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Home My WebLink About022-210-04122-21-41 FJOHNNIZ 99;pp `z mi: S of Grid- ley Biggs Cemetary, Gridley , Contr: Pacific Builders,. Sacto Permit#477-79B-(a minu idin gut , ters etc) SF �o oZ I 22-21-41 1515-91B DENIZ, John 1805 Hwy 99, Gridley cont: AMRE (soffit under eaves/sf) L-1 ---022--21=0=041 _ 93_-31347B - DENIZ, JOHN & JEAN 1805 HWY 99, GRIDLEYi"o. 3 CONTR: JE JOHNSON / REROOF/SF 022-210-041- .DUDLEY41 06-1103 _ Y 99, GRIDLEY� NER F t'. Butte1022-210-041 _ 06-1103_ �, DUDLEY, ROBERT r!. N O"TES CO` 1805 HWID Y 01-GRLEY `'.• (sso)'.Cont: OWNER " i RE ROOF -RE 51D`ENTIAL APN: Permit No. Owner: Site Address: Contractor. ^ Type of Permit: r 4 . • i r y3 ,b- �;L jjEAR .S7Aa/acS Ff 1�7. CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE. DATE JOB FINALED: 9 ^ as _0 SIGNATURE: ��`�`�" CX11^�ll�xY�%'�\ I { r t t t } A y3 ,b- �;L jjEAR .S7Aa/acS Ff 1�7. CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE. DATE JOB FINALED: 9 ^ as _0 SIGNATURE: ��`�`�" CX11^�ll�xY�%'�\ BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING,PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP061103 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/12/2006 APN: 022-210-041-000 the Business and Professions Code, and my license is in full force and effect. Site Address: License Class: License Number: 1805 HWY 99 GRI Date: Contractor: Map Index: OWNER -BUILDER DECLARATION Description: re roof 37 squares I hereby affirm under penalty of perjury that .I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: DUDLEY ROBERT K & MARY C permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for such permit to file a 1805 HWY 99 signed statement that he or she is licensed pursuant to the provisions of GRIDLEY, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95948 she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their / sole compensation, will do the work, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: DUDLEY ROBERT K & MARY C Code: The Contractors' State License Law does not apply to an 1805 HWY 99 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, GRIDLEY, CA provided that such improvements are not intended or offered for 95948 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). .❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner, WORKERS' COMPENSATION DECLARATION License #: I hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is Issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, C� and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: .Applicant: WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This per is herebyi a rider t appll ble provisions of the Butte County Code and/or 1 hereby affirm that there Is a construction lending agency for the Resol ions to do wor f icated a ve fo hlch fees have been paid. / performance of the work for which this permit is issued (Sec 3097 Civ.) . ' Name: BY: •. .Date: PERMIT EXPIRES ON: /2 .--0 Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is.unlawful to alter the substance of any official form or document of Butte County. I hereby authorize rep_reseritativ))es of Butte County to enter upon the above mentioned property for inspection purposes. Print Name:Signat Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor / \ B. C. Building Permit 01-16-04 pg 1 +=OK 0 - Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd • Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LPO Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer. Connected -C/O to Grade 1,2 Gas and Electficity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label1insignia Numbers Serial Numbers DATE ID E C K S'C O V E R S'C A R P O R T S'G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing . Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing-VeneerStucco-Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls s` DATE JPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcis/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec.Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcitng Egp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pniboards4nsultn•to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche , 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide Pool Drawing �I - =OK 0=No] RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Fig Main; Soils-Elec Grnd Fig Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Fig Garage; SoilsSteel-Elec Gmd Fig.Dpth 55 DWV; Test Fittings & Anchr. Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Fig Dpth 56 Shwr Pan; Test, First fir -Tub Acc . 