38.71. At. Ick .4 4v S.SOAC 1057.4 O 69.00 AC. 120 793. 0 48.041. AC. MAE 1059.5 1 794.6 �/7 JqSJ20-2 20.00AC. RS 120- V /0 /88 yC 19.22 A C. IL a jROA-q o O 17 ZS 5.00AC 10 O S.SOAC 1057.4 O 69.00 AC. 120 793. 0 48.041. AC. 7-9J.Z jV84r, O �� hh iso ot -4 .8 [310 0 4000 .40d,,& 0.37AC RS 101-9626 . 4F = c . . I — — — — BUILDING DEP 4& APPRO MAE 1059.5 1 794.6 JqSJ20-2 20.00AC. /88 yC 19.22 A C. ZS 7-9J.Z jV84r, O �� hh iso ot -4 .8 [310 0 4000 .40d,,& 0.37AC RS 101-9626 . 4F = c . . I — — — — BUILDING DEP 4& APPRO IgQn: All Materials. & Workmanship Shall Be 1n Accordance with Recognized Good practices and use o f a ' . ality prescribed for the Spevi� sc in the Uniform Building. plumbing -*Nff U' I. J D • �wi 1 1 �1QLi5'� 4-. Stepp i= t F. Thie het of plans and specifications MUST be kept o' tha j ob at all times and it isunlawful ful to make changes or .alterations on same without' writtel permission from the DepartmeiXt Of.P101W Works County of Butte. ALL STRUCI Unt OVERHANC3S SHf A SET BACK CF Fr:. FRO . CL E�AR- OF STRL (e S ' AND EQUIPMENT INCLUDING LL BE CLEAN OF .ALL EASEMENTS FT. FROM THE SIDE AND THE. REAF", PROPER TY LINES ANO. THE ROAD CEN-iERL..INE.SHALL BF% ;TURES AND EQUIPMENT tXCEP V : OVERHANG. dv�lG D�pAR,�,�cNf 0v �0 M N a. 1037.4 10 2.11 a� t RS 1!O- 1 /O 0 �o a a� 40 lock IL it B(T) jROAq o 17 r /320 30 S ODAC O fid P� S. BOAC 793.1 67 48.04= AC. 1039.5 T94.6 464.8 330 RS 120-21 '40 Q . 20.00AC. 74 5 5 Y 19.22 A C. 39.JAC N -- -- --- - - - - - ?OA D ,,r 0.37AC PB OU I I L COUNTY 9.69 RS 101-96 26 dU ����3 APPR®V -- 2.11 � S a a� lock o- 1039.5 T94.6 464.8 330 RS 120-21 '40 Q . 20.00AC. 74 5 5 Y 19.22 A C. 39.JAC N -- -- --- - - - - - ?OA D ,,r 0.37AC PB OU I I L COUNTY 9.69 RS 101-96 26 dU ����3 APPR®V -- This 00t Ofplans and specifications MMT I kept On ths ob 4atl tijm - . . 'i jaind it is ul)jaw"w Make oh Wbd,��tiOns On same wil wiltten rmissio frem the Depaxtmellt of I Works, COunt$bf Butte, 3 NOTE: All Materials & Workmanship Shall B In Accordance with Recognized lGood Practices ' cl _a_ o a Quality Prescribed fopthle Speoifted use- 'irt the Uniform Bidlding, pj-exj-Oing & Mac _ a4 W4'. CAft P -rd the National Electrical . ALL. . STRUCTURES AND EOUIPMENT INCLUDING OVERHANGS SHALL BE CLEAR OF ALL tASEMENTS, A Si<7 8AQFT. FP 10.,M THE SIDE AND R -F PROPER—ly LINES ANEW M FROM THE ROAD GENTERLINE SHALL. Sr CLEAR OF STRUCTURES AND EQUIPMENT 'EXCE FOR A.2 FT. EAVE OVERHANG. C -A r" J- + :M �cc V ovN 0\4 P, 91 '0' '17 , . qOS 0 s— /— //-0) GG 0 k � a� /— //-0) GG J7 Ago cJ a! ti c� j _ 3 d � S h L �E SU'LD" ' ` DEP• `FIT M P ROV� } 6-i Ko.h f'ry'f, 9...0 /,A -c " �' r � n•E l �.r � �'.cL . r—rc�or J� C t i j 5 ?C n U o G � 1 o Ko.h f'ry'f, 9...0 /,A -c " �' r � n•E l �.r � �'.cL . r—rc�or J