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HomeMy WebLinkAbout021-320-0222 1 ERIC HAGBERG 4 Z! 7 ..+*W.Dewsn u*p T d Ave., Gridley e1 /8 10/14/81) 0 �'(F IRE DAMAGE REP ORT- C ZFAN, 021-32-0-022 9337 HAGBERG, ERIC 1145 DE14SNUP AVE,'GRIDLEY 93 /9 CONTR: C%1M COOLER, ACTION AGENCY STUCCO/ STOVE, REPAIR STUCCO/SF' 'P I 021-32 0- 022 00-0461 HAG;FRG,Erjc Ave, Gridle y 1145 De,snup OWNER Demo/A,7 � � v �� � � �� •:`�;71Si'tta.��.i�y�.iz.�i:r-z::a�.r•'i;if:7�F.�?Fi!3,/!�5'-'r."G�e�f�'�J;;R'4LLe+i•'�if�;,r�^y�;y ���'h�:V.'�"�"s�nr�j4:".^�"..�6"y,T _.13+,i.,K..r,�7ra`M4,:� �+�.�; .r .,,r':. ..x,. t�� _ ., �.� •021-320-022. 00-0461 ' HAGBERG, Eric 1145 Dewsnup Ave, Gridley Demolition/AG r • ff Y_ ' 4 r 1 Y kj Ito t COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION r- _ . 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 PERMIT' NO. (Rev. 12/96) APPLICATION AND PERMIT`! ASSESSOR PARCEL NUMBER nn n 22 ZONING BUtf5INGPERMIT OWNEiT " `! TELEPHONE 846-5189 SQ. FT. OCC. BUILDING VALUATION owNEas•MAILING AooREss' 1145 TlM.JSVTTP AVF. , MIT)LEY. rA 95948 CONTRACTOR'S NAME (VNTER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 15.0r) ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1145 ??1't-JTvT n T AVT: rRTT)T,P.Y Energy Plan Checking Fee $ $ PERMIT FEE $ 35.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other Ar' RT'P1' SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: DT"210 AC PLM Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 800V OR LES Main Service 200." 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: bor 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 To +000." 46.00so NEW CONST, OWELLNJG EL OR ADDNS. ( 6 ACC. BLDS.OCCUP. SO 3.5¢FT. NO=T muLTI.OUTLET 97,50 POWER APPARATUS 8 SINGLE OUTLET CIR. EX. OCCU OUTLET OR FDCTURES x®'.50 BAL 50 Ex. Occup. o uTLEEpTSA AEsIp°Ew1 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEP $ Policy Number (The above sections need not be completed if the permit is for work of a valuation �0 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 rovisio s. ,X—) �2 l F�'%1 Date �/ _ OU _ nature of Applicant - Owner ❑ C actor ❑ Agent An OSHA permit is required for excavations er 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 35, 00 HAZ. p. FEES IMP I FLOOD CDF PARCEL PD I HO I ISSUE This permit is hereby issued under the applicable the Butte County Code and/6i Resolutions indicated above for which fees have been By Date,3/q PERMIT EXPIRES ON d A I m6te) provisions to do work paid. / V U IReceipt No. Ls WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI • N 7 County Center Drive • Oroville,.Califo.nia 95965 • Telephone (530) 538-75 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 320 022 ZONING B DING PERMIT ow ERI TELEPHONE 846-5189 SQ. FT. OCC. BUILDING VALUATION OWNER U 1145 DEWSNUP AVE., GRIDLEY, CA 95948 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1145 DEWSNL)P AVE. GRIDLE Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNMION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other AG BLDG SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: DEMO AG BLDG Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 'DDA 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors license Law jaf the following reason: I� 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. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. VO I am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING GCUP. ( DS. N 3.5QFa cooNS MULr1OCo NONREstD. @7.50 POWERAPPARATUS a SINGLE ourLFr cIR. Ex. Occup.OUTLET OR FD=RES AL Q 1.00 �u @ .50 Ex. Occup. p�LEEo� Rap °� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 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 above sections need not be completed if the permit is for work of a valuation one hundred dollars ($100) or less.) le 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 rovisio S. Date ���� �O 13.n—atureof Ap I' ant - Own r ❑ C actor ❑ Agent An OSHA permit is required for excavations crver 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 35.00 HAZ. p. FEES IMP I FLOOD I CDF PARCEL Po HD I as This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By I Dat PERMIT EXPIRES ON provisions to do work paid. O to Receipt No.0 WHITE-D.D.S.-B.D. CAN RY-A SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Attention Property Owner: An "owner -builder" building pemu �h`ass beeri applied"for is your name and bearing -yo signature. T, Please complete ,and; return .this .information+ at your earliest opportunity :to_' avoid _ unnecessary delay in processing and. issuing your budding permit. No building penaut will :. be issued until this verification is received. 1: I personally plan " J provide the major lab;—and`materials for construction _ _ proposed propimproyement�[ ] Z I HAVE[ a HAVE NOT[ ] signed an apphcation`foc,a*biu�lding penin t for the Y proposed work. --.Y ., _ , F 3. I have contracted with -.the -following .person: (firm); to provide ,the proposed -.-- construction: ,'. NAME• -.-' ,(, .:. ;` - 'r - ..i`` _ Z -- �%i c r _ R ._ 3r , .;' - -- .. -ADDRESS:". :.}' ,-t _ .•� .... _ � 'CITY - - - - - - ... PHONE: 4: I pla to'provide'�portions 'of this V ocW: but 1have : hired the `following per§oa to coordinate, supervise, and provide the 'major work: z` NAME: • _ s ... .... ,- . .. ADDRESS:, _ : , • i _CITY: _ ,.t PHONE: CONTRACTOR'S LICENSE NO. 5. ' .I will rovide. some of the work but I -have contracted hired the follow*& Y 6 _. provide the work indicated: r'- { NAME _ _.ADDRESS _.._ PHONE. TYPE OF WORK' SIGNED: L/uC PROPERTY OWNER: NOTE; SOCL-kL SECURITY NUMBER: DATE: 3--?—� This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. May 1995 2.26 Dear Property Owner: r An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. I . :- 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: 0 If you employ or otherwise engage. any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are -not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you. are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance; disability insurance costs_, and unemployirient'compensation:contnbutions. _ .. . 0 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. 0 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 C Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuildee, building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. _. Sincerely, Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. Mav 1995 2.27 Demolition permits Asbestos Notification Statement Date AP# Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5. A demolition permit shall not be issued by any city, county, city and county, or state and local agency which is authorized to issue demolition permits as to any building or structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit appli- cation." Attached is a copy of my written asbestos notification to the United States Environmental Protection Agency for the demolition project located at Signature of Applicant 6R I hereby declare that a written asbestos notification to the United States Environmental Protection Agency is not applicable to this demolition project. Signa e of ppp i t 2/19/91 • COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville,+Califomia 95965- Telephone (530)1x538.7541 PERMIT NO. Rev' 1 6 APPLICATION AND PERMIT . ASSESSOR PARCELNUMISER ZONIPM BUILDING PERMIT i OWNER. TELEPHONE SO. FT, OCC. BUILDING VALUATION �. be s, OWNER0 ADDRESS CONTRACTOR'- NAME TELEPHONE �oL CONTRACTOR kVJU ADDRESS ( \ y � '�>Z,v� CONSTRUCTION LENDER LENDER'S MAILJNO ADDRESS Fireplace