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub '& Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frpic FtgSteel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12. Elec Undrgrnd DATE IM E C H A N'I C A L 13 Plenums & Ducts; Cirnc-MaterialSupport4nsultn 61 AC Ducts Insultn & Support 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & VnUtn 63 Condensate Drain & Ovrfiw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic DATE IFRAMING 17 Sills Proper Materials & An DATE F I N A L 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mach Prtctn 22 Headers & Beams-Sz: & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frpic Ties or Type A Flue-Frpic Throat Cirnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Cirnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cirnc 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Cirnc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace IntlExt Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Cirnc Drnge Planters ❑ Yes ❑ No .00 �s °a° 0`S 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Cirnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz qa 0 C or ❑AL 98 Address Posted AC Wire Sz , ❑CU or DAL 99 Fire Sprinkler 48 Range Clic ga ❑CU or DAL Oven Circ ¢a [::ICU or ❑ AL Insulated Neutral E] Yes ❑No °+9 ��` o0 ops` 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnis-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt n ,' /� 52 Smoke Detector l� —� °9 �s BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP061103 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/12/2006 APN: 022-210-041-000 the Business and Professions Code, and my license is In full force and effect. Site Address: License Class : License Number: 1805 HWY 99 GRI Date: Contractor: Map Index: OWNER -BUILDER DECLARATION Description: re roof 37 squares I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: DUDLEY ROBERT K &MARY C permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 1805 HWY 99 signed statement that he or she is licensed pursuant to the provisions of GRIDLEY, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95948 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: DUDLEY ROBERT K & MARY C Code: The Contractors' State License Law does not apply to an 1805 HWY 99 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, GRIDLEY, CA provided that such improvements are not intended or offered for 95948 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the properly, am exclusively contracting with licensed. contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner WORKERS' COMPENSATION DECLARATION License #: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy#: Valuation: $0.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' % compensation provisions of Section 3700 of the Labor Code, I shall fV� forthwith comply with those provisions. Date: 2 Applicant:�o' WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This per is hereby i e Afrider to appligoble provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol ions to do Worl i d cated a ve fo hich fees have been paid. / performance of the work for which this permit is issued (Sec 3097 Civ.) Name: BY: •• Date: Address: PERMIT EXPIRES ON: Date 5-1-/2-07 7 ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have -read this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize represeRtativ))es of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: �[9A-e? ` �UQ (P-1 Signat� e Date: +Owrier ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor / ! B. C. Building Permit 01-16-04 pg 1 A Attention Property Owner: 4 OWNER -BUILDER VERIFICATION ..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 material for construction of this proposed property improvement: YES .P'9 NO [ I. 2.` I HAVE HAVE NOT [ ] signed an application for a building"permit for the proposed work: 3. I have -contracted with the following person (firm) to -provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and- provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will,provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER- DATE: WNERDATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the Butte County Department of Development Services ADMINISTRATION `BUILDING GIS ° PLANNING o , o o o o 7 County Center Drive ` Oroville, CA 95965 0 (530) 538-7541 Telephone (530) 538-2140 Facsimile CDU N� OWNER -]BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your naive listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do'your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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 inst rance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under .state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or. through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor 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 contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from 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, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name_./D,,,// Name e Address City / r city Zip S� State Phone 0 o Fax _ E-mail E-mail APPLICANT INFORMATION CONTRACTOR Name � • Address City / r City Zip S� State Zip Phone Page Fax E-mail Date Approved: Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name Address G Address City / r City Zip S� State Zip Phone Page Fax E-mail Date Approved: State License Number APPLICANT INFORMATION Name �QeaerjI v Address G SRA City / r State Zip S� Phone G Subdivision Name E-mail Page APPLICANT SIGNATURE X For office use only: Zoning Flood Zone /Ci?ty v7%��O /t� SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. 