HomeMy WebLinkAbout024-090-044�2
>B SLL 4:-Z 9T- �4444
VS -- of -- Nie e. 800-1 W-.-of---
Gilstrap Ave., Gri �4ew�off!g
Permit 3845-73B,P,E,M sing
-11tW 24-09-44
Dar lene Fetters
NIS Nielson Ave ., 800'W.of Gilstrap
Ave., Gridley
Permit #1090-80B,E(ponv.garage to
famil , V
y'room/SF)2
24-og-44
GU� I 4go
7 1 Al
L eOO'er
24 N son yj
e
Perm 8" P
swim p
9 p,
03-3A72
004-090-044
ROD G EZ ESTELLA
247 NIELSO� RD.; GRIDLEY
BILLS ROOFING
-RF
ROOF_�
05,-2947
"024-000-044.
' RIGUES, ESTELA
ROD
247 NIELSON AVE, GRIDLEY
Cont: MICHAEL SToUDT GENER
REMODELBATH
B07-0976 024-090-044
MISCELLANEOUS WindoN�/Glass Door
Misc. Plumbing,electrical replke- HVAC/
,247 NIELSON AVE
GONZALES, ESTELA
0
M
Clq
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 247 NIELSON AVE
Owner:
Permit No: B07-0976
APN: 024-090-044
GONZALES,
ESTELA
Issued Date: By
Permit type: MISCELLANEOUS
247 NIELSON
AVE
Subtype: <none>
GREDLEY, CA 95948
Expiration Date:
Description: Misc. Plumbing,electrical replace HVi
Occupancy: Zoning: A5
Contractor
Applicant:
Square Footage:
BAKKUM CONSTRUCTION
BAKKUM
CONSTRUCTION
Building Garage RemdI/Addn
1819 HAZEL STREET
1819 HAZEL STREET
GREDLEY, CA 95948
GRIDLEY, CA 95948
Other Porch/Patio Total
(530) 846-0612
1 (530) 846-0612
1
FEE INFORMATION
DBE Misc Residential Wiring $55.00
DBM Other Mechanical Inspectio $109.98
DBMSC Window/SlAng GIs Dr-Repl $220.00
DBP Water Pipe Repair/Replacem $55.00
Total Charged: $439.98 Fees Paid: $439.98
Balance Due: $0.00 Receipt No: B2934
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
BAKKUM CONSTRUCTION 721034 / B / 04/3012008
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing S ction 7000) of 3 f Business and Professions Code, and my license
pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000)
is in fu:11 f 4.,
a act.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
xDivisio
r:�n
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X oo
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Con(ractors Signature Date
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
WORKERS'COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, by
1. As OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
as required
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Carrier: Employers Insurancipolicy Numb,,:WCJ 2914426016Cp' D,te:05130/2007
Contractor's License Law.).
(This section need not be completed if the permit is or one hundred dollars ($100) or less.F_
I AM EXEMPT under Section B. & P.C. for this reason:
CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
SSUED. I shall not employ any person in any manner so as to become subject to the Workers'
Compensation I s of California, and agree that if I should become subject to the workers'
X
compensation rovisions of Section 37 o I Labor Code, I shall forthwith comply with those
Owners Signature Date
pro
X
1 hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any side stre t' r subsidewalk. I hereby authorize representatives of Butte
r1ted
ATTORNEY'S FEES.
Countylto enter the above peoperly for inspection purposes. I hereby certify that I am the
d to act operty ees a alf.
CONSTRUCTION LENDING AGENCY
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name of Pirmift6e [SIGN] Print Date
'he performance of the work for which this permit is issued. (3097 civ. code)
1:1 Owner Elcontractor OR: E]Agent for Owner E]Agent for Contractor
I FILE COPY
Lender's Address city State Zip
Z�f
(a 0
0
0
� 0
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
0 OFFICE#: (5'10)538-7541 FAX#:(5')0)5')8-2140
0
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
0
Website:.www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name ,I First Name,---
A,�
Mailing Addres
Pw A'e—
City
State/4
State,,4W
Phone
Fax
E-mail
CONTRACTOR
Name
Address
City
State,,4W
Zip/ w
.o,, e
Phone
Fax o�l
E-mail
Lic. #
Class
APPLICANT INFORMA TION
ARCHITECTIENGINEER
Name
Address
"'Address
City
City
Zip
State
Zip
Phone
Fax
E-mail
Open Cov
State License Number
APPLICANT INFORMA TION
Name
Address
City
State
Zip
Phone
Fax
E-mail
,APPLICANTSIGNATIJRE
I PROJECTLOCATION
AP#
Property Address
City
PERMIT
NO.
06 -7 __Oq
BIN #
WORKER'S COMPENSATION
Policy Number
Carder
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
DESCRIPTION OR SCOPE OF WORK:
Z-7
e -e
SRA
I Yes
I No
Occ.
Type Const.
Sq FT- Living Garage
Open Cov
0 Structure Built without Permits
El Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
Flood Zone
SRA
I Yes
I No
Occ.
Type Const.
