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021-260-045
�7 p RICHARD SIMMONS(r--t-k 1247 Losser Ave, Gridley Permit#356-81P,E(util, MH) ELEC GAS OMPACT ION-- TE-!TT'- R-EQ SUPPORT STRUCTURE REQ 21-26-45 new, psi le Permit #4§5-8243,P,EYM family) & 021-260'045 94,0102A,E`',`! SIMMONS, RICHARD-& LELA w 1239 LOSSER AVE.-,' GRIDLEY NEW DINING AREA/MH_:, /��/9y.• 021-260 045' PERMIT#96 t SIMMONS, "Ricl;aid,' 1239,Losser Ave.; Gr'idley- Furnace/SF T) 021-260-045 107 SIMMONS, RICHARD FINALE 1239 LOSSER AVE., GRID EY 45, RE-ROOF a Let � e 00-21-26045 078i? t' SIN1N10NS, RICHARD �',- , "w •; ' - s� • t 1239 WSSER AVE;; GRIDLEYj' RE-ROOF g', • I CC!_ i i t ' F 1 COUNTY ,OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 1 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 02-1078 ASSESSOfflad1 5 ZGNNG BUILDINGPERMIT OWNER RICHARD SIMMONS T96 4253 SQ. FT. OCC. BUILDING VALUATION OWNER'S MrfMER AVE, GRIDLEY 95948 CONTRACfE TELEPHONE CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ • ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGJF% WSSIER AYE# GRIDLU 1 3 Energy Plan Checking Fee $ $ PERMIT FEE $ • LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF A Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other$' Describe Work: REROOF W/CW _water Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A OR 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 I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 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 200A TO 1000A 46.00 NEW CONST. DWELLNIO OCCUP. OR ADDNS. ( a ACC. BLAS. SO 3.5,s NOrFREOSID.' MULTI -OUTLET 97,50 8 SINGLPOWER APPARATUS E OUTLET CIR. Ex. Occup. OUTLET SAL ° 1.00 FlXEDAPPLNS. OR Ex. Occup. ounETs RESID. Ew 5,00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FET= $ 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.) l 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 w'th those provisions. + , X �► 1.Date — 7i _ Signature of Applifanf - 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 4900 TOTAL FEE $ • HAZ. D. FEES IMP I FLOOD I CDF PARCEL PD I HD I IJUE This permit is hereby issued under of the Butte County Code and/or indicated abo ' for which fees have y PERMIT EXPIRES -01 15 the applicable provisions Resolutions to do work been paid. Date 1 .J pe/e Receipt No. • WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 02-1078 ASSESSOPdTJELw�,� R 045 ��JJ�I L ZONING BUILDING PERMIT OWNER RICHARD SIP�`'IONS D TE HONE 8�+6-4253 SO. FT. OCC. BUILDING VALUATION 2nF.Q 1900.00 '"" fI_nADDTSER AVE, GRIDLEY 95948 CONTRACjQMM I TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Fills Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1239 LOSSER AVE, GRIDLEY Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF & Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ OtherjE[ Describa Work: RFROOE W.1COMP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 500VR LE Main Service 200A OR 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.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. ❑ 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 46.00So WEE200A CCU000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. eLns. SO 3.5QFT; NpµRESID MULT' .OurLET @7,50 APPARATUS 8 SINGLE OUTLEr CIR. EX. OCCU OUTLET OR PICTURES 20 00 Bna .5 0 Ex. Occup. OUTLETS R=.) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating 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.) lid 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 w'th those provisions. X i Date "Z — Qy _kindicated Signature o Appli ant - 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 $ 49.00 HAZ. p. FEES IMP I FLOOD CDF PARCEL PD I HD I tSXJE This permit is hereby issued under of the Butte County Code and/or abo for which fees have RMIT EXPIRES the applicable provisions Resolutions to do work been paid. Date ' I - pate ReceiptNo. 353382 49.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER -BUILDER VERIFICATION Attention Property Owner: An `owner -builder" building permit has been applied for in your name and bearing your signaam. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing ' your building permit. No building permit will be issued until this verification is received. �I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES LW, NO 1 HAVE- HAVE NOT C3 signed an application for a building permit for the proposed vinotk. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO., 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAItiEE: ADDRESS: PHONE: CITY: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK —9/ SOCIAL SECURITY NUMBER: �;SJ/3 ' �� 'Sy DATE: S- % - 0 NOTE: This Owner -Builder Verification is required by Section 19831 and 19833 of the California Health and Safety Code. This verification must be eompkted and returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION Dear Properri Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible parry of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract„ you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors. then you may be an employer. ♦ If you are an emplover, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed conrractors.are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1030 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder. Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Ilt�vt rely, el C. Vi ICd, C.B.O. ger, Building Inspection NOTE: Tris Owner -Builder Information is required by Section 19810 of the California Health and Safety Code- OVER oda OVER 77 021:260-045 '''� PERMIT#96`1638 SIMMONS, Richard 1239.-Losser •,Ave. , Gridley`.'44. FurnaF'ce%St+,r.. ; . 1 - w _ 2OFFICE COPY Address'/ '':: 1 GAS ' `Meter By //` Date% • ELECTRIC - Meter By Date. 61 S ; 1 COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DMS N ' 7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538-7 ` PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 021-260-045 ZONING AS BUIL ING PERMIT OWNER RIGURD SIMMONS TELEPHONE 846-4253 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1239 LOSSER AVE GRDLY CONTRACTOR'S NAME OWER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER UCENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISIONSNAME PARCEL MAP Solar or heat pump Water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 5. Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: VM FMACE — Mobile Home I S I G W 1 920.00 PERMITFEE S 3`'5.00 Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main ServiceOOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO IoaoA ) 46.00 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. ❑ 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 NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BLDS. ) SO. 3.50 FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS (a SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES ) BZL 0 I.50 Ex. Occup. ( OUTELETS (RESID.OFRA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 g Heating 15.00 Cooling Hood 6.50 Ventilation PERMITFEE $ 35.00 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollarst($100) o{ less.), �] I certify that in the performance of the work foi'Which this permit is issued, I shall not employ any person in any the 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�L��' J�Q Date � Z_ Signature of Applica t Owner ❑ Contractor ❑ Agent An OSHA permit is rewired for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 70.00 HAZ. I D. FEES I IMP I FLOOD CDF PARCEL I PD I HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. � ) By Date 47, PERMITEXPIRESON , (Date) Receipt No. 202137 WHITE-D.D.S.-R.