2, BPO6 /(6/ BIN # PROJECT LOCATION Amount: 221713ldg !N SRA Property Address /�f • / �6 J G �TiV /Ci?ty v7%��O /t� Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address — 2 Description or Scope of Work: ct� Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: (5) Amount: 221713ldg !N SRA Receipt #: (�2 Dat ' � �/ b6 Sheriff SMIP Other Total Page 1 of 2 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy, compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, ' and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 I loo 022=21=0=041 7-9-3-- 313-47B` DENIZ, JOHN & JEAN 1805-HWY 99, GRIDLEY CONTR: JE JOHNSON REROOF/SF i. yeti I loo COUNTY OF BUTTE=jDEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION i 7 County CentePDrive - Oroville, Cajifornia-95065 - Telephone (916) 538-7541 PERMIT NO. APPLICATION ND PERMIT ASS RPARCELNUMBER 022-21-041 ZONING 0^ I, ^846=23' BUILDING PERMIT OWNER JOHN & JEAN DENIZ TELEPHONE --, SQ. FT. OCC. BUILDING VALUATION !► 0 , OWNER'S MAILING ADDRESS •rye BOX 232 GRIDI.EY 95948 -H CONTRACTOR'S NAME JE JOIRMI� p T9-7Ep7O`k24 CONTRACTOR'S MAILING ADDRTb21 ARII0TTIGATE DR YTYBA CITY 9591971 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 5 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1805 11WY 99 GRIDLEY 95948 PERMIT FEE $ 74.00 PLUMBING PERMIT Filing Fee 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 SF CY Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W �20'CC TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REROOF W/COt'fP PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( B.. OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( S ACC. BLOS. ) so. 3.50 FT, CONTRACTORS LICENSE LAW( I ec re under penalty of perjury (check one) I 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. $fs?f f 7 I Classification C^ ❑ 1, 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) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES 20 @ 1.00) BAL. @ .50 Ex. Occu FIXED APPLNS. OR P• (OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ' • ' WORKER'S COMPENSATION INSURANCE I dec,twe under penalty of perjury (check one): ❑ •Thi:,; permit is for $100.00 (valuation) or less. I have•, placed on file with the County of Butte Dept. of Development Services, Buildinyr Division a Certificate of Workmen's Compensation Insurance or a Certificates of Consent to Self -insure. ❑ I shall not empiloy any person in any manner so as to become subject to the Worker's Compensation Maws of California. Notice to Applicant: If'alfter making this statement, should you become subject to the Worker's Compensation prc`visions of the Labor Code, you must forthwith comply with such provisions or this permit; will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing F---' '20.00 Heating Cooling Hood - 6.50 Ventilation PERM('' FEE $ Contractor n Fee $ Mobile Home Installp'' • ee $ Energy Inspection .YPE DCC CONST. TOTAL FEES 74.00 o. FEEs IMP FLOOD CDF � I certify that I have read this applic&tion and state that the above information is correct. I agree to comply to all Butte County C rdinances and California State Laws relating to building construction, and hereby authc �?ze representatives of the County of Butte to enter upon the above mentioned propertyl,for inspection purposes. I also agree to save, indemnify and keep'lharmless the County of Butte against all liabilities, judgments, costs, and expensesw ch may in any way accrue against said County in consequence of the granting of this ermit. X Date 'I/-� p^moi Sigh ure of Appl' nt - ® Owner LIContractor ❑ Agent An OSHA permit is required for excavations ov 5"0" deep and demolition or construction of structures over 3 stories in height. "A' I I I PARCEL PD HD ISSUE it is hereby issued under This perrrutte County Code and/or of the P d above for which fees have indica* DIRECTOROFPUBLIC By ERMIT EXPIRES ON P the applicable provisions Resolutions to do work been paid. WORKS Date (Date) % 14872' Receipt NO. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK-INSPECT&R GOLD ENROD•APPLICANT L1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - UILDING DIVISION 7 County Center Drive , Oroville, California 95965 - Teleh 6) 538-7541 p PERMIT NO. APPLICAT,I01 AMD PERM ASSESSOR PARCEL NUMBER 029-21-041 ZONING A-40 BUILDING PERMIT VOWNER JOHN & JEAN DENIZ TELEPHONE SQ. FT. OCC. BUILDING VALUATION 43 @ 60 2 580.00 OWNER'S MAILING ADDRESS PO BOX 232 GRIDLEY .95948 CONTRACTOR'S NAME JE JOHNSON %"Nb228 - CONTRACTOR'S MAILING ADDRTb21 NORTHGATE DR YUBA CITY 95991 ��J Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1805 HWY 99 GRIDLEY 95948 PERMIT FEE $ 4.00 PLUMBING PERMIT Filing Fee 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 SF CXDuplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.0 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ElInstallation 1:1Other O Describe Work: REROOF W/COMP TE PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service I BOOv OR LESS ) 200A OR LESS 23.00 Main Service I 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. I & ACC. BLOS. ) S0. 3.5C FT. CONTRACTORS LICENSE LAW I ec re under penalty of perjury (check one) I am a licensed under provisions of Chapter 9, Division 3 of the Business and 17 Professions Code and my license is in full force and effect. License No. $$ 3 (� I Classification �— g � ❑ 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) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON -RES ID. ( BRANCH CIRCUITS ) @7.50 I POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B20 @ 1.00 Ex. Occup.FIXED APPWS. OR ( OUTLETS IRESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. 0 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. O 1 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 $ 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. X . dL - _4_�_ Date '7_2 p^ 4, :5 Si re of Appl nt - W 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 $ %4.00 HAZ- I D. FEES I IMP I FLOOD I CDF PARCEL I PD NO 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. DIREC OR /OF PUBLIC WORKS a BY 14 ° 4/ Date PERMITEXPIRESON2 fete) Receipt No. 14872 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 4 -.1. COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENTS - BUILDING DIVISION 7 COUI1V- CENTER DRIVE - OROVILL't, hC, RNIA95965 - LE. HO E (916) 538-7541 �.• t PERMIT APPLICATION DATA SHEET OWNER ►/i/�7 Proposed Building Use �4(io Building Inspector Date At time of�1. plication, I was advised the following data must submitted prior to permit processing and/or issuance: DATE RECEIVED BY l items have been submitted. .. ........ )............................ 2. Plot plans, 3/4 sets, signed by preparer of plans.N .......................... 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 ....... . 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). . . W(Afo; rest 20. Pre -inspection for required. . toBuild g nspecQtor Date 21. Contractors 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 . .....................:.................. . 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. ail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation cT av 9� Acreage Applicant4~ Date < c . 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 ne \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 �tl".�nr''�`�52��'.1�..'�`!ZSZ'R,LJ�`r`;�:. .. .. �,.- f..1'rd'+">si/`},*�hi:�.`+45,��'�w,'T""�.Fk�!,�„�'}�`4�;��G��`��':�:*#.li;-�” .if:.+alr;�, ..y �. . � . ♦ �. A .�' � '.- tG v - _ .. ,' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95955 ; Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. 1 4 �_...�.574 ASSESSOR PARCEL NUMBER 22-21-41 ZONGC r, -f-' BUILDING PERMIT OWNER John Denis TELEPHO SO. FT. OCC. BUILDING VALUATION cont est 1!50M0 OWNER'S MAILING ADDRESS 1805 Hwy 99, Gridley 95948 CONTRACTOR'S NAME Amre Siding TELEPHONE 371-6151 CONTRACTOR'S MAILING ADDRESS ' 1400 Enterprise Blvd. Suite D, W. Sacramento 95691 Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is Filing Fee g $ X0.00 LENDER'S MAILING ADDRESS Permit Fee $ 26.50 ARCHITECT OR L.v ,INEEP, None LICENSE No. Plan Checking Fee ,$ Energy Plan Checking Fee n $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1805 Hw 99 Gridley Permit fee $ 36.50. PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 lot !volar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping ; �S:OO . Each qas water heater or vent 610 `'0 USE OF STRUCTURE SF [N Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 ; Mobile Home I S I G JW 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other R1 Describe work: install soffit under eaves _ Permit Fee s. $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 OR LESS 100 OROR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I decla a under penalty of perjury (Check One): am licensed under provisions Of Chapt. 9, Div. 3 of the Business and Professio S, e and 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) 1 ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) i ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW OR AODNS. CONST. ACC. BLDGS. DWELLING OCCUP.tr) '/zQsgft NEW CONSTR.MULTI-OUTLET NON•RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS tr SINGLE OUTLET CIR, / EX. Occup(OUTLETS OR FIXTURES ewLO 30 5ALg 30 Ex. Occup. OUTLETS P(RESID.)FIXED APLNS.REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 9 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): j ❑ The permit is for $100.00 (valuation) or less. { .