ARCHITECT OR ENGINEERTotal Valuation S LICENSE NO. Filing Fee $ 20.00 I ARCHITECT OR ENOINEERS MAILING ADDRESS Permit Fee suwr+oADDREss Plan Checkin Fee b C-4 5 S� y� Energy Plan Checking Fee %Filing ' PERMIT FEEUDTNO. SUBON6pNS NAME PARCEL MAPPLUMBING PERMIT ee 20.00USEOFSTRUCTURE Each Trn 00Solar or hent um water heater00SF ❑ Duplex ❑ Mobilehome ❑ Other Water i in 0 TYPE OF WORK sic Each gas water heater or vent 15.00 Gas piping system t - 5 outlets 15.00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Building sewer 15.00 Describe Work: Mobile Home S G W 020.00 PERMIT FEE S ELECTRICAL PERMIT I Filing Fee 20.00 Main Service 000V OR LESS 2ooA oR LEss1 23.00 Main Service 200A TO 1000A 48.00 NEW ' OR ADONS. D a LUNG ACC. OLDS. P 3.5QR. NONEW CONST. .RESID. BRANCH MULTI CIRCUITS IU@7.50 POWER APPARATUS t swmE ounAT CIR I✓ i Ex. OCCU OVRE r OR nXTIAtES � 0x:500050 Ex. Occup. vTLETs MAPP"ES.D6 .0 5.00 lam^v Temporary Service 23.00 Mobile Home Facilities 20.00 MisC. Wiring 23.00 t&A tu--- PERMIT FEE $ I MECHANICAL PERMIT Fling Fee 20.00 i Heating r y— Cooling V Hood 6.50 -) 1, Ventilation PERMIT FEt: S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST' TrPE TOTAL FEE $ NAZ D. FEES WP FLOOD COP PARCEL I PO I NO ISSUE This permit is hereby Issued under the applicable provisions Lq of the Butte County Code and/or Resolutions to do work Indicated above for which tees have been paid. By Date PERMIT FXpIRFc nm 0 021-32-0-022 2 ' —32-0-022 'HAGBERG ERIC — 1337 B 9371337 B,E,M 45 DE Up N AVE G Y C w L-:MM::R D Lr Y v 0 T S 1: 145 DEWSNUP AVE Co N R CTI COOL `eWCONTR: COMN F ACTION AGENCY COOLER FAN, STOVE, - V tp E S U CCO/SF FAN, STOVE , RtPAIR.S D STUCCO/SF COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT Q9_MIT NO. O. s$Eso11 1A 11 cYE�LXNUMB 021-32--0-022 ZONING A-5 - BUILDING PERMIT OWNER IC HAGBERG TELEPHONE 846 -.UN SO. FT. OCC. BUILDING VALUATION scy- OWNER'S MAILING ADDRESS 1145 Dewsnup Avenu, Chico CONTRACTOR'SNAME TELEPHONE C CONTRACRIM I 55 2640 South 5th Avenue, Oroville Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS None Permit Fee $ 1 10-10 , ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS None Penalty $ BUILDING ADDRESS 1145 Dewsnup Avenue, Gridley Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFO Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW 1 1 615.001 TYPE OF WORK NewAddition;_ Remodel Utilities] Installation❑ 0th Describe work: Eva r ler a stucco reor Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR 200A OR LESS 18.50 Main service 200A TO 1000A1 37.50 CONTRACTORS LICENSE LAW ` I declare under penalty of perjury (check one): �7-7 I am licensed under provisions of Chapt. 9, Div. 3 of the Business L�/ and Professions Code and my license is in full forge and effect. License No. � �7 `�`' � Classification �j 17 I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING OCCUP.&) OR ADONS. ACC. SLOGS. I 3.64 sq.ft. NEW CONSTR. ULTI.OUTLET NON•RESID BRANCH CIRC ITS 5 00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES Ao '6a Ex. Occup. OUTLETS FIXED (RESID.)REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. E/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. MECHANICAL PERMIT Filing Fee 15.00 Heating Cogaiing t Hood 6.50 Ventilation permit Fee $ y� Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X C� /Jr /� Date '`— -- '?