ZIP
Page I of 1
'Ira
Rutherford, Scott
From: Rutherford, Scott
Sent: Monday, July 03, 2006 3:56 PM
To 'TinaSutterHA@sbcglobal.net'
Cc: Brown, Starlyn
Subject: CDBG Gonzales and David Osborn
Tina, ' '
I have approved Gonzales. Building, permits required -for thd bathroom repair, removal,of wooden deck, AC
repjacerri6rit'and any other HVAC work-,glass-doors"6rfd —window replacement,'and wall repair in -garage.
Also Osborn. Permits required for roof, sub floor and underlayment repairs, all electrical and plumbing, window
and door replacement, drywall repair, and AC replacement if needed.
I have sent package to Star in the county courier system.
Question: Do you need building permit requirements delineated, or is it a given that the contractor will apply for
necessary permits?
Scott
I
07/03/2006
Z7
247 Nielson Ave, Gridley # 243 Gonzales, Estela
HEALTH & SAFETY
1 HALL BATHROOM REPAIR. Repair bathroom areas damaged due to
roof ceiling leak. Replace missing sheetrock, install shower, reset toilet,
tape and texture entire bathroom. Paint entire bathroom with a satin or
semi -,gloss paint, "Sherwin Williams" or approved equal. Owner's choice
of color.
2. HALL BATHROOM VD\TYL. Remove and replace vinyl in hall bathroom.
New vinyl shall be FHA grade minimum. Owner's choice of pattern and
color prii or to installation.
3. BACK PORCH DECK. Remove and dispose of wooden deck. Replace with
a 12' x 12' concrete landing. Concrete landing to confom-1 to current UBC.
TOTAL HEALTH & SAFETY
ENERGY CONSERVATION
1. AIR CONDITIONING UNIT. Remove and replace central heat and air
conditioning unit. New furnace shall be 80% minimum efficiency and
$
air conditioning unit shall be 13 seer minimum.
2. GLASS DOORS AND WINDOW REPLACEMENT. Remove and dispose
of existing, windows and sliding glass doors. Replace with'vinyl dual glaze
r> s 011,7
windows and doors. Windows shall be "Milgard" or approved equal. -,5,'
TOTAL ENERGY CONSE RVATION $ 7:!5�
EXTEN91ON OF USEFUL LIFE
1. KITCHEN VR-�-YL. Remove and replace vinyl in kitchen. New vinyl to be <7,9
$
FHA grade minimum. Owner's choice of pattern and color.
2. WALL A/C UNIT. Remove AJC wall unit in converted aarage. Repair wall
openings on exterior and interior to match existing. $
3. GARAGE DOOR. Remove and replace garage door. New door shall be pre-
huna unit and confom-i to current UBC. Door hardware shall be "Kwikset" or
t;l
approved equal, keyed to match existing locks. $ Z
4. ROOF GUTTERS. Remove and replace existing, roof gutters and downspouts.
C)
Install new seamless 5" fascia gutter with "Leafguard" and downspouts�. $
5. KITCBEN CABINETS AND COUNTERTOPS. Remove and replace
kitchen cabinets and countertops. See grades and standards for cabinet
construction. New countertops to be post -formed laminated countertops.
Owner's choice of color.
6. KITCHEN SINK AND FAUCET. Remove and replace kitchen sink. New
sink to be steel and enamel or stainless steel, owner's choice. New faucet
shall be "Moen�' or approved equal. $
7.
EXTERIOR PAINTING.—Prep and paint exterior of home. Prime all bare
wood with a suitable primer. All doors and trim'shall be semi -gloss latex.
Paint shall be "Sherwin Williams" A-100 series or approved equal. Owner's
$
choice of one base color and one trim color.
8.
DOORS. Reinstall Kors where needed. Replace doors and hardware if
necessary. New doors to match existing. Hardware to be "Kwikset" or
approved equal.
$
EXTENSION OF USEFUL LIFE
$Iol,
CONVERTING TO CURRENT UNIFORM BUILDING CODE
1.
Install GFC1 outlets to meet current UBC.
$
Install smoke alarms to meet current UBC.
3.
Install a 5 lb. ABC rated fire extinguisher in kitchen.
TOTAL CONVERTING TO CURRENT UBC
$
5
CONTRACTORS ARE RE SPONSIBLE FOR ALL PERMITS, BONDS,
PEST CLEARANCE AND NOTICE OF COMPLETION FILING AND /"0/Zw
FEES. $ D/V,
,F
TOTAL HOMEOWNER'S BID 7 7��
ButteCoRehab:Cost243No
Date:
Contractor's Signature:
t -(I ereby authorize the submission of the attached Work
Write -Up witti my application package for the purpose of securing loan funds to
accomplish the work described.
k
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE M (530) 538-7541
PERMIT NO.
BPO52947
A r. P.dirli— P.—it ni-ir.n4 — 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 10/27/2005 APN: 024-090-044-000
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 License Number:
Site Address: 247 NIELSON AVE GRI
Date:/O" '7' 671— contractor: M t L4* &-� S* 0 4 1 -
Map Index:
Description: REMODEL BATH (75)
OWNER -BUILDER DECLARATION
1 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: RODRIGUEZ ESTELA GONZALES
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
247 NIELSON AVE
the Contractor's State License Law (Chapter 9 commencing with Section
GRIDLEY, CA
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom -and the basis for the alleged.exemption. Any
95948-9758
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).):
d 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 (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not.apply to an
Applicant: MICHAEL STOUDT GENERAL
owner of property who builds or improves thereon, and who does
CONTRACTOR
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
PO BOX 328
sale. If however, the building or improvements'are sold within one
YUBA CITY, CA
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
95992
sale.).
