HomeMy WebLinkAbout024-090-07324-09-73 %�
Marvin M. Long �J
N/S O'Brien Ave.,app.380'W.off Gilstrap
Ave., Gridley 4 ,j
per it #5028-76B,P,E,M(new shgle family)
024-090-073 02-1516
KILMER, JAMES & CHERY'
271 O'BRIEN AVE., GRIDLKINALED
CONT: DAN ELIAS CONT. (-6-04
UPGRADE ELECTRIC TO 200 AMP
t
1024-090-073 05-1716
KILMER, JAMES& CHERYL
271 OBRIEN AVE, GRIDLEY
Con
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OWNER
RE-�o A A '
ROOF (25) �il�!"/ '
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NOTES
PERMIT NO.
U
i
L
RESIDENTIAL
024-090-073 05-1716
KILMER, JAMES& CHERYL
271 OBRIEN AVE, GRIDLEY
Cont: OWNER
RE -ROOF (25)
SPECIAL CONDITIONS
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY '
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
`7
CHECKED
BY
JOB FINALED (Date) Z ;� 6 �'
Signature
= OK
.Not OK
= Not Applicable MOBILE HOMES
= Not Readyeady
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer, Location -Test -Fall -C/O -Concrete
4. Water, Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or/ /" L "ftJ P LPG
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date
7. Well Clearance & Disconnect
8. Utility Clearance
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
Date
Card B-1 Date Card B-1
Date
Cana B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water, MH Test-Regulator-Connectot
7. Water and Sewer Connected -C/O to Grade -HD Approval
Date
8. Gas and Electricity Tagged
Date
9. Tie Downs -Type -Installation Cert.
Date
10. Exits; Insp.-Sketch
11. Cert of Occupancy
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Blocking
4. Gas; MH Test -Demand -Valve
5. Electricity; MH Test
6. Water, MH Test
7. Water and Sewer Connected
Date
8. Gas and Electricity Tagged
Date
9. Exits
10. License Decals
11. Verify #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg- Frg- Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date
Card B-1 Date Cana B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J = OK
= Not OK
= Not Appricable
. = Not Ready
RESIDENTIAL, (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ P' Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Ging. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting= Rtng.
49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card 8 1
Date
PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler, Test
72. Elec. Outlets at Wood Panel, Int. & Ext.
Date
Cab B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) .OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI
31. Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or AI
Insulated Neutral O Yes 0 No
32. Service -Riser Conductors & Ground Main Disconnect .
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
87. Water Well, Disconnect, Electrical, Plumbing
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain &.Overflow, Size & Grade
39. Fumace-Vent Access -Comb. Aft -Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Ging. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting= Rtng.
49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Au -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door, Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor -Meth. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (FF1.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
83. Following InstldJDrive 0 Yes D No/Walks D Yes 0 No/Planters 0 Yes D No
84. Stucco Brown -Finish
85_ A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fre Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
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
PERMIT NO.
BPO51716
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: 06/30/2005 APN: 024-090-073-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 271 OBRIEN AVE GRI
Map Index:
Date: Contractor:
Description: RE -ROOF (25)
OWNER -BUILDER DECLARATION
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: KILMER JAMES R & CHERYL,L -
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance„also requires the applicant for such permit to file a
271 O'BRIEN AVE ; ” ` `• - : t;"
signed statement,that;ha or she is licensed pursuant to the provision`s of
GRIDLEY; CA �'
the Contractor's State`License Law (Chapter 9 commencing with Section
95948 1
70obybf Oivisiori 3 of,die Business and Professions Code) or that he or
i
she is'exempt therefroniiand the bashkjor theralleged exemption. Any
violation of Section;;703.1.5 by any applicant for a permit subjects the
applicant I giyin9enaIty1bf not more than five hundred dollars ($500).):
:. '.fir F,,,.r.• , ..' '
I, as owner -of the property, or my employees with wages as their
X`
sole compensation, will do the work, and the structure is not
,,inlertded Qr,otfxred,Tfol,sale,(Sec, 7o_4a.,rpusioess and.,Professions_
_ ,, . AppllCant:_•KILMER JAM,ES,R, &,CHERYL. L
-`� - ��
Code: The: ContractorsTS.tate-.License Law does not apply to an
271 O'BRIEN AVE
- owner of, property whq guilds or, improves thereon, and who does
GRIDLEY, CA
•such.work:himself,or,,heeself or through -his or her own employees,
provided that, such improvements are not, intended or offered for
95948
sale. If however, the 6uilding'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.).