�L I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate rtificate of Consent to Self -Insure. I ❑ 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 10.00 Heating Cooling g od 3.00 ntilation rPermit 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Couytyin copse uence of the granting of this permit. X Date .5 / -"',, 7/ ` Signature of Applicant — 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 $ Energy Inspection Fee $ occ CONST TYPE E TOTAL FEE $ 60 6. 0 HAZ CUA PARK scHL FLo - PAR PD I ed%rb This permit is hereby issuer the applicable provi- sions of the Butte County.Code and/or resolutions to do work indicated above for which ees have been paid. DVIC OF P'ABLIC WORKS / " B Date PE IT EXPIRES, Date Receipt No. 89142/36.50 WNIT!-D.P.W., YELLOW -ASSESSOR. PINK-IN3PECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT.OF PUBLIC WORKS 7 County Center Drive - Qrovil•le,�California 95965 - Telephone: 916/538-7541 APPLICATION- AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 22-21-41� zogJGi11 f V BUILDING PERMIT OWNER John Deniz TELEPHO E SQ. FT. OCC. BUILDING VALUATION cont est 19500 OWNER'S MAILING ADDRESS 1805 HwV 99 Gridley 95948 CONTRACTOR'S NAME AmreSidin( TELEPHONE 371-6151 CONTRACTOR'S M LING ADDRESS 1400 Enterprise Blvd. Suite D W. Sacramento 95691 Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 26:50 ARCHITECT OR LN ;INEEP, None LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING 1805Gridley ADDRESS Permit fee $ 36.50 PLUMBING PERMIT Filing Fee 10.00 Each Trap 1 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFFT Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other u Describe work: i itStal l snffi t limier Paves _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6111 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I decla a under penalty of perjury (check one): am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profess' s o e and y 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 NEW CONST./ DWELLING OCCUP.5 OR ACDNS. (ACC. BLDGS. , h¢sgft NEW CONSTRESID. RANCHUTLET NO N.R ESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES BALM20@30 AL030 Ex. Occup. OUTLETS P(RESID )FIXED APLNS. REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. 6yirin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department (w� Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the 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 Cou y in con uence of the granting of this permit. r S/� �� X Date Signature of Applicant — Owner ❑ tractor ❑ Agent 0x 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 $ Energy Inspection Fee $ OCC CONSTTYPE TOTAL FEE $ SO HAL I CUA- I PARK I SCHL FLD I CDF I PAR PD ) HD. ISSU This permit is hereby. issued under the applicable provi- sions of the Butte County -Code and/or resolutions to do work indicated above for which ees have been paid. DI R OFgP�BI WORKS �/11 B �S Dater PEWIT EXPIRES Date Receipt No. 89142/36.50 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEP, WYitI�NT OP -PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILL€ G° fjDRNIA 95965 - TELEPHONE: 916/536-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER D HA) V t�e4- Z A. . No. Z _Z— �— Proposed Building Use NeW SDC F r� Building Inspector 6 Date S_ l' At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED \1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Compfete.engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6.; Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... r 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ........................................ 12. Park fees paid .................................................... 13• School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................:.... ® Plot plan and business license approval from City of t~t� (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-inspec.request to t" Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement':........ Letter of signature authorization ................................... 5 26. 27. When you issue the permit, process as follows: , Mail to'owner. Mail to contractor.' .:,r Telephone and hold for pickup at office. Deliver w/inspector. Other Applicante r _ Copy of Hdz-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---jnail—counter by -.date Contractor, designer, owner, was advised of above required data by_phone_mail_counteP\by date Plans checked by Date Plans approved by \ Date Sets of plans on hold in File cabinet AP folder Copy—DPW + a 79 OUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. �Z 7.County Center Drive - Orovi,llp, California 95965 - Telephone: 916/538-7541 APPLICATION ANIS PERMIT ASSESSOR PARCEL NUMBER— ZZ — 2 1 -- L BUILDING PERMIT OWNER TELEPHONE SO, FT. OCC. BUILDING VALUATION - N Q LN OWNER'S MAIG ADD ESS r On CONTRACT 1 ^� TELEPHONE M - 'AV( 37 �/J / CONTRACTOR'S MAILI G ADDRESS �, 00 &NS>° tD1u so to D W,15 Fireplace CONSTRUCTION LENDER, � _ _JU.