530-674-7152
0 1, 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
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.).
Contractor: MICHAEL STOUDT GENERAL
CONTRACTOR
0 1 am Exempt under Article 3 of the Business and Professions Code
PO BOX 328
Date: — Owner:
YUBA CITY, CA
95992
WORKERS' C OMPENSATIO N DECLARATION
530-674-7152
1 hereby affirm under penalty of perjury one of the following declarations:
0 1 have and will maintain a certificate of consent to -self -insure for
workers' compensation, as provided for by Section 3700 of the
License #: 596837
Labor Code, for the performance of the work for which this permit
is issued.
4T I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
insurance carrier and,policy number are:
Engineer:
Carrier: P—,ft -r
Policy#: ZVI —Do?-- 3qld)
C3 I certify that in the performance of the work for which this permit is
Total Square Ft: 0 S. F.
issued, I shall not employ any person in any manner so as to
Valuation: $0.00
become subject to the workers' compensation laws of California,
Census Code:
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:
Applicaft.
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
1 hereby affirm that there is a construction lending agency for the
This permit der the applicable provisions of the Butte County Code and/or,
Resolutions r wWLh fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
OF
Name:
By: Date:
PERMITEXPIRESO
(Da(A)
Address:
0 1 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.
C3 Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
0 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 dulyyfiuthorized 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 anicifflial form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos.�
Print Name: C. I-kAcc" Signature:
Date: 10 '7—"0
-0 owner ONcontractor 0 Agent for Owner 0 Agent for Contractor
A r. P.dirli— P.—it ni-ir.n4 — 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTIONA: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED A T TIME OFAPPLICA TION
"PLEASE PRINT CLEARLY"
OWNER
Last Narne(
n a 4,rt,
iFirst Naine,,,,,,
Address
-e s
City Go
State,,,.
Zip L?,SCfvf
Phone fy&-
Fax
E-mail
CONTRACTOR
ARCHITECTIENGINEER
Name M I e- 14.4 A L S -to
L;
ctr-�—
Address
City
Fax
city
Iq 6.4 C
State
6.4.
Zip
1 qq5-
Phone (6 7 Y
Fax
E-mail
LE --mail
Ljc.#S9(p -BY 2 Class
APPLICANT NAME
ARCHITECTIENGINEER
Name
City C(L'34 C1 !if
Address
ZjPq.S9?_3
City
Fax
-State
Zip
Phone
Map
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name 144 4r S70%jor
Address L't 4-9 -4 -1-r P , -
City C(L'34 C1 !if
State
4-A
ZjPq.S9?_3
Phone("
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Property Address
?_ y I X/ 14 L
Flood Zone
Cross Street
SRA I
Yes
I No
Occ.
I Type Const.
Subdivision Name
Map
Lot #
Planner
Date Approved:
PERMIT
NO.
6 'zo .2'9'4�
BP
BIN 9
LOCATION
AP#
C? Z. I 0q0 a y y
Property Address
?_ y I X/ 14 L
Cross Street
WORKER'S COMPENSATION
Policy Number
Z�zq -
Carrier -39 Tz
0- c C' tm
If hiring anyone other than license contractors, a certificate of worke
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
-Addres.
Description or Scope of Work:
-4rm "a wt 4-4t.—
Sq. Footage
0 Structure Built without Permits
0 Proposed Change of Occupancy
(Note previous use):
OVER FOR SUBMITTAL REQUIREMENTS 11
KWORMSMILDING F0RMS\B1dgApp1SubRqmts.doc Page 1 of 2
EXPIRATION OF APPLICATION
Applicatioris 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
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-
16�0
Kwj
Receipt #:
qt409:�_4
Date: �01 �a 1 (0
-b PD- /
Amount: " Y-6 B I do
SRA
Sheriff
SMIP
Other
Total
REV 6-16-04
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building* Division in order to apply
for a permit.' INCOMPLETE SUBMITTALS RTLL NOT BE ACCEPTED. ALLPLANSMUSTBE
LEGIBLE AArD IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
11 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
0 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
OR .3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of staml56dand signed
calculations..
0 3. 2 Engineered truss details andlayouts (if required) (NO FAXES!).
o 4. Letter from Engineer or Architect for truss design review.
D 5. 2 Energy compliance design and supporting documentation. (Note: Not requiredfor additions to
mobile or modular homes.)
6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
* 7. Detached Accessory Building Form, filled out by the property owner (if required).
* 8. Sanitation and site plan approval from the Environmental Health Department.
* 9. Metal Buildings: (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-simed by the engineer.
Mobile, Manufactured, or Modular Homes:
0 1 . 3 Site Plans, signed by the preparer. NO GRAPff PAPER!
0 2. 2 Data sheets and installation instruction manual.
0 3. 2 Marriage line information.
0 - 4. 2 Floor plans.
0 5. 2 Engineered Tie Downs or Foundation plans.
ci 6. Sanitation and site plan approval from the Environmental Health Department.
o 7. 2'Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
11 1 . .
