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HomeMy WebLinkAbout024-110-011J I 024-110-011 99-2612 JEFFERS, WINCHEL 906 GILSTRAP AVE., GRIDLEY CONTR. K DESIG VINYL SIDING 024-110-011 01-3] 23 WIN JEFF 5 906 GILSTRA GRIDLEY CONT: NORTH VALL C NEW MAIN SERVICE la' a 024-110-011 C4-1495 JEFFERS, KEVIN 906 GILSTRAP AVE, GRIDLEY Cont: SPENCER INC IMALE HVAC REPLACEMENT BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-766 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.Wttecounty.net\dds t PERMIT NO. BP041498 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under I �/ provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/25/2004 APN: 024-110-011-000 the Business and Professions Code, and my license is in full force and effect. License Class: &—ZD License Number: t'pd /�I Z`� Site Address: 906 GILSTRAP AVE GRI Date: S L5 06 Contractor: �� l»�r��r �-�� Map Index: Description: HVAC REPLACEMENT 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 permit to construct, alter, improve, demolish, or repair any structure, prior Owner: JEFFERS KEVIN E & SUSAN to its issuance, also requires the applicant for such permit to file a 906 GILSTRAP AVE signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section I GRIDLEY, CA 7000) of Division 3 of the Business and Professions Code) or that he or r 95948-9757 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their ) ., t sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: JEFFERS KEVIN E &SUSAN Code: The Contractors' State License Law does not apply to an pP owner of property who builds or improves thereon, and who does I such work himself or herself or through his or her own employees, t ' provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one t year of completion, the owner -builder will have the burden of , proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor:. SPENCER INC., R.B. and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1188 HASSETT AVENUE ❑ 1 am Exempt under Article 3 of the Business and Professions Code YUBA CITY, CA 95993 530-674-8307 Date: Owner: License #-- 664429 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect' - ' is issued. I have and will maintain workers' compensation insurance, as + Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: T ,4ec- Total Square Ft: 0 S.F. Policy #: Z o 41-58 Z :7 o l Valuation: $0.00 t Census Code: ❑ 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, C /e and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Z Applicant: (f v WARNING: Failure to secure workers' compensation coverage is 4., unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of JY� compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This p it s here i u der he licab�e provisions of the Butte County Code sndlor hereby affirm that there is a construction lending. agency for the ,Rewt� _io to d o _' __. _, _ _ o f h _ es ay een paid, _ -6030 performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: Date : PERMIT EXPIRES ON: Date Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. 1 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 purpose I -" N d— 13�U/ �� Print Name: I` C h a cf Signature: Dater 0 Owner ❑ Contractor ❑ Agent for Owner IrAgent for Contractor ��-.., _ _.. . _ -- -_... ..� ...r.;.r - • -.�.: ,a-.�.,:�;•--.-:�.-, mac° v .. . , ., .iq COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751; 7 County Center Drive • Oroville, CA • (530)'538-7541 =. • Y+ CORRECTION NOTICE OWNER PERMIT NO. f A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately.' 