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING DIVISION , DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891=2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER PERMIT NO. r > A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. I you have any questions pertaining to this matter, or need additional explanation, please cont t this office immediately. 6A� 4r8V`iIX ! -'/ti a- r/ A OQ AY,0Va T - •a r. Y { r s_ :t Date —o Inspector REV 10/92 COUNTY OF BUTTE -DEPARTMENTOFDE�ELOPMENTSERVICES -BUILDING DIVI N 7 County Center Drive - Oroville, California 95965 - Telephone (916) 5 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 021-260-045 A5 ZONING BUIL ING PERMIT OWNER RICHARD SIMMONS TELEPHONE 846-4253 SQ. FT. OCC. BUILDING VALUATION OWNER'S "UNG ADDRESS 1239 LOSSER AVE GRDLY CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMITFEE S PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO.SUBDNISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: _ VENT FURNACE Mobile Home I S I G W 920.00 PERMITFEE g 35.00 Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main ServiceEODV OR LESS ( 200A OR LESS / 23.00 Main Service ( 200A TO 1000A ) 46.00 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: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NEW CONST. DWELLING OCCUP. OR ( 8 ACC. BLDS. ) SO. 3.52 N. CNS. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS (a SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES) BAL @ I.50 FIXED Ex. Occup. ( PLNS. OR OUTLETS (RESID.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 9 Heating 1.5.00 Cooling Hood 6.50 Ventilation PERMITFEE $ 35.00 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X ��� Date �f� _ Signat re of Ap is t - Owner ❑ Contractor ❑ Agent An OSHA permit is re uired for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE I TOTAL FEE $ 70.00 HA2. I D. FEES I IMP I FLOOD I CDF PARCEL I PD I HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for whi fees have By PERMITEXPIRESONHITE-D.D.S.-B.D. the applicable provisions Resolutions to do work been paid. (Date) rReceiptNo. 202137 CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary.delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES[ XJ NO[ ). 2. I HAVE(} —] HAYS NOT[ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY PH0NE: CONTRACTOR'S LICENSE NO. 4. I pian to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NMYIE: ADDRESS: CIZY: ADDRE CONTRACTOR'S LICENSE NO. PHO5. I will provide some of the work but I have contracted (hired) the following persons to provide'the work indicated: INA.NIE ADDRESS PH0�NE TYPE OF WORK SIGNED: PROPERTY OWNER: SOCIAL SECURITY NUMBER: 15k.7--44-S-Z) DATE: NOTE: This owner -Builder Verification is required by Section 19331 and 19332 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oro% lle, Ciilifornia 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO ASSESSOR PARCEL NUMBER ! _ -) /_ D ^ a�`'/�`^^ ZONING �5--- BUILDING PERMIT l!}'�s ,M D/✓``"S OWNER ., /��1 TELEPWNE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS /V/l/7L y �/f7 60zv- CONTRACTOR'S NAME ti / TELEPHONE CONTRACTORS MAULING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Fling Fee $ 20,00 LENDER'S MAILING ADDRESS - Permit Fee - $ ARCHITECT OR ENGINEER - - LICENSE NO. Plan Checking Fee. - $- Energy Plan Checking Fee $ ' ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS - PERMITFEE S ' PLUMBINGPERMIT Fling Fee 20.00 Each Trap - 7.00 LAT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ .Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 45:_1 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work, (/ Mobile Home S G W @20.00 PERMITFEE S Contractor ELECTRICAL PERMIT Filinq Fee 20.00 Main Serviceeoov OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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 Coltractors License Law for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation,. will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. NEW CONST. DWELLING OCCUR sO. OR ( a ACC. BLAS. ) 3.5¢ FT. CNS. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) a SINGLE OUTLET CIR. EX. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL Q .e0 Ex. Occup. (oFIXEEDrAPPLN o.OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT FilingFee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ Q 40 HAz. 1 o. FEES I IMP I FLOOD I CDF PARCEL PO HO KSSUE This permit is hereby issued under the of the Butte County Code and/or Resolutions indicated above for which fees have By PERMIT EXPIRES ON applicable provisions to do work been paid. Date (Date) Receipt No. WHITE -0.0. .- .D. CANARY -ASSES R PINK -INSPECTOR GOLDENROD"APPLICANT 1 V= OK O = Not OK N tReeaadyable MOBILE HOMES Date/Initlals MOBILE HOME UTILITIES (Plana) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Teat -Fall -C/O Concrete 4. Water; Location -Teat -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 8. Gas; Location -Teat -Wrap: / /'L"ft. / /"Nat. or/ /'L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date/Initials MOBILE HOME INSTALLATION (Plana) OK except #'a 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 Teat -Fell -Flex Connector 8. Water; MH Test -Regulator -Connector J. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy MISCELLANEOUS Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Grlders and/or Joista-Decking-Bracing-Stairs-Rails 4. Wood Awn.; Posts-Beams-Rftrs: Connectors Shthg -Rfg :Bracing S. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 8. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date/initials POOLS (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, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 8. 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-Panel boards- Ins. to Mein in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK O = Not OK - = Not Applicable = Not Ready Date/Initials UNDERFLOOR (Piens) OK except #'s RESIDENTIAL (Single & Duplex) �`!� "1✓2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth -� 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /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 -Anchor -Regulator -Service Test 12. Electric; Underground 13. lenums & Ducts; Clearance -Material -Support -Ins. 1 Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 8. Insul tion Date/Initials PLUMBING Permit OK except #'s 16. Water Htr.; Vent -Access- bustion Air -Baffle 17. Water Pipe; Test nchor-Nail Protection 18. D.W.V.; Te$ ttings & Anchor -Nail Protection 18. Shower Pan; Test, First Floor -Tub Access 20. Yist Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'s 22. ture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors . Size Boxes & No. of Conductors -Stapled 25. x Installed Close to Edge of Studs & C.J. 26, Equip. Ground made up w/Meth. Fastners-Bond Gas & Water _ ______27-.- -Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ge. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Mein Disconnect 31. Equip. Clearances Panels -Motors -Meth. Equip. CIo es Closet Light -Shower Light -Spa Light 33. oke Detector Date/Initials MECHANICAL Permit OK exceppk 34. A.C. Ducts Insulation,4.816pport 35. Vent Fan; Exh above insulation 36. Conde a Drain & Overflow; Size & Grade 37 rnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet -'38. Attic Access & Platform if Furnance in Attic s) OK except #'s Material & Anchors nd C/41._AaerrfFg Wells over Girders & Floor Nailing �3. fJrdSfoos: Furred Ceilings -Stairs -Chases -Tub ✓44. Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) G most Caps -Anchors -Connectors '�l6'CIng. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. _ es or Type A Flue -Fireplace Throat clearance Atize & Romex Protection -Draft Stop -Ins. Baffles 49 Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garaae-Fire Protection Framino roperty Line Firewall & Openings Le�52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits idth-Headroom-Rise-Run-Landing-Fire Protection on Roof Overhang -Attic Vents -Rafter Outrigi ailing Veneer lest -Drip Screed -Fd. Vents-Underflr. Access 57. Glazin -Glass Protection -Skylights -Plastic _: 5 ear Walls; Nailing -Bolts 59 sulation-Walls-Ceilings 60. Inf Itrat -We 1 ws Date/Initials' INAL Plans OK except #'s Steps -Door & Sidelight Protection -Landings 62. Smoke Detector s- liarance-Comb. Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection e room Exiting & Bat _fixtures & Tub Access -Spa lac. Trim & Subpanel; Breaker Sizes & Labels ce or ov , Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit. FjA,&-A_ppllance; Grnd: Air Gap -Cooking Clearance GW. Elec. PuUets & Receptacles at Kit. Counter arage-ire Door. Swing -Landing -Closer ,_73-A.C. Duct in Garage -Damper 7 r.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection 75W-Mech. Equip. Listed for Location 76�lea=SIeeeot9cles in Garage; (G.F.I.)-Romex Protection ,4;_';-_77. Insulation -Foam -Looked in Attic ❑ Yes uard Rails & Deck Construction -Post Caps ants & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 8 towing instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. rown-Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 8 s - Roof; Pibg.-Appliance-Fireplace: Clearance to Wings _ni�ngs __. 84 _W r onnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground i ation Throughout House Protection ____-88retTl`fbctions from Previous Inspections Test-Meters Tagged; Gas -Electric i9B.- r & Sewer Connected -C/O to Grade -HD Approval 81. Energy Compliance Certificate -Other Certificates Comments et Fl COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7V4 PERMIT NO. APPLICATION AND PERMIT 0 ASSESSOR PARCEL NUMBER 21— 26-45 ZONING BUILDING PERMIT OWNER RICHARD & LETA SIMMONS TELEPHONE 846-4253 SQ. FT. OCC. BUILDING VALUATION 180 9,720.00 7 OWNER'S MAILING ADDRESS 1239 TOSSER GRITHEY CA 9994R CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS NONE Permit Fee $ 117.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 76-05 Energy Plan Checking Fee $ 23.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE $ 236.05 1-2-39 LOSSER GRIDLEY 95948 PLUMBING PERMIT Filing Fee 1 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF4 Duplex O MobilehomeA Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition {Remodel El Utilities ❑ Installation Other Describe Work: 12 X 15 DINING ARFA PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 'OA OR LESS ) 23.00 200A OR LESS Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. Sr.-_ OR ADDNS. ( & ACC. BLDS. ) 3.50 FTNEW CONTRACTORS LICENSE LAW( I declare under penalty of perjury (check one) ❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 8 I, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BA20 @ 1.000 FIXED APPWS. OR Ex. Occu p' OUTLETS IRESID.) EA. ) 5.00 ( Temporary Service 23.00 .00 Mobile Home Facilitiest23 Misc. Wiring .00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code; you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S26-30 Contractor MECHANICAL PERMIT Filing Fee 20.00 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 Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes.>� I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. 1 X rDate L-1,7,, Sig t re of Appli Owner O ontractor ❑ Agent An OSHA permit ig 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 $ CVo BjF yrPE l/ TOTAL FE S 308.35 HAZ. I D. F S I IMP I FV I CDF I PARCEL I PD N 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. y WORK; DIRECTOR OF PUBLIC WORKS,Q B � Date 2v 6 / PERMIT EXPIRES ON j (Date) Receipt No. / �r5-48D WHITE-D.D.S.-S.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT l I`'`t'r'1t7✓Y �+-�'y�--r'^s,�.�-"1'y��k1(ti�!''��"`'�75,�.'l},I�y°`..�7+�s�.�.'y,"('ki}�y""•^-.v'►�+i"i-r•:'4S�7Y�n.�•-�,..Y,.-.�..... QOUNTYOF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER t 6 A/J2Cj 1 __^j S A. P. No. Z/ _ 2- 6 l Proposed Building Use .S/� i�✓i J� Building Inspector �'Ji.�.G.� Date y At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECENIED BY 1. All items have been submitted . ....................................... . 2. Plot plans, 3/4 sets, signed by preparer of plans. 3, Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans. ...... .... . 5. Hazardous Material Form . .............................................. 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ..................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). . . 9. Mobilehome data and manufacturer's installation instructions, 2 sets . ............ 0. Fees of $ . .................... . Impact fees as shown on attached schedule. .�!��� .'�^�!�J ............. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval, Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. -Contact Land Development.about (A) Improvements (B) Drainage. .......... . ,19. Driveway permit (construction approval required prior to occupancy). .. ..... F;1nepection requesi- 20. Pre -inspection for required. .. to Building inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . ............. . 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner . ........... 24. 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 . ..................... a .................. 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. r 32. Plan check list . ..................................................... 33: • 34. When yo issue the er it, process as follows: Mail to owner. Mail to contractor. /Telephone t5Y1 yZ 0 and hold for pickup at ©R .0LJ1 e office. Deliver with inspector. Other Parcel Creation 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 ( ' cle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date' Plans checked by Date Plans approved by 0(�)- Date 7' Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance USIi c,.l. / . HolPlanAttached ..Floor clic 1 flan Att chrd A t C x 2i-� '� " ? Owner Location AP// Plan Approved for: Sewa,e Disposaly Water Supply: Public Private Well Clearance for bedroom mobile home. Other �C S a 'As -J+— 0 -v• - Hold final for: Final clearance O.K. for: NOTE: Jo r, Environmental Health Specialist 8/92 /'" 7 1 - Date Insulation Certificate BUILDING OWNER: BUILDING LOCATION: Description of Installation ROOF Material Thickness (inches) N LING BUILDING PERMIT #: 0 / 0 Brand Name Thermal Resistance (R -Value) Baa or Blanket Type — /�or/y� Brand Name — I 1,04 Thickness (inches) Thermal Resistance (R -Value) _ Loose Fill Type Brand Name Contractor's minimum installed weight/ft lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) )�TERIOR WALL_ Material Brand Name (� Thickness (inches — 3 %2. Thermal Resistance (R -Value)' FLOORRAISED / /ame �Tbimc less inches), / / SLAB FLOOR Material Thickness (inches) Width (inches) FOUNDATION WALL Material Thickness (inches) Declaration Brand Name Thermal Resistance (R-Vaiue) Brand Name Thermal Resistance (R -Value) I hereby certifv that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. cnerai unEr"=tor (Buiider) iccnse Number t Signature and Title S ub-Cunaactor (Insulation installer) Signature and Title License Number Dace 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 =t Installation Certificate: Residential CF -6R BUILDING OWNER: BUILDING PERMIT #: BUILDING LOCATION: An installation certificate is required -to be posted at the building site prior to the issuance of the occupancy permit. This form may be used to meet these requirements. All appliance categories listed below are the actual equipment installed. Note that the efficiency and type of the appliance installed must be equivalent or better than the appliance specified on the Certificate of Compliance (CF -1R). This certificate (or its equivalent) shall be prepared and signed by the person(s) assuming overall responsibility for the appliance installation. 1, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment installed and that the equipment meets or -exceeds the requirements of the Appliance Efficiency Standards. In addition, I have verified that the equipment -is equivalent to or more efficient than the equipment specified on the Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for residential buildings. HVAC SYSTEMS Note: Hydronic boiler information is entered here. Other hydronic or combined hydronic equipment is listed under Water Heating Systems. Heating Equip. CEC Certffled Actual Distribution Duct or Heating Load Heating Type (furnace, Manuf. Make & Efflclency Type and Piping Before Over- Equipment, heat pump, etc.) Model Number (AFUE, etc.) Location R -Value Sizing (Btuh) Capacity (Btuh) `CEC Certified Cooling Equip. Compressor Unit Actual Distribution Duct or Type (air cond., Manuf. Make & Efficiency Type and Piping heat pump, etc.) Model Number (SEER) Location R -Value �A The building design heat loss and design heat gain rate have been determined using a method specified in Section 150(h) of the Energy Efficiency Standards, and are two of the criteria used for equipment sizing and selection. Signature Date WATER HEATING SYSTEMS HVAC Subontractor (Co. Name) or General Contractor or Owner Energy' External Water Heating CEC Carttf led Rated' Tank Factor or Tank System Type Manuf. Make & Input (kW Capacity Recovery Standby' Insulation (storage gas etc) Model Number or Btuh) (gallons) Efficiency Loss (%) R -Value For small gas storage (rated input 5 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input >75.000 Stwhr), list Rated Input, Recovery Efficiency and Standby Loss. For Instantaneous gas water heaters, list Rated Input and Recovery Efficiency. For Instantaneous electric water heaters, list Rated Input. FAUCETS & SHOWER HEADS All faucets and showerheads installed are listed in the Commission's Directory of Certified Faucets and Showerheads, pursuant to Title 24, Part 6. Subchapter 2, Section 111. Signature Date Plumbing Subcontractor (Co. Name) or General Contractor or Owner THIS CERTIFICATE MUST BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AINM A COPY SHALL BE POSTED WITHIN THE BUILDING. JANUARY 1993 BUTTE a-- BUTTE COUNTY SCHOOLS IMPACT FEE_CERTIFICATION FORM (One Form Per Building)' School District ��C/��% Building Department No. A.P. Number ��' Z� ' Jurisdiction 0 City �ounty Property Ownerl.G !�I/c12� ����''�'✓-r Property Location/Address �Z .J G. Subdivison Lot No. Residential Development 0 0 / Sq. Footage No. of Living MHI Addition (Group R) Units Commercial/Industrial 0 Sq. Footage New Addition (Including Exterior Roofed Areas) Buildi'n-jErDeDaftment Renresentative Date (Floor Plans reviewed by School`District Personnel) District Identification No. S 4- School District certifies that v,2Arte( 8( W M /iT)Q) (Applicant) (Street Address) , A t .. (City) �" (State) has complied with the requirements of Resolution No. representing square feet. School Paid by Check Number Bank Number Paid by Cash fst'da — .Z0\ (Phone Number) (Zip Code) by payment of $ i-i,a-9! Date Remarks: (2dd.LJV_6XJ _tz _L,60 • a—I'd i i +I If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this,project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeformmkf (4/92) ADDITIONS TO RESIDENTIAL BUILDINGS ENERGY SHEET PACKAGE COMPLIANCE Owner �/ r� r�D�S Climate Zone Permit # D/D� Floor Area JD The following data showing mandatory and required features shall be installed for additions to dwellings. Additions to dwellings include room additions, converting garages and patios to living areas, house moves that add footage and attic conversions, and any space that is existing non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. Climate Zones 11 and 16* Component <=100 sgft � — 91-499 500-999 >=1000 sgft- Ceiling R -19R=38~\ R-38 R-38 Ins. __- Wall Ins. R-13 R-13 R-13 R-19, 21 Floor Ins. R-13 tiR-19 R-19 R-19 Slab Edge NR NR, R-7 NR, R-7 NR, R-7 Ins. Glass (U) .75 75 .65, .60 .65, .60 Max. Glass 50 sq.ft. �16�7_+'N 16% + 16% Removed Removed Shading NR .667 .66 .66 Coeff(S&N) Shading NR �Z�; . 4.0 , .66 . 40 , .66 Coeff(W&E) ,- Thermal NR 5% Raised 5% Raised 5% Raised Mass 20% Slab 20% Slab 20% Slab Heat, Elect Not Allowed Not Allowed Not Allowed Not Allowed Resistance Heat, Gas AFUE 78% AFUE 78% AFUE 78% AFUE 78% Heat Pump HSPF 6.8 HSPF 6.8 HSPF 6.8 HSPF 6.8 Split Sys. Heat Pump HSPF 6.6 HSPF 6.6 HSPF 6.6 HSPF 6.6 Package Cooling - SEER 10.0 SEER 10.0 SEER 10.0 SEER 10.0 Split Sys. Cooling - SEER 9.7 SEER 9.7 SEER 9.7 SEER 9.7 Package Increased # Allowed w/ Allowed w/ Allowed w/ Allowed w/ of Wtr Htrs calculation calculation calculation calculation. * One entry/column = req both zones, 2nd entry = req zone 16. SPECIAL FEATURES/ REMARKS + LOOSE FILL INSULATION (Density) INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) DUCTS PER UNIFORM MECHANICAL CODE - Ch. 10 LIGHTING KITCHEN & BATH NOT LESS THAN 40 LUMENS/WATT DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. (Jan 93) SIGNATURE OF BUILDING DESIGNER OR APPLICANT i �l A , V) /APPROVED Butte County 'Wnvironmental Health to Ono, Da ----- ------ _S�anature ---- Date tmTtmqt*x Jp lhrTqu on PgqWgU',,-, ( Oft dew Rita IMiM dMMu "o 04 ly4mleTm ST bq,LSDR suo' w M reamwx mn ptm Sam VT LT mgh -a Li q,, u jf � i oiEp Ul -WS Pz-cffj'-,lSwj A4nwn?) w jo mcC, .-OWU Xr4TAI- OOW8pjOOOV Q& Q qViae4ex Hv:Rwx e,ql mm4 umsTummd txKIT�m. jo SaDuelra &M GXVUI .2 c -G -a -.q RV ,e qo;-aqq uo qde:q ...... ..... c - N 0 �1'� = - � a , Y ' ;��,._, - v` 1, i � .rF �t_ . 'A t 0 Mo� r�4 o' H. I 3 4" 12 GUSSET B GUSSET D 2-9 GUSSET A :112 12 GUSSET C 1 '::�5 1/2" GUSSET DIMENSIONS MAY 2 -8 *1 BE MODIFIED 'TO ACCOMODATE GUSSET E NAIL SPACING AND EDGE DISTANCE REQUIREMENTS L/3 l L/3 L = 30' MAXIMUM GUSSET NAILING IS 8d EACH SIDE OF EACH MEMBER OF JOINT, STAGGER TO PREVENT SPLIT71NG NO TES: 1. PROVIDE CONTINUOUS LATERAL BRACING AT BOTTOM CHOR IMTH 2X4 ® 6' O.C. OR BY RIGID CEILING 2. PROVIDE TOP CHORD BRACING KITH PURLINS @ 24" O.C. OR BY RIGID ROOF SHEATHING 3. ATTACH BRACES TO ADEQUATE SUPPORT AT ENDS 4. PROVIDE RIDGE BLOCKING BETWEEN TRUSSES 5. NAIL GUSSETS BEFORE GLUE SETS GUSSET NAILING SCHEDULE SCHEDULE •. SPAN A' B C D E 24'-0" 12 4 6 12 10 26'-0" 14 4 6 12 10 28'-0" 15 6 8 14 12 30'-0" 1 16 6 8 14 14 L/3 l L/3 L = 30' MAXIMUM GUSSET NAILING IS 8d EACH SIDE OF EACH MEMBER OF JOINT, STAGGER TO PREVENT SPLIT71NG NO TES: 1. PROVIDE CONTINUOUS LATERAL BRACING AT BOTTOM CHOR IMTH 2X4 ® 6' O.C. OR BY RIGID CEILING 2. PROVIDE TOP CHORD BRACING KITH PURLINS @ 24" O.C. OR BY RIGID ROOF SHEATHING 3. ATTACH BRACES TO ADEQUATE SUPPORT AT ENDS 4. PROVIDE RIDGE BLOCKING BETWEEN TRUSSES 5. NAIL GUSSETS BEFORE GLUE SETS L/3 I , W 'DESIGN• CRI TERIA � MEMBER SCHEDULE •. SPAN TOP CHORD BOTTOM CHORD WEBS 24'-0" 2 X 4 2 X 4 2 X 4 26'-0" 2 X 6 2 X 6 2 X 4 28'-0" 2 X 6 2 X 6 2 X 4 30'-0" 2 X 6 2 X 6 2 X 4 L/3 I , W 'DESIGN• CRI TERIA � Z � TOP AND BOTTOM CHORD SHALL BE DF#2 EXCEPT WEB MEMBERS MAY BE DF#2 OR HF#2 SPACING 24 O.C. j O SPECIFICATIONS: O • � W D 1. GUSSETS SHALL BE 1/2" C -C EXTERIOR PLYWOOD,'' GLUD. 2. NAILS SHALL BE ..l sm/IVI 8d COMMON, 2" O.C. M EDGE CLEARANCE J. GLUE SHALL CONFORM TO APA AF�' P 1a ON 1 4. TOP CHORD SHALL BE CON11NUOlU�"�0TTOM CHORPI MAY.: QBE SPLICED AS SHOWN AT GUSSET E' TC LL=20, PSF TC DL -"10 PSF p BC LL=fO 'PSF Z BC DL= 5 PSF j 4:12 MINIMUM PITCH m 6•.12 MAXIMUM PITCH Z � TOP AND BOTTOM CHORD SHALL BE DF#2 EXCEPT WEB MEMBERS MAY BE DF#2 OR HF#2 SPACING 24 O.C. j O SPECIFICATIONS: O • � W D 1. GUSSETS SHALL BE 1/2" C -C EXTERIOR PLYWOOD,'' GLUD. 2. NAILS SHALL BE ..l sm/IVI 8d COMMON, 2" O.C. M EDGE CLEARANCE J. GLUE SHALL CONFORM TO APA AF�' P 1a ON 1 4. TOP CHORD SHALL BE CON11NUOlU�"�0TTOM CHORPI MAY.: QBE SPLICED AS SHOWN AT GUSSET E' NOTES. 