4 Site Plans, signed by the preparer. NO GRAPHPAPER!
0 2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
0 3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
0 4.
Letter from Engineer or Architect for truss design review.
[1 5.
2 Energy compliance design and supporting documentation (if required).
ci 6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
o 7.
Statement of Intent for Non -heated and A/C (if required).
[3 8.
Metal Buildings: (A) Metal Bldg Plans, (B) Frid 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.
* 9.
Letter of intent.
* 10.
Hazardous Material Form.
* 11.
-Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Pen -nit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSMILDING F0RMSM31dgApp1SubRqmts.doc Page 2 of 2 . REV 6-16-04
0
40
td -3 47 2
(.OQ4-090-044
R O�D 'G JEZ, ESTELLA
'R'
24 NIELSON RD, GRIDLEY
C.nt: BILLS'ROOFING
RE ROOF
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 1
7 County Center Drive * Oroville, California 95965 e Telephone (530) 538-7541 PE R2 ff rJ NO.* 7
(Rev. 12/96) APPLICATION AND PERMIT C 3
ASSESSOR PARCEL NUMBER
�'24-09,1-044 —
ZONING
BUILDINGPERMIT
OWNER P0QRTQF7, FSTELA f72-4ZA.I.R.13
TELEPHONE
—
SO. Fr. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
247 INTEI-50IN AVT�71.,, rRTDT,FY. rA QC;01, q
—1
)c; n -on
CONTRACTOR' NAME
,MsUJS RWFTNG 77
TELEPHONE
r�441—lqpi
COWRACTOWS MAILING ADDRESS
1770 KI)FFnRI) RD., "IRTT)TFY, rA Or%/
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation_$ I_t;M_oo
ARCHITECT OR ENGINEER
LICENSE NO.
—Filing Fee $ 20.00
Permit Fee $ 35.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS
'247 NIFISC—fl RT)- (�R T 1`71IFY
Energy Plan Checking Fee $
,
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex 0 Mobilehome 0 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 0 Addition' 0 Remodel 0 Utilities 0 Installation 0 Other 0
Describe Work: --RF—ROOF
Gas piping system I - 5 outlets 15.00
Building sewer 15.00
Mobile Home Pi-�i VV 1 @?20.00
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
Main Service ( "ovA 'ORR LE. 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 Vn full force and effect.
�30
ti, 0 /5 2
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:
0 1, asownerof theproperty, ormy employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service( 200A TO 1000A 46.00
NEW CONST. DWEWNGffUP. so.
OR ADDNS. & ACC. S. 3.50FT.
—00-
NE97 �. =LT,,, 0
NON-RESID. U. @7.50
g
.T
OWELR AP= U
&P.ING E 0 CSR.
20 @ 1.00
Ex. Occup. OUTLET OR FIXTURES BAL @ .50
O.FLIED A UNS OR
Ex. Occup. PPR ES, 6. 1 EA. 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:
0 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.
0 1 have and will maintain workers' compensation insurance, as required by Section
3700ofthe Labor Code, for the performance of work for which this permitisissued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
—of one hundred dollars ($100) or less.)
0 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith CorKply with those pFovisions.
X Date
Signature of Applicant - 0 Owner 11 Contractor 0 Agent
An OSHA permit is required for excavation ve 5'0" deep and demolition or construction
,rstories.in hLaight..
of structure::::Zv G I 2Q —
Mobile Home Installation Fee s
Energy Inspection Fee s
occ
CONST. TYPE
TOTAL FEE$ it�_9.00
RAZ.
HAZ
I D. FEES III ISS
E
Th4s permit is hereby issued under the applicable provisions
of the Bult-PeCou ty Copeleandlor %solutions to do work
es ave
h
d1abo elffd!Ue n een paid.
111irk
R (-V I J Dat
If
PERMIT EXPIRES ON 61
(Date) —J
Receipt No. � — 1 1 1
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive -. 01ro . ville, California 95965 9 Telephone (530) 538-75410 3
(Rev. 12/96) AP P I LICATIONAND-PERMIT
ASSESSOR PARCEL NUMBER
024-090-044
ZONING
BUILDINGPERMIT
OWNER Rnpplaz, F-am.1 coNj_�,I_Es
TELEPHONE
SO. Fr. OCC. BUILDING VALUATION
OWNER'S MAIUNG
247 NTEJ SSON AVE GRIDLEY rA Q5Q/,2
25 r.0 -5 Q Q . on
Q
CONTRACTOR'S NAME
I'M LS 'ROOFTNC,
TELEPHONE
CONTRACTOWS MMUNG ADDRESS
1770 VOEFMD RD_ C-RIDLEY, CA 95949
CONSTRUCTION LENDER
LENDER'S MAJUNG ADDRESS
Fireplace
Total Valuation 1 9C)n
oo
ARCHITECT OR ENGINEER
UCENSF_NO
Filing Fee
$ 20.00
Permit Fee
$ 35.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS
947 NIBI-SON RDI GRIPLEY
Energy Plan Checking Fee
$
$
PERMIT FEE
$ C)
LOT NO.
