HomeMy WebLinkAbout024-100-026B06 -2861 024-100-076
MISCELLANEOUS Ag Exempt
Ag permit- pole barn with lean-to's
1096 LARKIN RD
FIELDS, LEIF DAVID & JACKI
24 10-76 '
HAROLD L. COBEEN '
1096 Larkin Rd, Gridley
Contr: Richard H. Carter, Live
Oak -
Permit#2605-81B(reroof/shop &
garage)SF
/9
24-10-76 593-91E
PARAPID, Michael
1096 Larkin Road, Gridley
(upgrade electrical)
`ter,
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: 1096 LARKIN RD
Owner:
Permit No: B06-2861
APN: 024-100-076
FIELDS, LEIF DAVID & JACKI
Issued Date: 01/31/2007 By KCG
Permit type: MISCELLANEOUS
1096 LARKIN RD
Subtype: Ag Exempt
GRIDLEY, CA 95948
Expiration Date: 01/31/2008
Description: Ag permit- pole barn with lean-to's
(530) 846-1430
Occupancy: U-3 Zoning: A10
Contractor
Applicant:
Square Footage:
FIELDS, LEIF DAVID & JACIt
Building Garage Remdl/Addn
1096 LARKIN RD
GRIDLEY, CA 95948
Other Porch/Patio Total
(530) 846-1430
FEE INFORMATION
Ag Exemption Permit $109.98
EH Building Review Fee $70.00
Total Charged: $179.98 Fees Paid: $179.98
Balance Due: $0.00 Receipt No: B1235
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
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 with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
X
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil of not more than five hundred dollars
01/31/2007
penalty [$500];
Pease check one of the following: ,
Contractors 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
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
WORKERS' COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
HAVE AND
the work himself or herself or through his or her own employees, provided that such improvements
❑I 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, as required by
❑❑
Section 3700
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
The Contractors License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Cartier: Policy Number: Exp. Dale:
(This section need not a competed if the permit is or one hundreddollars ($100) or less.)
❑ IAM EXEM der Se n B. 8 P.C. for this reason:
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 ws of California, and agree that if I should become subject to the workers'
O 01/31/2007
compensatio rovisions of ctio 700 of the Labor Code, I shall forthwith comply with those
wne Signature Date
provisions.
X q 01/31/2007
I 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
ShAtifure Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, 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
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
injury, including dee and property mage caused arising out of, in any way connected with
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
t is
the issuance of lh' ermit. I hereb no ledge that issuance of this permit does not authorize the
a
use or occupan f any sidewa , ree r subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to en t above me ed party for inspection purposes. I hereby certify that I am the
pro er am author' d to on the property owners behalf.
CONSTRUCTION LENDING AGENCY
01/31/2007
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
me of ermitt SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
Owner 1:1Contractor OR; ElAgent for Owner ❑Agent for Contractor
FILE COPY
Lenders Address City State Zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVIILE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
AGRICULTURAL BUILDING EXEMPTION STATEMENT
Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house
farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of
human habitation or a place of employment where agriculrural products are processed, treated or packaged, nor
shall it be a place used by the public.
Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for
an agricultural exemption.
Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any
requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte
County Environmental Health, or any state and federal agencies
Initials L, AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
Initials �,� AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence,
10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings
Initials, L ,,.Ae- AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a
residence and a manufactured home, and 40 feet from a commercial/industrial buildings
Site Address:
1096 LARKIN RD
Permit No: B06-2861
APN:
024-100-076
Square Footage: 0
Permit Type:
MISCELLANEOUS
Occupancy: U-3
Permit Subtype:
Ag Exempt
Zoning: A10
Description:
Ag permit- pole barn with lean-to's
Required Setbacks:
Applicant:
FIELDS, LEIF DAVID & JACKI
Front: 55' Side: 20' Rear: 20'
1096 LARKIN RD
GRIDLEYCA95948
Type of Construction:
(530) 846-1430
Type of Siding: Other
Owner:
FIELDS, LEIF DAVID & JACKI
Est. Const. Cost: $ 8,000.00
1096 LARKIN RD
GRIDLEY, CA 95948
Roof Covering: Metal
(530) 846-1430
Floor Type: Roadbase
I declare under penalty of perjury that the building will be used as stated above, and the proposed use
conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will
contact the Building Divison aobtain t e necessary permits, inspections and approvals to comply with the
te requirements in effect at tha an for to occupancy.