1. FOOTINGS TO BE EXCA VA TED INTO - UNDISTURBED SOIL TO DEP TN D 2. ANCHOR BOL TS SHALL BE PER UBC SEC. 2907 (f) J. STEAof HEIGHT OVER 32" REQUIRES REINFORCING (SEE STD 12.3) 4. SEE UBC SEC 2404 (f) 2 FOR CONCRETE BLOCK STEM WALL REDWOOD OR P. T. SILL 6" MIN 6" MIN [I' T �. FLOORS B D TW T ONE 12" 12" 6" .6" TWO 150 18" 8" 7" FLOORS REFERS ..TO NUMBER OF FLOORS PER UBC_ TABLE 29—A, FOOTNOTE J. T _ JOIST GIRDER 18" MIN 32" MAX (NOTE 3) 12" MIN WVinw/ B RAISED FLOOR FOOTING, AS D /' SLAB ON GRADE FOOTING TYPICAL RE�-IDENTIAL FOUNDATION DETAILS REV DA IF . , 2 SCALE J/4 DATE. 4/92 BUTTE COUNTY BUILDING DEPARTMENT DWG: STDFTGI TSTD 12.1 RESIDENTIAL PLAN CHECKING GUIDE 8/91 (S.F., DUPLEX & MISC. ONLY) �y Bldg. Permit # Ole OWNER (� A.P. # - Plan Checker _ GENERAL oning requirements: (sideyards and number of permitted living units). aluation. Plans signed by designer. Proper description of work on application. Existing violations on property. 6 Items on data sheet. (W.C., fees, Health, Developer Fees, License law, etc). �f! Recorded notice of violation. PLOT PLAN Complete parcel size and dimensions. Setbacks, sideyards, easements, etc. Other buildings or structures. Grading, fills, drainage. Flood hazard. Special conditions on creation map, ustible, and foundations). FAU & FAS road setback. (noise, CDF, fire sprinklers, non -comb- . Building or utilities across lot lines (Record form). FLOOR PLAN Complete to scale plan with dimensions. Required windows for light and ventilation (Sec. 1205). Required windows for second exit (Sec. 1204). Skylights (Chapter 34 & Sec. 5207). Human impact glass (Sec. 5406). Required room sizes, ceiling heights (Sec: 1207). GFCIs in baths, garage, kitchen, and exterior outlets (Article Light fixtures, switches, receptacles, and exterior receptacles tenance of mechanical equipment. 210-8). for main - Locations of water heater, heating and cooling equipment, other electrical or gas equipment. Garage firewall, door size, and closer (Sec. 503(d)(3)). 1 - 3'0" exterior exit door (sec. 3304 (f). Fireplace and wood stove location, alcoves, and clearance. Smoke detectors (Sec. 1210). Plumbing fixtures, water closet clearances and shower size. STRUCTURAL DETAILS Standard bracing or engineered design (Table 25V) Unusual shape, size, or split level house requiring lateral design. Clerestory requiring balloon framing and/or engineering. /Three story building requiring engineered calculations and plans. Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. elevations and wall construction details complete enough to construct Roof construction details complete enough to construct building. Fireplace construction details and calcs if necessary. Rafter ties or bearing ridge beam. .Garage door or porch header sizes. '"Stud heights. i Adobe soils - special foundation design. :, Retaining walls requiring design. .,Special Inspection required. building RESIDENTIAL PLAN.CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR Stairway details: landings, rise and run, head clearance, handrails Sec. 3306). Guardrail details (Sec. 1711 & 33O6(j). (Sec. or stone veneer (Chapter 30). Exterior plaster - weep screeds (Sec. 4706). Proper roof pitch for roof convering (Chapter 32). Roof covering type - (fire hazard). Foam insulation - protection. 8. 36" halls and stairways. Living area over garage - complete 1 -hour separation including supporting walls and posts, etc. Two exits on,three-story dwellings (sec. 3303 & see Attic access and ventilation (Sec. 3205). Underfloor access and ventilation (Sec. 2516). . Combustion air for fuel burning appliances - L.P.G. No e requirements on duplexes. nergy design. Flashing at all exterior openings. CDF responsible area requirements. 8/91 required on garage side Mezannines - 1716). requirements. S moo,,✓ �1 .. !l a d (gyp 16- — 00 0 PERMIT NO. 485-82B,PE,M PERMIT EXPIRES Richard Simmons OWNER CONTR. owner ASSESSOR PARCEL 21-26-45 LOCATION W/S Losser Ave.,app.450_'N.*0'f West Liberty Rd.,/Gridley tis t qji 4, 11:r Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINAEQ /(Date) Signature_ J OK O - .Not OK i• . = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS `. 16a Date MOBILEHOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2.Soils; Special MH Support -Sketch Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4• Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors, 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI ,. ;,% :Date% MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date _ POOLS (Plans) OK except #'s 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 Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4• Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI ' d 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding;'Metal w/5` -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulating Equip. -Pool Lghtg'. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit y.' 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI • Date' ; Card B-1 Date Card -BI Date Card -BI Date Card -BI Date ♦J S J = OK 0 = Not OK - = Not Applicable * = Not Ready RESIDENYTAL (Single and Duplex) Date UNDERFLO Plans OK exce t#'s Date FRA G Continued -a Z 1. Z4wrg requireme is -Se c se nts Property Line Firewall & Openings tg., Main; S s -S -Elec - // ]y' Ftg. Depth xt. Doors -One 3' -Check Garage -3rd story, 2 exits eel- / /" Ftg. Depth 5 Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 0-4. Ftg., Porches & Decks; Soils- teel- / /'' Ftg. Depth 5ae"Plywood on Roof Overharig-Attic Vents -Rafter Outriggers temwalls, WA4d, Steel -BI outs-Wrt ppEU-Liam 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab r t 7. Piers -Fireplace Ft el 53. 5 iding-Nailing-Veneer Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access lazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fal i way C/Otgewalest 5 hear Walls; Nailing -Bolts A-9. Gas Pipe; Size -An ors Water Pipe Anchors- Rogelater-Service Test and Clearance -Material -Support -Ins. irders-Sills-Anchor Bolts -Joists -Vents -Cripples Card -B C BI Date - C rd -BI Date Date ,T-jCard-BI Date Card -BI Date Card -BI Date BI Date - Card -BI Date Date FINAL Tans) OK except N's Card -BI Date /—/f— f12_,eCard-B I Date Date i JLURING (Permit ),& except N's 56. xt. Steps -Door & Sidelight Protection -Landings oke Detector ater Ht.; Access -Combustion Ai -. 58. Furnace; Vents -Clearance -Comb. Air -Connector - In rage; Above Floor-Ducts-Mech. Protection 15. Yater Pipe; T t & Anchors -N it Protect' n D.W.V.; Fttngs 8<F-n`c§6rs CNailote 59. edroom Exiting n� Test, First Floor -Tub Access .F.I. & Bath Fixtures & Tub Access Test Shower, 2nd Floor -Tub Access Elec. Trim & Subpanel; Breaker Sizes -Labels as Pipe; Size & Anchors airs _ 3. Fireplace or stove; Clearances -Hearth 1 . Outlets at Wood Panel; Int. & E Card -BI J4, Date Card -BI Date Kit. & Appliance; Grnd.