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HomeMy WebLinkAbout025-240-041DZ)S-- aI4 D L I ql 025-240-041 PERMIT #95-2642 DOWTY, Leona 1233 Palermo Rd., Oroville Ele Ser Ch/SF ` 10 f 025-240-041 PERMIT#95-2642 .,� ,o,, DOWTY, Leona , 1233 Palermo Rd., Orovillet ,E'le Ser Ch/SF A6 � 1 , i� t �p r • I r as r - OFFICE COPY Address d GAS Meter ByDate— ELECT ate ELECTRI Dat/o '-3AFS Meter By e.a+ (7 �� N v 7 t � r + 4 ` 025-240-041 PERMIT#95-2642 .,� ,o,, DOWTY, Leona , 1233 Palermo Rd., Orovillet ,E'le Ser Ch/SF A6 � 1 , i� t �p r • I r as r - OFFICE COPY Address d GAS Meter ByDate— ELECT ate ELECTRI Dat/o '-3AFS Meter By e.a+ (7 �� N r+ COUNTY OF BUTTE -;DEPARTMENT OF DEVELOPMENT SERVICES=-�WILDINGDIVISION 7 County Center Drive - Oroville, Caiifornia 95965 - Telephone (916) 538 -7541 -PERMIT NO. APPLICATION AND PERMITgs 41(0Va. . ASSESSOR PARCEL NUMBER ,. _ ZONING BUILDING PERMIT OWNER`TELEPHONE e SQ. FT. OCC. BUILDING VALUATION OWNER'S MAI NG ADDRESS Ir I F' E CONT OR'S NAME TELEPHONE) CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRj1CTIONLE DER UN -OWN Total Valuation $ LENDER'S MMAIUNG ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHr;r OR ENGINEER n LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADP _� ,- _T7 PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME I PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other - SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets ' 15.00 Building sewer 15.00 - TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ublibes Installation ❑ Other ❑ j` .y� ��Q� Describe Work: n ��1Q ,Q_Z�L� l �,� =�.-leu-- ef° e, - box Mobile Home I S I GI W @20.00 PERMITFEE _ Contractor ELECTRICAL PERMIT Filing Fee 20:00 T� Main Service ( zoon oa mss ) 23.00 Main Service ( 200A TO I000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingwith Section 7000 of Division 3 of the Business and PJofessions 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 Law/for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. OR ADDNS. DWELLING OCCUR ( 8 ACC. B.S ) SO.. 3.50 FT NEW CONST. MULTI.OUTLET NON -RES ID. ( BRANCH CIRCUITS ) 97.50 ! POWER APPARATUS CI ) \ 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) 2U @ + 50 BAL 50 Ex. Occup. OUTLEEOTS (RESID.j OR ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc . Wiring 23.00 O 1PERMITFEE $ 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' compensaticn, 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 t MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number I (The above sections need not be completed if the permit is for work of,a valuation of one hundred dollars ($100) or less.) C 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 _ya PDate tf12,-t j Sig` atMe- of Applicant -iV Owner o Contractor ❑ Agent An OSHA permit is requir4d for excavations over 60" deep and demolition or construction of structures over 3 stories height. Mobile Home Installation Fee Is Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ HAZ. I D. FEES I IMP I FLOOD CDF PARCEL PO HD ISSUE 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. i /�/s�/I�! Date / J (Date) -lin Receipt No. #lam of �S� I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT • COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDINGDIVISION 7 County Center Drive - Oroville,yCalifornia 95965 - Telephone (916) 538-7541 9s—, MIT No. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING �Q— BUILDING PERMIT O NER ONE SO. FT. OCC. BUILDING VALUATION E C r CONT OR'S NAME TELEPHO E1 CONTRACTORS MAILING ADDRESS Fireplace CONS ON LENDER( UNIwOWN Total Valuation $ LENDER'S MAIUNG ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHIT T R ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS Energy Plan Checking Fee n $ ' Penalty $ B ILDINGADD sS ab r AL nqan RJL L e C PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISDNS NAME PARCEL MAP Solar or heat pump water heater 23,00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation ❑ Other ❑ Describe Work: t4- f\ 10 Z!�,, L � _ R / `' �PERMITFEE &e e re Ile fox Mobile Home I S I GI W @20.00 $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 • Main Service E00V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO ,000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 ( commencin g on with Secti7000) 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,for the following reason: I i, 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 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. ) SO, 3.5¢ FT. NEW CONST. MULTI -OUTLET UTLE NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS (8 SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES) 20 O 5o BAL SO PPLNS. OR Ex. Occup. OUTLETS RES D.) EA ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Mi c. Wiring 23.00 — 310C PERMITFEE $ 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 (rhe above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I� 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 ___ Date / _ Signature of Applicant �Owne Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HA2. D. FEES I IMP I FLOOD I CDF PARCEL PO HD ISSU This permit is hereby issued under the of the Butte Count Code and/or indic abo for hichLfees have BY PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date a (Date) Receipt No. WHITE-D.D.S.-B.11f. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENTOFDEVEIOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER E© � A. o. '0- 0 Proposed Building Use 21c -dr -,c Building Inspector Date 19, At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 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) Improveents (B) Drainage. 19. Driveway permit (constr i n app oval required rior to occupancy). 20. Pre -inspection for r required. 21. Contractor's license in rmation. (No., Name Btoe, Class cation). 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 owper. Mail to contractor. Telephone and hold for ku a office. Deliver with inspector. Other Applicant Date EXPIRATION OF APPLICATION Applications for which a permit has not been issued, will expire by limitation one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. FEE REFUNDS Refunds can only be made upon writtten request by the person who paid the fee. The request must be made within one year from the date of fee payment on permits not issued, and one yearfrom the date of permit issuancefor permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan checking fees for work plan checked and other department costs are not refundable. Original - Applicant rr-w,�`T'b.JF"`�^Ys'rh+Ty(`"i'�'.�v�wn`'jfffjjj{�+srfr+r,'1'i►'��R�u "', ,'„rl,�'�����T+i�T.'7h'ry�',.2Y'�i.1e..�r.l"r,.,..i•''z.�7 '�,",:-r ..-.w�fi"{ CO NTYOF BUTTE - DEPARTMENTOF DEV OPMENTSERVICES -BUILDING DIVISI, N 7 COUNTY CENTER DRIVE - OROVILLf!, CALIF,ORNIA95965 -TELEPHONE (916) 538-7541 / PERMIT AP LICATION DATA SHEET OWNER A. o. Proposed Building Use c� Building InspectoreDate O 13 At 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 preparerof plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and talcs, 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 . ...................... Y 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 $ .......................................... 't 11. Impact fees as shown on attached schedule . .............................. 12. "California Department of Forestry plan approval/fees..................... r... . 13. 'Flood elevation letter (100 year flood) by California Engineer .............. f ... . 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. .. 1.,......... 17. Planning approval for (A) Use: (B) Parking: . ........ 8. Contact Land Development about (A) Improve ents (B) Drainage. .......... . �.. 19. Driveway permit (constr i appr val required rior to occupancy). .. .. .. . Preanspection roque 20. Pre -inspection for Y" required. .. to Building Inspector - (Date) 21. Contractor's license info mation. (No., Name Styl , Classification) . .............f. 22. Certificate of Workmans Compensation Insurance. ..... t'.,'•r :................ . 23. Owner -Builder Verification (Given to owner , Mail to owne4 {,,. .......... . 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 le �f access . ..................... :.................. 30. Documentation of 0 o 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. *r 34. When you issue the permit, process as follows: Mail to o��pIe.r. Mail to contractor. Telephone and hold for u a (LLJ �-c� office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. .� 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ maili .r . Counter by _ Date . ♦ ,` Plans checked by Date Plans approved by,/' 1 ,' t 7 �,e '4 ,, rye""" """" Date i, Sets'of plans on,hold in File cabinet AP folder �I f Copy - Department of Public Works O.B.-1 }::,.:}.::isi{4'4::.}:i:.::i.}::.}:.i:.»}:«>:ii: ii:>::i':i::i::i.:ii.:}...:.........{:::ii........:::.:i.:{' •:•Y.:iiii:'viiv... \ ... .... v : : : •i i:;+. a .;h :{:i<i:>..............::..v..........:.::n•}.�n\•::}:.vvx}::::: }:::::::::: }:.: �:: i.� :v.::..:.:. ♦....:::.:::..::::ri. v........:.v..: ... ., •:Y ••.vv.i., ..,. ...\\;::::w: nv:. �:::::•.}v..:.:.};:::v.:.. \v�.vy�\�}.v.{.C•v*ti..4: }: x.r k q'+:•}i�4C{v�!y'F.^• '.iii•: i}:y. `:i.,:4`: \' l'.Ri• :)( E. no 4 \. . v:Yr: iii t :{w .• ...•i�vti:�. is ±• .l p $}. v. K 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 pTropdrty improvement: YES[ NO[ ]. 2. I HAVEK ) 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: 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: PROPERTY OWNER: SOCIAL SECURITY NUMBER: ^ DATE: NOTE: This owner -Builder Verification 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 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 various trades 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 "ownerbuilder" 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. Sold rel . 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. O Q DATE:/ o X2,3119,S— OWNER:— TION: A.P.#: LOCA CONTRACTOR: n F ZONING: PRE—INSPECTION FOR: PERMTT,HISTORY: [)]NONE [ ]AS FOLLOWS: s/ F J. DATE TO INSPECTOR: �i. BUILDING INSPECTOR'S REPORT uilding Description: aVLT [ J Commerce 0"5%'. [ ] ResidentialJ# of Units: Mobile Home: Yes[ ] No[ ] [ ] Currently Occupied. [ ] AbandonedNacant- lectric: [ 'I Yes [ ] No Electric is currently : [ ] On [ ] Off Condition of electrical? :as: Natural [ ] Propane[ ] None[ ] Currently On[ ] Off ] Obvious problems: ] sanitation: Plumbing working Yes[ ] No[ ] r Well: Yes[ ] No[ ] Potable water: Yes[ ] No[ ] Obvious Sewage Problems: lection Recommended: [ ]Issue [ ]Hold for: c ;r r Date: r . �� • ;.nvMiH+ K r