Signature of owner: o
g Date: 12/18/2006
Si
FILE COPY
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buftecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name
-i�l,o
Name
irst Name
LrlF
Mailing Address 0 q (D
L9 ouN 2 otgo
City /'_R 10L9
Fax
State C�
Zip 9:yq q�
Phoney 8qL- Iy3'o
Lot #
Fax
E-mail
Date Approved:
APPLICANT INFORMATION
CONTRACTOR
Name
.�
Address
Zip
City
Fax
State
Zip
Phone
Lot #
Fax
E-mail
Date Approved:
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Lot #
Fax
E-mail
Date Approved:
State License Number
APPLICANT INFORMATION
Name or
u� r'1.2
Address
City
State
Zip
Phone
Fax
E-mail
AP LICANT SIGNATURE
'Al2el"I'l i
X .S
For office use only:
AP# 10Z) - 0-7
Zoning
Flood Zone SRA I Yes No
Occ.
Type Const.
Subdivision Name
Carrier
Map Book
Page
Lot #
Planner
Address
Date Approved:
PERMIT
NO.
BIN #
PROJECT LOCATION
AP# 10Z) - 0-7
Property Address
109(a trialN coo
City,
�t�rOL
Cross Street
04if) reN
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at Me time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
iALf- bj4klo WIT L g.4
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
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 Amount: �. V Bldg
SRA
Receipt #: ___Sheriff
b _,._ _SMIP
Other
Date:
Date: `� f V --7 t -Total
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
I PERSONALLY PL TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT.S OR NO)
I IAV HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: Ag permit- pole barn with lean-to's
Reference Number: B06-2861
Applicant Name: FIELDS, LEIF D ID & C
Signature of Property Owner: Z Date: /o7 $ a
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
0 Make sure your application is complete.
0 Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY
Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the pe who originally paid the fees. Refunds for permit applications
(not yet issued) must be requested within two years m the date of fee payment. Fees paid at the time of application are
for Plan Check and administration. The Plan C portion of fees i�dedu
ridable only if the permit is cancelled or withdrawn
before any plan checking is done. Buil g Division costs will bted prior to authorizing a refund and a charge of
$54.99 to process the refund applicatio ill be assessed. Refunds on permits (i�s need) may be requested prior to the expiration
of the permit, provided no work h een done pursuant to the permit. An Inspection 4y be required (and deducted from any
refund amount) to determine work was done. \
Fee/refund information can be read on-line at http://municiDalcodes.lexisnexis.com/codes/butteco/
Reference Number: B06-2861
Location: 1096 LARKIN RD
Parcel Number: 024-100-076
Owner Name: FIELDS, LEIF DAVID & JACKI
Description: Ag permit- pole barn with lean-to's
Signature of Property Owner: I b
FILE
Date: 12/18/2006
Phone: (530) 846-1430
Date: 12/18/2006
BUTTE COUNTY FEE SUMMARY
7 County Center Drive
Oroville, CA 75965
Department of Development Services
Phone (530) 538-7541 Fax (530) 538-2140
Permit Number: B06-2861
Job Address: 1096 LARKIN RD
Contractor:
Printed: 12/18/2006
3:06 pm
Fee Description Account Number Fee Amount Paid Date Pmt Amt
Ag Exemption Permit
0010-440001-4210500-1010 $109.98 12/18/2006 $109.98
EH Building Review Fee
0021-540013-4614901-1010 $70.00 12/18/2006 $70.00
Printed By: Gwyn Benedict
179.98 $179.98
Balance Due: $0.00
At the time of permit application, I was advised the above fees are required prior ro issuance of the permit. These fees may be changed during the plan
checking process.
