The URL can be used to link to this page

Home My WebLink About022-240-10110 i 22-24-101 + ILDA KOFFORD KOFFORD, Hilda 2725B 1 r NE cor Justeson & Kofford, Gridle ° ��a-a-�-�p� 2171P Contr: Quist Const, Gridley I2 5 Pere#37 5-80B (rer of)SF I ' _ n e .corner Kofford & Justeson, Gri ey. afi . _t yld -LDJA1 �CONTR: J.R. Hillesheim, 1487 Sheldon -Ave. 022-240-101 PERMIT#95-1667 (remodel) Gridley LONG, Kenneth %vy�s-�� Y 1804 Kofford Rd., Gridley 8( �� ia a -��(- fb /t ('pa Cont, Skilled Builders Replace Ex Fnd Front _& One Side/SF 022-240-101 'PERMIT#98-0776 LONG, Kenneth 1804 Kofford Rd:, Gridley v %a -Cont: Mike Hurst Electric.`{,A[ !f , Repair..Ele Ser/SF i 11 022-240-101 PERMIT_ #98-0776'.' LONG, Kenneth 1804 Kofford Rd., Gridley Cont: Mike -Hurst Electric Repairl-Ele Ser/SF OFFIC C P Address i M8t2rBy Arte------ ,. ELECTRIC Meter By Date Z� r. 1 4 � I 1 i l 022-240-101 PERMIT_ #98-0776'.' LONG, Kenneth 1804 Kofford Rd., Gridley Cont: Mike -Hurst Electric Repairl-Ele Ser/SF OFFIC C P Address i M8t2rBy Arte------ ,. ELECTRIC Meter By Date Z� r. 1 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, ! aliforr}ia 95965 -Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT OT 71 ASSESSOR PARCEL NUMBER 022-240--101 ZONING AlUIL,6ING `, PERMIT OWNER LONG, M;NffH TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1804 KOFFORD ROAD, GRIDIEY, CA 95948 0.MRST CONTRACTOR'S NAME MIKE 1"111�.1:� 11V i�JL TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1804 KOFFORD ROAD, GRIMY, CA Energy Plan Checking Fee $ $ PERMIT FEE $ LOTNO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ,O Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: RE --PLACE DAMAGED WCTRIC SERVICE Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ + ELECTRICAL PERMIT Fling Fee 20.00 Main Service Zoon oa .ss 23.00 l3 • 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 I II force and effect. License Class904/0 Lic. No. 73S947 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service ( 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADONS. ( a ACC. BLDS. 3.5QFT: NON-RES110T ANCTI-OUTLCIRCUI @7.50 POWER APPARATUS 3 SINGLE OUTLET CIS. Ex. Occup. OUTLET OR FIXTURE 200'.00 BAL @ .SO Ex. Occup. ouTLEt-Drs RESPPLND.OEA_ 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation Lft of one hundred dollars ($100) or less.) LET 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 comp y with those provisions. QQ X Dates �! v Signature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 43.00 HAZ. I D. FEE IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. ! C - By , Date PERMIT EXPIRES ON (Date) Receipt No. �0 \D . (Rn �i[.,j WHITE-D.D.S.-B.Cr CANARY -ASSESSOR ' PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIV S"ION 7 County Center Drive - Oroville, Cakfornia4,95965 - Telephone (916) 538-7 1 PERMIT O. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 022-240-101 ZONING A5 BUIL ING PERMIT OWNER LONG, KENNETH TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1804 KOFFORD ROAD, GRIDLEY, CA 95948 CONTRACTOR'S NAME MIKE HURST TELEPHONE ' CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1804 KOFFORD ROAD, GRIDLEY, CA Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF X] Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other i Describe Work: RE—PLACE DAMAGED ELECTRIC SERVICE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 600OR UE Main Service 200AORLESS 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is I II force and effect.&SI License Class C- lO Lic. No. 33S�/ p OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reasonAi Main Service 200A To I000A 46.00NEW CONST. DWELLING OCCUP. OR ADON ( a ACC. BLDS. SO 3.5QFT; S NON-RESIDT MSCI c,�C� @7.50 POWER APPARATUS NGLE OUTLET CIR. Ex. Occup. OUTLET OR FocruREs 2O @ ' 00 B,AL @ .w APPLNS Ex. Occup. ouTLEETS RES D.OEA 5.00 Temporary Service 23.00. Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S nn WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 comp)y with those provisions. X u i�,( fly-- Date Signature of Applicant - ❑ Owner ;Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ �CONST.TYPE TOTAL FEE $ 43.0 AZ. D. FEES IMP I FLOOD I CDF PARCEL PO HD I ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date c(— I Dale ReceiptNo. 77, on WHITE-D.D.S.-B.D. CANARY-ASSES?'OR PINK -INSPECTOR GOLDENROD -APPLICANT . r -.......y.lr^.y..•a-:h'r�^�5..�k'[sae?!Tv�str�r!;.