SUBDIVISIONS NAME 7�
MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex 0 Mobilehome 0 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
TYPEOFWORK
New 0 Addition 0 Remodel 0 Lifilities 0 Installation 0 Other 0
Describe Work: RE -ROOF
Gas piping system I - 5 outlets
15.00
Building sewer
15.00
—Mobile Home I S I G I W
@D20.00
PERMIT FEE
ELECTRICAL PERMIT
Filing Fee 20.00
O*OV OR UE:.S )
Main Service .A OR LE
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 fUQ force and effect.
License Class Lic. No. Z2
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
0 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.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A J
46.00
NEW CONST DW:�JNGffUp.
OR ADDNS. C S.
so.
3.5oa-
OONST. LT., 0
=R
@7.50
OWE.RAP= U
PSIN. 0 C SIR.
Ex. Occup. OUTLET OR FDMRES
SAL @ .50
_L
O.FIXED A OrR
Ex. Occup. P(P=
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:
0 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.
0 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.)
fri 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
w k rs - compensation provisions of section 3700 of the Labor Code, I shall
orK,e
forth Ah ly WV those pjovisions.
X Date
si�� 13 Agent
An OSHA permit is required for excavationgpver 60" deep and demolition or construction
of structures ght.
,wrAstories in
MECHANICAL PERMIT
Filing Fee 20.00
Heating
— Cooling
Hood 6.50
Ventilation
—
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTALFEE$ 95_C)()
1. FEES
permit is hereby issued under the
P"
I
of Buo Vounly Cove and/or
in *ca d bo e w ib(feave
as h
Ies have
B
Xp
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
b
been paid/.
I f /() f63
Dat
(04t.) /
ReceiptNo. Ti
WHITE-D.D.S748 D�CANARY-ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
PERMIT NUMBER B 3845-r73B,P,E,M
P
E
PERMIT EXPIRES 7-
,�OWNER Bill,Pearsall
CONTR: Owner
LOCATION (A.P. 24-09-44
NIS of Nielson Ave... 8001 W. of
Gilstrap Ave., Gridley Colony #1
Zoning 9
Foundation(KA=::::�
Rgh. Plumbing dv�z—::7V
Rein. Steel
Framing
Wtr. Htr.
Firewall
ELECTRIC
COUNTY OF BUTTE
Department of Public Wotks
BUILDING INSPECTION RECORD
Setback
Piers & Girders
Bond Beam
Gas Piping & Test
Plmg. Topout
Furnace
Garage Vents
GAS
e 1-41
Forms C,64/— / — 2 - 14
Fireplace
Loth & P [aster
Found. Vents
Rough Elec. .49614—" c;2 -
Kitchen Ven
Sanitation & Water
BUILDING
Temporary Ez Tempor ert. of Occup. Cl/
Final <�— 7:5 (4 Final i n a I
DATE
REMARKS OR CORRECTIONS
J! j701
Ar
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WO
7 County Center Drive - Orovi Ile, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
y
above-mentioned property for inspection purposes.
X �-��Date �;w
-signature of Permitee or Agent
Receipt No. / / 3 il 5-(
Ihite-D.P.W. - Yello-Assessor - Pink -Inspector - Goldenrod-Appli cant
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 OF,,PUBLIC WORKS
By V -Date
Building permit expires Date
BUILDING
Owner I , zj� 0_at�� <"d./- �_
SQ. FT. occ. BUILDING VALUATION
Z �K 3,�r2
Mailing Address J_302 w.ad�,69,-7-4 44FE.
A (/' n -g e.;�ry
Tele hone No.
7 �5
Fireplace
Contractor
Total Valuation
_49�0
Mai I ing Address
Permit Fee
&2_
PlanChecking Fee&/orPenalty
Telephone No.
Permit Fee
$
—
/a2
1$
Building Address A//5 (21 k1Z9Z9Q,0P Al 0 -a-
PLUMBING
No.1
@
FEE
PERMIT FILING FEE 1 $2.00
Q, ��
f
e S. 7- it -sr
Each Trap '71 1.50 /0
15,61
Repair drainage or vent piping
1
1.50
Water piping 1 1.50
Each gas water heater or vent 1.50
A. P. No.
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
ti -0
I
Each additional outlet .30
FWs
I W -in- Fi re Dept. Fire Zone Use Permit
Parking Parcel Parcel Map 60' R/W Improvements
Plans Declaration I I I
Building sewer 5.00
EQA
Lawn sprinkler system 2.00
lattx Plans Rec'd
Parcel Approval
Plans Approval -
Permit Fee
$
NEW E' ADDITION UTILITIES OTHER
ELECTRICAL
No.1
@
FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each
1.00
Single Family Duplex Mobi I HomeE] Others El
Sub -panel (12 orlte-s s) (more than 12)
zro
Range, Cook -top or Oven - 1.00
Water Hel-ter or Space Heater
1.00
Light fixtures I 20P2
R sw/cl�bs & fixL60ts 4� riffy
I! �0
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
42tol t2 ff�
Hoo�, Ex.,'Ka-n or F.A. Fi 110tor
1.00
Evap. cooler, gar. di sp. or D.W. 1.00
Air conditioner or heat pump
Water pump X4, Af
ev 0
Mobil Home� Facilities 5.00
Temp. Power Pole 5.00
License No./20 Classification 'PI/
Misc. wiring
I am exempt from the contractors License Laws of the State of California.