Signature: Date: 12/18/2006
Pursuant to Government code Section 66020, you are herby notified those items listed above may been imposed on your project. You have 90 days from
the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a
protest are specified in Government Code Section 66020(a).
Butte County Department of Public Works
J. MICHAEL CRUMP, DIRECTOR
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 75965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
0
0
O
0
0
0
O
on
uc =;V_ �
National pollutant Disharche Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
[LESS TH.!%-N 1 ACRE 1
Reference Number:
B06-2861
Date:
12/18/2006
Location:
1096 LARKIN RD
By:
GLB
Parcel Number:
024-100-076
Sub Type:
Ag Exempt
Owner Name:
FIELDS, LEIF DAVID & JACKI
Phone:
(530) 846-1430
Description:
Ag permit- pole barn with lean-to's
By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more
of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California
Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but
when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm
Water Permit from the state of California Regional Water Quality Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water
Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or
more of land may result in revocation of grading and/or other permits or other santions provided by law.
Signed:
Title: QW N,(R_
FILE
Date: 12/18/2006
s _ NO. 2605-81B
p PERMIT EXPIRES 7/10/82
OWNER HAROLD L. COBEEN
CONTR. Richard H. Carter, Live Oak
ASSESSOR PARCEL 24-10-76
i'
LOCATION 1096 To kin Rd, Gridley
Temp. Power Pole—
Called PG&E —
Temp. Elec. Service
Called PG&E_
Temp. Gas Service _
C;
JOB F
Si
J = OK
0 = Not OK
- = Not Applicable
* = Not Ready
MOBILEHOMES MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
2. Footings; Size-Depth_Spacing-Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"_PG
7. Utility Clearance
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
MOBILEHOME INSTALLATION (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Date
POOLS (Plans) OK except Lt'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 Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
4. Elec.; Receptacles and Lighting; Distances-GFI
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
9. Exits; Insp.-Sketch
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg,
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
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 -BI Date
I
7
a
V = OK
O = Not OK
- = Not Applicable' RESIDENTIAL (Single and
� Not Ready
r
Duplex)
Date UNDERFLOOR Plans OK exce t#'s
fate
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
Elec. Receptacles Spacing -Lights & Switches at Doors
48.
Property Line Firewall & Openings
2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
2 Appliance Circuits in Kitchen & Conductor Size
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes El No
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
Equip. Clearances; Panels-Motors-Mech. Equip.
51.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
Card -BI
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
_
10. Water Pipe; Test -Anchors -Regulator -Service Test
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof) Qf
Fire Stops: Furred Ceilings -Stairs -Chases -Tub
-41.
42.
43.
43.
44.
11. Electric; Underground
_
45.
46.
47.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Garage Fire Protection Framing
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Card -BI
Date Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI Date Card -BI Date
Date
FINAL (Plans) OK except #'s
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI Date Card -BI Date
Date PLUMBING (Permit) OK except #'s
57.
Smoke Detector
_ 14. Water Ht.; Vent -Access -Combustion Air
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
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
19. Gas Pipe; Size & Anchors
62.
Stairs & Rails
Card -BI
Date Card -BI Date
Card -BI Date Card -BI Date
_Date ELECTRICAL (Permit) OK except #'s
20.
Fixture & Transformer Clearance -Ins. Protection
21.
Elec. Receptacles Spacing -Lights & Switches at Doors
22.
23.
24.
Size Boxes & No. of Conductors -Stapled
Romex Installed Close to Edge of Studs & C.J.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
25.
2 Appliance Circuits in Kitchen & Conductor Size
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes El No
28.
Service -Riser Conductors & Ground -Main Disconnect
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
30.
Clothes Closet Light -Shower Light
Card B -I
Date Card -BI Date
Card B-1
Date
Date Card -BI Date
MECHANICAL (Permit) OK except #'s
31.