�.4y a�ic�,,.e._:T:. ;;;sr..si^.� .� :iu-w.. . .. E 022-240-101 PERMIT#95-1667 LONG, Kenneth 1804 Kofford Rd.,.Gridley Cont; Skilled Builders ,., Replace Ex Fnd Front & One Side/SF 0,477 sE P COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDINGDIVIS N 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75 PERMIT NO. APPLICAVON AND PERMIT ASSESSOR PARCEL NUMBER 022-240-101 A-5 ZONING BUIL NG PERMIT OWNER'S \ LONG KENNEZ'�i TELEPHONE 846-6525 SO. FT. OCC. BUILDING VALUATION ". 2,700.00 OWNERS MAILING ADDRESS .Jr 1804 KOFFORD RD GRIDLEY CONTRACTOR'S NAME SKILLED BUILDERS TELEPHONE 533-6585 CONTRACTOR'S MAILING ADDRESS PO BOX 526 PALERMO, 95968 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 2,700.00 Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 54.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS 1804 KOFFORD RD PERMITFEE $ 74.00 GRTDIZY PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USE OF STRUCTURE SF CK Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other D I Describe Work: REPLACE EXISTING FOMATION ! — FRONT AND ONE SIDE Mobile Home ISI GI W1 920.00 PERMITFEE S Contractor LECTRICAL PERMIT FilingFee 20:00 i ervice eoov OR LESS ( 200A OR LESS F—N:EW 23.00 ervice ( 200A TO 1000A ) 46.00 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 m license is i5full force and effect. n y ! �V6oS / License Class �_, Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason ST. DWELLING OCCURSD.LICENSED a ACC. BLDs. 3.5Q FT. CS NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS 97.50 ( POWER APPARATUS ) a SINGLE OUTLET CIS. Ex. Occup. (OUTIFT OR FUTURES ) 20 Q 1.00 BAL SO Ex. Occup. (OFIXED ETS(RES D.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. 11 ]/ "71 �^ 1-11 X _ �� _/e, Date _/ 7 _ Sign4ty'e of Applicant - ❑ Owner r,Y Contractor ❑ Agent 1 An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in'�eillght. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 14.00 HA2. I D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the ofthe Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON 7- applicable provisions Resolutions to do work been paid. Date ��- 7 0 9-6HITE-D.D.S.-B.D. (Date) rwReceiptNo. d' CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT O.,DEVELOPMENTSERVICES -BUILDING DIVIS N 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75 PERMIT NO. APPLICATION AiAP PERMIT ASSESSOR PARCEL NUMBER 022-240-101 ZbNING k A-5` BUILONGPERMIT OWNER LONG KENNETH TELEPHONE 846-6525 SO, FT. OCC. - BUILDING VALUATION CONT. PRICE 2,700.00 OWNER'S MAILING ADDRESS 1804 KOFFORD RD GRIDLE1 CONTRACTOR'S NAME SKILLED BUILDERS TELEPHONE 533-6585 CONTRACTORS MAILING ADDRESS PO BOX 526 PALERMO 95968 Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation $ 2,700.00 LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 54.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 1804 KOFFORD RD PERMITFEE $ 74.00 GITRIDT EY PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF EX Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 -]—G TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other N Describe Work: REPLACE EXISTING FOUNDATION FRONT AND ONE SIDE Mobile Home TS I V@20.00 + PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service EOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i full force and effect. �C�1 License Class Lic. No. S�6 W / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. so. OR NS. ( 8 ACC. ) 3.5¢ FT. NEW CONST. MULTI-OUUTLETLET C NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) 20 @ 1.00 BAL 50 EX. Occup. OUTLEEOTS (R sISD.)EA ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall P p not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions./ / X _/� Date -7/1 T Sign a of Applicant - ❑ Owner W Contractor ❑ Agent An O HA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ corusr-� PE TOTAL FEE $ 74.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HO ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By o Date - , g - PERMITEXPIRESON 7- (Date) ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �1'+�Ct tz "rrn *"►'+"`iwr.^+R'^+r+«`°+r�ru '^ i;rR""V, °sC"1w`�i"1 '`iiFvt►+%i� i*r.`ltid�e" mrt . VM r J .-77_..1.`�3 COUNTY OF BUTTE - DEPARTMENT OFE€�OPMENTSERVICES -BUILDING DIVISION 7 COUNTYCENTER DRIVE - OROVILLE, CALIF-. ' IA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER -0n/G KF.Inlf'T14 A. P. No. [72(2-? !