� Si nature ofApplicant,—"' owner g❑ Contractor ❑ Agent An OSHA permit is required For excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Ener Ins ection Fee $ 9Y P occ CONST TYPE TOTAL FEE ✓-', HAz 1 DFEES I IMP I FLOOD I CDF I PARCEL I PbHD 1!!U,. - � This permit is hereby issued under the sions of the Butte County Code and/or work indicated above foi which fees IiIR"-CTOR•GSF PUBLIC \ By 12,W. , y w PERMIT EXPIRES Date " applicable provi- resolutions to do have been paid. WORKS -� Date Receipt No. 141-'749 WNITE•D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER x1011XNXMXX 021-32-0-022 ZONING A-5 BUILDING PERMIT OWNER RIC HAGBERG TELEPHONE 816-5189 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1145 Dewsnup Avenu, Chico CONTRACTOR'S NAME TELEPHONE CONTRAC#geftey of Btt 538 -7-214 I S 2640 South 5th Avenue, Oroville Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS None Permit Fee $ 4S ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS None Penalty $ BUILDING ADDRESS 1145_Dewsnup Avenue, Gridley Permit fee $ ,3 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF QX Duplex Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New Addition u Remodel ❑ Utilities ❑ Installation[ Other Describe work: Evatpdrati vP ronl Pr cpi 1 i nR fan, aa� c Gtnve stucco repair Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 20CATO1000AI CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full for a and effect. License Ao. 6i� a� Classification F1 I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUPM OR ADONS. ACC. BLDG S. _37.50 3.66sq.ft. NEW CONSTR.ULTI.OUTLET NON.RESID BRANCH CIRC ITS @ 5 00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 76rFIXED i Ex. Occup. OUTLETS ( R RESID.IEA.) I 3.00 Temporary service 15.00 Mobile Home Facilities Ho 15.00 Misc. 9 15.00 Permit Fee $ Contractor — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X �& ADate 6 --,Yg �3 Signature of Applican"400, 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 S Energy Inspection Fee $ OCC CONST TYPE I�^ TOTAL FEES -7&_04:::) I HAz OFEES IMP I FLOOD CDF I PARCEL 1 PO HD I ISSU This permit is hereby issued under the sions of the Butte County Code and/or work Indic dab e f, Awhich fees R F PUBLIC By applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 141249 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT PE EX IRES Date I COUNTYOF BUTTE - DEPARTMENTOF DEVEMP-MENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE (916) 538-7541 / k V PERMIT APPLIC TION DATA SHEET OWNER Z,e/� A// A. P. No. Proposed Building Use Lt/.�// /'oo/PSG- Building Inspector Date At time of permit application, I was advised the following ,ata must be submitted prior to permit processing and/or issuance: � v Y DATE RECENED 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. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer. ................. . 14. Sanitation and plot plan approval Health Department . 15. City of Chico plumbing permit................I......................... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. ......... . 19. Driveway permit (construction approval required prior to occupancy). .. .. .. . 20. Pre-inspection for I, Invecti°" feQO�- P 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. .................. a 25. Letter of signature authorization. ........ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use.......................................... . 28. Mobilehome utility clearance.......................................... . 29. Documentation of legal access . ..................... :................. ­*­*****­­ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. ............... 31. Existing violations/expired permits....................................... 32. Plan check list . ..................................................... 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. I / Telephone egiff and hold for pickup at d office. Deliver with inspector. Other x33 e - 7 2/y Parcel Creation ,p Acreage Applicant A5U%J 13 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: (Circle 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 Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works • �-��'•�)-�-�-•'•" vii..