_A.C. Ducts; Insulation & Support
32.
Vent Fan; Exhaust above Insulation
_
33.
Condensate Drain & Overflow; Size & Grade
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
____Date
Card -BI Date
Card -BI
_
Date Card -BI Date
Date
FRAMING(Plans) OK except #'s
36.
_Sills; Proper Material & Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
_
38.
39.
_40.
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof) Qf
Fire Stops: Furred Ceilings -Stairs -Chases -Tub
-41.
42.
43.
43.
44.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rftr. Ties -Purl in -Roof Brac.-Truss-Shthnq.-Rfnq.
Fireplace Ties or Type A Flue -Fireplace Throat
_
45.
46.
47.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Garage Fire Protection Framing
63. Fireplace or Stove; Clearances -Hearth
64. Elec. Outlets at Wood Panel; Int. & Ext.
65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
66. Elec. Outlets & Receptacles at Kit. Counter
67. Garage Fire Door; Swing -Landing -Closer
68. A.C. Duct in Garage -Damper
69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
70. Plb., Elec. & Mech. Equip. Listed for Location
71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
72. Insulation -Foam -Looked in Attic El Yes
73. Guard Rails & Deck Construction -Post Caps
74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes []No;
Planters ❑Yes CJ No
76. Stucco; Brown -Finish
77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79. Water Well; Disconnect, Electrical, Plumbing
80. Exterior Elec. Trim; G.F.I. Receptacle -Underground
81. Ventilation throughout House
82. Glass Protection
83. Corrections from Previous Inspections
84. Gas Test -Meters Tagged; Gas -Electric
85. Water & Sewer Connected -C/O to Grade -HD Approval
86. Energy Compliance Certificate -Other Certificates
Card -BI Date Card -BI
Card -BI Date Card -BI
Card -BI Date Card -BI
Comments at Final:
(NOTE: Anentrymust be made each time you visit job site)
Date
U
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4 41%���
APPLICATION AND PERMIT
ASSESSOR PAR EL MB
/f —` /4,
ZONING
BUILDING PERMIT
Op7 �L� L�v�
�OWNER'S /iM/
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
�
V
ING ADDRESS
•0. 50K D/
CONTRy rA ^�IJ{ME
/'/9/'Mrn/,ILING_0;Y
yEyyEp�Oy / +
l/i/�S�L OBJ
CONT�/GCTO
`/(/`�, Z[ V I_ : "
/// /-�
S /C�Ji/jCJ� jJJ/ �
Fireplace
CONSTRUCTION LENDER
_
U K�, NOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ W -OD
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ r 00
BUILDItl PRESS [.A �ez A/ /
UU (/v"
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
n
/v(�T
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTU�RRE, dQ f,
SF Duplex❑ Mobilehome❑ Other ��P //�4�
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instal lationOther
Describe work: _eE ,000JC Lt%% GDy%�
S/1J/ _ LeS
NNN
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 00V OR LE
100 AMP ORSLESS
5.00
Main service EA. ADD'L too AMP
2.50
NEW CONST. DWELLING OCCUP.N)
OR ADDNS. ACC. BLDGS.
2Q Sq ft
VCONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
.1 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.;L0 �� Classification V
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR. .OUTLET 2.5Oea
NON.RESID BRANCH CIRC TS
NEW CONSTSL ( POWER APPARATUS 61
NON.RESID. SINGLE OUTLET CIR. /
Ex. Occup OUTLETS OR FIXTURES a ��
IXED APPLNS. OR
EX. OCCup.(OUTLETS (RESIDJ EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
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
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant': If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply' with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
S
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, j gments, costs, and expenses which may in any way accrue
agains said C nt i consequ nce of he granting of this permit.
X Date
Signature of Applicant — Owner ❑ Contractor X AgenIt"D
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. GROUP
TYPE of CONST.