/,O_ w) Proposed Building Use S. F . 'N L'l 5: L L) V 6 Building Inspector G G . Date _]-1 S -1I S At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY ✓ 1, All items have been submitted. ........ X1, w.............................. 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. .......... vl' 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.a bout (A) Improvements (B) Drainage. ........... f 19. Driveway permit (construction approval required prior to occupancy). .. ` Preanspectct request- ,- 20. Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. No., Name Style, Classification . ' 22. ,Certificate of Workmans Compensation Insurance . .......................... 23�� Owner -Builder Verification (Given to owner , Mail to owner _). .......... . 24`' Recorded copy of Agricultural Acknowledgement.Statement. .................. 25. Letter of signature authorization. ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 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. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation / Acreage Applicant Date 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. F' % 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 • 7 K PER 3785-89B • r �s , r PERMIT EXPIRES V22/81 OWNER HILDA KOFFORD ,C ONTR. Guist Const I , ,%LOCATION (A.P. 22-21._101 ) .-NE cor Justeson & KOfford, Gridley r" i r Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB n / FINA<=:ED � p( (Date) (2 , (Signature) } COUNTY OF BUTTE — DEPARTMEN-i OF PUBLIC WORKS - BUILDING INSPECTION RECORD BUILDING BU I LDING `(Cont'd) • PLUMBING Setback Firewall Soil Pipin Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows t3rd Floor Stemwall SIdina To out Slab Roof Sheathing Water Piping Piers Roofing — !- -Sewer Garage Fdn. Vents Fixtures Footings Stemwa l l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for ph sically handlca ed Conformance of ex. structure Appliances Gas Piping& Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing I ELECTRICAL Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS I Motors aiucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Tempa Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping 1 EHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping in 9 DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) V COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT Q lJ ASSESSOR PARCEL NUMBE ZONING BUILDING PERMJT Ow R TELEPHONE S0. FT. OCC. BUILDING ALUATION 11 OWNER'S MAILING A—— 1 01 _ t1 C SS CONSTRUCTION LENDER / p2NKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS— Permit fee $ BUIL I G ADDRE h PLUMBING PERMIT Filing Fee 3.00 Ir- CL Each Trap 2.00 Repair drainage or vent piping 2.00 2.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 $ TYPE OF WORK New ❑ Addition ❑ emodel ❑ ti lities ❑ Initllation� Other Describe work: CONTRACTORS LICENSE LAW I declar 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 orce and effect. License No.-�932-3 � 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 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ermit 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. 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 enW upon the above-mentioned property for inspection purposes. I also agr to save, indemnify a ep harmless the County of Butte against all liabi s, judgments ost expenses which may in any way accrue against d Coun ins e e f tMe anting of this perm/. X Date Signature of Applicant — Owner Contractor Agent LJ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 13 stories in height. Receipt No. I WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Permit Fee $ Contractor $ ELECTRICAL PERMIT Filing Fee 3.00 Main service ;0001 OR 0 AMP ORLESS5.00 Filing Fee 3.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2�sgft NEW CONSTR MULTI -CUTLET NON .RESID BRANCH CIRCUITS) 2.50 ea NEW CONSTR. POWER APPARATUS &) NON.RESI D. SINGLE OUTLET CIR. 2.00 Ex, OCcup(OUTLETS OR FIXTURES BAL@tOC FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Land Development Fee $ Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 3.00 Heating Cooling Hood 2.00 Ventilation Permit Fee $ Contractor Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. IPARCELI PD -1 HD I ISSUE 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 fees have been paid. D E PUBLIC WORKS 0 By - Date7—r2-1.`�� PERMIT EXPIRES Date --.42 2 — P