Permit Fee
$
V&
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 W en's Compensation.
have placed on file with the County of Butte a certificate of
Workmen's Compensation insurance.
I
X/A certify that in the performance of the work for which this
-�r.
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.1
@
FEE
PERMIT FILING FEE $3.00 3.
tl�_
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
TO�AL PERMIT FEE
y
above-mentioned property for inspection purposes.
X �-��Date �;w
-signature of Permitee or Agent
Receipt No. / / 3 il 5-(
Ihite-D.P.W. - Yello-Assessor - Pink -Inspector - Goldenrod-Appli cant
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 OF,,PUBLIC WORKS
By V -Date
Building permit expires Date
xuuz
OROVILLE, CALIFORNIA
GENERAL CLAIM
Gus D Gelle an
CLAIMANT:
ADDRESS: 247 Nielson Ave.
Gridley, CA. 95948
CITY & STATE: IMPORTANT:
June 4, 1981. - SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Not going to build. (Bldg.Permit #1854-81B,P�E Receipt #50961
AP 24-09-44)
Building permit fee paid -------- $76.00
Retain filing fee ------- $10.00
Retain plan check fee --- $22.00
Amount retained --------- $32.00 -122-_00
AMOUNT OF REFUND DUE --------------------- $44.00
'Plumbing permit fee paid -------- $15.00
Retain filing fee --------------- $10.00
AMOUNT OF REFUND DUE --------------------- 5.00
Electrical permit fee paid -----.-$17.50
—R—etain ----------------
tiling fee 110.00
AMOUNT OF REFUND DUE --------------------- J_L.50
TOTAi, REFUND DUE ----------------------- ::-$56.50
$56.,50
'rn'rAl
0_1^� I
L% 5
50%
1, the. undersigned, declare under penalty of perj ury that the services or articles claimed have beererformed or 5elivered, and Liat this
claim is true and correct as stated.
Dated this ....... ... day of . --TU ........ . 19,9 Calif.
A ................. ................... ..... ........ ........ / .. .........
e of
1, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above -have been berformed or de-
livered and that there Is a Budget Appropiiation [D or Specific Board Approval [:j (Checkone) for the same.
Dated this ............. ............. day of .... ............. lq.�A at Oroville
.............................. . Calif . ................
artm
Dep en a ad o r u on z ed D eputy
Dept. Exp.
Code ... * .......................................... Code ................................................ PAYABLE FR.0,M ............................................................................... ........... F UND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR
CODE
DEPT.
& SUB.
P ROJ.
SUB.
0 B.I.
CLAIM
NO.
INVOICE
NO.
INVOICE
DATE
DISC.
GROSS
AMOUNT
ENCUMB.
SUB -DIST.
T-1
PERMIT NO.
PERMIT EXPIRES -5r,1.2
OWNER GUS D. GELLEPES
CONTR. nwnpr
ASSESSOR PARCEL 24-09-44
LOCATION 247 Nielson Avenue, Gridley
LA
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
Temp. Gas Service
CalledPG&E
JOB FINALED (Date)
Signature
V = OK
0 = Not -OK
- = NotApplicable MOBILEHOMES
* = Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except #'s
1. Zoning Requ i rements-Setbacks- Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requ i rements-Setbac ks- Easements
2. Soils; Special MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or Joists -Decking -Br -acing -Stairs -Rai Is
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Dec -al -Enclosures
6. Gas; Locatior�-Test-Wrap: / /"L"ft./ Nat. or/ /"L"ft./ LPG
6. Carports: Windows -Doors
7. Utility Clearance
7. Elec.
Card -61
Date Card -BI Date
Card -BI Date Card- BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1 . Zoning Requ irements-Setbac ks- Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH T est -Crossover s- Brea kers-C I eara nces
4. Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/0 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -E nc I osures- Pane I boards- Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -61 Date
= OK
= Not OK
= Not Applicable
= Not Ready RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR (Plans) OK except #'a
Date
FRAMING (Continued)
1.
Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
2.
Ftg., Main; Soils-Steel-Elec. Grnd.- / / Ftg. Depth
49.
Ext. Doors -One X -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; W idth-Headroom-R i se -Run- Land i ng- F ire Protection
4.
Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
51.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Sternwalls, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6. Sternwalls, Garage; Steel- Bloc kouts-Wrapped-S lab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underfir. Access
7.
Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protect i on-Skyl i ghts- P last ic
8.
D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test-Anchors-Regu lator-Sery ice Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -61 Date
Card -BI
Date
Date Card -BI Date
FINAL (Plans) OK except #'s
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
Date Card -BI Date
PLUMBING (Permit) OK except #'s
57.
Smoke Detector
14.
Water Ht.; Vent- Access -Combustion Air
58.
Furnace; Vents -Clearance -Comb. Air-Conneclor-
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL (Permit) OK except #'s
67.
Garage Fire Door; Swing-Landi ng -C loser
68.
A.C. Duct in Garage -Damper
20.
Fixture & Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb, Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21.
Elec. Receptacles Spacing -Lights & Switches at Doors
70.
Plb., Elec. & Mach. Equip. Listed for Location
22.