'tea • l;2 r. Y; 4t `3 .4 cy* 4 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.neAdds PERMIT NO. BP041498 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/25/2004 APN: 024-110-011-000 the Business and Professions Code, and my license is in full force and effect. License class : 6-20 License Number: Site Address: 906 GILSTRAP AVE GRI Date: 5 L5 O Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: HVAC REPLACEMENT Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: JEFFERS KEVIN E & SUSAN to its issuance, also requires the applicant for such permit to file a 906 GILSTRAP AVE signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section GRIDLEY, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95948-9757 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: JEFFERS KEVIN E &SUSAN pp owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor:. SPENCER INC., R.B. and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1188 HASSETT AVENUE ❑ 1 am Exempt under Article 3 of the Business and Professions Code YUBA CITY, CA 95993 530-674-8307 Date: Owner: License #: 664429 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 Architect: is issued. I have and will maintain workers' compensation insurance, as ' Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Zen:-F(� ��5 — i><o� Total Square Ft: 0 S. F. Policy #: Z 0 6S *Z :7 S o ( Valuation: $0.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued, 1 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 forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This p it s here i u er he lice a provisions of the Butte County Code anrUor I hereby affirm that there is a constructionlendingagency for the Re io to d o o f h es av een paid. performance of the work for which this permit is issued (Sec 3097 Civ.) —" Name: By Date: PERMIT EXPIRES ON: Date Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos . Print Name: GNa d— cetf I' r^ _C,9!�J CP+\ o Signature: Date: ❑ Owner ❑ Contractor ❑ Agent for Owner 'Agent for Contractor L BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVELLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION OWNER Name Address - �) 54 Atl-- City State G� Zipc3 S9 Its Phone �`/6 Fax E-mail CONTRACTOR Name Address Pee an Cityc`_. / v StateC � Zip �s Phone _87`307 Fax G 7 —3P Z - E -mail Lic. W z/v Clas� Z. APPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name oh, e_ Address SRA City I No State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT SIGNATURE X For office use only: APPLICANT NAME Name Flood Zone Address SRA City I No State Zip Phone Map Book Fax E-mail Planner APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS KAFORMSWILDING F0RMS\BIdgApp1SubRgmts.doc PERMIT NO.4 B BIN # LOCATION Property Address 5awt� Cross Street I —J WORKER'S COMPENSATION Policy Number z ops sZ 73- a r -H -d Carrier ; f� 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. . per, Address Description or Scope of Work: JAp d- Air Ga N1a,-e^e n .4- Sq. Footage ❑ 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. -RoNved by. Amount Bldg SRA eceipt #' , / J Sheriff AUV 1� ::D—Smlp �—' Date: Other 1010 _J—J � Total Page 1 of 2 REV 4-30-04 SUBMITTAL REQUIREMENTS ` The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to mobile or modular homes.) ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. ❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 024-110-011 01-3123 WINCHELL, JEFF 906 GILSTRAp AVE, GRIDLEY CONT: NORTH VALLEY ELEC NEW MAIN SERVICE' OFFICE COPY Address, GAS Date----' Meter BY ELECTRIC Datw&4 Meter By 1 . �l ,f.C" ,,ft • ,ly f• • IIl rslt�•'fiiL - t gCOUNTY 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 01-3123 ASSESSOR PARCEL NUMBER 024-110-011 ZONING A r% BUILDING PERMIT OWNER X1Ne- 1� ��r�r S t TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS GRIMM906 (;TTJq'MAP AVE, 059AS CONTRACTOR'S NAME vF,ry ac TELEPHONE 946-2081 CONTRACTORS MAILING ADDRESS ' CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 6 G n • 1lC�+ M AVE GRIDLE Energy Plan Checking Fee $ $ 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 as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities/ O Installation ❑ Other ❑ Describe Work: �,. A y y f ,, r �,� r✓ f INSTAM NN MAIN SL= SERVICE PANE. & Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ �1/LJ4 REL=TE M SF ELECTRICAL PERMIT Fling Fee ,20.00 Main Service "AOR LESS 23.00 '23 • 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. License Class l' - / e Lic. No. i /nlaC/ �.r OWNER -BUILDER DEC ARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service TO 46.00 OCU000A NEW CONST. DWELLING OCCUP. W OR ADDNS. ( a ACC. BLD S. SO 3.5Q�: CONST. TI -OUTLET @7,50 POWER APPARATUS a SINGLE OUTLET CIR. DR Ex. Occup. OUTLET OR FURES 20 00 SAL. Q': 0 50 FlXED APPLNS.. OR Ex. Occup. ounETs RESIDEn 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 3.00 PRE INSPECTION 23,00 PERMIT FEE $ 89.00 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. O . I 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 a d policy number are: Carrier 7-r,,7 f C 0' -" ry/L r MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number h fe, .ars (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ` ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. / i ! — %i-/� / X i i!I(A I.