O 1, as owner of••:the.-,pcoperty,,,: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 underr Article 3 of the Business and' rofess' ns'Code
Dater O'6SOwner:
I
License #:
WORKERS' COMPENSATIO CLARATION
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
Architect:
Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ I have .and will :maintain. •workers' compensation insurance, as
-required-by Section.37o0 the Labor Code, for the performance of
the work for which this permit -Js issued. My workers' compensation
insurance carrier and, policy,number,are::.
Carrier:
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy Jt:
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
forthwithcomply with those provisions.
2 I� Co!}, '
J J`
Date:
Applicant:
i
WARNING: -""Failure to secure workers' compensation coverage is
I
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 attomeyis fees..
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Coda anrljor
I hereby affirm that there is a construction lending agency for the
Name�ance of the work for which this permit is issued (Sec 3097 Civ.)
Resolluultio/ns to do1w-o'rk indicat d above for which fees have been paid.
By t; 111�/y1 f , ��,,n )nom 1i1 Date: Go �0 ��
PERMIT EXPIRES ON:
Date
Address:
O 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 8 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 representatives of Butte County to enter upon the above mentioned property for inspection purpo es
Print Y Name: e- V- Signature:
Date: ' 30 - t�S
Owner ❑ Contractor ❑ Agent for Owner ❑Agent for Contractor
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
CONTRACTOR
Last Name /1 / L
First Name
Address 2 -7/ O '
VC
City �2!
Stat
j
ZipgS9y8
Phone/� _ �O
Fax
Fax
E-mail
l• %1
APPLICANT NAME
CONTRACTOR
Name
City
Address .
Zip
City
Fax
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Type Const.
Fax `
E mail
Map Book
State License Number
APPLICANT NAME
Name
OmmEp-
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
For office use onl
AP# c72q _ O q o -092)
Zoning
City/
Flood Zone
.
SRA
Yes
I No
Occ.
Name
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
BIN #
LOCATION
AP# c72q _ O q o -092)
Property Address
271CM 4 UCit/cee
City/
Cross Street,
/S 2 u e
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
Page 1 of 2
Description or Scope of Work:
OQ4
Sq. Footage S'
❑ 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
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 -.JA. Amount: �� r �� Bldg
SRA
Receipt It: LA a(03 Sheriff
SMIP
Date: ' 3VOther
5� Total
REV 2-24-05
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 A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (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. Detached Accessory Building Form filled out by the owner (if required).
❑ 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.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
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
K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541P MIT NO.
(Rev. 12'/96) . APPLICATION AND PERMIT 10�-1Ih
ASSESSOR PARCEL NUMBER
L:.
ZONINp
BUILDING PERMIT
OWNER
KTT ^ "" '
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAIuNG DRESS
271 ' T C-RiDLEY
CONTRACTOR'S NAME
T T .031-
TELEPHONE
1246-6472
CONTRACTORS 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
np
0"22
271 CRIDL—EY
Energy Plan Checking Fee $
-1 -EN
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ 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: UPGRADE ELE=JC SERVICE TO 200F,MP
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
Main Service 2o0A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
'�/„A1 /� 1
License Class lar. I Lic. No. V[/ l 1
-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 1, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
� I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. S.
SO
3.5Q�:
NON.REOSID. MULTI.OUT CIRCUI
@7,50
POWER APPARATUS
a SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FWTURES
B20 @ 1;00
OWNER
Ex. Occup. oTs RESSID OERA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring23.00
Pre_
PERMIT FEE t
66-00
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
Phe above sections need not be completed if the permit is for work of a valuation
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
rth ith comply' h tho"se provisions.
/
X Date
Signa re of App (cant - ❑ 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
Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee Is
Energy Inspection Fee s
occ
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP FLOOD
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.
By �� ate o2
PERMIT EXPIRES ON � �J
D to
Receipt No. 354014 $66.00
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
i k ,
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drip e,.Oroyille `CA 95965 Phone (530)538-7541 Fax (530)538-2140
' PE11MA TkAPPLICATION DATA SHEET
00L�, 096
OWNER:
nn ASSESSOR PARCEL NUMBER r
Proposed Building Use: �_ �C. Counter Technician: Date: cp -
Items required in order to apW for a permit. All boxes MUST be checked OR ma a NA in order to apply.
❑ 1.. Plot plans, 3 or 4 sets, sigtted�by the preparer of the plans:'
❑ 2. Complete plans, 3 or 4 sets; signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Energy compliance design and supporting documentation in duplicate.
❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or
foundation plans, all in duplicate..
❑ 7.. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate.
(D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be
indexed and returned to the plan review line-up when required items are received.
I Date Received By
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................
❑ 9. Plot plan and business license approval from the City of Biggs ....................................
❑ 10. Letter of intent for non-residential buildings.........................................................
,❑ 11. Detached Accessory Building Form filled out by the owner .....................................
❑ 12. Hazardous Material Form...............................................................................
❑ 13. Other ...
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet .......................................
❑ 15. Statement of Intent for Non -heated and A/C Buildings .............................................
❑ 16. Sanitation and plot plan approval from the Environmental Health Department in
❑ 17. City of Chico Plumbing permit.........................................................................
❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ......................
❑ 19. Planning approval for (A) Use: (B)Parking: (C) Parcel Check:
❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ...............................
❑Encroachment Permit for dr}veway from the Public Works Dept. (construction approval prior to occupancy).
22. Pre -Inspection for (1� �/ required ................
❑ 23. Contractor's license information. (Number, Name Style, Classification) ....................".
❑ 24. Worker's Compensation Carrier and Policy Number ...... ........:........
......................
❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
❑ 26. Letter of Signature authorization.: ..................................................................
uthorization.:..................................................................
❑ 27. Recorded copy of Agricultural Acknowledgment Statement ....................................
❑ 28. Manufactured home utility clearance...............................................................
❑ 29. Existing violations and/or expired permits.........................................................
❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
❑ 31. Other:
When issued Telephone and hold for pickup.
I have been inf m d of the abo�v�e�temi s and requirements for obtaining a building permit.
Applicant:
C"""" Date:
1. Index permit application for the above items numbered:
2. Additional items required
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by
Plans reviewed by: Date: Plans approved by:
Structural reviewed by: Date: Structural approved by:
Note transfer by: Date:
Yellow: Building Division
Plan Check Letter
_Date:
_Date:
Date:_
Date
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
APPLICATION AND PERMIT Z, P_a II
f.:UES:°4oAACEENuusEA Q� U�� U� :o.ra BUILDINGPERMIT
� C•vwEn "1 -�,,j n � � TEED-0NC
�G S i�1 �C/ �s 3ib Sa FT OCC. ! BUILDING VALUATIO�,
^w•.EA 9 w�AiNO �On152 ,� _ -�
_.^. •n-y�C 70A 5 N►Ur+O �DOAES�� 1 �� �C � -- � --
CJr•S rauC r-QN VeMO EA
VVV Ai
a i .L•.OEA s i° AooNess Fireplace
ww.—
Total Valuatlon I S
A: C••rrECT OA ENGNEEA I UCENSE NO
Filing Fee
.. C.arECT OA ENOWEEAS 4w.UNG AOCAESS Permit Fee � b
Plan Checking Fee ( 5
I S�a7+rG AGOAESS
C91 1 '1() Energy Plan Checking Fee S
5
urNO 7UaONeCN7NAYE
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
PAACEE YAP
i TYPE OF WORK
i
i New 0 Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
i
"PMkM T FEE PAID
SkA
SHERIFF
OTHER
AMOVNT RE46XVf0
$
• fir
To " Pvr sKro co#PVeie
PERMIT FEE 1_
I I Filing Fee' 20 C:
PLUMBING PERMIT
Fling Fee, 20 C:
Each Trap
7.00;
Soler or heat pump water heater !
I 23.00,
Water piping
1S.00 -
S.00 -Each
Each as water heater or vent
1S.001
Gas piping system 1 • S outlets
! 1 5.001
Building sewer !
15.00'
Mobile Home ! S! G' W j
@20.00'
!
i
I PERMIT FEE I S
ELECTRICAL PERMIT
I I Filing Fee' 20 C:
Mein Service
eoov oA ttss
200. oA tFss
I j 23.00 . -�
Main Service
pd TO IOWA
_
I i 46.00'
NEW co.ac.
OA ADONS
owEU.w° Occur
( & ACC RDS.
I I 3.SCr
NEW CONS,
NOr.AES o
I MuETFOVru T
I ! @7.50
POW" AMAAATUS
A MOLE Ouny CIA
- -
! I I
EX. Occup.
OVTUT OA nrM4Es
I ! zo 00
SAL
Ex. Occup.