`fin UNKNOWN S Total Valuation Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Per til Fee O S ARCHITECT OR LN.;INEER LICENSE NO. Plan Che -,king Fee $ Energy Plan Checking Fee .. $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ () BUILDING ADDRESS1 j �O w C Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Szf!!� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 9,___Jnstallation ❑ Other Describe work. :2-11251-11 i/ •,'3o67P;: D�3de ' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR 0 AMP OR 0LESS 10.00 Main service EA. AOD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW _ I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification. 1 as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST, DWELLING OCCUP.A OR ADDNS. � ACC. SLOGS. , �2dsgft NEW CONSTR U TI -OUTLET NON-RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS e\ SINGLE OUTLET CIR. 1 Ex. Occup(OUTLETS OR FIXTURES 20030c BAL030 EX. OCCUp. OUTLETSPRESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 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. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT 10.00 FiIirq3.00 Heating Cooling ng Hood Ventilation Permlt 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 County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ ,_ CUA PARK scHL FLO coF PAR PD l Ho. ISSUE This permit is hereby issued unaer sions of the Butte County. Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date C Receipt No. ( r Ll 2 � WNITE-D.►.W., YELL0W-A33E330R. PINK -INSPECTOR. GOLDENROD -APPLICANT 1' PERMIT NO. 477-79B 7 - K' PERMIT EXPIRES 1/'31/80 bWNER JOHN DENIZ CONTR. Pacific Builders, Sacto LOCATION (A.P. 22-21-41 ) WS Hwy 99, app �2 mi. S of Gridley Biggs E` Cemetary Rd, Gridley k t 'C t _ Temp. Power Pole Called PG&E • Temp. Elec. Serv. Cal IedyPG&E Temp. as Serv. C Iled PG&E t J. B FINALED (Da v;J11-'eZe-Y } ( i nature) 1 COUNTY OF BUTTE — DEPARTMENT.OF PUBLIC WORKS ' BUILDING INSPECTIONRECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping! Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwaII Siding S& Jv0 / i L.O To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physic ly handica ed Conformance of ex. structure Appliances Gas PI in & Test Temp. G Slab Final — A4,- Sanitat,16n Patio` FIREPLACE Fina ' Footings Footing ELECTRI L Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh AECHANICAL Grd. Fault Pr/t. Scratch Heating Service Brown Cooling Temp. #ole Finish Ducts Undelfiround Interior Lath Ventilation Pe anent Door Closer Final I Find! MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer z Gas Piping OBILEH )ME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE _.' ^ r REMARKS OR CORRECTIONS �T�-1"%� � �.'�l/�r� �b /ems d' �Qc��S'�.,� t� o�✓L ��`� �%.t"c. r � (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE,, — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 +z� Telephone: 534-4541 APPLICATION AND PERMIT • BUILDING Owner V1- \ SQ. FT. OCC. BUILDING VALUATrTN s Mailing Address i Telephone No. v Contractor L'�'C f za-rC Mailing Address S921/ Fireplace Total Valuation ph Tel hone No. 3 Permit Fee ✓ Building Address) �NW ® -on Vox Plan Checking Fee&/or Penalty Permit Fee 7 3L .► S' G r11L ,- PLUMBING No. @ FEE SS, PERMIT FILING FEE $3.00 Each Trao 1.50 �' 4:.r I. Repair drainage or vent piping 1.50 t _ A. P. No. �• � Zoning 8 Planning Water piping 1.50 Each gas water heater or vent 1.50 s tlelt Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W ImprovementsEach additional outlet .30 Building sewer 5.00 Parcel Approval Plans Approvol Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ 1 wr - G l t— ELECTRICAL No. @ FEE �.l PERMIT FILING FEE $3.00 _ Main service 600V OR LESS 100 AMP OR LESS 5•00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER sooV 25.00 100 AMP OR LESS Main service EA. ADD -L 100 AMP 1.00 NEW CONST. OR ..DNS. ( DWEACCLBLDGS.LING CCUP. 41 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of C lifornia Business & P ofessions Code under the name style ofe ` NEW CONSTR. MULTI.OUTL T NON•RESID BRANCH CIRCUITS) 12.50ea NEW CONSTR. (POWER APPARATUS B NON•RESID. SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXTIIRES BAL 1� 0t FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA/ 2.00 Temporary service 10.00 i Mobile Home Facilities 15.00 License No.. Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. O,� I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 Land Development Fee $ TOTAL PERMIT FEE $�yZ authorize representatives of the County of Butte to enter upon the above-ment a ty for inspection purposes. X Date ignoture of Permitee Agent d� Receipt No. �� g White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR # PUBLIC WORKS - By h� c;°�16'�V\ Date frJ / —! Building permit expires Date