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23. Romex Installed Close to Edge of Studs & C.J.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
1 nsu lat ion -Foam- Looked in Attic E] Yes
73.
Guard Rails & D-ec-k Construct i on- Post Caps
25. 2 Appliance Circuits in Kitchen & Conductor Size
26.
Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ga. Cu or Al
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor El Yes
27.
Range Circ. / / ga. Cu or Al -Oven Circ. ga. Cu or At,
Insulated Neutr I E]Yes 0 No
75.
Following instid.: Drive [] Yes - E] No; Walks [I Yes C1 No;
Planters []Yes 0 No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Pane I s-Motors-Mech. Equip.
77.
A.C. Unit; Disconnect-Cirnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepi.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
Card B -I
Date Card -BI Date
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
81.
Ventilation throughout House
Card B -I
Date Card -BI Date
82.
Glass Protection
Date
MECHANICAL (Permit) OK except #'s
31. A.C. Ducts: Insulation & Support
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas-E'ectric
85.
Water & Sewer Connected -C/O to Grade -HD Approval
32. ---Vent
Fan; Exhaust above Insulation
86.
Energy Compliance Certificate-Olher Certificates
-3,3. Condensate Dra n & Overflow; Size & Grade
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
__35.
Attic Access & Platform_i I. Furnace in Attic
Card -BI
Date Card -61 Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Ca d -BI
Card -BI Date
Card -BI
Date Card -BI Date
Comments at Final:
Date
FRAMING(Plans)
36.
OK except #'s
Sills; Proper Material & Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing W ails over Girders & Floor Nailing
_38..
39.
-
Draft Stop in Walls (rat proof)
-40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
-__44.
-41.
42.
43.
45.
-Header & Beam -Size- & Bearing
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-W-tr. T--tes-P��riTr�---F�o-of-B-rWc�.---Truss-Shthng.-Rfng.
Fireplace Ties or Type A Flue -Fireplace Throat
Attic Access: Size & Romex Protect i on -Draft Stop -Ins. Baffles
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
bl",
PERMIT NO.
ASSESSOR PA CEL NUMBER
.? P- 0? - -,/Y
Z:WO I N G
_Z_
BUILDING PERMITfl
OWN��V ;
, 0, 6elleoes
TELEPHONE
SQ.FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
0 /
?,7 lvl;!�IC501LI �,Ome_ G; ollra 041217 76Y$115
-7
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing'Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 4,141110
ARCHITECT OR E ER
eN E
LICENSE NO.
C 02W
Plan Checking Fee
$ &-06
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
-Penalty
Permit fee
$ 76-190
BUILDING ADDRESS
,12 V 7 &C1,56AI
PLUMBING PERMIT
FilingFee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
—31 ?10
LOT NO.
SUBDIVISION NAME
1
PARCEL MAP
1
Each qas water heater or vent
5.00
Gas piping system I - 5 outlets
USE OF STRUCTURE
SFEI DuplexF� MobilehomeF-1 Other 10290
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New Pf""Addition [:1 Remodel[-] UtilitiesEl instaiiationO Other Ej
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
main service 6001 OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD -L 100 A M P
2,50
NEW CONST. I DWELLING OCCUPIIII)
OR ADDNS. V ACC. BLDGS.
20 sq ft
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)
0 1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
0 1 am exempt under Sec.—, Business and Professions Code
for this reason
NEW CONSTR. MULTI -OUTLET 2.50 ea
.0..RES'D. BRANCH CIRCUITS)
NEW CONSTFL POWER APPARATUS
NON-RESID. %SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 150 @ 2ft
BAL01100
P.(, IXE:D APPLN5 OR
Ex. Occu 0 LITLETS ( RESI'D.) EA.) 2.00
service 10.00
-Temporary
Mobile Home Facilities 15.00
-49/-t -7_
Misc. Wiring 7.50 17,
Permit Fee $ 17 W
Contractor
MECHANICAL PERMIT
Fi I i rig Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
The permit is for $100-00 (valuation) or less. -
I have placed on file with the County of Butte Building Department
a' Certificate of Workmen's Compensation Insurance or a Certificate
f Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Venti lation
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 ot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agrIft to save, indegirilly and keep harmless the County of Butte against
all liabi i es, judgment. ost- and expenses which may in any way accrue
against id Coun y in lrj;� We�Icee'�of tihe granting of this permit.
X Date
SignIt"'. . f Applicant Owne'r n Contractor [] Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
occup. rROUP
TYPE OF CONST.
I "
I PARCELI
PD
1
1;7E
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRE F PUBLIC
By
PEFJWIT EXPtRES Date
the applicable provi-
resolutions to do'
fees have been paid.
WORKS
Date s-,
Lp
Receipt No.,0941
WHITE-D.P.W., YELLOW-ASSMSSOR, PINK -INSPECTOR. GOLDEN ROD-APPL I CANT
F!EFRAIT 'NO. 1090-80B,E
PERMIT EXPIRES
Darlene Fetters
OWNER
CONTR. owner
4 24-09-44
LOCATION (A.P.
91S Nielson Ave 800'W of Gilstran Ave
Temp. Power P t/e-
Called P 7E
P
Temp. Ele . Serv.
C C I
alle PG&E
Temp. as Serv.