F111 0 oil
OVRFT. m p EA
i I 5.00' _
Temporary Service
i 23.00
Mobile Home Facilities
20.00
'Misc.n q,
23.00' „
v,rl— I
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 1 2)
HeatingI j
Cooling! i
Hood i ! 6.50:
Ventilation 1 _
PERMIT FEE I S
Mobile Home Installation Fes I $
Energy Inspection Fee I S _
°Ca I coNaT "" TOTAL FEE $
imp ft=O col
I I
This permit is hereby issued under the applicable provisicr:
of the Butte County Code and/or Resolutions to do N
indicated above for which fees have been paid.
By
RecelptNo. PERMIT EXPIRES ON
WHIT11.00.S.•11.0. CANANV•ASSFSSOR PINK•INSPICTOR O0L0tdNA00•APP%.ICANr
024-090-073, Vo'
.,
KILMER, JAMES & CHERY'L
271 O'BRIEN AVE., GRIDLEY
CONT: DAN ELIAS CONT,
UPGRADE ELECTRIC TO 200 AMp
Fe
COPY
+�
I
i
Date
a Dat
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
• "' 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev.12 96) APPLICATION AND PERMIT � ' 15 90
ASSESSOR PARCEL NUMBER
ri ' *�
ZONING
BUILDING PERMIT
OWNER
i 1riL' , 'V A" - !7 t
I TELEPHONE
l Z 1
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING DRESS
CONTRACTOR'S NAME
S
"TELEPHONEDAN
CONTRACTORS MAIUNO ADDRESS
11147 1AURE1, Slav GRIDLEY
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 ADDRESSEnergy
271 X13_2 l
Plan Checking Fee
$
$
PERMIT FEE
$
LAT NO.
SUBDNISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump 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 ❑
Describe Work: UPGRADE rl.E MIC SERVICE M 200MIP
Gas piping stem 1 - 5 outlets
15.00
Buildina sewer
15.00
Mobile Home ISI GI W1
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 20.AORLESS
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 in full force and effect.
I Lic. No. ,L-12 /t 1 _'�
License Class.00
OWNER -BUILDER DECLARATION
I 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.
Q• I, as owner of the property, am exclusively contracting with licensed contractors
to construct the f roject.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
I 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
Pfl Riwith comply with those provisions.
i ; f
Xi. �%' : lh: Date /�-y _
Signattire ofsApoll-scant - ❑ Owner ❑'Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A 1000A
TO.INO
46.00
. SO
NEW CONSTDWELLING OCCUP. CU
OR ADDNS. ( a ACC. BLDS. 3.5¢FT.
=Ralp, MULTBRANCI-OUTLET @7,50
POWER APPARATUS
a sM1GLE CUTLET CIR.
20 Ex. Occup. OUTLET OR FDRUREs SAL I. 0
FIXED ALNS. OR
PP5.00
Ex. Occup. ourLETs RESID, EA
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
Pre-Inowtion 1. 23, 00b. 00
PERMIT FEE $ 66,
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 $
HAZ.
D. FEES
IMP
FLOOD
COF
"—
PARCEL
PD
HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
B 4,i, e
y T'
PERMIT EXPIRES ON•'
I
the applicable provisions
Resolutions to do work
been paid.
/ Date
Ddta
Receipt No. j�+C�- �
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
PRE -INSPECTION REPORT
OWNERG� .
LOCATION:
CONTRACTOR:
PRE-INSPETION FOR.
DATE: l9 � I - ua
A.P. #•�c� 69 G-
ZONING:
DATE TO INSPECTOR: N U PERMIT HLSTORY:( ) NONE KAS FOLLOWS:
Building Description:
camneroial/Usage:
Residential/# of Units:
Currently Occupied
Abandoned/Vacant
Electric:
Yes No
Gas:
Condition of Electric
BUILDING INSPECTOR'S REPORT
Electric currently On—.z Off
Natural Propane None Currently On Off
Obvious Problems:
Q
Sanitation:
Plumbing Working
Well Working Potable Water
Obvious SewageProblems —�
i
Comments:
ACTION RECOMMENDED: LSS
Inspector.