-Air a-Cookin Clearance C BI at Z d -BI Date lec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except p's68 67. ser n - amper fixture & Transformer Clearance -Ins. Protection Wtr. Htr.; Vents -Clearance -Comb. -C_ ne h. Igg,Lwge; Above Floor-MecProtection 4J!€lec. Receptacles Spacing -Lights &Switches at Doors 74)�Ib., Elec. & Mech. Equip. Listed for Location 29f -Size Boxes & No. of Conductors -Stapled 71. x rotec. Rom x Installed Close to Edge of Studs & C.J. uip. Ground made up w/Mech. Fasteners -Bond Gas &Water Ins ion -Foam -Looked in Attic ❑Yes 73. uard Rails & Deck Construction -Post Caps QY2 Appliance Circuits in Kitchen &Conductor Size _ 6. Subfeed Wire Size /r�/ ga. or AI-A.C. Wire Size / / ga. Cu or At n. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. /Q/ ga. Wor AI -Oven Circ. / / ga. Cu or At, Insulated Neutral es ❑No 75. Following instld.: Driv Yes o; Walks es ❑ No; Planters El Yes ffNo 20,' -Service -Riser Conductors & Ground -Main Disconnect 76. - finish 2 E ip. Clearances; Panels-Motors-Mech. Equip. 77. s-Brkr. & Cond. Size -115V Outlet - othes ClosetLight-Shower Light en Bove Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 7ter Well; Disconnect, Electrical, Plumbing i Exterior Elec. Trim; G.F.I. Receptacle -Underground Car B -I Date - - !(rd -BI Date � g til roughout House rd B -I An Date Date BI Date t g Protection Date MECHANICAL (Permit) OK except N's 8 om Previous Inspections Gas Test -Meters Tagged; Gas -Electric 1. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval ant Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates _ 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 Card -BI Card -BI Date _��-TZCard-BI Date Date Card -BI Date Ca I Date �_ Card -BI Date Card -BI Date -Card-BI Date Card -BI Date Card -BI Date Date FRA NG(PN S) OK except q's Comments at Final: Proper Material & Anchors _ �TSills; ;i�r. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 3k'�Oearing Walls over Girders & Floor Nailing JM ft Stop in Walls (rat proof) _ Fire Stops; Furred Ceilin s -Stairs -Chases . _Header & Beam -_Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors Ing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Ring. Cff'Pirglace Ties or Type A Flue -Fireplace Throat tic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4fiydrm. Windows or Exiting Doors -Sill Hgt. & Dimensions _ 47-6ar3gc Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE DEPARTMENT,OF PUBLIC WORKS'- r 196 Memorial Way, Chico — Phone: 891-2751 - 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work Is completed. If you have any question pertaining to this matte or need additional explanation, please contact this office immediately. CIJ_v/',�—�, 1 i•4-1U:J4)0/> S1/UUPr66 (, D , R' '-t— A t_. c_ f1T LOO K.. !4•'�CC >y 04. �/j 5 1 �.—^!�'7 /zlUly�-tr}y (2z^ F. -en Inspector If-- I I Date . f COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS ' 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance ` exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. _�Z,ik ,a'"" e Inspec Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS A.A ERMIT NQ. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534- -APPLICATION AND PERMIT ASSESSOR PAR L NUMBER ZO ING2�, BUILDING PERMIT IV IIIO Wnef ELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING AD ESS V / en O T AC OR•S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace " 11 D 00 CONSTRUCTION LENDER UNKNOW Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee •$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 1 BUILDI ,G ADDRESS Al PLUMBING PERMIT Filing Fee 10;00 V� ~ Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping , LOT NO. 7UBDIVISION NAME PARCEL MA Each gas water heater or vent 5.00 O Gas piping system 1 - 5 outlets '' 8 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ 0 r Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS 100 AMP OR LESS 0 , Main service EA. ADD'L 100 AMPNEW 2. CONST. DWELING OR ADONS. ( ACCLBLD S U ) 0 ft CONTRACTORS LICENSE LAW I declare under penalty of.perjury (check one): ❑ l d licensed under provisions of Chapt. 9, Div. 3 of the BUeffe t. and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NNEW ON -RESIT IR BRANCH ITLETITs 2.50 ea NEw CONSTR POWER APPARATUS .&) NON-RESID. (SINGLE OUTLET CIR EX. OCCUR(OUTLETS OR FIXTURES BAL 01 FIXEDoo APPLNS. OR Ex. Occup.(OUTLE TS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10,00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): F] The permit is for $100.00 (valuation) or less. ❑ i have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating VX0 Al - Cooling Hood 3.00 Ventilation Permit Fee S Contractor 1 certify that I have read this application and state that the above information is correct. f agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in c nsequence of the granting of this permit. XDate _ 3 _ I _ IP Z Signature of Applica — Owner W Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP RJ13 I TYPE OdONST. PARCE PD NO -]ISSUE Y This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DJRECT OF PUBLIC BY P T XPIRES Date _ the applicable provi- resolutions to do fees have been paid. WORKS Date7�—�j�L J L —O -s-toori/e�s Receipt No. �_�(, WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Return to DPW AGRICULTURAL STATEMENT. OF ACKNOWLEDGEMENT sZ FOR RESIDENTIAL DEV,9LOPMENT OFFIC:AL RECN0FI05 Section 26-8.1 of the Butte County Code requires this acknowledgemeTMR UTTE COUNTY -CALIF. be recorded prior to issuance of a building.permit. ET t78y0The property described herein is adjacent to land or included 14.S within an area zoned for agricultural purposes, and residents of :CLARK A. NELSON this property may be subject to inconveniences or discomfort arisiflgERK,RECOROER from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, "and harvesting which occa- sionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property'should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, described as follows: - State of California, A part or portion of Lot 31 of Gridley Colony No. 4, according to the map of ` Sald'C010ny, filed in the Office of;-the�Recorder�of=the County�of Butte;-9tate °of California; February 5, 1907,in'Book 6 of Maps at.Page 8, described;;as follows: �.. ; c i Beginning,at;the Northeast+corner of said Lot 31,'being in the centerline ofIa codnty road•, thence' South along the centerline of said county road, and 'the ;7lp�? lid rad """04 J017 8q nd do do Nnoo RES IDENT IAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFO CE WITH CURRE ENE GY CONSERVATION REGULATIONS AT (location) ) BUILDING PERMIT NO. A;P. NO. "CK/d X A THE FOLLOWING HAVE BEEN INSTALLED AS PEA APPROVED.PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge 1 Fdn. Walls Floors Walls Ceiling/Roo Ducts Circulating Pipes APPROVED HEATER APPROVED WTR.HTR. GLAZING: / ^I Single Glazed v Special (Insulated)_ CERT. & LABELED WDS. & SLIDING DRS. & WEATHERSTRIPPED DRS._ BACK DAMPERED FANS INTERMITTENT IGNITION DE CES. CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name Signature of (pleqAe print) Insulation Applicator State Contractors License No. General Contractor/Owner Name dkfo _ J I m Signature of (p ease print) General Contractor/OwnerC Date State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. 311111 RLCOROING RI,OULtiYE.O eV A Richard J. Simmons pt:f'tC:Ai `.G uivSC: BUTTE COU4 r;- 1;;.._jf RE q0 RE:( -1 cTcT �• / /, ANO WHV4 11LC011OL0 MAIL 10 �Q�.W -[I�- IWC 24 AN IQo� Richard J: Simmons "94K-RECOAOER !i s, 1239 Ivy Street Chico, U 95926 - 27 683 SPACE ABOVE 1'MIS LINE 1r0 a USE �rpd of t��ftC04)S.,roo a T J«fs I j ---t, `a�weon. { �VIiB . ttl duroP.nada Iht, nineteenth _ ................ ..................................................... y of ..... lluguei .....,Ino Itv,rrnand rune hundred and ...... niubtY..................................... ........................ f1! Ben W. Chisum"and Clemmie M. Chi sum. his wife itr..........................................................................................•....................... fhelwrfiROr;f the first port. and:........................... :.................................................... ".......... ".............................................................. Richard J. Simmons and Lela 1►. Simfaonsr...his, �rifg..".................................................... .......... the parr.*Mstof the srrond part. 1� { 111tnPlfiirt1j: Thal the l,arAR8 of Ilse fir.l luul. (ur ar:d in runsidrrulinn of the love and f afjertiirn u•hu-h ::t..hr Y...bn.!l? (or the parl.bAs„( flee of fond lrarl, dto .....bi Iheve presrflls sinand ' 1•� lzra;it unto the pflrl"1;e9,( lite .e, and lrart, n►td furneic heirs anal, assign+ forever• al..................... fe�l Ye4o .....� �....�.................................................................A.4........snn..11u............. i 1h.9t..... rennin lot.......... , pial e ........... or l,r✓re! ............... of hind sifualr in the .............................. •.............Counlr of Butte ...................................................... ............... . Staff, of ..... ...li...f.orni.....a .............•,. , ., ...• ...••.••••. , flood hounded and deseribed as jollous. to wit: I....... ;f A part or portion of Lot 31 of Gridley Colony No. 4, according to the map of said Colony, filed in the office of the Recorder o_Rthe County of Butte, State of California, February 5, 1907 in Book 6 of Naps at Page 8, described as follows t ` Beginning at the Northeast corner of said Lot 31, being in the centerline of a fi I bounty road; thence South along the centerline of said county road, and the . Easterly line of said Lot 31, a distance of -191.4 feet to a point; thence West and parallel with the North line of said Lot 31, a distance of 234 feet to a j point; thence North and parallel a+ith the East line of said Lot 31, a Aistance of 95:0 -feet to a point in the North line of said Lot 31; thence East along the ' North lire of,said Lot 31, a distance of 234 feet to the point of beginning. �j1lfQt�pr u•ilh flit, tenements. heredilantenls, _.u1 appnrtrnruurs thereurtlo helonging or 1I appertaining, and the reversion fined rcversir,ns• reutainder and n•rrtflinders, rents, issues and pro(ils u �' thereof: lr - I 1 LTo Jim and to E.01d the .aid premises. logelher ullh flit- appurtenanves. unto - 1 the ,,,I.1e5rf Ili• .rI and hurl. flnrl to . theA.irheio and cosigns forerer................................................... ................................................................................................................................................................ at f.........................................:.......................;................ .......................................................................... JDf ' �i 7itO�ti�Q� flee l,nrf.le�rjthe firs) lxrrl hr;..Ve.................. hereunto sof their ............. luuud. $. the .lav and come tial n lulr ;caftan. r i rr -livered in fire 14e-111 e )f ' 1 rl,ned and +' 4ij/�iVy`; er.................:.............RittBen W. h sum -1 /t.......... + I ! ......................................................... 1rJ1r(,Q...rw.•l..Chis.... �,ti.4..cr�rL M. 1 }A,I pr �.,r„nI •I self • W-0 lam w,n.n m.v e. rreefl In I.. m I,eolf •"mw ;W m' n0 m M woof Kll. P •. �wMIC le KI N YI M,IIe/nh •M p.IVifA,l Et,,) nal ,N.f Ml wFr p,If f.IIIN f.J)•M V nT••f•I , to m IfW f,llOff f1I ,fIY pP.MOn a IM W11Mnf I �r � fel IIIffI lylm n,nf p�..:ti I•,ny.InM ��....r..��.w��r��r�.-� ._L m. --.-e '+r-•. f mMrn<f mm M. �tnr -1M_� hl tw f� 4�.1F�-M••Mf�!Itte1. ' . . -- .. _ _. __. _Y �-.�.—�^ie�--^--r�cs�e+rm•+sas�"e•-•->aczs�e - 1. - - __ I - "M NA r ro •sac � O k I(.A`irnY�h i � ]1 s-f11'fF: IIF CSI IFIIRN1\ y 1 `1.111 \ll IIF BUWa I,rlon• mr. Ihr und,•tld¢nr,l, a Notary rahlir in anfl !nr ' n B_llly Jay Ritter prr-onelly knoxn to me It, 1>r Qlr Iter'+^ r• nallr 11 •Irrd �. In a \1'iuu••. _ Ihrn•b,, Nhr, Iwing by mr duly ?xorn, drlu r.r• wlur.r name i• .ubrlriln•d to for xilLin -n uno•nt„e. } and my•: t Gridle Californi_ a� , � _ y_ _.,� _, ami tlmt_he _ x'as rresrl+t a^d +a a 11+al.he�. n•-idr� in, _ - _ him _•�lo Ix• tllr •amrVft ” Ben W. Chisum and_CleMmie M• Chisum l .,.,,,,,,dly Lm•Nn In. __ _ _ S are T..nl,.rld,l•.! J 8 dl••i /llrr'd I11 :111iI Nlnr�r Iln lllr• ..- ` .. � r {x•f 5llll i 6 r IIIII11111 `a 1r•rl - /y�/yll oPiMC!AL SEAL •' 1 tr —" t, ntll _ they pAti%LA A. BROCK I • i they, m lmrxlpdgrd b, .aid olliunt that _ fi15�a,'' • N01=1, vu6LIC- CALIF00.NIA M . / rlrruti•d Ihr,yuur: xnd Ilult •:lid e(liam nuLsorii,,,,l ��. BUTTE COUNTY ..i 1 I18Im• Iilvl l't lr p, e N Il llr•�r. 1 /f" AlyCommii.ioe [r.i:,res JUNE 16, I983 Signatutr RID (IF Cct7UMENT Pamela A. Brock- }lamr 1'i'yprd ^r I'rinb•d 1 ..__ 1 1� t Itet. u.e tr .41.t +.Io181 ...^ - l •tea- �#. A y �' 4�dt"x'ey: i st-..y ..}5. ' ;T.• RECORDING REQUESTED BY Richard J. Simmons i Filed. (c. -- "' :? R 3 T AND WHEN RECORDED MAIL TO - S ,a to moil ng Richard J. Simmons Name 1239 Ivy Street A'ddez,s Chico, CA 95926 Ertwrrn.............................................................................. City a ..... Ben. and . G.Lemmiie . X....Chi.sum,..his..wife................................................................ S;ote I CFF!C! EUTTE 0�T 23 CLARK A. CLERK-P,ECORDER 354.43 r SPACE ABOVE THIS LINE FOR RECORDER'S USE ship eta,. merit& i Filed. (c. -- "' :? R 3 T S ,a to moil ng VCode) ���� address on e"ument. .J p rrtfrcle the ......................... twenty,..first.............................. da)' °f ..... .. ..October ,,,,,,,,,,,,,,,,one thewsand nine hundred and_..9igh!;Y ................... Ertwrrn.............................................................................. ..... Ben. and . G.Lemmiie . X....Chi.sum,..his..wife................................................................ part the first part: . .........................:...........................:..................:.........................:...._. :.....:�4�sof • tlie and ......... ... . . Richard.J,..Simmons..and,I,el ..A.. Simmons.,..his.wi,fe.......................................................... ........ ........ ........ .................. ................. the part.iewf the second part, Miitnmirt4: That the part..iesof the first part, for and in consideration of the love and affection which .t..he .X..haYI. for the part.le%f the second part, do .....by these presents give and grant unto the part..1e*f the second purt,. and to thg; heirs and assigns forever, all ............................ lad situate in the .............................. th:.at.... certain lot:......... , piece ....:..... , or parcel ......""" I. . Butte ......................................... ............................County of.......................:..........................................:..... State of ................... .California ............................ . and bounded and described as follows, to unit: A part or portion of Lot 31 of Gridley Colony No. 4, according to the map of said Colony, filed in the Office of the Recorder of .the County of Butte, State of California, February.5, 1907 in Book 6 of Maps at Page 8, described as follows: Beginning at theNortheastcorner of said Lot 31, being in the centerline of a Ii county -road; thence South along the centerline of said county road, and the lil I Easterly line of said Lot 31, a distance of 191.4 feet to a point; thence.West i I) and parallel with the North line of said Lot 31, a distance of 234 feet to a point; thence North and parallel with the East line of said Lot 31, a distance of i 95.0 feet; thence East along the North line, a distance of 234 feet to the point f of beginning. ` ogr$irr with the tenements, hereditaments, and appurtenances thereunto belonging or appertaining, and the reversion and reversions, remainder and remainders, rents, issues and profits HI I thereof. I cc 01 a !gaur anb to L601h the said premises, together with the appurtenances, unto I, I. i the partigt5of the second part, and to .the.ilr heirs and assigns forever ................................................... .................... ................................................................................................................... i I I ... .......... ........... ........................................................................................................... ............. N Mums 304preld. the partiesof the first part ha.ve. .................... hereunto set .their hand.::S the day and year first above written. .Signed and Delivered in the Presence of Y=,.EtN ..�j?.. �[•:............................................. r..=%? :: G.Y.. ....?:...?.................................. ✓Jay/RitterBen W. Chisum Billy i _ ........ e. &I, ..Y' L..... .. � eil?.�1............ Clemmie M. Chisum This document is only a general form which may be proper for use in simple transactions and in no way acts, or is intended to act, as a substitute for the advice of an attorney. The punlishe+ does not make any warranty, either express or implied. as to the legal validity of any provision or the witability I I I of these forms in any specific transaction. PERMIT NO.� 356-81P,E PERMIT EXPIRES .215rl� OWNER Richard Simmons CONTR. owner ASSESSOR PARCEL 21-26-Y4 port. LOCATION 1247 Losser Ave., Gridley .k �Yt1gY; tA. � 1 ITem .Powe 'Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service t Cal led PG&E z JOB FINALED (Date) Signature V = OK ' O = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME'UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -.Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance 6. Carports; Windows -Doors 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'s 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 Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/0 to Grade -HD Approval 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK , 0 = Not OK Not Applicable RESIDENTrAL (Single and Duplex) = Not Ready Date DERFLOO Plans OK except N's Date FRAMING (Continued) 10 requirements-Setb Easel5ents 48. Property Line Firewall & Openings , Main; Soils -Steel -E ec. / / tg. Depth 49. Ext. Doors -One 3' -Check 9arage-3rd story, 2 exits / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg.,NPorches & Decks; Soils -Steel- / Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers emw Is, Mgteel-Blo215ee § 52. Siding -Nailing -Veneer 6. Stemwal , Garage; Steel- outs -Wrapped -Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fir lace Ft eel 54. Glazing Area -Glass Protection -Skylights -Plastic -9C8. D.W.V.: Fal F' Ings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; -Anchors 10. Water pe; Te -Anchors-Regulator-Service Test 11...-5 ctric; Underg and 1 a c -Material-Support-Ins. 3. Girders-Sills-Ancho ts-Joists-Vents-Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -B Date , r -BI Date Date FINAL (Plans) OK except q's Card -BI Date Card I Date Date PLUMBING (Permit) OK except q' 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -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-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails &Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / /-ga. Cu or At, Insulated Neutral ❑Yes ❑No 75, Following instld.: Drive [I Yes E] No: Walks ❑ Yes El No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except p's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade 34. 35. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Dale Card -BI Date Date FRAMING(Plans) OK except q'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 Walls (rat proof) _ 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub _ 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors _ 43. 44. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat _ 45.Attic 46. Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKSPERMIT N 7 County Center Drive - Orov?Ile, CaUfornia 95965 - Telephone 916/534-4541ZZ l ' APPLICATION -AND PERMIT ASS S P R EL NU qR ZONI G BUILDING PERMIT OW CA"Y TEL PHONE /r SQ. FT, OCC. BUILDING VALUATION OWNE 'S MAILING DRESS n� IR W CONTRAC OR'S NAME • N �- TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION_LiENDER UNKNOWN C Total Valuation $ Filing Fee - $ . LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ a0,00 BUILDINGADDRESS �� V� Qp� eAr PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 c Water piping 0,0 LOT NO. SUBDIVISION NAME PARCEL MA Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 01M USEOF SJRUCTURE SF F-1Duplex ❑ Mobilehome Other SPECIFY Building sewer , ' Lawn sprinkler system 1 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation ❑ Other ❑ Describe work: Penult Fee , - $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 I� NEW CONST./ DWELLING OCCUP.51 OR ADDNS. \ ACC. BLDGS. 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): F1NON I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification FA 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) El I, as the owner, am exclusively contracting with licensed contract- (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR •OU LET 2.5Oea NO N.RESID BRANCH CIRC TS NEW W.D CONSTR. (POWER APPARATUS.&) R ESID. ( SINGLE OUTLET CTR / Do @ 25¢ Ex. Occup OUTLETS OR FIXTURES BAL@1 EX. OCCUp. �OUTLE TSP(R FIXED APLISIS )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 1120 Misc. Wiring 7.50 00 4ors. Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ® I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Penult Fee S Contractor I certify that I have read this application and state that the above information i.s correct. I agree to comply to. all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in onsequence of the granting of this permit. I '7, n X Date Signature of Applico — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCE PD HD/ 15sy This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE R OF PUBLIC BY PE XPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS DateA— Receipt No. `7F0 ,% WHITE-D.P.W.• YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT NOTE—All Materials - & Workmanship Shall Be in This sef of plans and specifications MUST be accordance with Recognized Good Practices and kept or, the iob at all times and itis unlawful to . Of a quality prescribed for the Specified use in the r, r� ,, rynv chancaes or altere4lons on same without Dumbing-&- Machan' d- ---- t e National Electrical Code. written permission rom 't a Departmer� Works, r.nunty of Butie. GAS)'E IECT RIC, . i D 5�-< ' v �rl 7o� IL A setback of 5 ft. from to property lines and a setb ck. of 50ft. from the. road ' centerline shall be clear c f structures or equipment Txpf for a'2 ft. eave overhangl GAS) EIECTRIC, NO WA70, Utility connections shall be within '4 ft. of the mobilehome, either directly behind or within the rear half of the roadside (left) of the mobileh ome. I a . s SEPTIC S to 2 �--I-A i I rTE COUNTY JG DEPARTMENT -PROVED