I I I
led PG&E
JOB
FINALED—
(Date)
(Signature)
Gridley
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTIOW RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwa I I
Siding
Topout
Slab
Roof Sheathing
Water Piping
Piers
Rooting
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for physically
h ndicappe
Conformance of ex.
structure
Appliances
Gas Piping & Test
Temp. Gas
SJab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown Cooling Temp. Pole
Finish Ducts Underground
Interior Lath Ventilation Permanent
Door Closer Final Final
MOBILEHOME UTILITIES ------------------ Elec- Service Elec. Pedestal
Water Piping Sewer Gas Piping
WgJII,EtJOME INSTALLLk1J.0N -------------- Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE ---REMARKS OR CORRECTIONS
4
e- A'-7>
CIA (9,�
t
(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
Telephone: 534t4541
APPLICATION AND PERMIT
I
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X z 1 06
", -C?-' _' - Date3—,7_J
Signature of Per itee or AgAvt
Receipt No. —3. (.et
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Gal denrod-Appli cant
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 Of PUBLIC WORKS
By Date �7_17—cP-
A,
Building permit expires Date 7— (7—P
BUILDING �Z Z 4
-7
Owner
SQ. F T. OCC. BUILDING VAN-9TION
7Z!V Q 0
Mai I ing Address zo,
Telephone No.
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee 0'0
Building Address
PI an Checki ng Fee &/or Penal ty
Permit Fee $
6
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. L'o
1PAZoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fl�le-s
Sla-�ni
Fire Dept.
FireZone
Use Permit
Gas piping system I - 5 outlets 1.50
EQA
Parking
1 Plans
Parcel
Declaration
Parcel Ma4 60' R/W
I
improvements
I
Each additional outlet .30
Building sewer 5.00
Bldg. Pl�M. �R..'d
F Parcel AEEroval
-
P I a n s A p A,01'v"G'I
Lawn sprinkler system 2.00
NEW ADDITION UTILITIES OTHER
Permit Fee $
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS,
100 AMP OR L =SS 5.00
Single Family Duplex Mobi I Home Others
Main service EA. ADD -L 100 AMP 2.50
OVER 600V
Main service 100 AMP OR LESS 25.00
Main service EA_ ADD'L 100 AMP 1.00
NEW CONST. ( D W E ��LOff UP. N
OR AD A C 20 sq f t
..S. r
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
NEW CONSTR TI-OUTLhT
NON.RESID, ( MUr
BRANCH CIRCUITS)i 12.50ea
NEW CONSTR. (POWER APPARATUS &J
NON-RESID. -SINGLE OUTLET CIR.
50 @ 250
Ex. OccuD(OUTLF=TS OR FIXTIIPES) BAL@1
FIXED APPLNS. OR %
Ex. Occup.(OUTLETS (RESID.) EA) 2.001
Temporary service 10.00
Mobile Home Facilities .00
License No. Classification
Misc. Wiring
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ JII (411b
WORKMEN'S COMPENSATION INSURANCE
.
1 am aware of the provisions of Section3700 of the California Labor ,
Code which requires every employer to be insured against liability
for Workmen's Compensation.
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL NO. @ -FEE
PERMIT FILING FEE $3.00
Heating -�tom erw,
Cooling
Ventilation
Hood 001
Permit Fee $
T_
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
I Land Development Fee
$
I TOTAL PERMIT FEE
1$ -7*71
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X z 1 06
", -C?-' _' - Date3—,7_J
Signature of Per itee or AgAvt
Receipt No. —3. (.et
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Gal denrod-Appli cant
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 Of PUBLIC WORKS
By Date �7_17—cP-
A,
Building permit expires Date 7— (7—P
a qrkvA
i
/044,3
NOTE:—All Maferials & Workmanship S!ljll Be in
Accordance wN&I, 116coalnized Good Practices -anci
of 0 clualify prei-crilbe,-I �r
'iOr The Specified use in the
Uniform Duilding, ing & MechanicdI Codes -an
the National Eleerical Code. d�__
a -Ar A setback of 5 ft. from the
I.
A6.v_,,y_ property lines and a setback
of 56ft. f ro', I +he, road
centerline shali b 'ear of
3e cl
structures or cCluipment e.,,'cept
for a 2 f1t. eaVe overhanfl.
This set of picns and specificatilons MUST I;e
kept on the 106 of all times and it is unlaw'ful'to
/ de ma!,e any chninges or alf erations on some wit hout
BUTTE COIRIITY written permission frorn f lie Department of Public
BUILDING DEPARTMENT Works, County of 84fe.
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,�f ...... ........ sq. f fj*k ... Degree Days, and Design TeTp. aret.
Slab edge ..... R
sq. ff. —
Fdn. Walls
Flwrs -'* - - - - - - R
Walk - : .. . . . . . R IL&O
S,
Ceifi6g/Roof
*-Vuvulafing 1�jpes
M f ri. Wd s,�' D f
& lolcaied
Dwh TaVe 10-D U.M.C.
swiliging E)uQt$
wedifis stripped
Hfg. & Ar�z
Eihaust Fans
baT dcawspar6d
TvPe
Gas Pif�fi;,
A� Appl6nm
intufmiffent ignition,
BTU Max A114
ce"ed
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