HOLD FOR
Date b ( �L
Sketch buildings on reverse and indicate location on pfopert3
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDI N
7 Count Center Drive • Oroville, California 95965 •Telephone (530) 538-7541
APPLICATION AND PERMIT
oR•.acawr.eEr 0a ,l(1 v BUILDING PERMIT
--�G e-
I :`-'•fR T w.LNa•OORESf
ani v,
:O•n �C' 4 N�LNO �O W+ESS
---LL4
_orrS Ta�CT�ON LeNOEA
j 1••OER f w Lfto AOORtSS
I
A%C-nECT OR EKrHEEA
+ C—TECr OR ENGWEERS WW.ING �CCRESS
ACOnESS 911
'111 (3 1
ur..o Sueorvs ON7 wWf
USEOFSTRUCTURE
S;: O Duplex O Mobilehome O Other
SnEcw
i TYPE OF WORK
%ew ❑ Addetan ❑ Remodel O UbWes O Installation O Other O
LICENSE No
�b SC Fr OCC ! BUILOING VgLUATin..
"PEP IT FEE PAZ0
5 P -A .
SHERIFF
OTFi�R
i
Fireplace
Total Valuatlon ! S
Filing Fee
Permit Fee
b 2:
Plan Checking Fee
Energy Plan Checking Fee
I b
I b
Mein Service
00O" oR utss
pow oR tFss
b
Main Service
PERMIT FEE
_
NEW coNs-.
OR .BOONS
PLUMBING PERMIT
; 9.SCii
Filing Fees 20
Each Trap
@7.50:
7.00•
Solar or heat pump water heater
I I
I 23.00,
Water piping
I 20 11
Y.L >0
15.00
Each gas water heater or vent
i 5.00'
15.00
Gas piping system t • 5 outlets
I
; 15.00,
Building sewer
!
15.00
Mobile Home I S G W I
@20.00'
PERMIT FEE I S
ELECTRICAL PERMIT I
I Flin Fee 2:
Mein Service
00O" oR utss
pow oR tFss
I 29.0C
Main Service
pw TO i000A I
46.00'
NEW coNs-.
OR .BOONS
ow'f1ys1pA occurs
( C RDS, 1
; 9.SCii
NEW CONSTeut
NON.Aes'o
noUTLgT I
@7.50:
rower x►ruusTvs i
a shat a aR
I I
Ex. Occup.
OVTUT Oil /DRUB ES I
I 20 11
Y.L >0
Ex. Occup.
o , ;
i 5.00'
Temporary Service
23.00'
Mcbile Home Facilities
20.00
Misc.V r 23.00
i
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 1 2:
'Heating
CoolingJ
Hood i ! 6 50
Ventlle'icn
t
PERMIT FEE i S
Mc -bile Home Installation Fee I i
Energy Inspection Fee I S
oc_ I Geier TtirE TOTAL FEE S
" TO FtJT s l+O CONI'Vt'!R o RE7 �„ no0a
This permit is hereby issued under the applicable provis'c
of the Butte County Code and/or Resolutions to
indicated above for which fees have been paid.
By 0ate �—
RecelptNO. PERMIT EXPIRES ON
WHITt-O 0.11 •8.0. CANARV•A33ES30R PINK•INSPICTOA OOLOtNR00•APPLICANr /Dole/
PERMIT NO. 5028-76B,P,E,M
m
PERMIT EXPIRES
9 ao A
OWNER Marvin M. Long
CONTR. � owner
LOCATION (A:P. 24-09-73 )
NIS O'Brien Ave.,app.380'W.off Gilstrap Ave.,
Gridley
.I
r
�11772Q�-
10
y:
7
Temp. Power Pole
Called PG&E
Temp. Elec. Serv. 'Ivla F 7�a
Called PG&E /
Tern as Serv. /— T/C�
Called PG&E
JOB
FINALED J
(Date)
(Signature)
I
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
Setback
Door Closer
DATE REMARKS OR CORRECTIONS
�daf
,;p!9��� - baa 1/.i,��2ow?' u •--Q /%/%/7
(NOTE: An entry must be made on this form each time you visit the job site.)
S2
Fiber Glass Insulation
BUILDERS INSULATION STATEMENT
BLOWN INSULATION
Manufacturer's minimum thickness to provide the level of insulation
resistance (R) Values as shown:
R Values are determined in accordance with ASTM C-687 and C-236.
Conforms to Federal Specification HHI-1030A.