PARCEL
PD
HD
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
e
BY d 04RQOF PU LIC
PERMIT EXPIRES Jr Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
7Date ��,�Q�
L �O"Vz—
Receipt No. �ZS�2 �
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
YR#t`j:.'ijlij:�hr.`r� Yipy(�' `�T'.s�.r < ..y ..,r .. _ r .sg.,: .*r.. . .:,y „Z, ;..t•
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovllle, Callfornle 95985 - Telephone: 918/538.7541•,� 93 —Cl/
APPLICATION AND PERMIT
A811195111OR PARCEL. NUM1111KIIII
ZONING
BUILDING PERMIT
"arapid, Michael
`j
SO. FT. OCC. BUILDING VALUATION
D 1lJ`j0' %ar yA 1�tj iE; °Gridleq 95148
CQLNTReAr TOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
C%S RUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS -
Permit Fee
$
ECT OR ENGINEER
AWITTne
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BY1W1a°r'kYAsRd. , Gridley
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
E
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
1
Water piping
5.00
Each gas water heater or vent
5.00
USE OF STRUCTUggE
elec
SF ❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
0.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities F! Installation ❑ Other
Describe work: upgrade elec
fleffnit Fee
$
bontractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADO'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the uslness
and Professions Code and my license is in full force an effect.
License No. Classification.
compen-
sation, will do the work,and the structure Is not intended ooffered
1, as the owner, or my employees with wages as their sole1'ontrac
for sale. (Sec. 7044)
ElI, as the owner, am exclusively contracting with licensed t-
ors. (Sec. 7044) I
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUR.& ,
OR ADONS. ACC. BLOGS. /20sgft
NEW CONSTFL ULTI.OUTLET ' Q,SOea
NON•R ESID BRANCH CIRC ITS
POWER APPARATUS 6
SINGLE OUTLET CIR.
/
EX. OCCUp\OUTLETS OR FIXTURES Z0950t
eAL030
FIXED APPLNS. OR
EX. DCCUp. OUTLETS (RESID.) EA.� 2.00
Temporary service 10.00
Mobile Home Facilities .� 15.00
Misc. Wiring !c: 15.00
Perm t Fee $ ?fi...Sd25
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
E] I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure. '
I shall not employ any person,in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal l be deemed revoked.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
AL
Cooling
g
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. 1 agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree`too—s� indemnify and keep harmless the County of Butte against
all Iiabili les, judTments, costs, and expenses which may in any way accrue
against s County in conseq ce of the granting of this permit.
?, _ 19Z
X Date
Signature of Applican — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
-
52.50
HAz.
CUA
PARK
SCHL
FLD
coF
PAR
PD
I Ho.
Iss
This permit is hereby issued unoer the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRE 0 0 PUBLIC WORKS .
�r : 9l
By `, 13' to 3
PER IT EXPIRES Date Z--
Receipt No. RUIIX (
WNITC-D.P.W., TELLOW-ASeE790R, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
_�V93-ql
AA
A33IK32OK PARCEL NUMMIER
_
BUILDING PERMIT
arapid, Michael
T M_899S
SQ. FT. OCC, BUILDING VALUATION
O1plbF�rj 3 rAI IIyG AQD,RE"Gridley 95948
l �f (� j,ar in
C NTRACTOR'S NAM
8wner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CRNNSTRUCTION LENDERoneUNKNOWN
Total Valuation $
Filing Fee
$ 1000
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
done
LICENSE NO.
Plan Checking Fee
,b'
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
By�q`Lar�CinSRd. , Gridley
Permit fee
$
PLUMBING PERMIT Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping ,
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
elec
SFO Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ttt��
� Installation ❑ Other ❑
Describe work: upgrade elec
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service eooV OR LESS
100 AMP OR LESS
10.00
10 QQ
Main service EA. ADD'L 100 AMP
2.50 2 50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
•
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license Is In full force and effect.
License No. Classification.
I, as the owner, or my employees with wages as their sole Compen-
TTT sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.d+
OR ACDNS. ACC. BLDGS.