-//') ,r! 1,C ! 1 Date _ Signature"of Applicant - ❑ Owner` O Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy'Inspection Fee Is / occ CONST. TYPE , r i TOTAL FEE $ , -89,00/ HAZ. ..,.. I D. FEES r,.. IMP ...— FLOOD —�° FCD «..- PARCEL 7:7 ro ,„' HD ISSUE_ This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRESON the applicable provisions Resolutions to do work been paid. Date r QI 1QIL Dat Receipt No. 3�/3l1 ' WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 01-3123 ASSESSOR PARCEL NUMBER 024-110-011 ZONING BUILDING PERMIT OWNERTELEPHONE SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS CONTRACTOR'S NAME NORTH VATIFY FIRC TELEPHONE 846-2083 CONTRACTORS MAILING ADDRESS PO BOX 911, GRIMEY 95948 CONSTRUCTION LENDER Fireplace LENDERS MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 906 GILSTRAP AVE, GRIDLEY Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF 6 Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities A Installation ❑ Other ❑ Describe Work: a �.p�r�-V'i P ft � S./ ✓� ✓ too ,� INSTALL NEW MAIN ELECT SERVICE PANEL & Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ RELOCATE TO SF ELECTRICAL PERMIT Fling Fee 20.00 Main Service z�o.AoaESS 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. / Q /-.p License Class r — �/ Lic. No. bd &tr;e 3 OWNER -BUILDER DEC RA ION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason 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. I 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' co pens on insurAnce car ier a policy nk{mber are: Carrier I C JA -0 Policy Num er (The above sections Feea not bE completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensatio ovi ' ns of section 3700 of the Labor Code, I shall f h ith co ply with a pr isions. X _ Date /� —��-� Sign re of App ican - ❑ ner ❑ ontractor ❑Agent An OSHA permit is required for excavations over 60" deep and demolition or constru :tion of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLDS. sD 3.5¢FT_ . MULTI -OUTLET @7.50 r",oNA°�IDT POWER APPARATUS a SINOIE OUTLET CIR. 00 EX. OCCU . OUTLET OR FIXTURES BAL 1 0 Ex. Occup. DFIXUTLEEDTS RAID °� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 3.00 PRE INSPECTION 1 123.00 PERMIT FEE $ 89,00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI: $ Mobile Home Installation Fee Is Energy Inspection Fee Is 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 Date 1 �- i o PERMIT EXPIRES N t�ITE•D.D.S.-B.D. Dat rReceiptNo. 337371/$89.00 CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD-APPLICANT__4 I ,q Pica wreEr W;A/C- 4, "94 -40 ADD1K!8 vGrMll I yr uevLLUPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville,, California 95965 - Telephone (530) 538-7541 APPLICATION AND PERMIT a PERMIT NO o? y' 1 — l ( m _j BUILDING PERMIT e r S TcoMc SO FT OCC. BUILDING VALUATION CONK gACTpq'! T��E COM 1Qg7 rq AD !f �>�tl ' `Q le - e -LENDER �1 C0r6TAUCflON u:wFA LENDER S L"L-,O ADORE!! Fire lace AACnRE.10.. rftt;R Total Valuation E UCEr4E NO. ARCH -TER on D/ONEEJI7 1NlJN0 ADORES! Filin Fee S Permit Fee E &U&DNO ADDRESS Plan Checking Fee S P d- Energy Plan Checking Fee i .oT HO lueDev°10Nt NAj� PARC � Lw PERMIT FEE $ PLUMBING PERMIT USEOFSTRUCTURE Ench Trap SF a Duplex O Mobilehome O Other Solar or heat pump water heater Water DiDino TYPE OF WORK New O Addition O Remodel O Utilities O installation 42r p. O Describe Work: l �-- *PERMIT FEE PAXb SRA SHERIFF OTHER AAWUNT 1REC r FO $ 61• $-2f -- 0-r-2 '0 TO iE PtJT INTO epMvrm cacn gas water heeler or vent Gas piping ayetem t - 5 outlets Buildin sewer Mobile