This insulation has been installed in conformance with the above recom-
mendations to provide a value of R Z using 1� bags of insul -
tion to coverZ24-Zsquare feet of area. i
S
or (Sign) f�� Builder
Company Name Company Name
BATTS AND BLANKET
R INSULATION R INSULATION
R-22 6�/z" R-13 35/e"
R-19 6" R-11 3�/z"
/f_� %
Meets Federal
Specification HHI-521E
Fiber glass batts or rolls have been -installed in accordance with the
manufacturer's recommendation to provide an R -Value of in the
ceiling, in the exterior walls, in thev loor or crawl space
perimeter.% Ili ./9 . _1z
`Ins ation'ContracitSr (Sign) /_/Builder (Sign)
�v
Company N me Comp y Name
(CSG -32-11-C D to
CERTAIN -TEED PRODUCTS CORPORATION. P.O. BUX 860, VALLEY FORGE, PA. 19482 C
CERTAINTEED
VALUE
THICKNESS
VALUE
THICKNESS
/f_� %
Meets Federal
Specification HHI-521E
Fiber glass batts or rolls have been -installed in accordance with the
manufacturer's recommendation to provide an R -Value of in the
ceiling, in the exterior walls, in thev loor or crawl space
perimeter.% Ili ./9 . _1z
`Ins ation'ContracitSr (Sign) /_/Builder (Sign)
�v
Company N me Comp y Name
(CSG -32-11-C D to
CERTAIN -TEED PRODUCTS CORPORATION. P.O. BUX 860, VALLEY FORGE, PA. 19482 C
CERTAINTEED
J -O 74
TO: Building -Department
i
FROM: Lnvironme6tal riealth
jRE: Sewage and/or Nater Clearance
"LOCK^1 TIC)
A ' P
ER
Has been approved for:
S�AU� DISPOSAL/
. ;2
:)ATTR SUP -PLY /'o�C� ' 77 ✓� / ��
_ L
Sanitarian
f
1-2-s-7 7
ate
1
I S95-775
COUNTY OF BUTTE - DEP, %RTIVIENT OF PUBLIC WORKS
^ 7 County -Center Drive, Urovi I ie, Cali torn' a 95965
Telephone: 534-4541
APPLICATION AND PERMIT
Z-710
auinurize representatives of the County of butte to enter upon the
above-mentioned property for inspection p oses.
Dat 7.
Si e
oture`vof Permiteee for Age t
/
Receipt No. S 021
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 OF PUBLIC WORKS
BY Date .Zo
Bkpg permit expires Date/T���
BUILDING
Owner ��vr/V y Z
SQ. FT. OCC. BUILDING VALUATION
Z 6. / od
�`-
Mailing Address , Q, /3k Izsw-
_
9Y 2. 376 '
G
Telephone No.
673—s2#0
Fireplace / ^�s�
n_
Contractor �i®`�
Total Valuation
Mailing Address d✓
Permit Fee
/Z7. 00
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
12 .0
/ O(
Building Address s
PLUMBING No.
@
FEE
PERMIT FILING FEE $3.00 3.00
,3 44/1 0 —F
Each Trap Ag 1.50 Z. 0
Repair drainage or vent piping
1.50
Water piping 1.50 , 5
Each gas water heater or vent 1.50 . y 0
A. P. No. 2 L/_ 0 Of— -73Gas
Zoning &Planning
piping system 1 - 5 outlets
1.50/.So
Each additional outlet .30
F�
/
V)rrC tion Fire Dept.
FireZ ne
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel SA�'M
Declaratioonnj
60' R/W
Im r
p ove ents
Lawn sprinkler system 2.00
Bldg. Plans Recd Parcel Alro
Plans pproval
Permit Fee
$
Q
$
NEWJO ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No.
@
FEE
PERMIT FILING FEE $3.00
Main service 100 AMP OR1 OR LESS5.00
Main service EA. ADO'L 100 AMP
2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
IIR 600V
Main service 100E
EAMP OR LESS 25.00
Main service EA. ADO'L too AMP 1.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ACC. BLDGS.Z,4;
20sgft
0
NEW CONSTR. (MULTI -OUTLET
NON•RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS &)
RESID. (POWER
NON •( OUTLET CIR.
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
st If
style
e O:
Ex. Occup(OUTLETS OR FIXTURES) BAL@t¢
FIXED APPLNS. OR
EX. Occup. OUTLETS ( EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
EgI am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
"a to
$ ;"-07(—o
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.
❑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.1
@ I
FEEPERMIT
FILING FEE J$3.00 1 3-00
Heating
Cooling 3P'OAI 7.j O
Ventilation
Hood 2.00 00
P
Permit Fee $ , 7
$
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
TOTAL PERMIT FEE
auinurize representatives of the County of butte to enter upon the
above-mentioned property for inspection p oses.
Dat 7.
Si e
oture`vof Permiteee for Age t
/
Receipt No. S 021
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 OF PUBLIC WORKS
BY Date .Zo
Bkpg permit expires Date/T���