,/2¢sgft
NEW CONST R.U OUTLET
NO N•R ESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS e\\
SINGLE OUTLET CIR. /
Ex. OCCUp\/ OUTLETS OR FIXTURES
20®e0t
eALeeo
Ex. Occup. FIXED APPLNS. OR OUTLETS L SID.) EA.I
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
9 Misc. Wiring
15.00 15 QQ
Per It Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
i17( I shall not employ any person in any manner so as to become subject
J� to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
9
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that i have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agr o s e, indemnify and keep harmless the County of Butte against
all liabi hies, jud ments, costs, and expenses which may in any way accrue
against Cou yin conseq nce of the granting of this permit.
%� Date
Signature of Applican — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height..
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
EH,
CONST TYPE
TOTAL FEE $ 52.50
HAz.
cuA PARK
SCHL
FLD
cDF
PAR
PD
I HD.
ISS
This permit is hereby issued under the applicable provi-
cions of the Butte County.Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRE O O PUBLIC WORKS
By � Date
P IT EXPIRES Date �L Z�
Receipt No. X391 X
WNITE-D.P.W.. YELLOW-ASeE330R. PINK -INSPECTOR, GOLDENROD -APPLICANT
OWNER
--- --��i
COUNTY OF BUTTE - DEPARTMEN'T,OF PUBLIC WORKS!- BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
V,
PERMIT A-PEld"AT:ION DATA SHEET
Permit No.
Proposed Building Use
A P _
Bui ding Inspector
Date
1
M,/
At time of permit application, I was advised the following data.must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . ........................ ..........
2. Plot plans in duplicate/triplicate, signed by preparer of plans ........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ...............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions........................................................
10. Fees of $ ........................
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
10Driveway permit (cont—G r ct' . approval required prior to occupancy)
IZ 20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization .................................. .
26.
27.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup a office. Deliver w/inspector.
Other
Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone--nail_counter\by ..date
Contractor, designer, owner, was advised of above required data by—phone —mal l_counter by date
Plans checked by Date Plans approved by \ Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnece sary delay in processing and issuing your building permit. No building permit
will le issued until this verification is received.
1. I personally plan to provide the mlabor and materials for construction of
/the proposed property 'mprovement (yes)or no)
2. I (hav / ave not) signed an application for a building permit
fo a proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed:
Property Owner
Social Securit Nu er $
Date .?—/- �i
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit. .
PRE -INSPECTION
OWNER: / 1 ! T �i ( a M i f D DATE
LOCATION: �D � L2 eel A D A.P. # - eoe-e'7�
CONTRACTOR: (�N /� ZONING ! U
-v
PRE -INSPECTION FOR: U T (1 J12,47,
DATE TO INSPECTOR,
PERMIT HISTORY: E NONE 0 AS FOLLOWS:
TYPE OF OCCUPANCY
FIELD - INFORMATION
BUILDING USAGE:
TENNANT:_/�n� e/cl32-
CCUPIED Eg-HAS ELECTRIC 6S GAS EErHAS SANITATION FACILITIES
[El"H*EATED-COOLED PERSON CONTACTED /V/,4 -
OTHER COMMENTS:
ACTION RE.COMMENDED:
ISSUE Q HOLD FOR
OTHER:
BY
DATE 3
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSESSOR PA L NUMBER �
'
ZONI
BUILDING PERMIT
OWNER 1
TEL PMO E
_ 693
S0. FT. OCC. BUILDING VALUATION
OWNER 'kJ1ALLLIN AICIPRESS
/09 �14rk1"w ,fid
CONTRA R•S N
TELE HONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 10.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING AOpR S it
p(`
49 A) k77
Permit fee
$
PLUMBING PERMIT Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
Duplex❑ Mobilehome❑ Other a
SPECIFY
924e
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00 ea
TYPE OF WORK
New❑ Addition [_1 Remodel❑ UtilitieXS Installation Other ❑
�Describe work: _ 9
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP OROR LE SLESS
10.00 c
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.
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
El I,
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. Business and Professions Code
for this reason
Main service EA. ADD'L 100 AMP
1 2.50
NEW CONST. DWELLING OCCUP.aI
A
New
,
hLDGS.¢sgft
CONaSTR.� ULTBI OUTLET
....RF
ON.R ESID BRANCH CIRC ITS
2.50 ea
POWER APPARATUS e
-SINGLE OUTLET CIR.
EX. Occup( OUTLETS OR FIXTURES
P
2093ot
eAL030
FIXED
Ex. OCCUp. OUTLETS PAPLNS.(RESID 1REAJ
2.00
Temporary service
10.00
Home Facilities
15.00
Misc. Wiring
15.00 O
s
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
Hood
3,00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County or
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
�( Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ S ' �—
HqZ
CUA PARK
SCHL
FLD
coF
PAq
PD
I HD. ISSUE
This permit is hereby issued unser the appiicab:e provi-
sions 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
PERMIT EXPIRES Date
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
��R o SITE D LAN
.....:......:...........:...:.....r..••----..:...- ...---••-:••--..7_•...:__.-- ..... -_....-:-•----:.....--••--------: --•----.-- •- •---_•._•:.---- - -....................- -..................• •..............
.._..... . • ....
......:.. _.. _.:..........._ .. ..
:. : :3:�ie
..
:..
.. ._ .. .. ..4.....� .. .. ..
:r
'.
�._ ..
---- ..
' 1/ I
—w:
-- .. .. .. .. .. ._ . .
.. .. .. ..
..
- --. D-- -tea-- .. ..
n!a
rr {
t�
.... .. _.
[ i_ is . _. .. _ _ .. .. _ .. .. ._........ .. .. -----------
.. .. .
k `1
:1
__ ..:._ ...... .. ......... ...................................._ ..
• V
-��A- :
........_ :...;....._ : ..__._ _ .. _ .. +� , o { ,�
/ ,. /� _ .. _ .... F.r fYvi r� f•CJ�t.•tit Y�JtX'17Y rt �'t!: •• ••
d
yl _.•
..............{ h F Pa;icin Lard n
•,err• .�;.. .�. .-ci-•-s-•-•• ..�--`--`-• - -- -_P�. .. ..
.............. .. OtE�er.
- - . -..................... .. -• -......• .. .._.. _ ........... ............
�"
S::n
ate:
n.
__ _ _
F� C
4
5
i r
• -v
i
—
_ _ y'
_ t•.f i� •:- f
:.j
t-
r G
t'
J
7 _ -�--. _.a.,
. . . . . . . . . . . .
.. _ ..a._ : �"i.
_.
E..
•N
�C
6
f
(_ 4
ti
_
`.
1�
✓ _
- Pk��
w
v� _
_ h
c.
t
•_4
i
f h
E .�
rF •s:
'1
r .y
I'
t
Y
t� .
:�
_ .... .. .. .. .... _
E
.-- -. ' • .... - - . _ .. _ _.. _.. .._... .....- --- .. .. .. . .. .. .. .. .. .. ..
- - - -
.. .. =-#
.. .. ................ .{. .{. _. -. .. .. .. .. .. _. .. .. .. _. ..
.4...j... ..
i.............i......y..........{............} .. .. R i
' V
�ra
N L
U
tIV �.,'
_ _ _= —-
7 7\c ,p�
9
..... 1CT...
:
. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . : . .
t iJ �ro i c......
t� t7C�i%'
.. r�
:.
;.. ......
!.:
z
.t s
•X•c......
P ..... . ..... .
... . ........... . ..... ...... ..... ............Lr...... . ..... ..... . ..... ..... . ..... . ........... . ..... . ........... . ..... . ........... . ........... . ..... . ........... . ... ......... .... . ..... .............
Assessors Parol Number. 0®®0 M 0 F m F® F Scale: 1" _
Owner name LF -Ir frtw-L CE 5
Address / Phone No. 10q W LA SE►t1 ROAD ���� -� � l If -111159419
Site Location S A nt. E
Contact: Name Phone
oezb= 4 2=3 .
FOR OFFICE USE ONLY
Zoning:
General Plan Desig:
Size, Acres
4.0(r
PROVIDE FOR ALL -
ADJACENT PARCELS
SIZE (AC):
ZONING:
GEN PLAN:
USES:
..
.. ......
...... ...
++P 7 F
.. ..
`.
_ _
............. .......!.
aL........
• ice._
��R o SITE D LAN
.....:......:...........:...:.....r..••----..:...- ...---••-:••--..7_•...:__.-- ..... -_....-:-•----:.....--••--------: --•----.-- •- •---_•._•:.---- - -....................- -..................• •..............
.._..... . • ....
......:.. _.. _.:..........._ .. ..
:. : :3:�ie
..
:..
.. ._ .. .. ..4.....� .. .. ..
:r
'.
�._ ..
---- ..
' 1/ I
—w:
-- .. .. .. .. .. ._ . .
.. .. .. ..
..
- --. D-- -tea-- .. ..
n!a
rr {
t�
.... .. _.
[ i_ is . _. .. _ _ .. .. _ .. .. ._........ .. .. -----------
.. .. .
k `1
:1
__ ..:._ ...... .. ......... ...................................._ ..
• V
-��A- :
........_ :...;....._ : ..__._ _ .. _ .. +� , o { ,�
/ ,. /� _ .. _ .... F.r fYvi r� f•CJ�t.•tit Y�JtX'17Y rt �'t!: •• ••
d
yl _.•
..............{ h F Pa;icin Lard n
•,err• .�;.. .�. .-ci-•-s-•-•• ..�--`--`-• - -- -_P�. .. ..
.............. .. OtE�er.
- - . -..................... .. -• -......• .. .._.. _ ........... ............
�"
S::n
ate:
n.
__ _ _
F� C
4
5
i r
• -v
i
—
_ _ y'
_ t•.f i� •:- f
:.j
t-
r G
t'
J
7 _ -�--. _.a.,
. . . . . . . . . . . .
.. _ ..a._ : �"i.
_.
E..
•N
�C
6
f
(_ 4
ti
_
`.
1�
✓ _
- Pk��
w
v� _
_ h
c.
t
•_4
i
f h
E .�
rF •s:
'1
r .y
I'
t
Y
t� .
:�
_ .... .. .. .. .... _
E
.-- -. ' • .... - - . _ .. _ _.. _.. .._... .....- --- .. .. .. . .. .. .. .. .. .. ..
- - - -
.. .. =-#
.. .. ................ .{. .{. _. -. .. .. .. .. .. _. .. .. .. _. ..
.4...j... ..
i.............i......y..........{............} .. .. R i
' V
�ra
N L
U
tIV �.,'
_ _ _= —-
7 7\c ,p�
9
..... 1CT...
:
. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . : . .
t iJ �ro i c......
t� t7C�i%'
.. r�
:.
;.. ......
!.:
z
.t s
•X•c......
P ..... . ..... .
... . ........... . ..... ...... ..... ............Lr...... . ..... ..... . ..... ..... . ..... . ........... . ..... . ........... . ..... . ........... . ........... . ..... . ........... . ... ......... .... . ..... .............
Assessors Parol Number. 0®®0 M 0 F m F® F Scale: 1" _
Owner name LF -Ir frtw-L CE 5
Address / Phone No. 10q W LA SE►t1 ROAD ���� -� � l If -111159419
Site Location S A nt. E
Contact: Name Phone
oezb= 4 2=3 .
FOR OFFICE USE ONLY
Zoning:
General Plan Desig:
Size, Acres
4.0(r
PROVIDE FOR ALL -
ADJACENT PARCELS
SIZE (AC):
ZONING:
GEN PLAN:
USES: