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HomeMy WebLinkAbout024-282-001BEATRICE PERRY 24-282-01 DONOHO, Mr. & Mrs. Lowell 1386 Gilstrap Ave., Gridley (fire report - 6/17/87) i 5 041 4849E 4 2 1 w/s..Gilstrap 300' no. of Obermeyer� R L Casey ,,,_..1 ® CONTR: Loris Root s R 1, Box 1,28 Gr 1328-87B,P,E,M(repair fire damage , (new single family) 12_8_6 '024-28-2-001 93-2480 B .PERRY, Beatrice A'/ 3 Q 1384 Gilstrap Avenue,' ridley ��/ (Vinyl siding/SF)- Contr: Harward & Co. 024-282-001 02-`l 6 CARRASCO, . iA l� 1386 GILSTR REPLACE GA L $t� VE 024-282-001 02-3132 / CARACSO, ELIAS 1384 GILSTRAP, GRIDY ELEC. SERV. PANEUR SHEATHING 024-282-001 03-318 CARR -ASCO, ELIAS 1386 GILSTRAP AVE Cont: UNKNOWN GAS HVAC UNIT TO0 -100 B06-2785 024-282-001 .MISCELLANEOUS Electric Pinel Comcast Meter Box �1/UALI /1 40 1386 GILSTRAP AVE COMCAST rill CQ C] �s , BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-21140 Website: www.buttecounty.net/dds Permit No: B06-2785 Issued: 12/06/2006 Address: 1386 GILSTRAP AVE GRIDLEY APN: 024-282-001 Permit Subtype: Electric Panel Owner: COMCAST Applicant: CLEAR CONNECTION CORPORATION Description: Comcast Meter Box MUST BE ON JOB SITE JOB SHALL BE READY PRIOR TO CALLING FOR INSPECTION. THE INSPECTION CARD AND APPROVED PLANS MUST BE AVAILABLE FOR EACH INSPECTION OR THE INSPECTION WILL NOT BE MADE AND A RE -INSPECTION FEE MAY BE ASSESSED. ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING t Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre-Sla ----- j Gas Te; OFFICE COPY k Masoni MasorI Adddrdress Underf C� � PZ_ — 0 7 M Underfi GAS Shear 1 Meter By Date Under 1, ELECTRICY9 Under < Meter By Datj I Gas PiX; j Do Not-rnstatrr-roor-sr eatuitfg or-srwanti( Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Roof Nail 129 Shower Pan/Tub Test 408 Fire Sprinkler 702 Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Gas Test 404 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Project Final 801 Z �- Z f,, , is -71 PERMITS BECOME NULL AND VOID 1 YEAR COMMENCED, YOU MAY PAY FOR A 1 YEAR' RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy s BUTTE COUNTY ,DEPARTMENT MENT 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: 1386 GILSTRAP AVE Owner: Permit NO: $06-2785 APN: 024-282-001 COMCAST Issued Date: 12/06/2006 By - AAM Permit type: MISCELLANEOUS 4450 EAST COMMERCE WAY Subtype: Electric Panel SACRAMENTO, CA 95834 Expiration Date: 12/06/2007 Description: Comcast Meter Box (916) 515-2851 Occupancy: Zoning: Contractor Applicant: Square Footage: CABLECOM OF CALIFORNIA CLEAR CONNECTION CORP Building Garage . Remdl/Addn 4585 PELL DRIVE 814-B STRIKER AVE SACRAMENTO, CA 95838 SACRAMENTO, CA 9834 Other ' Porch/Patio Total (916)567-9956 (916)567-0144. FEE INFORMATION Single Phase Service - Res $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires CABLECOM OF CALIFORNIA 826295 / C7 A / 10/31/2007 1 HEREBY AFFIRM DER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with S jpn 790 of Division 3 of the Business and Professions Code, and my license is in full force and X Contractors Sib 12/06/2006 Date Balance Due: $0.00 Receipt No: B1097 OWNER / BUILDER DECLARATION ' 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, '9 also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any 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 WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 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; Cartier: Liberty Mutual Policy Number: WC76310042700qxp. Date:07/31/2007 (This section need not be completed if the permit is or one a hundred dollars ($100) or less.) ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall note toy any person in any manner so as to become subject to the Workers' Compensation laws Califomia, and agree that if I should become subject to the workers' compensation prov' ' n of S ction 3700 of the Labor Code, I shall forthwith comply with those provisions. X 12/06/2006 Signature -/. Date WARNING: FAILU E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 'AND SHALL SU ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO SAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS AOVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTIONLENDINGAGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip Please check one of the following: ❑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 Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the 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 improvement is sold within one year of completion, the owner -builder will have the burden of proof 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 Provessions Code: The Contractor's 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.). ❑ I AM EX PT under ection B. & P.C. for this reason: K 12/06/2006 Own Signature Date I Aeby 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 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 injury, including d th, and property damage caused by, arising out of, or in any way connected with the issuance o is permit. I hereby acknowledge that issuance of this permit does not authorize the use or occu cy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of. Butte County to erjh ove mentioned property for inspection purposes. I hereby certify that I am the property et/o�authorized to act on the property owners behalf. 12/06/2006 Owner Contractor OR; Agent for Owneno Agent for Contractor FILE COPY y , 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 OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name first Name Mailing Address City State Zip Phone Fax E-mail CONTRACTOR Name CA&EQA4 — M/ICE SAub Address 4.S95' PELL .DR citySACRAllatrb State CA Zip 95838 Phonej,(' Fax 9/, p? 99.s8 E-mail Lia #82/O29s Class{ APPLICANT INFORMATION ARCHITECT/ENGINEER Name City SAMANIF.grg Address Phone 7p/o' city E -mail State Zip Phone Address Fax E-mail State License Number APPLICANT INFORMATION Name COMGAST- &4RY tIA1,/SDA-/ AddressmTo irA5T COM14611.6 WAY City SAMANIF.grg State eCA Zjp Phone 7p/o' Fax o'S/S' 2,594- E -mail APPLICANT SIGNATURE X _ For office use on Zoning Flood Zone SRA I ves No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. _-�i K BIN # PROJECT LOCATION Property AddressCt?F4D1,6 No etD EYE- 14 V WORKER'S COMPENSATION Policy Number WG -1,31- 0104260- 030 Carrier LamTse' l4dv1.li- 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 L M / Address Description or Scope of Work: . anz CATV awat -QlpaY DN 9AST/.Vl L/ -/L/T; POLE 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 required. 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 Bldg SRA Receipt M Sheriff SMIP Date: Other Total GyoZ-/ 6z 024-282-001'02-3132 . i CARACS6,ELAM , a 1384 GILSTRAP, GR'IbLtY' ELEC. SERVIPANEUR'OOP ; * I I SHEATHING A m COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 n� ,►yl (Rev. 12/96) APPLICATION AND PERMIT ' (,/ ASSESSOR PARCEL NUMBER 024• -282 -WI ZONING BUILDING PERMIT r/ 1 OWNER Caracso Elias TELEPHONE 846-2732 SQ. FT. OCC. BUILDING VALUATION 10.1 00 OWNERS MAILING ADDRESS - 1384 Gilstrap Gridley CA 95%8 est 500,00 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 1100.00 ARCHITECT OR ENGINEER • LICENSE NO. Filing Fee $ 20.00 Permit Fee s27.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1:384 Gilstr& Gridley Energy Plan Checking Fee $ $ PERMIT FEE $47-W LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE _ SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ A8'dition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: new electric Sery Ranel/netw roof/ Shcathing Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ " ELECTRICAL PERMIT Fling Fee 20.00 Main Service ( a mss 23.00 • LICENSED CONTRACTOR'S DECLARATION I hereby . affirm under penalty of perjury that I am licensed under provision s 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 Lic. No. OWNER -BUILDER DECLARATION I hereb)Laffirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: dl 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 _ I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permitis issued. My workers%compensation insurance carrier and policy number are: Carrier("`1/„--. l i, �.— _.v .... Main Service Zoog TO 46.00 NEW CONST. DWELLING OCCUP. SO CCU000A .50so OR ADONS. ( 6 ACC. BUDS . 3.5¢FT. T. NON-REESID. MU LTI.OUTLFT @7,50 POWEPPARATUS . b SINGLER AOLm.ET CIR. Ex. Occup. en0 @ 1.00 OUTLET OR FIXTURES Ex. Occup. GFI'LETS a AUIS oEa 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ 43.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ _ Policy,N ber �`- (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X n� % n .G-�+�^-�- �'� Date Signat&6 of Applicant--❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or constructionB structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 90.00 HAZ. D. FEES IMP FLooD CDF PARCEL PD HD IS This permit is hereby issued under the applicable provisions of the Butte unty Code and/or Resolutions to do work indica 'd al5cIve for which fees have been paid. Datof YReceiptNo. PERMIT EXPIRES ON 4vo­ Data WHITE-D.D.S.-B.D. CA ARY-ASS SSOR PINK -INSPECTOR GOLDENROD -APPLICANT f reg r- :,� 024-282-:,:02-10966 ~,. 00CgRSC03-31871386 GILST�DiEy,Cont: UNKNGAS I y r , i � A f j i y* 10 ti (�/l 2, 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 ASSESSOR PARCEL NUMBER ()24-282-001 ZONING BUILDING PERMIT OWNER TELEPHONE RA 1 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 955048 CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: NW GAS HVAC UNIT Ann TO Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W 1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 OOOV OR LESS Main Service ZOOAORLESS 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.FOWER License Class LIC. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License w f r the following reason: III as owner of the property, or my employees with wages as their sole compensation, ill do the work, and the structure is not intended or offered for sale. 'tpv as owner of the property, @m 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 ADONS. ( a ACC. BLDS. SO 3.5¢Fr. =Rale ' MUL,,CU,TLET P7.50 APPARATUS a SINGLE OUTLET CIR. EX. OCCU OUTLET OR FIXTURES .00 BAL @ I. 0 Ex. Occup. .'.'ED A RLNs oEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 1have 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' compensation insurance carrier and policy number are: Carrier I Policy Number (The above sections need not be completed if the permit is for work of a valuation f one hundred dollars ($100) or less.) 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. �% _ X Date / '6)f ' ' _ Sign 6 -re of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations oVer 60" deep and demolition or construction of structures over 3 stories insheight. / ( MECHANICAL PERMIT Filing Fee 20.00 Heating 15.00 Cooling Hood 6.50 Ventilation PERMIT FEE $ 55.00 Mobile Home Installation Fee $ Energy Inspection Fee $ ocD CONST. TYPE TOTAL FEE $ 55.00 HA2. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE+ V This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated abovl for which fees have been paid. - (/, • 4 B . Date 6 � ) — I ­_ PERMIT EXPIRES ON Date �'i ReceiptNo.k WHITE-D.D.S.-B.D. — CANARY—ASSESS PINK -INSPECTOR GOLDENROD -APPLICANT - 11 OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION - - COUNTY County Center Drive • Oroville, California 95965 =MI7 •Telephone (530) 538-7541 101_` APPLICATi®NAN®���IT I� (Rev: T2/96) Z BUILDING PERMIT ASSESSOR PARCEL NUMBER !� (� ,�T _ 036-460-069 TELEPHONE sa• FT. OCC. BUILDING VALUATION OWNER MC CORD SAM 60 . OWNER'S MAILING ADDRESS 4837 SEAL TELEPHONE CONTRACTOR'S NAME SKILLED BUILDING CONTRACTORS MAILING ADDRESS P.O: BOX 5269 CONSTRUCTION LENDER 1 Fireplace LENDER'S MAILING ADDRESS Total valuation $ 4160. LICENSENO. $ 200 Filin Fee ARCHITECT OR ENGINEER 1 permit Fee $ 72.00 ARCHITECT OR ENGIN ERS MAILING ADDRESS Plain Fee $ 46.80 n fiheck Energy Plan Checking Fee $ r y BUILDING ADDRESS Q `;� i../ C / S 1 �' J 3 C $ ' ( PERMIT FEE $ 238. 0 OLD—' PARCEL MAP e 20.00 PLUMBING PEAheater LAT NO. SUBDNISIONS NAME 0 Each Trap USEOFSTRUCTURE Solar or heat um w0Water piping0SF ❑ Duplex ❑ Mobilehome Other rn rprej s�Fr Pr Each as water heate00TYPE OF WORK Gas i in stem 1 -00 New ER Addition ❑ Remodel ❑ Ubli6es ❑ Installation ❑ Other ❑ guildin sewer 15.00 S G W @20.00 Mobile Home Work: Describe PERMIT FEE _ Filing Fee 20.00 ELECTRICAL PERMIT I"OR"23.00 Main Service 200' OR LESS Main ,,ViCe 200A TO 1000A 46.00 LICENSED CONTRACTOR'S DECLARATION NEw CONST. ( DWEUJNG oCCUP. 3.50FT. OR ADONS. & ACC. BLDS. I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 7000) Division 3 of the Business and Professions Code, N CONS . MULTI-OUTLET @7.50 tOWRESID. 9 (commencing with Section of and my license is in I force and effect. F PEAPPARATUS & OUTLET CIR. zap 1.00 License Class Lic. No. J��dS� Occup. OOR FDRUR6 SAL p .50 OWNER-BUILDER DECLARATION PPLNS.OR 5.00 oM. EA 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License nEx-OccuP.. Service 23.00 Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, me Facilities 20.00 will do the work, and the structure is not intended or offered for sale. n 23.00 ❑ 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 PERMIT FEE _ reason MECHANICAL PERMIT Filing Fee 20.00 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: satin Heating ❑ -1 have and will maintain a certificate of consent to self-insure for workers' Cooling compensation, as provided for by section 3700 of the Labor Code, for the Hood 6.50 performance of the work for which this permit is Issued. Ventilation ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: PERMIT FEP_ S Carrier Mobile Home Installation Fee $ Policy Number (The above sections need not be completed the permit is for work of a valuation Energy Inspection Fee $ Of one hundred dollars ($100) or less.) occ TOTAL FEE $ 138.80 1,t I certify that in the performance of the work for which this permit is issued, I shall IMPFLOOD CDF PARCEL PO HD ISSN not employ any person in any manner so as to become subject to workers' HA2. D. FEES Al 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 This permit is hereby issued under the applicable provisions fo ith comply with se provisions. the Butte County Code and/or Resolutions to do work ` Date 1 of indicated above for which fees have been paid. X Sig re of Applicant - ❑ Ow er ❑ Contractor ❑ Agent An SHA permit is required for excavations over 5'0" deep and demolition or construction By Date of structures over 3 stories in height. 3 1) fes_ PERMIT EXPIRES ON Receiplg4o. WHITE-D.D.S.-B. D. C NA - S SOR PINK-INSPECTOR GOLDENROD-APPLICANT are r`�.r+.-...re'""�-."�.`r.`�.""_"`�r�rsn'+vc' -' --"`��..;�,.':v.+..-.'�.-:.�--�•-Mi,..i.-•=-r- - '•Y.�`sz"-v'lJi....:�.r'�.fj COUNTY OF BUTTE BUILDING -DIVISION . { DEP"HATMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE , O NER PERMIT NO. 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. I Date �/� Inspector �� u REV 1Qi92 FG �-282-001 � t 02-0641 , ELIAS _ { TItAP, GRIDLE ,. Y �G &FURNACE • I 1 f r Le FFICE COPY 4 j +r Dat�..��5.. . } IJ Date , Y r { IA COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-75.41 s. PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 024_282-001 ZONING BUILDING PERMIT OWNER TELEPHONE ^'! 1 1 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS 1384 GILSTRAP Til (L;iP4-n CONTRACTOR'S NAME owmm TELEPHONE CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHRECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ B UIL ING DRESS 1 GILSTRAP GRIDUY, CA 9594.11 Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE IT SF I& Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other )n Describe Work: GAS PIPING F" FURNAA(T Gas piping system 1 - 5 outlets 15.0013.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE 35.W ELECTRICAL PERMIT Filing Fee 20.00 800VOR LESS Main Service OA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License L r the following reason: f as owner of the property, or my employees with wages as their sole compensation, Vwill 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 thre project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO OCCU000A 46.00 NEW CONST. DWELLING OCCUP. SO .,,sQ OR ADONS. ( a ACC. BLDS. 3.5¢FT; NpµRE°S,pT MULTI.CIRCUITLETS @7,50 POWER APPARATUS a SINGLE OUTLET CIR. Zo @ 1,00 Ex. Occup. OUTLET OR FIXTURES BAL @ .50 Ex. Occup. ouTLEEDrsA pUYS,p.°.R, 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 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 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' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating W FUMCF 15.00 Cooling Hood 6.50 Ventilation PERMIT FEE s35.00 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) �Q, I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. Ce: _ r- +_ D to - �' OlOr_Q Agent gnature of Applicant Owne ❑ CntrflC An OSHA permit is required r exca ations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 70.00 FEES IMP I FLOOD I CDF I PARCEL I PD I HD I 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 aid. v'� E C ti Date PERMIT EXPIRES / Dere Receipt No. W, 40 D WHITE-D.D.S.-B.D. CA P Y -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 024-282-001{ 02-1.006 CARRASCO, 1.ELAS 1386 GILSTRAP, GRIDLEY ' REPLACE GAS LINE FOR STOVE r 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 o2-1006 ASSESS O ARfs NUMBER 0741% 1—Utjl ZONING PERMIT'\ BUILDINGC, - ` S OWNER ELIAS CARRASCO 6.6-2732 TELEPHONE SO. FT. OCG BUILDING VALUAI'(ON�., _ ►) !' s ,. 1 ` ' C , OWN 1386 G=TRAP, GRiDLEY 95948 / CONTRACTOR'S NAME OWNER TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation Is ARCHITECT OR ENGINEER LICENSE NO. Fee $ 20.00 —Filing Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS �. 1386 GIL,STRAP GRIDLEY Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF 8 Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 01 Installation ❑ Other ❑ 1 Describe Work: REM ACR (:AC LINE W)R MINE Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 Mobile Home I S I G I W I @20.00 PERMIT FEE $ • ELECTRICAL PERMIT Fling Fee 20.00 Main Service 20oAORLESS 23.00 �. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Lave for the following reason: �j1, as-ownerof the property, ormy employeeswith 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 s Main Service 46.00 TGNG NEW CONST. DWEWSO EL OCCUP. CU OR ADDNS. ( a ACC. EMS. 3.50FT. IpµgESID T. MULTICIRCUITS -OUTLET @7,50 POWER APPARATUS a SINGLE OUTLET CIR. 20 EX. Occup. OUTLET OR FIXTURES .00 BAL O I. 0 Ex. Occup. ouTlFrs aESlo�ea 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: . have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Libor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The abov'es ections, need not be completed if the permit is for work of a valuation of one hun red doliars; ($100) °or less.) I certify that in the performance of.tfte woTkrfot which this permit is issued, I shall not emp%ll any person in)any manners to become subject to workers' compensition'laws, of California, and agree that 'rf I should become subject to the workers' compensation-provisionsNof section 3700 of the Labor Code, I shall forthwith comply with those provisi ns> i X/�T=-- Date'r��, Lp.--."Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or constructionits 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 CDF PARCEL PD HD UE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work Indic ted ab ve for which fees have been paid. ate ByDate- L. PERMIT EXPIRES Date Receipt No. 3'>Jj ` $J5.UU 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 9 Oroville, California 95965 •Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) - APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 094-982-001 ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDNISIOWS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other sPEclw Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: NEW GAS HVAC'. TTNTT ATT TO BM2-1 QM Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 OOOVOR UE Main Service A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License w f the following reason: as owner of the property, or my employees with wages as their sole compensation, ill 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: torhave 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. l 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service To 46. 00 CCU000A WEE200A NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BLAS. so SO 3.5¢FT: NOOWt4RESNIDT' MULTI -OUTLET @7,50 POWER APPARATUS a SINGLE OUTLET CIR. OUTLET OR FIXTURES Ex. Occup.BAL 20 @ I.50 @ .so Ex. Occup. oFurLEEDTSA AE�sID.DER.w 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating 19-00 Cooling Hood 6.50 Ventilation PERMIT FEE $ 55.00 Policy Number (The above sections need not be completed if the permit is for work of a valuation f onehundred dollars ($100) or less.) thatin the performance of the work for which this permit is issued, I shall Xnotemploy any person in any manner so as to become subject to workers' compensation laws of California, and agree that H I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall fort with comply with those provisions. 09P40 A — l{�� 6 X _ Date / Ig ure of Applicant - ❑Owner CO3 ),Conactor ❑Agent An OSHA permit is required for excavations 60" deep and demolition or construction of structures over 3 stories inigh . do Receipt No. i WHITE-D.D.S.-B.D. C NAR -ASSE S PINK -INSPECTOR GOLDENROD -APPLICANT Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPEcertify TOTAL FEE$ 55.00 HAZ. D. FEES IMP I FLOOD cDF PARCEL PD HD ISsu This permit is hereby issued under the applicable provisions of the Butte unty Code and/or Resolutions to do work indicated abo for which fees have been paid. / e IIJJ v B �\i Dlatgoo PERMIT EXPIRES Date Rev.12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION PER 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 APPLICATION AND PERMIT IT zONING BUILDIPIG PERM ASSESSOR PARCEL NUMBER '• �•� �C/� OO 1 U C-•� o �+ TELEPHONE SQ. FT. OCC. BUILDING VALUATIOP ,.I , CONTRACTOR'S NAME /V , `'/ b /522 aAL @ .50 Ex. Occup. LnIEM FUILDRESIe)EA. CONTRACTORS MAILING ADDRESS Temporary Service 23.00 CONSTRUCTION UUENDER 20.00 Misc. Wirfnq 23.00 Fireplace LENDERS MAIUNG ADDRESS Total Valuation $ uCENSE NO. Filin Fee $ ARCNITECT OR ENGINEER $ Permit Fee ARCNRECT OR ENGINEERS MARtNG ADDRESS Plan Checking Fee $ BULLDINGADDRESS . / l/V^ / f` Energy Plan Checking Fee $ PERMIT FEE $ NE IDT NO. SUBDN610N5AM PAR CEL MAP PLUMBING PERMIT Each Trap USEOFSTRUCTURE Solar or heat pump water heater SF Duplex E3Moblehome [3Other Water piping s� Each gas water heater or vent TYPE OF WORK Gas piping system t - 5 outlets New ❑ Addition ❑ Remodel ❑ U50fies ❑ Installation Other ❑ Building sewer Mobile Home S G W Describe Work: " PERMIT FEE S ELECTRICAL PERMIT 000v0:= DR LESS Main Service .0A oR tEss Main Service ( 200A TO ,0 ) .PERMIT FEE PAID SRA SHERIFF OTHER AMOUNT RECEIVED $ DATE RECEIVED RE[EIPT # �� MIT N0. 20.00 iling Fee 20.00 7.00 23.00 15.00 15.00 15.00 15.00 (_W20.00 Ig Fee 20.00 23.00 46.00 3.510 @7.50 Ex. Occup. Ovnzr OR F n;RES aAL @ .50 Ex. Occup. LnIEM FUILDRESIe)EA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirfnq 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee20.00 Heating Cooling u__ A 6.50 PERMIT FEL: S Moble Home Installation Fee $ Energy Inspection Fee I $ c c --T. TVI TOTAL FEE $ —� NAZ I D. FEES I IMP I FLOOD CDF PARCEL I PD I HD I 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 PERMIT EXPIRES ON /Date) a COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P I (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 024-282-001 ZONING BUILDING PERMIT OWNER Caracso Elias TELEPHONE 846-2732 SO. FI-. OCC. BUILDING VALUATION 101 C'0000 .OWNERS MAILING ADDRESS 1384 Gi"lstrav Gridley CA 95948 est 500.00 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER j LENDER'S MAIUNG ADDRESS 4Fireplace Total Valuation $ 1100.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee ARCHITECT OR ENGINEERS MAILING ADDRESS -� Permit Fee Plan Checking Fee $ 20.00 $ 27.00 $ BUILDINGADDRESSEnergy 1384 Gils*I.rao Gridley$ Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: new electric Sery Panel/new roof/ sheathing Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zo.A OR IFS. 23=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.POWER License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License LaVor the following reason: I, as owner of the property, or my employees with wages astheir 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. OWEILING OCCUP. OR ( a ACc. BLOS. SO 3.50' CNS. T. r,DµpESID. MULTI -OUTLET 97,50 APPARATUS d SINGLE OUTLET CIR. Ex. OCCUp. OUTLET OR FD(TURES 20 @ 1'00 BAL @ .50 PPLINIS Ex. Occup. ourEitrs RESD.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 43.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My worker c pensatio surance carrier and policy number are: Carriers Policy, ber 2�-® (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall lo iwit h comply with those provisions. Date eig-4i'14--of Applican - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" 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 S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ go. 0 HAZ. I D. FEES IMP I FLOOD I CDF PARCEL PD HD Iss This permit is hereby issued under the of the Butte Count=iDatip Code and/or indi ed By7 PERMIT EXPIRES ON I applicable provisions Resolutions to do work been paid. (/ f(Date) Receipt No. WHITE-D.D.S.-B.D. CAIVARYISSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 Ifiev.12/96) APPLICATION AND PERMIT ArSESSOR PARCEL NUMSEM q -5;X- yz,—QO / ZONING BUILDING PER OWNER `/�•-/ �` E�L� TNONE 73� SO• FT. OCC. BUILDING VALUATION OWNER ralu ADORES CONSTRUCTION LENDER IENDER S MNUNO ADDRESS ARCHRECT OR ENGINEER ARCHITECT OR ENGINEERS MAILING ADDRESS BUILDING ADDRESS /,3 2� Fireplace I Total Valuation Filing Fee Permit Fee ■ 0 Plan Checking Fee Energy Plan Checking Fee $ 20.01 PERMIT FEE PLUMBING PERMIT Each Trap $ Filing Fee 7.00 20.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater Water piping 23.00 15.00 TYPE OF WORK New ❑ Addition ❑ model ❑ Util 'es ❑ Installs ❑ Other Each as water heater or vent 15.00 Gas piping astern 1 - 5 outlets 15.00 Buildingsewer 15.00 Describe Work: Mobile Home S G W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee! 20.00 " OR LESS Main Service 60 .A 200A OR LESS 23.00 7,-3- Main Service 200A TO 1000A NEW CONST. ( Ow- ING OCCUP. 2RDONS 8 ACC. BLDS. NEWCONST.MULTI-OUTLET 28ANCH CIRCUITS NON arslo. 46.00 i SO. 3. SCS, @ 7.50 -- POWER APPARATUS 6 SINGLE OUTLET CIR. I -_ Ex. Occup. OUTLET OR FDCTUREs 20Cd tZ. BAL g1 *PERMIT' FEE PAXb � Ex. OCCU ,FU(ED APPLNS. )0R OUTLETS REA EBID. 5.001 Temporary Service 23.00, Mobile Home Facilities 20.00 -SU • Misc. Wiring23.001 r7G+4 SHERIFF OTHER s �PERM�ITFEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation AAkOVW RE : PERMIT FEE I S Mobile Home Installation Fee =$ Energy Inspection Fee $ A 1// \(/ .•✓JJ ` � OCC CONST. TYPE R � TOTAL FEE $ 9�)'•'' TO 1111 Kff zwo corona HAZ. 0. FEES IMP I FLOOD I CDF PARCEL I PO I NO i ISSLE 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 ReceiptNo. WHITE-O.D.S.-S.D. CANARY -ASSESSOR PINK•INSPECTOR OOLDENROD•APPLICANT PERMIT EXPIRES ON ef0 O`VNER-BUILDER VERIFICATION A tendon Property Owner: An "owner -builder" building permit has been applied for in your name and bearing yaw si�od+e. Please complete and return this information at your earliest opportunity to avoid unoeme -. 15,MW in processing and issuing your building permit. No building permit will t e issued Mon his verification is received. 1. I personally pian to provide major labor and materials for construction of the proposed property improvement: YES, NO El 2. I HAVE � HAVE NOT D 'geed an application for a building permit for the ppc+opoted m& 3.' I have contracted with the following person(firm) to provide the Proposed_.--Wjedm NANIE: b ADDRESS: CITY: PHOT: COiti-MkCTOR'S LICENSE NO. 4. I plan to provide portions of this work; but I have hired the following person to cootdinafti supervise, and provide the major work: ' MA E: ' ADDRESS: CM: PHONE- COi+1MkCTOR'S 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 NOTE: This Owner -Builder Verification is required by Section 19831 and 19831 e&W California Health and Safety Code. This verification must be tonrl&W wed returned to our office before we are permitted to issue the permit OVER i OWNER BUILDER INFORiNIATION A.z application for a building perTnit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection. you should be aware that as "owner -builder" you are the responsible p vty ofreeoed =such a permit. Building permits art not required to be signed by property owners unless they are personally pa�octn 15eir 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 same. 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 subcontrac4 you ibould 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 Cincluding materials and other costs) is 5300 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 Governments 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 eontnbutions. ♦ There may be Financial risks for you if you do not carry out these obligations, and these risks are especially serious w;th respect to worker's compensarion insurance. ♦ For more scecitic information about your obligations under Federal Law, contract the Internal Revenue Service (nerd, if You wish, the U.S. Small Business Administration). For more specific information about your obligations under Save Law, cerract he Department of Benefit Payments and the Division of Industrial Accidents. If;he snit%, T! is intended for sale. property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building pernit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your cornmunir+ er at 10:0 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. I rely. Ltie el C. Vi ira, C.B.O. �M ht ger, Building Inspection NOTE: Tltis Owner -Builder Information is required by Section 19810 of he California flealllt and Safety CO& OVER V COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVIS 7 County Center Drive Oroville, California 95965 •Telephone (530) 538-7 PERMIT No. (Rev. 12/96) APPLICATION AND PERMIT o2-1006 ASSESS R ARCELNUMBER 02�+-282-001 ZONING B ING PERMIT OWNER ELIAS CARRASCO 846-2732 TELEPHONE SO. FT. eft. BUILDING VALUATION . OWNERS MAILING ADDRESS 1386 GILSTRAP, GRIDLEY 95948 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 1386 GILSTRAP GRIDLEY Ener Plan Checking Fee Energy g $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.0023.00 USEOFSTRUCTURE SF & Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities CK Installation ❑ Other ❑ Describe Work: REPT ACE GAS BINE FOR STOVE Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ . ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Levi 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 hey affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the w rkers' compensation provisions of section 3700 of the Labor Code, I shall ith comply with those provisions. Date Fav — d�_ Signature of Applicant -Owner ❑ Contractor ❑ Ag nt An OSHA permit is required or excavations over 60" deep and demolition or construction of structures over 3 stories in height. TO Main Service( 200A 1000A 46.00 NEW CONSTDWELLING .CUP. SO OCCU OR ADONS. ( a ACC. BMS.3.5¢x: NO"ON.pESID. T. BRANCH CIRCUITS MULTI.OUTLET @7,50 POWER APPARATUS & SINGLE OUTLET CIR. 20 @ 1.010 EX. OCCu OUTLET OR FDRURES BAL @ .50 FIXLNS Ex. Occup.oimErs AEsID �ERa 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ++ PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE 35. U0 TOTAL FEE $ HAZ. D FEES IMP FLOOD CDF PARCEL PD HD UE This permit is hereby issued under of the Butte County Code and/or indic ted a ve for which fees have rBy MI EXPIRE ON the applicable provisions Resolutions to do work been paid. (. ateReceipt - Date No. 353312/$35.00 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) 538-754�a /,PERMIT r;� =tev ,2/96, APPLICATION AND PERMIT - A: SESSOR PARCEL MIMBER ()c -)4--,.b . / ZONING BUILDING PERMIT °""E" (= SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS CONTRACTORS NAME I TE ONE I1 CONTRACTORS MAIUNO ADDRESS ! LO NO. I SUBONIS IONS NAME IPARCEL MAP USEOFSTRUCTURE SF Duplex ❑ Mobilehome O Other SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilibes�d Installation ❑ Other ❑ "PEPA T FEE PAlb SRI • . SHERIFF 0THV AMOVNT RECEMO a - � "R ul%w a NVAA�lit " TO " IVT INTO COMDR PERMIT FEE 1 f CONSTRUCTION LENDER Fireplace LENDER S MNUNG ADDRESS Main Service ARCHITECT OR ENGINEER LICENSE NO AaCHITECT OR ENGINEERS MAILING ADDRESS BUIIOrtIG AGGRESS 1��n �\` � tDG LO NO. I SUBONIS IONS NAME IPARCEL MAP USEOFSTRUCTURE SF Duplex ❑ Mobilehome O Other SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilibes�d Installation ❑ Other ❑ "PEPA T FEE PAlb SRI • . SHERIFF 0THV AMOVNT RECEMO a - � "R ul%w a NVAA�lit " TO " IVT INTO COMDR PERMIT FEE 1 $ MECHANICAL PERMIT 1 Filing Fee 1 20 00 Heatin Coolin Hood 6.50 I PERMIT FEE I S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. Tr PE TOTAL FEES NAz. 10. FEES I IMP I FLOOD I COf I PARCEL I PO I nD : SSL= 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 ReceiptNo. PERMIT EXPIRES ON WHITE •0.O.S.•8.0. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROO•APPLICANi PERMIT FEE 1 f ✓ J Fireplace Fling Fee' 20.00 Main Service Total Valuatlon S 23.00; — Main Service Filing Fee S 20._0 Permit Fee Plan Checking Fee S S NON•RES D. Energy Plan Checking Fee S F,=0APPARATUS a OUTLET CIR. S Ex. OCCU PERMIT FEE $ Ex. Occup. PLUMBING PERMIT 1 Filing Feel 20.G0 Each Trap Mobile Home Facilities 7.00: Solar or heat pump water heater 23.001 Water piping I 15.00 Each gas water heater or vent 15.001 Gas piping system 1 • 5 outlets 15.00! Building sewer 15.00: Mobile Home I S I G I W @20.00• PERMIT FEE 1 $ MECHANICAL PERMIT 1 Filing Fee 1 20 00 Heatin Coolin Hood 6.50 I PERMIT FEE I S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. Tr PE TOTAL FEES NAz. 10. FEES I IMP I FLOOD I COf I PARCEL I PO I nD : SSL= 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 ReceiptNo. PERMIT EXPIRES ON WHITE •0.O.S.•8.0. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROO•APPLICANi PERMIT FEE 1 f ✓ J ELECTRICAL PERMIT I Fling Fee' 20.00 Main Service 2p0A OR LESS 23.00; — Main Service 200A TO IoaoA 46.00: NEW CONST. OR ADONS. DWEL1W0occuP. ( a ACC. BLDS. 3.5C5O — VT.; NON•RES D. O, -cg g7.50i F,=0APPARATUS a OUTLET CIR. I —. Ex. OCCU OUTLET OR ""AES P I'� 1 BAL yp Ex. Occup. (OImtTS FlXEO APPINS. (RES10OR .)Temporary Service I 23.00 Mobile Home Facilities j 20.001 Misc. Wiring 1 23.00; PERMIT FEE 1 $ MECHANICAL PERMIT 1 Filing Fee 1 20 00 Heatin Coolin Hood 6.50 I PERMIT FEE I S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. Tr PE TOTAL FEES NAz. 10. FEES I IMP I FLOOD I COf I PARCEL I PO I nD : SSL= 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 ReceiptNo. PERMIT EXPIRES ON WHITE •0.O.S.•8.0. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROO•APPLICANi 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 unnecessary delay in processing'and issuing your building permit., No building permit will be issued until this verification is received. R 1.I personally plan to provide th " ajor labor and materials for construction of the proposed property improvement: YES NO ❑ ' 2. I HAVE HAVE NOT 13 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: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S 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: CONTRACTOR'S 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 PROPERTYOWNER: SOCIAL SECURITY NUMBER: DATE: NOTE: - This Owner -Builder Verification firequired by Section 198.31. and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we. are permitted to issue the permit. OVER O— OWNER BUILDER INFORMATION - I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible parry 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 S300 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 Governments 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 for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit 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 their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors 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 required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. i rely, Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the Californla Health and Safety Code. OVER V COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, Califorkdg 95965 • Telephone (530) 538-7541 PER71T NO. (Rev. 12/96) APPLICATION AND PERMIT � -o6`�i ASSESSOR PARCEL NUMBER 024-282-001 ZONING BUILDING PERMIT OWNER CARASCO84f;-27 TELEPHONE 2 SO. FT. OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS 18 CONTRACTOR'S NAME OWLY r.1� TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Ellin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 1384 GILSTRAP GRIDLEY CA 95948 Energy Pian Checking Fee $ $ PERMIT FEE $ LOT NO. SUBONSION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 TEach USEOFSTRUCTURE SF [K Duplex ❑ Mobilehome ❑ Other SPECIFY Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other XI Describe Work: GAS PIPING & FURNACE Gas piping system 1 - 5 outlets 15.0015.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S 35.00 ELECTRICAL PERMIT Filing Fee 20.00 "OOV OR LE Main Service 20.AORLESS 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. License Class LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License L r the following reason: I, es 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. C❑ I 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: 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 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' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I,should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall focthwith comply with those provisions. D to .� Z O 2 Mg --n ure of Applicant Owne ❑ Contractor Agent An OSHA permit is require or excavations over 60" deep and demolition or construction of structures over 3 stories in h fight. Main Service z00A TO 46.00 OCU000A NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( 8 ACC. BLD S. 3.52FT: No RESDT MULTI -OUTLET CIRCUITS @7,50 PowER APPARArus a SINGLE OUTLET CR. OUTLET OR FaTUREs 20 Q 1.00 Ex. Occup.BAL @ .50 Ex. Occup. DFuTL�ETs RESIp.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating GAS FURNACE 15.00 Coolin Hood 6.50 Ventilation PERMIT FEE $ 35.00 Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 70.00. HAZ. I D. FEES IMP I FLOOD CDF I PARCEL I PO I HD I 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. Date 3 PERMIT EXPIRES 3/a a1 Defe Receipt No. 3 D.Od WHITE-D.D.S.-B.D. CAN Y -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 PE Ilev 12/9e, APPLICATI--- N A"ND PERMIT -d ASSES:On PARCEL NUMBER v® ZONING BUILDINGPERMIT TELIPHONE 8 -� 3� SO. FT. OCC. BUILDING VALUgTION _ Owr ER S MAIU N ADORESS t^ �- - --. . -]3 COW—A�TOOASS)LN-A-ME CONT ZTCRS MAIUNO ADORES TELEPN NE — - — I —.--- CO nS T RUCTION LENDER Fireplace '----"--' - - UNDER S MA -UNG ADORESS Total Valuation S ARCr•rt ECT OR ENGINEER UCENSE NO Fling Fee5 2 0 Permit Fee ARC.ITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee S BUILOIUG ADORESS Q � � ` Energy Plan Checking Fee $ S PERMIT FEE $ LOT NO SUBDIVISIONS NAME I PARCEL MAP PLUMBING PERMIT Filing Fee 20 c USEOFSTRUCTURE SF'�6 Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap I 7.00 ; — Solar or heat pump water heater 23.001 Water piping 15.00' Each as water heater or vent _ 1 5.001L r TYPE OF WORK New ❑ Addition ❑,� �Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: �- /O.t.0 ,�•il,�-e/� I, 5 Gas piping system t - 5 outlets 15.001 -- 5.00hew Building sewer I 1 5.00 Mobile Home S GI W I 920.00; PERMIT FEE S fig,(, ELECTRICAL PERMIT Fling Fee: 20•_1 000 OR LESS Main Snice 200A OR IESS I 23.00: - . 6 y *PERMIT FEE PA10 s � U U _ SRI SHERIFF OTIM � �'�'� • AMovw aEcEZWo : 2/1- 0 O 3qaolj TO N PVT 32�" COMPVM Main Servic MA TO Io00A i 46.001 - NEW CONST. OW FEEING OCCU P. 3.5Cso OR ADONS. 6 ACC BLDS. I FT NEW CONST. TI -0 E I@%SO; NON-RESIO. I .- POWER ARATVS 6 SINGLE O CIR. — Ex. Occup. OUTL£T OR FOR ES 20 8 1 00 SAL � SO FlXED APPLNS. OR I 5.001 Ex. OCCU GUTLET9 RESID EA Temporary Service 23.00: _ Mobile Home Facilities I 20.00; i .00; Misc. Wirin I I I — PERMIT FEE _ MECHANICAL PERMIT Filing Fee 1 20 Heating 5; —(5;1— Cooling Coolin — Hood 6.50 1 Ventilation PERMIT FEE S .00 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEES 90. O v RAZ. 0. TEES I IMP FLOOD COF PARCEL PO This permit is hereby issued under the applicable provisi of the Butte County Code and/or Resolutions to do N indicated above for which fees have been paid. By Date ReceiptNo. PERMIT EXPIRES ON WHITE •D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ,.0 . O.B.-.L a 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 unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 0 I personally plan to provide the major labor and materials for construction of the proposed property im rovement : YES E3 NO 1301 HAVE HAVE NOT ❑ signed an application for a building permit for the proposed WO& 3. I have contracted with the following person (firm) to provide the proposed co NAME: ADD S: CITY: PHONE: CONTRACTOR'S LICEO. N 4. I plan to provide porn of this work, but I have the following person to -coordinate, supervise, and provide the m ' r work: NAME: 11 ADDRESS: CITY:. PHONE: oNTRACTO LICENSE NO. 5. I will provide some of the ork but I have contracted (tur the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER. SOLI ECURITY NUMBER: DAT NOTE. This Owner -Builder VerViication is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit OVER 0 OWNER BUILDER INFORMATION . I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible parry 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 S300 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 Governments 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 for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's 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 under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. r ` If the structure is intended for sale,.property owners who are not licensed contractors are allowed to perform their work personally or through their.ov-vn employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice`of unlicensed persons professing to be contractors 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-noi required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. i 1 rely, Mic el C. V► ltd, C.B.O. tit ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19810 of dre California Health and Safety Code - OVER f' COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California'95965 - Telephone (916)'538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PAR7)rNUMBER `l r. / ZONING BUILDING PERMIT OWNER •� TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNS AILING ADRESS /t y OA (�J CONTRACTOR'S NAME MrWjjr C- TELEPHONE - CONTRACTOR'S MAILING ADDRESS JS I M or a W 1,41#CI J`�Z Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ eU�J4DI DREZ;i II PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15_00 USE OF STRUCTURE SF Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets /15.00 Building sewer 15.00 Mobile Home S G W I @20.00 TYPE OF WORK New ❑ Addition O Remodel ❑ Utilities O Installation El Other O �/ Describe Work: L ,t j �f j.- 1( !/�/�y� C, /i/f % +/ (> X I'll PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 600v ORLESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLOS. ) So. 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) P-1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full forceand effect. License No.S2,3lpy Classification /J O I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-RESID. ( ORANCH CIRCUITS ) @7.50 ( POWERAPPARATUS ) 6 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET on FIXTU B20 @ 1.50 Ex. Occup.FIXED AP OR ( OUTLET ESID.)EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20,00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) -or less. %OJ have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. O 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X_ . t -_Date ' � Signature of Applicant -Owner ❑Contractor .$� Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ n% / HAZ• I D. FEES I IMP I FLOOD I CDF PARCEL PO HD ISS This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have DIRECTOR ;OF PUBLIC B /Al y'. PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. WORKS I Date �-/_/; IDetel Receipt /y33c)9 Jrli � WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .D. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT 3 ASSESSOR PARCE NU ER -- D / ZONING BUILDING PERMIT OWNER n TELEPH NE O SQ. FT. OCC. BUILDING VALUATION o OWNER'S s ILWS9 CONTRACTOR'S NAMETELEPHONE rvVol 6D 03 2S CONTRACTOR'S MAILING ADDRESS 1,� 3B,5pr 't Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ / , YLT ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ 85 I G DRES/ rA PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15 6 USE OF STRUCTURE SFjdl Duplex O Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ��// �y��� . / y��(% ,r� / Describe Work: EG\ 6141 D � V `//i / �7 �!/���V PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 20OA OR LESS 23.00 Main Service ( 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLDS. ) S0, 3.5 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. 2� �9 Classification n License No.s 1 ❑ 1, as the owner, 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) ❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON-RESID. ( BRANCH CIRCUITS ) 7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET ORFIXTU 20 .00 BAL.@1.50 Ex. Occu FIXED AP OR p' ( OUTLET ESID.I EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. lIAJ have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation p RMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California 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, judgments, costs, and expenses which may in any way accrue against said Cou ty in conspquence of th ming of this permit. Date��a3 Signa re of Applicant - 0 Owner ❑ Contractor NtAgont An OSHA permit is required for excavations over 5"O" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ �� DU HAZ. 1 D. FEES IMP I FLOOD I CDF PARCEL I PD HD Iss This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate ve for which �e shaff'-,,eeaid. DIREC PUBKS BY e PERMIT EXPIRES ON !Dare) ReceiptNo. 1-r/ oo WHIT E•D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT J .'i.' � ,i,,.�`.,.r.^R"`' �„�i`.^i �.lat'+"�.:+�E'<,:e1I"'+r~���•`�'3='�`�'4.....-.�c�.iv°r.t "'"'r*t,'�^..+^�r-�.y .-„� � ., ., 4�` 1 • COU NT-YOF BUTTE -DEPARTMENT OF DkVgLOPMENT SERVICES -BUILDING DIVISION 1 jfflP !a . 7 COUNTY CENTER DRIVE - OROVILLE,-CAL-tFO.RNIA95965 -TELEPHONE (916) 538-7541 ` V PERMIT APPLICATION DATA SHEET OWNER PA. P. No. Proposed Building Use (Z-3 Building Inspector Date -7 g� At time of ermit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECENED BY 1. All items have been submitted. ............... 2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... . 3, Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ........ ....................................... 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ...... 20. Pre -inspection for Pre Inspection requestrequired. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ........................... 23. Owner -Builder Verification (Given to owner , Mail to owner _). .........: . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. 31. Existing violations/expired permits . ...................................... . 32. Plan check list . .......................................... . 33. 34. When you issue the permit, process as follows: Mail to gwner. Mail to contractor. Telephone Z93 -SWR and hold for pickup at (1 q,�) office. Deliver with inspector. Other Parcel CreationrrQQ''A" n Acreage Applic l 'l Date 7 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 _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works '- r� $''�t,f-`�:i.f d>.d':..�y1`. �1 * ,;� •�$S•'• �..=,�.-'F,rv'''=� +�,rer `� "�i�d, u.�r'i°'�'r�.'^l--P'�i"�+�Y;,'.�.'� �,.,, "'Y st,.T'?t�!�+`�!"�r�W'-4'.�.'f'r.�.y. ' 4 ' •+."-"`, b i,�"ri�., ihT V � r , ..., $• ,y'��..,�w Zjiti *L'> P,ermit##2'328-87 r !` Beatrice Perry 1386 Gilstrap, Gridley Oltf OFFICE COPY Address GAS Meter By ELECTRIC ,,Date D-� } Meter.Bv :1.A._ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT O Ur -j �,Nom, ASSE,$SOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER j ���' 1 r ✓� � I TELEPHONE SQ.FT.OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS /� /� n a / <"1 l/ / / l•^ /001 CONTRACTOR' SHAME TELEPHONE CONT'RACTOR'S MAILING AD ESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS - Permit Fee $ / oe ' ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS / Permit fee $ , PLUMBING PERMIT Filing Fee 10.00 Each Trap 2 2.00 4 /2 , 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 SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 ,- 5 outlets 5.00, Q Building sewer 5.00 Mobile Home Is G W 10.00ea TYPE OF WORK New ❑ Addition ❑ R,emodeI ❑ Uti liities ❑ Installation ❑ Other Describe work:k1r 17/, t' / �C �HII��/ _ Permit Fee $ -.90262 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR 00 AMP ORSLESS 10.00 ,1) Main service EA. ADD'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 BusinesS and Professions_ Code and my license is in full force and effect. q License No.2 1,1J �T� Classification ` �� ❑ 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 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 OC?11� K 4 OR ADDNS. ACC. SLOGS. h2sgft NEW CONSTRMULTI-OUTLE 2.50 ea NON-RESID BRANCH CIRC ITS POWER APPARATUS h) SINGLE OUTLET CIR. Occup(OUTLETS OR FIXTURES .20050t Ex. Occu 20 ° z0` AL@30 FIXED Ex. Occup. OUTLETS P(RESID )KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The.permit is for $100.00 (valuation) or less. ©,,.1 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 FiIingFee 10.00 Heating A, Q( ) (J, t ✓� Cooling '}T ��• �� / Hood 3.00 n J 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 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. -�/ X U - k Date 3� Signature of Applicant � ner ❑ Contractor 0 Agent ❑ permit is required For excavations over 5'0" deep and demolition or construct- An OSHA ` ion of structuresConv/e�r7)3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ / OCCUP. CONST.TTPE __J_FLOOO PARCEL PD ND 1­135IJE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. I �hREsiTQ�� PUBLIC/1NORKS y ri I/r� ! A B �IV019 &Date � . I/V r � - � � - � �� PERMIT EXPIRES Date- Receipt No. (. " / �iV , WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 - Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE 7 211111101911 A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. " COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 - APPLICATION AND PERMIT NO i� 1a ASS E�50 PARCEL NUMBER OC) ` ZONING BUILDING PERMIT ow RTELEPHONE r ` YJ r SQ. FT. OCC. BUILDING VALUATION ,.- O NER'S MAILING A RE 5 C CORA OR•5 N ME / C - TELEPHONE CONT'RACTOR'S MAILING AD ESS Fireplace CONSTRUCTION LENDER UNKNOWN C� Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ . ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS^_ �� lr�`(,j' 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 Int USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 S Q Building sewer 5.00 Mobile Home S I G W 10.00 ea TYPE OF WORK New ❑ Addition ❑ gmodel ❑ Uti li 'es ❑ Ins I lation ❑ Other ( Describe work: tf' -t ►� "1 � Permit Fee $ , Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 1 OR LEAMP ORSLESS 10.00 10.047 Main service EA, ADD'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 Business oonCode'a�)andd my license is in full force and effect. and Professions Code License No�u ,"5M L� ,�_ Classification —1 Fl 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 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 OR ACONSDDNST ( DWEACCLLIN GSCC 2'/4sgit NEW CONSTRMULTI-OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS ( POWER APPARATUS a' SINGLE OUTLET CIR. Ex. OCcup(oUTLETS OR FIXTURESFIXED 20050Q 6AL0 30 EX. Occup. OUTLETS P(RESID IREA.� 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 66 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ Th rmit is for $100.00 (valuation) or less. have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating /1.00 Q CoolinglOc 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. 1 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 a st sa' Co ty in consequence of the granting of this permit. X Date Sig pp ❑ Contractor Agent ❑ Si nature of Applicant - 0 ner 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 $ TOTAL PERMIT FEE $ tJ OCCUP, CONST.TYPEJ PLOOD PARCEL PD I NO ISSUE This permit is hereby issued under sions of the Butte County. Code and/or work indicat above for which RE PUB BY PE T EXPIRES Date the applicable provi- resolutions to do fees have been aid. P ORKS Q' D to v Receipt No. S Q WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT r i• + ` h FIRE I NUMBER RANGE � � I; e r FIRE NAME: � 4OIv• RE REPORT:, R.SI. NO. ORDER NUMBER ' ! _thru f._ FI REI R G. R.U. INCIDENT NO. START M . DTE EAR COi FC- IS iI 4r LOCATION I`t 'i °'� 1 ,"�trl�3.,i��•�:(�ff ��y �,',,,; PORlIG51N MILES [DIRECTION. I �7 FROM ❑ IN.1NATIONAL FOREST, FIRE DIST., CITY 8 STREET NO./ I+ r i• + ` h FIRE I NUMBER RANGE � � I; e r FIRE NAME: � 4OIv• RE REPORT:, R.SI. NO. 1 ' t. s _thru f._ L t FC- IS iI 4r LOCATION I`t 'i °'� 1 ,"�trl�3.,i��•�:(�ff ��y �,',,,; PORlIG51N MILES [DIRECTION. I �7 FROM ❑ IN.1NATIONAL FOREST, FIRE DIST., CITY 8 STREET NO./ I+ - �If�+��i CIDENT-ITYPtil +' a' I,'i' ' ' �'' ' ` ` f1� ��t�(1#Aj + ACRES -OF it EGETATION BUR D eIN I f I y 8A 7: 1 1 t ,{ iI > J j: r .Y;.}<,:{.S::S:n }..Y•,S{••: :•.; •:: v: .'S` :vY:j4 ki { $ ' • :.: '. 1 4 i.:i'i'�I! 6, •.2��• ' a:,z:;�{;5{•�'�i Y � # a A4jtY ; •,,;'•i.i:•:J;S:?Y�:�:yn,;Y' \•rY: j�j�:v>S 3 t SEC. TOWNSHIP k' 1� ' RANGE � � TO ;. � 4OIv• .Fly W FIRE AGENCY°f+ °PROTtECTION . (, —22a .. , I�1 �''i1 +' ) • ( +� ,y; '4� 'ACRES�BURNED j ACRES BURNED £# RESPONSIBILITY - 4A , , ., cDFIM'; ' J) STATE ZONE "STATUTORY' BEI 02 ❑'.WILDLAND'lBURNED�OR• THREA. NED RESPONSIBILITY +� $,`.•'� ;,'� '' ': O ❑ CDF'LQCALII GOVTd CONTRACT D UNPROTECTED{��� t 'AT `ORIGIN 3�LAND' + 1 ❑ ti ' OTHER Or• i ;I, d ❑STATE ' I ❑ ASSIST',OTHER rAGEyCY�y(Not City), I �j ��-4 ❑ U.S.F°S..BRUSH r._+' • TOTAI,� -"w r. 'F•'LOCAIL 'ZONE # + . � �•� r _ f t � B.L.M. ;" 1�' 1 r : I •ri•.>;:'•wNf,,'r�?�� 'S ;k :aRA33 1 Q$ � CDFa•L,OCAL GOVT' CONTRACT f •�'} ft''� B.I.A.. r �wr i �M •r ❑ ' O' ❑+IASSLST;,OTHER``AGENCYa'(Not ),:+4 ::>•:.,�>." ! ,>...., '' ERIC. : yl y t r ❑':OTHER FEDERAL k {r•; .,. � ; PROD. �r+BB FEDERAL ZONE II'({ ''� ': d I ; ❑ 'OTHER I • '�' CDF ® ❑''ASSIST FED 'AGENCY (Not' ' t '�Y. '. M ��• ,k �' 4 � NOTAL 8 SIZEuCLASS ❑ 'CDF LOCAU GOCONTRACT z 'MISQ. AND OTHER...,.,.....,...,.,::::,:..:::::::>: ❑ASSIST :CITY r• �CTRACT •CO., tOTHER:, • - ' A .25- ....... O ON � IL, ' .'' • { ❑ = STATUT. :y r . tRESPON. ACRES BURNED ' # ❑ e .26 -9 ACRES 0 CAUSE (STA RTS IN OR O ONLY) i 5 10-99 ACRESktt � STATE LIGHTNING DEBRIS, PLAY W FIRE El -1- �; �• ❑ CAMPFIRE C] ARSON OTHER/MISC. D 100-299tA�C Sa .: . U.S.F.S. " ❑ C3 SMOKING= .:+1.:..�, EQUIPMENT t���� .?• �• + ❑ E 300-999 ACRES;' B.I.M. `LANDj'USE}(STARTS'iNhr 1 2 $ 10R ' 8 ONLY) ❑ F 1000-4999 ACRES B.I-A.' b •� _ . G. t :t r ; i�� . , '~ ❑ 5000 ACRESkOR MORE B.O.R. ,' I ❑:,FOREST INDUSTRY'.I , ❑ RANCH-FARM.RECREATION OTHER ❑ I.,.OTHER INDUSTRY-COMRCL. '::,'•.'•c�: r�¢ : :.?f : � �r. DUMPIr+El ROA 1 � �`' .::.s,..... • ,E:•,t :::'�> : y 6�. `�::�.� :� • OTHER aj 1 Y. . ,1 t UTI IITY `RAI LROA D s. t' lr N O N-WILD ' ND ? 11 .. f LA ^ik. :•w{ il-c]."rLDLAND .r F !yy Y ' I( i' . !� �• T. t 1 S � 'ELECTRIC :F is, 1 }, El OTHER " z�,••�'` t TOTAL h Y lit ❑ FALSEI ALARM—GO TO ;. } LOCK I 1 ' t. s .1 4 s, :.'u .w.',;Y:::t•t,¢Y?:{: ••a+;Y:::: •};'.,• , DAMAGE` R;! 8 NL (��:. � � �' I I• tli . tf i :.� . `-0"OI�, a` % i 1.3 DAMAGE (kk� • i} '1 yI��N1 Ym �pf (Ratmil b oN.Nsoro:e f100 l�,�t:��. �II `r �il��+ ; 1 ` 2 &16,08 5 ,, TIMBER. 8/04( k',. ;:r YOUNG GROWTH � � •� � ii �; I � WIIDLAND VEGETATION , i. Other than T!8:Y G). AGRICULTURAL';PROD ' 1i (Other than T+6 Y 0). DWELLINGS c 8/OR CONTENTS OTHER STRUCTUIjES.I�j 8/OR CONTENTS. i 1 VEHICLES 8 CONTENTS I' +'• OTHER ii ON "ARRIVAL (Ol VEGETAjION.FIRES rONLY) ' 9 'SIZE '' +' f • �� �� �; � ' �f 'DISTANCE (Origin to head)' Its, +' i ACRES FEET WEATHER ESTIMATE11AT)SC6411.` I;,''!" WIND SPEED (M.PF), 'DIRECTION (PROM) TEMPERATURE I { , ; t F 1 OVER PLEASE `•�� ' CDF 7540.130-86 39852 0118 TOTAL {� `�,• .:�• S ON "ARRIVAL (Ol VEGETAjION.FIRES rONLY) ' 9 'SIZE '' +' f • �� �� �; � ' �f 'DISTANCE (Origin to head)' Its, +' i ACRES FEET WEATHER ESTIMATE11AT)SC6411.` I;,''!" WIND SPEED (M.PF), 'DIRECTION (PROM) TEMPERATURE I { , ; t F 1 OVER PLEASE `•�� ' CDF 7540.130-86 39852 0118 min ❑ P"Fm faint -Date _ 0 t L z°r - Daft alyb BUTTE COUNTY -DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT t ' ZONING Owner: i +: r A . Y. if — Address • `t 9Date of Inspection . i Tenant: i Inspector 1 � Building f S Location:Re Type of Inspection requeja: W }� 1. Housing / / 2. Financing / / 3.. Change of Occupancy to 4. Work W/0 Permit / / 5. Ocher (speciy) S , k Present use of building: � A. Sanitation (Housing) 1. Water closet: 2. Lavatory: -3. Bathtub or shower: L' 4. Kitchen sink: t 5. Hot and cold water to fixtures: 6. Heating facilities: 7. Natural light and ventilation: ' 8. Room and space requirements: ` 9. Bedroom window or door for second exit:` 10. Infestation of insects', vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water supply: r 13. Rubbish and garbage facilities: 14. Stairs:(Rise, Run, Headroom, 1HR, Tolerances,Handrails) _ 15. Comments: B. Structural 1. Piers and footings: +... 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: " 6. Comments: C. Electrical r 1. Service and ground:' 2. Receptacles: 3. Fusing: 4. Comments: I a E. F. Plumbing 1-. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Energy:. 7. Comments: Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: _ 4. Restroom floors and walls: 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: / / A. Information only - file. / / B. Hold for ten days, then write letter. %-% C. Write letter. / 1/ D. Other: CID Fp I. M FC- IS (3/86) e -N ORIGIN LOCATION SEC. MOWNSHIP BN RANGE ZE NATIONAL FOREST, FIRE DIST., CITY & STREET El S LW U.S.F.S. ETC. I T, - love' 0 U 7Nry (�-,/ - �Ril - i"(1111 /:. i MILES DIRECTION R FROM IN. NATIONAL FOREST, FIRE DIST., CITY & STREET SIZE -,CLASS.` � U.S.F.S. ETC. I T, - 1 Jbf—v B.I.A., 1�--UFIRE ❑ FALSE ALARA"O TO 'BLOCK 10 RESPONSIBILITY 4A t 4B STATE 'ZONE STATUTORY WILDLAND BURNED OR THREATENED RESPONSIBILITY CDF LOCAL GOVT. CONTCONTRACTAT ORIGIN) 0 UNPROTECTED 0 STATE' E] ASSIST OTHER AGENCY (Not Ci 0 U.S.F.S. LOCAL ZONE' CDF LOCAL GOVT. CONTRACT' El B.I.A. 0 ASSIST OTHER AGENCY (Not Ci OTHER FEDERAL FEDERAL ZONE N , l t'! ED OTHER ASSIST FED. AGENCY (Not Mil.) CDF LOCAL GOVT. CONTRACT 4, MISC. *AND OTHER —ASSIST CITY, CONTRACT CO., MIL,. OTHER CAUSE (STARTS IN OR ONLY)' Z/ C] LIGHTNING ❑ DEBRIS PLAY W/FIRE 1,k ❑ CAMPFIRE. E] ARSON OTHER/MISC. ❑ SMOKING* EQUIPMENT LAND USE (STARTS IN 1 2 5 OR 8 ONLY) DOMESTIC ❑ FOREST INDUSTRY ❑ RANCH -FARM ❑ IiECREATION, E] DUMP ❑ OTHER INDUSTRY-COMRCL. ❑ ROAD ❑ WILDLAND ❑ UTILITY, RAILROAD ❑ NON-WILDLAND ❑ UTILITYj" ELECTRIC ❑ OTHER ) DAMAGE <� OR ONLY) 77 -------- S DAMAGE ACRES I OF VEGETATION BURNED DIRECT AGENCY PRIOTECTION ACRESdBURNED x'j? CDF OTHER TOTAL Number I.— on 10 ne­? s,w) SIZE -,CLASS.` U.S.F.S. 1 10 02 8/or 08 1 TIMBER 8/OR B.I.A., tA, .25 ACRE -'OR,,LESS'! YOUNG GROWTH 0 OTHER FED. ,PROD. CDF TOTAL WILDLAND'VEGETATION • 'A61?Eii,1 E -C 10-91�4 (Other than T & Y G) E 300-999 ACRii4 AGRICULTURAL PROD (Other than T & Y G) DWELLINGS G 5000'ACRES'OR MORE 8/OR CONTENTS OTHER STRUCTURES 8/OR CONTENTS VEHICLES & CONTENTS OTHER TOTAL $ ACRES I OF VEGETATION BURNED DIRECT AGENCY PRIOTECTION ACRESdBURNED x'j? CDF OTHER TOTAL ON ARRIVAL SIZE VEG. TYPE 813 f ACRES BURNED STATE SIZE -,CLASS.` U.S.F.S. .WOOD LAND B.L.M. BR US Hti2 B.I.A., tA, .25 ACRE -'OR,,LESS'! 3 eaB-.26�-9,ACRES. OTHER FED. ,PROD. CDF TOTAL • 'A61?Eii,1 E -C 10-91�4 -i99 ❑ D 100-299 ACRES- E 300-999 ACRii4 1000-4999. ACRES G 5000'ACRES'OR MORE ON ARRIVAL SIZE VEG. TYPE ACRES BURNED f ACRES BURNED STATE TIMBER U.S.F.S. .WOOD LAND B.L.M. BR US Hti2 B.I.A., IG RASS B.O.R. AGRIC. OTHER FED. ,PROD. CDF TOTAL OTHER 4�Alwl. :RJESPON. OF• 1 1 Ol f ACRES BURNED STATE U.S.F.S. B.L.M. B.I.A., B.O.R. OTHER FED. OTHER VEGETATION- FIRES ONLY) DISTANCE (Origin; to he6d)l IES FEET WtA I HtK (ESTIMATE AT SCENE 1-d{ i 1 WIND EjWIND SPEED (M.P.H.) DIRECTION (FROM) TEMPERATURE OVER PLEASE C DF 7540-130-01 I a 86 3.9852 vrtULK INUMDCK ti 1 REG. U. INCIDENT NO. VEA&' t FIRE RECORD Mo DATE TIME CI Q 11 OUTSIDEOn00 8 37 FIRE STARTED Enter 1ST. CD Dispatch I ON1 FIRES. ENTER 2 8 TOTALS BELOW `<w•`:�i i�<8>� +'• ...%:: EE:ti.#•it:.<::»<;:;:;i;>:;:x;•»>•<:.. INSIDE l02005 OR 8 C '�U 1 N�--L ., FIRE DISCOVERED } "%'''`4'''"'•'' 6 FIRST REPORT COMM �. v SECOND REPORT t OTHER FEDERAL (Incl. Overhead) TOTAL FIRST ATTACK BY CDF ! �3 FIRE CONTAINED FIRE DIST. 8 'OTHER LOCAL TOTAL ;.'%`" `ti'z• u J ol;l 9198% LOOKOUTS (If Tl ST, or 2ND. re oit made b 'Lookout SITE r NAME: SITE NAME: 12 GKEW UVEKFIEAU KEGUKU CDF STATE 8 LOCAL GOVT. CONTRACT ORGAN- PERSON I AIRCRAFT CDF STATE 8 LOCAL GOVT. CONTRACT ORGAN- PERSON AIRCRAFT CREW NAME IZATION HOURS FLT. HRS. CREW NAME IZATION HOURS FLT. HRS. 1 ST. ATK , CDF CREW CDF OVERHEAD TOTAL ❑ FOUR SECTIONS ❑ MAP ATTACHED 37 ON1 FIRES. ENTER 2 8 TOTALS BELOW `<w•`:�i i�<8>� +'• ...%:: EE:ti.#•it:.<::»<;:;:;i;>:;:x;•»>•<:.. r:t^.:;•:.£::" . •:'.:::.:;.;;�;:>:::r:::::: r Eve:::>;'�>: rxvi;?:m:•: 1 N�--L ., . U.S.F.S. (Incl. Overhead) TOTAL "%'''`4'''"'•'' ;'c�'na M■. COMM �. ■■■m■mm■ OTHER FEDERAL (Incl. Overhead) TOTAL Ommommmm FIRE DIST. 8 'OTHER LOCAL TOTAL ;.'%`" `ti'z• PAID HOURLY (E.F.F.) TOTALX. X. VOLUNTEERS (Unpaid) TOTAL EE^'£'? ❑ FC -18B (Additional crew activity) ATTACHED A ❑ FOUR SECTIONS ❑ MAP ATTACHED 37 1 N�--L ., TG 2 ■■■r, ■mmW ;'c�'na M■. COMM �. ■■■m■mm■ Ommommmm ORIGINAL COMMENTS i r f� 13B MAP IS: Pff ONE SECTION ❑ FOUR SECTIONS ❑ MAP ATTACHED 37 1 N�--L ., TG 2 ;'c�'na �'•�' � ILC-= G- ' �. APPROVED BY: ATE INTL. DATE I , LOCATION SKETCH a f — — ! i I : ! i ; ; t i ! ! : : i 4 t ( i t i t i ! 1 � �! T• i � "i� � t� ! � � , - i i j ; ; i 4 [ r ; i ! ! t i i 1 ; i i' - i ! ; ! ; � , s � •3 U ; I � i , V i r i i i + ! i : - t t i i t , 1 ! : I i ; S I i 11 : k ; ! i ; j ! a �2 , ! ; ! I r + t � s i ' f it` !— -- — ' I i • I , a a _ —_—__�..._—i_.___ Wit__.._,:.___.. _—..__. _.—_ .•_____ _.___ _...._•.__.__ _..— ____' — ... _ _ __— _ _.— ! _ _ — _. j — 3 ; ! i CC ---- —4— castcommunications REGIONAL OFFICE: 4350 PELL OR., SACRAMENTO, CA 95838 PROJECT: f I i ` t t ! ! j t 1 i E I f ; ! I •�j1 �J/w ��v/�/7 As t LOCATION: I i j ? • i i I f 4 E � i � I t i 1 SYSTEM: I f i I i I ! I FIELDED BY: DATE: SCALE: ORAvnNG N0: REV of