- - vlllviilt;, L,a111ultild y:J`JUJ 1 ClCtifIU11C. yIU. JJb-lj41 L/ APPLICATION AND/PERMIT !)�! -3U0 - 62Z OWNER ZONIN BUILDING PERMIT. tL TELEPHONE ER11� -S OWNER'3 MAILING AOORE-SS 1 4S Ew ti ve Ca c.% t CONTRACTOR", NAM) SO. FT. OCC. BUILDING VALUATION - D �J�JS Q f /1 (n� 4, 7 ,p�/ �/ cage -V/ TELEP�IONE S38 a1 CONTRA/C�T�O/R'S MAILING ADDRESS o��0'y0 _596, y "5F ee G�.�Lr� Fireplace CONSTRUCTION `L ENDER y UNKNOWN Total Valuation S LENOER'3 MAILINGADDRESS � ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 15.00 Permit Fee Plan Checking Fee s ARCHITECT OR EN INEER•3 MAILING ADDRESS BUILDING ADORES > f /� Energy Plan Checking Fee s Penalty Permit fee . $ $ PLUMBING PERMIT Filing Fee 15.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each Trap 5.00 Solar or heat pump water heater Water piping 20.00 7,00 - Each qas water heater or vent 7.00 USE OF STRUCTURE 5F Duplex❑ Mobilehome[—] Other sPEC1 FT Gas piping system 1 - 5 outlets 5.00 Building sewer 15,00 Mobile Home S G W @I5 -0O TYPE OF WORK �-,/ New ❑ Addition -C' [ Utilities ❑ Instal lationL Other ❑ Describe work: V' "r LEfZ CLI LIN � Fl4tr4 Permit Fee $ Contractor ELECTRICAL PERMIT ling Fee 15.00 Main service 200X O„ LESS 18.50 CONTRACTORS LICENSE LAW declare under penalty of perjury (check one): •• `tel am licensed under provisions of Chapt. 9, Div. 3 of the Business J and Professions Code and my license is in full force and effect. License No. - It /7,20/Classification L! I, as the owner. or my employees with wages as their sole compen-. cation, will do the work,and the structure is not intended or offered . • for sale. (Sec. 7044) 1, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) U I am exempt under Sec. , Business and Professions Code for this reason Main service 200A TO 1000AI 37.50 NEW CONST.DWELLING OCCUP.& OR AOON3. ACC, eLOGS. i.3.6#ed.ft NEW CONSTR. U I.OU L T NON.REsIo BRAN R , @ 5.Q0 (POWER APPARATUS OULET C Ex. OCCUp�OUTLETS OR FIXTURES 20 X 76d AL_ R4 FUTL APPLE OR Ex. OCCUp. OUTLETS IRESI O.1 EA.I 3.00 Temporary service 15,00 Mobile Home Facilities 15,00 Misc. Wiring 1500 Permit Fee S /8.00 WORKMEN'S COMPENSATION INSURANCE teclare under penalty of perjury (check one): F1 The permit is for 5100.00 (valuation) or less. 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 J to the W. C. laws of California. `tfce to Applicant: If after'making this statement, should you become subject '-the W. C. provisions of the Labor Code, you must forthwith comply with such ,-)visions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ 43" Contractor ,artily that 1 have read this application and state that the above information correct. t agree to comply to all County Ordinances and State Laws relating ;3ul1ding construction• and hereby authorize representatives of the County of to to enter upon the above-mentioned property for Inspection purposes, so agree to save, indemnify and keep harmless the'Countyof Butte agalns, liabilities• judgments, costs, and expenses which may In any w y accr, a :Inst Said County in consequence of the granting of this permit. Date / /3 Mobile Home Installation Fee 5 Energy Inspection Fee $ occ I CONST TYPE 0 i TOTAL FEE S 73= HA1 OFEES IMP I 1 FLOOO COF PARCEL PO HO ISSUE t This permit is hereby issued under the aoolicable orovi- i:'oWn of Applicant — Ovvner !_ Contractor r Agent ✓ / cions of the Butte County Code and/or resolutions to do i'JSHA perms is reQu,,ed for eicavotrons over 5'0•' leea and demolrt,on ar construct. work indicated above for which 47 have been paid. t '•'If structures over J tronas h...yht. 1 DIRECTOR OF PUBLIC WORKS By _ ,Jislpl No. 1 #421/9 - — Date PERMIT EXPIRES Date .'e -o.►.«.. .eL�ow-,++esso.. '�s.eela•. :.,��e....00-,•.I.unr -- � t ""' J r � t • t. � ' b �s+ _ I � � � � a r � t Owner: j E5216 Address: 114 Tenant: a BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT 13�e6 - A. P. # 2� �(O ? AyE . Building Location: Type of Inspection requested: Date of Inspection,/X�� O Inspector 1. Housing 2. Financing 3. Change of Occupancy to 4. Other (specify) FIFE Present use of building: -- A Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating'facilities: 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water -.supply: 13. Rubbish and garbage facilities: 14. Comments: B. Structural 1. Piers and footings: 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments• C. Electrical 1. Service : ze ground:_ 2. Recept; c. 1s: 3. Fusing:_ 4. Comments: D. Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4.. Comments: innnt�mtori AA �1AC�Gi E. Others 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: .._-- 4. Weather protection: _ 5. 1juderfloor and attic ventilation: 6. Comments: F. Commercial Build� 1. Rcof covering: 2. Disrance to property lines: 3. Physically handicapped: — - 4. ?est-oom floors and :calls: 5. Exits _ 6. Improvements: 7. 8. Cortenexit �~ : G. Field Probl mms or Vicsla"iovs 1. Problem e~ violatic�r.� ,give ccmpleta description): _ epllirP4�ZE &07-- Q(1975 2. What action taken (give complete -.l.escription) : ASO 3. What ac.Lj.,on recrmmended: %/ A. s:nfon ation only - fit,-. / B. Hold for tcn (10) days, then write litter. / W -,I. e letter. % D. other: • fll FWill ow 1 ORDER NUMBER ��;(� _ REQ. R.U. JINCIDENT NO. Er<,' Di�w­ � FIRE NUMBERBER-�S R. NO. LAND USE( FjJrDDG. 4B ythn FC -18 ('1/80)`— } Ret• J STATE ZONE RESPONSIBILITY „' OVILDLAHD BURNED OR THREATENED O� SCHEDULE A O.P.R. ��Q STATE 03 Ej UNPROTECTED 2 DRiGIN LOCATION On OTHER AGENCY D.P.R. UTILITY, ELECTRIC t MAY >TART d0. DATE �p FrAR COUNTY FIRE NAME: a SEC. TOWNSHIPp, RANGE !�E MILES' IRECTIO. FROM []IN` L L�2 oS oW S 4 W�If �y ff It CAUSE (STARTS IN OOOOROONLY) Number BNOIOENT TAPE r5E)Did LIGHTNING 3 of IRS FALSE ALARM �`�'" T OP 10 ❑ ARSON ❑ OTHER/MISC. D 0 LAND USE( RESPONSIBILITY(AT ORIGIN) 4A 4B DIRE 7 PRt T,ESP.(•D.P.R') STATUTORY Ret• J STATE ZONE RESPONSIBILITY „' OVILDLAHD BURNED OR THREATENED O� SCHEDULE A O.P.R. ��Q STATE 03 Ej UNPROTECTED I a DISTRICT On OTHER AGENCY D.P.R. UTILITY, ELECTRIC CITY LOCAL ZONE y ❑COUNTY OL -<j SCHEDULE A D.P.R. L U.S.F.S. On OTHER AGENCY D.P.R. (Unincorp) AGRICULTURAL PROD B.L.M. FEDERAL ZONE ❑ B.LA. OFEDERAL(except Military) D.P.R. I❑ N.P.S. O[:] SCHEDULE A D.P.R. RIGS IQ OTHER FEDERAL W ❑ MISC.IOTHER(-ZONE•) l0 OTHER ff It CAUSE (STARTS IN OOOOROONLY) Number not start � 7 2 .05 oroE] SMOKING !•Kt EOUIPMENT r5E)Did LIGHTNING ❑ DEBRIS ❑ PLAY W/FIRE CAMPFIRE ❑ ARSON ❑ OTHER/MISC. l 8/or 8 0 LAND USE( IN oO�OR BOONLY) 6 C3 Did nol slrt in 2 5)CrSIJ FOREST tNDUSTRY R DOMESTIC E)RECREATION - E] RANCH -FARM nOTHER INDUSTRY-COMRCL. O DUMP [_]WILDLAND F] ROAD ❑NOM-WILDLAND ' UTILITY, RAILROAD MOTHER UTILITY, ELECTRIC X—%D AAOE (`J 2000 OROONLY) ATIONAL FOREST, FIRE DIST., CITY d STREET NO.. TC. ACRES OF VEGETATION BURNED YEQ. TYPE Number $ DAMAGE N/•O DAMAGE IN of (Nearest 100 1 l 8/or 8 0 UOS080R Veh/Dwlg TIMBER SiOR a GRASS 1 TOTAL, YOUNG GROWTH CDF TOTAL WILDLAND VEGETATION _ (Other than TS YG) AGRICULTURAL PROD (Other than TAYG) RIGS &/OR L/OR CONTENTS OTHER STRUCTURES 8/OR CONTENTS VEHICLES d CONTENTS OTHER , TOTAL 3 `i l; ';'• ATIONAL FOREST, FIRE DIST., CITY d STREET NO.. TC. ACRES OF VEGETATION BURNED YEQ. TYPE ACRES BURNED _ t 5 I TIMBER B.L.M. WOOD LAND B.I.A. BRUSH OTHER FED. a GRASS 1 TOTAL, AGRIC. PROD. CDF TOTAL STATUT.I RESPON. OF i O ACRES BURNED STATE U.S.F.S. B.L.M. B.I.A. W.P.R.S. Ex -BOR) OTHER FED. a OTHER. 1 TOTAL, Do a+I A�$R1i1AIr 1 VEGETATION FIRE ❑OTHER, GO TO 10 SIZE DISTANCE (Origin to head) ACRES FEET WEATHER (ESTIMATE AT SCENE) WIND DIRECTION FROM TEMPERATURE M.P.H. 10• OVER PLEASE Gf CDF 7540-130-011.