Home S G W PERMIT FEE ! ELECTRICAL PERMIT Main Service a00V ORLESS 7004 OR LESS Mein Service ( 2004 TO IOOOA 1 Ex. Occup. (ourLET oR Non a s Ex. Occup. ( �9A II O(REBIDR Temporary Service Mobile Home Facilities PERMIT FEE S MECHANICAL PERMIT ventilation 20.00 filing Feel 20.00 _13.00;73— --c 48.00 3.5¢',0 23.00 20.00 23.00 23 -0 3 � y� I F"T 20.00 8.50 PERMIT FEL: i Mobile Home Installation Fee i Energy Inspection Fee = occ CONST. nPE TOTAL FEE s c, -o . D. RES IMP PtAOD COP PARCEL PO M This permit is hereby Issued under the applicable provisions Of the Butte County Cods and/or Resolutions to do work Indicated above for which fees have been paid. By Date PERMIT EXPIRES ON ,,.T ^'", J:wy► Tw �s-.7Yd1�.w:.i�,,.,,��,;Pf,..;�,OCsi�j,..�' ' �....:a;.:/t�`=��••..�Or'X+awih �,.t `"""T� ` .Hw" . , `;;.s. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: 4!/ tir' A e& Se , ASSESSOR PARCEL NUMBER: C� - I _�) - 17 61. Proposed Building Use: peW 5e/Nh`c,e 1aa.vC�eing ilding Inspector: Date: n At time of permit application, I was advised the follo data must be submitted prior to permit processing and/or is ance: Date Received By ® i. All items have been submitted.................................................................................. ......................... 2. Plot plans, 3/4 sets, signed by the preparer of plans........................................................................... 3. Complete plans, 3/4 sets, signed by the preparer of plans................................................................... 4. Engineered plans and calculations, 3/4 sets, with wet signature on plans. All en ineerin must be shown on plans gg............................................................................................. Q 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ............... Q 6. Energy Design Compliance and supporting documentation................................................................ Q 7. Statement of Intent for Non -Heated and A/C Buildings...................................................................... Q 8. Hazardous Material Form.................................................................................................................... Q 9. Manufactured Home Data and Installation Instructions including Tie Down Specifications............... Q10. Fees of $.......................................................................................................... Q 11. Impact Fees as shown on the attached schedule.................................................................................. Q 12. California Department of Forestry Plan Approval/Fees...................................................................... Q 13. Flood Elevation Certificate.........................................:........................................................................ Q 14. Sanitation and Plot Plan Approval Environmental Health Department.......... Q 15. City of Chico Plumbing Permit............................................................................................................ Q 16. Plot Plan and Business License Approval from the City of Biggs ....................................................... Q 17. Planning Approval for (A) Use: (B) Parking: ........... Q 18. Contact Land Development about Q Improvements, Q Drainage, Q Legal Parcel ........................... 4k2lEncroachmentPermit for Driveway (construction approval rior to occupancy) .............................../re -Inspection fore/N -Oled SC �4NC required. Request to Building Inspectol l Ol t /�� . Contractor's License Information (Number, Name Style, Classification) ........................................... Q 22. Workers' Compensation carrier and policy number............................................................:................ Q 23. Owner -Builder Verification (Q Given to Owner, Q Mailed to Owner) ............................................. Q 24. Letter of Signature Authorization........................................................................................................ Q 25. Recorded Copy of Agricultural Acknowledgment Statement.............................................................. Q 26. Letter of Intent on Building Use/Detached Accessory Building Form ................................................ Q 27. Manufactured Home Utility Clearance................................................................................................ Q 28. Existing violations and/or expired permits.......................................................................................... Q 29. Q 433 A, Q Grant Deed, Q M.H. Title, Q Check to H.C.D. $ .................... Q 30. Other .................... Weheyou issue the ermit, process as follows: Q Mail to Owner, Q Mailtoractor. hone 020 and hold for pickup at U o i'ce. ❑ Deliyer1th�i"nspector. Applicant:/ ;�li/%�//I���ate:,�� /I' -- Copy of Haz-Mat form sent Q Health Department, Q Fire Department, Q Air Pollution Date: By: Copy of Plans sent Q Health Department, Q Fire Department, Q Other 1. Index permit Application for the above items numbered: Date: By: Q Plan Check List 2. Additional items required: �Contract6r,signer, owner, was advised of the above required data by: phone, Q mail, Q Building Division counter, By: Dater signer, owner, was advised of the above required data by: Q phone, Q mail, Q Building Division counter, By: Date: - Contractor, designer, owner, was advised of the above required data by: Q phone, Q mail, Q Building Division counter, By: Date: Contractor, designer, owner, was advised of the above required data by: Q phone, Q mail, Q Building Division counter, By: Date: Plans reviewed by: Date: Plans reviewed by: Date: Sets of plans on hold in Q Plan Cabinet, Q A.P. folder. Note transfer'by: Date: Yellow Copy - Department of Development Services - Building Division RE=INSPECT OWNER: Z,&)���� LOCATION: %b to i 45 r d( �E,y CONTRACTOR: o r+ �J eq F11t- �J PRE-INSPETION FOR: DATE TO INSPECTOR: Building Description: r-Mmercial/Usage: Residential/# of Units:— Currently nits:Currently Occupied Abandoned/Vacant Electric: Yes No Condition of Electric_ Gas: lit/ , el eG PERMIT HISTORY:( )NONE :.REPORT DATE: A.P.# ZONING:_ /, 1 0 103 eA4-,l - - K1 I 1 (4�—F&LOWS: BUILDING INSPECTOR'S REPORT 11/ , Electric currently On Off Natural---,—" Propane None Currently On Off Obvious Problems: . Sanitation: / Plumbing Working Well Working Potable Water Obvious SewageProblems_ Comments: ACTION RECOMMENDED: ISSUE: HOLD FOR Inspector:✓1 �� � Date /z, Sketch buildings on reverse and indicate location on property. m U% a 024-110-011 99-2612 JEFFERS, WINCIIEL 906 GILSTRAP AVE., GRIDLEY CONTR: K DESIGNE VINYL SIDING COUNTY OF BUTTE - DEPARTMENT -OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 F,R,',.'lA RP APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCCL NIUAIpp1 QM"' BUILDING PERMIT OWNER i, I�NL -e P re r s W Tao"o"E SO FT OCC. BUILDING V ADoeeaa !: ALUATION CONTRACTOR., TCLCF'raONC CONS TRUUCTIONLLAAANDER 66 LENDERS NNLMq ADOREae ARCHITECT OR ENOLNEEA ARCWTECT OR ENONCERS m4uuN0 AD S3 SUIDNO ADORESS L:•7 r. -q i ♦OTNO I aUWN1s K*1t&"* USEOFSTRUCTURE SF 0 Duplex O Mobilehome O Other S CA Ie TYPE OF WORK New ❑ Addition O Remodel ❑ Utilities O Installation 42rOther O Describe work: yti 4� l ( 4/e r,J /j;r1ai.N VERAUT FEE PAlb SRA •- SHERIFF OTHER AJKOVW RECEIVED $-13i "Reeaar NUMs��_ * To ee wr mm COWVTM Fireplace Total Valuation S Fling Fee S Permit Fee S Plan Checking Fee S Energy Plan Checking Fee S s PERMIT FEE _ PLUMBING PERMIT Each Trap Solar or heat pum water heater Water piping Each ea water heater or vent Gas piping system 1 . 5 outlets Building sewer Mobile Home—TS I G7 W4 PERMIT FEE ! ELECTRICAL PERMIT Main Service 0DO10R Lia 200A OR LESS Main Service ( 200A TO 1000A 1 Ex. Occu ovrLET OR FDfTURFy Ex. Occup. FttEo 1P°u's• OR ouTLtTa E9ID. EA. Tem orar Service Mobile Home Facilities Misc. Wiring elI`5 �C Pv PERMIT FEE $ MECHANICAL PERMIT 20.00 ng Fee 20.00 23.00 ' 3 48.00 3.505 —10 @7.50 5.00 23.00 20.00 23.00 Z3 a' -o 3 9 .-a I Fee 1 20.00 rtcRMIT FEE _ Mobile Home Installation Fee i Energy Inspection Fee S «c coNaT. TYPE TOTAL FEE $KkZ v -o . 0. RE9LMP FLOOD COf PARCEL PO /0 SSUE 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 Date PERMIT EXPIRES ON (Rev. 12/96) COUNTY OF BUTTE -DEPARTMENT OF DEVELORMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, Carnia 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 'fly%," ZONING BUILDING PERMIT OWNER - I / TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS `TELEPHONE CONTRACTOR'S ME I Y f' '. CONTRACTOR'S MAILING ADDRESS } ( CONSTRUCTION LENDER j Fireplace LENDER'S MAIUNG ADDRESS ' Total Valuation $ 111.; i / ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee - $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ BUI. ., ADDRESS f � f � Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDNISION'S NAME PARC L MAP � PLUMBING LLPERMIT 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 Hater heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑j Utilities ❑ Installation P"/ her ❑ ; Describe Work: ; / ( i L (i J Gas piping System 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 20 0A 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 II force and effe ( ( License Class - f O t t I L . No. "� b ll L � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service ( 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR SO OR ADDNS. ( & ACC. MDS. 3.52FT. NEW CONST. MULTI- NON-RESID. COUTLETI , @7.50 POWER APPARATUS b SINGLE OUrLET C1 R. OUTLET OR FDRURES 20 @ 1.00 Ex. Occup. BAL @ so Ex. Occup. T.(REs o.GEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirinci 23.00 PERMIT FEE S 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 nd policy number are: Carrier I > . MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number IL I (The above sectionsvn6ed not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forth/with comply With t 'se provisions. / ((X �_�___ ate' �l_j �'� _ i nature of plicant' - ❑Owner ❑Contractor gent An OSHA perFnit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height.Dat Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $�� Ll ePI HAZ. D. FEES IMP FLOOD CDF PARCEL 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. –&/ - / f PERMIT EXPIRES ONF7/w/-L;*__k3 Dare Receipt No. om WHITE-D.D.S.-B.D. A ARY-AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERT• (Rev.12/96)APPLICATION AND PERMITii-�� ASSESSOR PARCEL NUMBER ' ZONING 1 BUILDING PERMIT n I I n /1�, TE`EPHONE ��,}!�� l/�/i �Jf lJ/i-1l//,rf OWNER j/e. SQ. FT. OCC. BUILDING VALUATION ���✓8S�) / OWN U G ADVD'Vb �r/ ��( �lJ q qq M �b CONTRAW. ME TELEPHONE CONTRACT 'S MAIU Y k 6�/,(/ y- CINn , CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ BUIL GAD KESS ` n �/J - - l/ '¢\C1�./ (/J Energy Plan Checking Fee $ $ ev q PERMIT FEE $ LOT NO. SUBDrVISION'SNAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE 1_ SF ❑ Duplex 0 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 -❑ Describe Work: Vffi Gas piping system 1 - 5 outlets 15.00 Building sewer1 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service ioonoa.Ess 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 f Illfor a and effect. 1 J Q� / License Class 07.1 Lic. No. ' I q U �CQ 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. ❑ 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 I000A 46.00 NEW CONST. DWELLING Occup. OR ADDNS. ( so . NEW CONST. MULTI.OUTLET NON•RESID. ANC cl cu Ts 97.50 POWER APPARATus 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 Q 1.00 BAL p .50 D A Ex. Occup. OUTELETS RES D.OFRJL 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE 3 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 worke ' mpensation insurance c rher land p i mber ar Carrier r/iAQ Policy Number (The above sections eed not be completed if the pe it is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation Isions of section 3700 of the Labor Code, I shall forthwi comply ' h t provisions. X ate _�� ` 7 _ . nature of lice - ❑ Owner ❑ Contractor ❑ Agent An OSHA per it is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HAZ. I D. FEES IMP I FLOOD I COF I PARCEL I PD HD I ISSU 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. 1 Datq PERMIT EXPIRES ON S �uvv 1,Defe Receipt No. WHITE-D.D.S.-B.D. ANARY-AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT