HomeMy WebLinkAbout025-030-004A.P. 25-03-4
George Blackwell
S Box 2281 Grover In. (5th house E.. of
^Hwy. 70' on left side)
Chico
Permit 1023-71B (reroo & gutter)
25-03-0 yv `^
LOT -7 BLOCK JDA
AYNE ATKINS F ��/�i,/g`�
TYPE IT PERMIT NO. PLAN NO.1 Grover Lane, 06 111e 60 5SUED
PERMITontr: Mills Roofing, Citrus Hts
ermit#3723-84B(reroof/Sr)
025-030-004 PERMIT#95-2317
ATKINS,,, Wayne
61 Grover Ln. , Oroville i� I��
New-Pri Det Garage '
REMARKS
PERMIT DESIGNATION: B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING
DEPARTMENT OF P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT
BUILDING AND SAFETY T -TRAILER S/W-SIDEWALK NOTICE S -SIGN PERMIT D - DEMOLITION 600.1
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e RESIDENTIAL ----
025-030-004 PERMIT#95-2317
ATKINS, Wayne
61 Grover Ln., Oroville
New Pri Det Garage
JOB FINALED (Dat _ A-)
Signature
J=OK
O = Not OK
Not Applic
Not Readyable MOBILE HOMES
c
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ /"Nat. or/ /"L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Ext.; Steps -Doors -Landings
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
_
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
3
MISCELLANEOUS 1(
Date
DECKS, QGVERS, CARPORTS, GARAGES, (Plans)OK except If's
onin equirements-Setbacks-Easements
otings; Soils -Size -Depth -Spacing -Connectors -Steel
. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. A n.; Columns -Connections -Splice -Decal -Enclosures
6. Ca orts; Windows -Doors
ectric
Fr ; Sils-Anchors-Studs-Rftrs-Trusses
iding, Nailing -Veneer -Stucco -Mesh
fK of; Shthg-Roofing
Ext.; Steps -Doors -Landings
Date''/%
Dat 4/L---
- Card B-1 e je Date Card B-1
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.;Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
_
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Y=OK
O = Nol,OK
Not Ready plicable
Not ReRESIDENTIAL (;
=
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg:; Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation Z�
r
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit),OK except rr's
16. Water Htr.: Vent -Access -Combustion Air -Baffle
-- 17. Water; Pipe: Test &Anchor -Nail Protection ---------------- I
18. D.W.V., Test -Fittings & Anchor -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower. Second Floor -Tub Access
------------------------------------
21. Gas Pipe: Size & Anchors
Date Card B-1 Date Card -B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except a's
22. Fixture & Transformer Clearance -Ins. Protection
- --------------- --
23. Elec. Receptacles Spacing -Lights & Switches at Doors
-------------- ----------- -------------------------------------------------
24' Size Boxes & No. of Conductors -Stapled
------------------------------
25. - Romex Installed Close to Edge of Studs & C.J.
-------------------------
26. Equip.,Ground made up w/Mech. Fastners-Bond Gas & Water
------------------------------------ - ----------------- - ----------------------------
27.
----------- ----------------------------------------------------------------
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
--------------------- ------------------------
28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size 1 ga.
Cu or Al
-----------------------------------------------------------
29.
--------- -----------------------------------
29. Range Circ. / � ga. Cu or AI -Oven Circ. / / ga. Cu or AL
Insulated Neutral ❑ Yes ❑ No
---------------- -------------- --------------------
30.
------------------
30. Service -Riser Conductors & Ground -Main Disconnect
--------------------------------------------------- -------------------------------
-------------- 31. Equip -.Clearances Panels-Motors_Mech_ Equip_
32. Clothes Closet Light -Shower Light -Spa Light
------------ -------------------------------------------------------------------
33. Smoke Detector
------------------------- ---------------_----------------------------------------
Date Card B-1 Date Card B-1
--------------------------- ----- - -----------------------------------------------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except n's
_____________ 34. -.A. -C. -Du cis Insulation & Support
35. Vent Fan Exhaust above insulation
--------------------------------------------------------------------------------
36. CondenEtate Drain & Overflow: Size & Grade
-------------------------------------------------
37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet
---------------------------------------------------------- -----
38. Attic Access & Platform if Furnance in Attic
----------------------------------------------------------------------------------
Date Card B-1 Date Card B-1
-------------------------------------------------------------- ----------------
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK exceptg's
39. Sils. Proper Material & Anchors
------------ ---------------------------------------------------------- --------
40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound
----------- -------------------------------------------- ------------------------
41. Bearing Walls over Girders & Floor Nailing
---------------------------------------------------------------------
42.
----------------------------
-----------------42. Draft Stop in Walls (rat proof)
-------------------------------- - ----------------------- - -----------------------
-------------
43.. Fire -Stops: Furred Ceilings -Stairs -Chases -Tub
------ ---------------------------------------------------
44. Headers & Beam -Size & Bearing
'Ingle & Duplex)
Date
FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
--------------
----
50. Garage Fire Protection Framing
_
_
51. Property Line Firewall & Openings
_
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Width -Head room-Rise-Run-Landin Fire Protection
_Stairs;
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
--------------------
--
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
-------------------
--
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls: -Bolts
-Nailing
59. Insulation -Walls -Ceilings
r�
60. Infiltration -Walls -Windows
-----------------
------------------
-----------------Date
Date
Card B-1 Date Card B-1
--- --------------------------
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except ti's
- -
- 61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
---------------------
63. Furnace; Vents -Clearance -Comb. Air -Connector -
---------------
In Garage; Above Floor-Ducts-Mech. Protection
----------
-
-------------
64. Bedroom Exiting
-------------
65
65. G F.I & Bath Fixtures & Tub Access -Spa
____________
66._ Elec. Trim & Subpanel; Breaker Sizes & Labels
--------------
------------
67. Stairs & Rails
--------------------------------
68. Fireplace or Stove: Clearances -Hearth
69. Elec. Outlets at Wood Panel: Int. & Ext.
---------------------------
-------------
----------------------------
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
-------------71.
71.Elec. Outlets & Receptacles at Kit. Counter
---------------------- ---
--------------------------------------
72 Garage Fire Door: Swing -Landing -Closer
-
------------------------------------
73.- A.C. Duct in -Garage -Damper
------
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. .
In Garage: Above Floor-Mech. Protection
75. Plb.. Elec. & M_ech._Equip. Listed for Location
------------------------
76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
---------------------------------------------
-------------------------------------------
7;. Insulation -Foam -Looked in Attic ❑ Yes
--
78. Guard Rails & Deck Construction -Post Caps
----------------------------------------
-----------------
- ------------------ - - --- -
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
79
Clearance Looked under Floor ❑ Yes
---------------------------------
.-------------------------------80.
80.Following instld.; Drive ❑ Yes ❑ No; Walks 0 Yes ❑ No;
..---------------------------------------------
Planters ❑ Yes ❑ No
---
81. Stucco: Brown -Finish
-----------------------------
82. A.C. Unit Disconnect. Electrical, Plumbing
-------------- --
83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings ___ _
---------------
84. Water Well: Disconnect, Electrical, Plumbing
- ----
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
--- ---------------------------------------
_.... _ ..
87. Glass Protection
-------------------
---------------------------------
88. Corrections from Previous Inspections
-- - - - - - - -
Gas Test -Meters Tagged; Gas -Electric
- - - --- - -- - - - -- -- ---- ---------------------------------
----
----------------
90. Water & Sewer Connected -C/O to Grade -HD Approval
--------------------------------
91. Energy Compliance Certificate -Other Certificates
91.
..-------------------------------------------- --
Date Card B-1 Date Card B-1
------------------------------------------- -- ------
_Date Card -B- 1 ---------------Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DTVI ON
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75 PERMIT NO.
APPLICATION AND PERMIT �� ��� -�
ASSESSOR PARCEL NUMBER 025-030-004
ZONING . AR1
BUI NG PERMIT
OWNER WAYNE ATKINS
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNERS MAULING ADDRESS 61 GROVER LN OROVILLE, 95965
960 M 17,280-00
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
NONE
UNKNOWN
Total Valuation $17,280.00
LENDER'S MAILING ADDRESS
Fling Fee
$ 20,00
Permit Fee
$
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Energy Plan Checking Fee
$ -
Penalty
$
BUILDINGADDRESS 61 GROVER LN
PERMITFEE S 331.85
OROVILLE 95965
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
LOT NO.
SUBDNIS ION5 NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
PVT DET. GARAGE
SF ❑ Duplex 11 Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping y I In system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New [X Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work:
Mobile Home ISI GI W
@20.00
PERMITFEE _
Contractor
ELECTRICAL PERMIT Filina Fee 20:00
Main ServiceOOOV OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
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
Law fpr 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
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. BUDS. )
SO. 3`] • 0
3.5¢ FT. J
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS SINGLE OUTLEU CIS.
8 )
EX. Occup. (OUTLET OR FIXTURES
O 1.00
BAL SO
. OCCUp. OUTLETS RESID.)OEA
EX ( )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
S 53.60
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
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.)
fa l 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
f rthwith comply with those provisions.
'
XAq6 DateHA i___
Signa ure Applicant - ❑ Owner ❑ Contractor ❑ Agen
An OSp rmit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee Is
Energy Inspection Fee is
OCC
CONST. TYPE
TOTAL FEE $ 385.4J�WUE
HAZ.
D. FEES
_
IMP V OD
11
CDF PARCEL PD
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By
PERMITEXPIRESON
applicable provisions
Resolutions to do work
been paid.
!Y pN
/ 19 (p
I (Date)
Receipt No. 185397
I
WHITE-D.D.S.-R.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
� COUNTYOF BUTTE - DEPARTMENT OFD.EI,/FLOPMENTSERVICES - BUILDIN IVI I S ON
LN
�.
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 5 -7541
f
PERMIT APPLICATION DATA SHEET 0
% ,,rr��
OWNER 06t /'� A&N . V
Proposed,Bu�ilding Use Building Inspector Date 9196425-
A61At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED 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. .........: ............ I .
13. Flood elevation letter (100 year flood by Ca iffornia Engineer. . .
14. Sanitation and plot plan approval I�Ov��le_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 required bl�P Build �9 �spector (Date)
21. Contractor's license information. (No., Name Style, Classification). .. ........
22. Certificate of Work"mans Compensation Insurance. .............
23. Owner -Builder Verification (Given to owner , Mail to owner ............
24. Recorded copy of Agricultural Acknowledgement Statement. .
�25. Letter of signature authorization . ....................................... jF,
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 owner. Mail to contractor.
Telephone g' and hold for ickup at (10 V; Ile, office. Deliver with inspector.
Other�-WAWFIE-po,0
Parcel Creation
Acreage Applicant l��%c.-� Date y-ao� 9S
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 G I.3 a0,Irs Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
E.H. U_SH ONLY
Plot Pim AmcW
Floor PhD
Scat to
h �s►, fj`T ej h
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply:' Public Private Well
Clearance for bedroom mobile home. Other
'v
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist Date
2/01)
ll aS l
� howS
l
o e VeL Q c C
40 1000( /4n. a. �O e.
F�, ►-,, fP l � u� �
y
Return to: AGRICULTURAL STATEM NT OF -ACKNOWLEDGEMENT
Building Division FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code requires this
acknowledgement be recorded prior to issuance of a building
permit.
The property described herein is adjacent to land or included
within an area zoned for agricultural purposes, and residents
of this property may be subject to inconveniences or
discomfort arising from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and
fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying,
pruning, and harvesting which occasionally generate dust,
smoke, noise, • and odor. Butte County has established
agricultural zones which have as a priority use for produc-
tive agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience
or discomfort from normal, necessary farm operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date: PROPERTY OWNERS:
State of California )
County of )
On before me,
personally appeared personally
known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature Seal:
A.P. #
OWNER
COUNTY OF BUTTE
BUILDING DIVISION "
DEPARTMENT OF DtVLLOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
5x317
PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please cont9ct this office immediately.
D
(', // -6/- r,o ; , .5 ia, o
Date 7— g % Inspector X7.5 ei
REV 10/92
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.
1. I personally plan to provide the major labor and materials for construction of the
proposed property improvement: YES NO[ ]:
2. I HAVE q HAVE NOT[ ] signed an application for a building permit for the
proposed''work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
ADDRESS: CITY:
PHONE: 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:
PROPERTY OWNER:��__
SOCIAL SECURITY NUMBER:
DATE:Ln
n6NOTE: This owner -Builder Verification is required by Section 19831 and
<a 19832 of the California Health and Safety Code.
2°o�c This verification must be completed and returned to our office before
we are permitted to issue the permit.
�AP*� oas-O3o-Do4
4-rl<lil�o�ay� �P�'q5-a3i7
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 party of record
on such a permit. Building permits are not required to be signed by property owners unless they are personally
performing their own work If your work is being performed by someone other than yourself, you may protect
yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all permits
for which they apply.
if you plan to do your own work, with the exception of varioustrades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any persons other `than your immediate family, and the work (including
materials and other costs) is $300 or more for the entire project, and such persons., are not licensed as
contractors or subcontractors, then you may be an employer.
0 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.
0 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.
0 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 "ownerbrrilder"
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—m- 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.
Sincr1el r.
. a Michail C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
0VER
Wayne Atkins
61 Grover Lane
Oroville, CA 95965
To: Butte County Building Department
Kelly Chamberlin is authorized to sign any papers related to obtaining a building permit
for a garage at the address above. She is acting on my behalf, and with my permission.
Thank you,
Wayne C. Atkins
9- ,?S- �s
Wayne Atkins
Permit #3723-84
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orodille, Cal"ifornia 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR 'ARCEL NUMBER
r '
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC, BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME -
11 k..'
TELEPHONE
/
1
CONTRACTOR'S MAILING ADDRESS \'
r t 1
Fireplace
CONSTRUCTION -LENDER i 1
{ I
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ .�
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ '
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
PLUMBING PERMIT
Filin Fee 10.00
9
~
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF ❑ Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile Home S I G I W
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other,e�
Describe work: !� ,tet �^ t�.�•-.
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service BOOV OR LESS
100 AMP OR LESS
10.00
1
Main service EA. ADD -L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
2th2sgft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and m license is in full force and effect.
Y
License No. Classification r - !
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEw CONSTR ULTI-OUTLET 2,50 ea
NON-RESID. BRANCH CIRCUITS)
NEw CONST(POWER APPARATUS &)
NON- RRESID. SINGLE OUTLET CIR. /
OR FIXTURES BAL030
SAL@30
Ex. OCCUP.
FIXED APPLNS, OR
FIXED
Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
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.
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also 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 - Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ {
OCCOP. GROUP
I TYPE of CONST.
PARCEL
PD
ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
BY
IPERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
—PERMIT NO.
% :3, -All
ASSESSOR PARCEL NUMBER
6--L
ZONING
BUILDING PERMIT
OW ER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWER'S MAI ADDRESS '
CONT A TOR' AME EPHONE
CONTR C OR'SA LING ADD
Fireplace
cc STRUCTION LIENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ AMD
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
Y
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
5.00
Mobile Home JSJGJWJ
10.00 e
TYPE OF WORK
New❑ Addition RemUtilities InstallationOther
Describe work: odel —
S�...
I
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100V OR LESS
100 AMP OR LESS
10.00
�-'s"[�
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
2t/20sgft
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 Profess ons Code and my license is in full force ggg��nd effect.
���C7]"
License No. Classification h 1%
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR ULTI.OUTLET 2.50 ea
NON -RESID BRANCH CIRC ITS
NEW CONSTR. POWER APPARATUS &)
NON-RESID. ( SINGLE OUTLET CIR.
20e50e
Ex. Occup(ouTLETs OR FIXTURES eAL®3o
FIXED APPLINISTS (RES, OR
EX. QCCUp. OUTLETS (RESID.) EA,)
2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
FilingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
V I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ 1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
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
agais�saidounty nsequence of the granting of this permit.
�– / �� /
X 12--14-91
Date�-y
Signature of Applicant Owner ElContractor ElAgentSCJ
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
,
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST.
I
PARCEL
PD
I ND
ISSU
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTO PUBLIC
By
P IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
i
Date /
/ / 10 ��Ca
�7
Receipt NO.SI `9
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
F44
103;'1 B
PERMIT NUMBER - B l^
a E
PERMIT EXPIRES c�" / L—
OWN:Ett� eo.rge: l ckwell
f
CONTR•'Eggt4ill Const., Chico
��. LOCATION (A.P. 25-03-4
!J1 Box 2281 Grover Ln.., (5th. house E. of
t Hwy. 70 on left ,side )Q/GO?f-t��
K.
r�i j. .•
r
Zoning
Foundation
Rgh. Plumbing
Rein. Steel_
Framing
Wtr. Htr.
Firewall
ELECTRIC
Temporary
Final
DATE
f
COUNTY OF BUTTE
11
Of
Department -of Public Works
BUILDING INSPECTION RECORD
Setback
Forms
Piers & Girders
Fireplace
Bond Beam
Lath &.Plaster
Gas Piping & Test
Found. Vents
Plmg. Topout
Rough Elec.
Furnace
Kitchen Vent
Garage Vents
Sanitation & Water
GAS'
BUILDING
Temporary""
Cert. of Occup.
Final
Final
REMARKS
OR CORRECTIONS
Permittee Own
Mailing Addre
Contractor
Mailing Addre
BLDG. Addre:
COUNTY OF BUTTE
. DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
Phone: 533-1230, Ext. 259
APPLICATION AND BUILDING PERMIT
er �l _•�A ,. t- r- f
A. P. No.
2
joists- 1st Floor
\`1, Ctj <, tom•
Joists - 2nd Floor
�0� �� ,
;s
Fire Zone
Zoning
_ r
•
Sanitation
Planning
I
Interior Studs
is .•• r'--=--- - n:,
Plans
Fees
W.C.
S i •j . J / /' .�-+./
R/W
Encroachment
NEW El ADDITION D REPAIRS EJ OTHER [ElFOUNDATION
Others �- r r�. c-+�' +�..,r,. ,. _ MATERIAL EXTERIOR PARS
Single Multi Width at Top
USE OF STRUCTURE Family [x] Duplex 0 Dwelling Q
Others Width at Bottom .4 `vL gtD
Depth in Ground
SQ. FT. OCC. BUILDING VALUATION
R.W. PLATE (Sill) SIZE �SPA�I G r \ •' AN
c -
Girders va _ � J�
Total Permit Fee /4 � Bearing Walls Sf CONTRACTORS LICENSE LAW
A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING:
I am licensed under the provisions of Chapter_ 9, Div. 3, of the State of California Business & Professions Code under the name
styleof.... ..::1........... ................ .........................................................................................................................
License No ..................: I Classification,,,,,,, ,....,`,,,f..................., and certify that the aforesaid license is in -full force and effect.
B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING:
I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one):
Q I. am the owner of the above property and I will contract to have all .of the above work performed by licensed contractors.
(Sec. 7044).
Q I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the
improvements. (Sec. 7044).
Basis,. if any, for other statutory exemption...................................................................................:............................................:
WORKMEN'S COMPENSATION INSURANCE
I am_ aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil-
ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption
pursuant to Section 3800.
I certify that I have read this application and state that the
above information is correct. I agree to comply to all County
ordinances and State Laws relating to building construction,
and hereby authorize representatives of the County of Butte
to enter upon the above-mentioned property for inspection
purposes.
X.......................................... :..................... :...... :...... Date ...............................: ,
SIGNATURE OF PERMITTEE OR AGENT
ReceiptNo...........................f...........:................................................................
This BUILDING PERMIT is hereby issued under the appli-
cable provisions of County resolutions and/or ordinances.
DIRECTOR OF PUBLIC WORKS
• 1
By................................................................................ Date ................................
Permit Expires Date,,,
joists- 1st Floor
\`1, Ctj <, tom•
Joists - 2nd Floor
�0� �� ,
Fireplace
Joists -'Ceiling
r
Total Valuation
Exterior Studs
Permit Fee
Interior Studs
Plan Checking Fee &/or Penalty
Roof Rafters
Total Permit Fee /4 � Bearing Walls Sf CONTRACTORS LICENSE LAW
A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING:
I am licensed under the provisions of Chapter_ 9, Div. 3, of the State of California Business & Professions Code under the name
styleof.... ..::1........... ................ .........................................................................................................................
License No ..................: I Classification,,,,,,, ,....,`,,,f..................., and certify that the aforesaid license is in -full force and effect.
B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING:
I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one):
Q I. am the owner of the above property and I will contract to have all .of the above work performed by licensed contractors.
(Sec. 7044).
Q I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the
improvements. (Sec. 7044).
Basis,. if any, for other statutory exemption...................................................................................:............................................:
WORKMEN'S COMPENSATION INSURANCE
I am_ aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil-
ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption
pursuant to Section 3800.
I certify that I have read this application and state that the
above information is correct. I agree to comply to all County
ordinances and State Laws relating to building construction,
and hereby authorize representatives of the County of Butte
to enter upon the above-mentioned property for inspection
purposes.
X.......................................... :..................... :...... :...... Date ...............................: ,
SIGNATURE OF PERMITTEE OR AGENT
ReceiptNo...........................f...........:................................................................
This BUILDING PERMIT is hereby issued under the appli-
cable provisions of County resolutions and/or ordinances.
DIRECTOR OF PUBLIC WORKS
• 1
By................................................................................ Date ................................
Permit Expires Date,,,