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26-09-35 3046-90B _
BABB, Robert
it• b4.
e 7039 Lincoln Blvd, Palermo /
Contr: M. Bartholomew,
(front & back porches/sf) (�
30
026-090-035 05-2373
BABB FAMILY REV TRUST
7039 LINCOLN BLVD, OROVILLE
Cont: OWNER,
REROOF
i
i.�
►,
tD
3
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: •(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BPO52373
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 09/02/2005 APN: 026-090-035-000
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.
Site Address: 7039 LINCOLN'BLVD PAL
License Class : License Number:
Map Index:
Date: Contractor:
Description: re -roof 12 squares
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Owner: BABB FAMILY REVOCABLE TRUST
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
BABB ROBERT W & ELLEN M TRUSTEES
the Contractor's State License Law (Chapter 9 commencing with Section
P O BOX 212
7000) of Division 3 of the Business and Professions Code) or that he or
PALERMO, CA 95968
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Law does to an
Applicant: BABB FAMILY REVOCABLE TRUST
Code: The Contractors' State License not apply
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
BABB ROBERT W & ELLEN M TRUSTEES
sale. If however, the building or improvements are sold within one
P O BOX 212
year of completion, the owner -builder will have the burden of
PALERMO, CA 95968
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor:
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Busines and Professions Code
Date: Owner:
WORKERS' COOESATION DECLARATION
I hereby affirm under penaltyf p rjury one of the following declarations:
License #:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Policy #:
I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
f Q
and agree that if I should become subject to the workers'
U
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
\„1\
Date: / `
Applicant:
WARNING:(F flute to secure workers' compensation coverage is
unlawful, ahall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
V►
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereb ssued uri r` appl' able ovisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
of the work for which this is issued (Sec 3097 Civ.)
Resolutions to do ork fn i ed ove for hi fes have been paid. �y�^
C
performance permit
Name:
/u
By: Date:
2-2-6(1
PERMIT EXPIRES ON:
Address:
Date
❑,. 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize represen olives of gutty to enter upon the above mentioned property for inspection urposes.
bilSignature:
Print Na
Date:
0 Owner ❑ Contractor )Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last NameFir
a
Address q Z
City I %,-SIUk
SRA
i .�t�
-1 5 1(Cl
Phon,S,, 3 ^ 0
Fax
E-mail
C",
th APPLICANT INFORMATION
CONTRACTOR
Name
Q1
Address
SRA
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
Lic. #
Class
C",
th APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
Cit
Address
SRA
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
State License Number
C",
th APPLICANT INFORMATION
Name \ L,
�J
Addres,
Cit
e��
SRA
�1
Fax
E-mail
APPL ANT SIGNATURE
(S[7X)
,
For officlfusk only:
Zoning
PrSjrty Add 1JCDI � 1✓� �I
Flood Zone
Cs St re t
��
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
KAFORMS\BUILDING FORMS\BldgADDISubRgmts.doc
PERMIT
NO.
BIN #
PROJECT LOCATION
AP# e2G�o�a.�d 35-
PrSjrty Add 1JCDI � 1✓� �I
�� Ci
Cs St re t
��
WORKER'S COMPENSATION
Policy Number
Carrier
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
Address
i Descri i n or Scope of Work��
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
Page 1 of 2
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Receive by: Amount: Bldg
SRA
Receipt #: � J Sheriff
,NJ
`� SMIP
Date: Other
T:::J Total
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
O. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of -Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required). _
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.,
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire 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.
REQUEST FOR FEE REFUNDS
Refunds:can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
t fi
,
,
RESIDENTIAL
1` F. 26=09-35 3046-90B
BABB, Robert
i 7039 Lincoln Blvd, Palermo
Contr: M. Bartholomew
(front & back porches/sf)
i
z,
JOB FINALI
Signature
1
= Ok
= Not OK
Not
=Not Readyabler MOBILE HOLIES
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/ P L"ft./ /"LPG
7. Utility Clearance
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
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DE , COVERS, CARPORTS, GARAGES, Plans OK except #'s
j 1. Z Ping Requirements -Setbacks -Easements
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
rmg; - nchors-Studs-Rftrs-Trusses
mg; Nai 'ng -Veneer -Stucco -Mesh
Swig=Roofing
? Steps -Doors -Landings
Date Card 13-1 Date Card B-1
Dat 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-Panelboards-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
J=OK
O = Not OK
- = Not Applicable
Not Ready RESIDENTIAL (.c
' =
Date UNDERFLOOR (Plans) OK except k'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. Gas Pipe; Size -Anchors
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. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except If's
16. Water Htr.; Vent -Access -Combustion Air -Baffle
17. Water Pipe; Test & Anchor -Nail Protection
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 tf'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. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes 0 No
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 If's
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condensate 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 except tt's
39. Sils, Proper Material & Anchors
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
42. Draft Stop in Walls (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearino
(NOTE: An entry must be mad
jingle & Duplex)
Date FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties -Pu rlin -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. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls; Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except If'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. 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. 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. & Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic 0 Yes
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
80. Following instld.; Drive ❑ Yes 17 No; Walks ❑ Yes 0 No;
Planters ❑ Yes O 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
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
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:
e each time you visit job site)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541
APPLICATION AND_«PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBERZ
'�
N`NG
dnC J
BUILDING PER
11
o ER ff
7 Y�
TELEPHONE
SQ. FT. OCC. BUILDING VALUAT ON
04, R'S MAI ING ADDRE
e�-
�-
CONTRACTO , ME
'TELEPHONE
CONTRACTOR'S MAILING ADDRESS
e,e4�� I
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 10.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS `
JNC411111111, Q,
Permit fee
Ra 16VI VIW% 16 _t CCL
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2,00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5,00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other [
Describe work:1A_t_ QY`t &�__
�.— �k �—
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service j00 AMP OR00V OR LESS10.00
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.s!
OR ADDNS. ( ACC. BLDGS.
2h2sq ft
NEW CONSTR ULT LOUT LET
NON.RESID BRANCH CIRC ITS
2.50 ea
/POWER APPARATUS &)
-SINGLE OUTLET CIR.
EX; OCCUp(OUTLETS OR FIXTURES
20@50¢
9 AL@ 30
FIXED APLNS
Ex. Occup. OUTLETS PFESID.)REA.)
1 2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
9
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notce to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
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 ve, indemnify and keep harmless the County of Butte against
all liabiliti j gments, costs, and expenses which may in any way accrue
against s C ty in rise quenc t e granting of this permit.
%( Ct% Dat�'�c�„ C��
�
Signature of Applicant — Own ergl Contractor ❑ Agent ❑
An OSHA permit is required for a cavations over 5'0" deep and demolition or construct -E
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCCJ
CONST TYPE
TOTAL FEE r
HAZ
I CUA I PARK
I SCHL
I F
A
PAR
PD
D
Is u
This permit is nereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
OR OF PUB C
BY
PERMIT EXPIRES 4ate
the applicable provi-
resolutions to do
have been paid.
WORKS
Date u qD
Receipt No.33"
WHITE-D.P.W., YELLOW -ASSESSOR, INK -INSPECTOR, GOLDENROD -APPLICANT
HAS NJOT I\PPLI Lb PE?
COUNTY OF BUTTE - DEPARTMENT,QF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
n � 1/..�l� Permit No.
OWNER 130b fcib A. P. N 0. OZlo-690-0" �
Proposed Building Use 2 - ��'° HBuilding Inspector Date D<�G
;N*
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . ....................................
0K- 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........
0k 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material 'Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $ ......:.................
11. Chico Urban Area fees paid ........................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from rL0 Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required ... Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, C(assification�
�22. Certificate of Workmans Compensation Insurance n I hirUY►q UN71«►uPZZ ,t r
3. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ...................................
26.
27.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
11 —�-' Telephone and hold for pickup at office. Deliver w/in a or.
14 Jo�N��Oth
er I -
VIA alCons
968
. '�l�Vl�le, APPlica �/ .Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone---nail—counter by date
Contractor, designer, owner, was advised of above required data by_phone_mall_counter.•by date
Plans checked by Date Plans approved by -Date
Sets of plans on hold in File cabinet TAP folder
Copy—DPW
TO Buildina Department
z
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved
for: Sewaqe Disposal
Water Supply
Fold final for:
Water Supply
Final clearance
Clearance for
O.K. for:
bedroom mobile home. Other
o
Water Supply
'
NOTE ***
Date
Sanitarian
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville; California 95965 - Telephone: 916/538-7541
APPLICATIN AND PERMIT
ASSESSOR PRCEL NUMBER ONING
6 D 0- 035'
BUILDING PERMIT
OWNER TELEPHONE
� ob .lob 533 -19(00
SO. FT. OCC. BUILDING VALUATION
2 2
23
OWNER'S MAILING ADDRESS
- O- o Z / p� 5(]
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
.CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 919
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ T 2i
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
39
Permit fee
$ -7, 7
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
'Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF®/Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer]5.00
Mobile Home S G W
0.0
TYPE OF WORK
New ❑ Addition ❑ /Remod'e/l/❑ Utilities ❑ Installation❑t Other [-
Describe work: �'(Q,M l/(.!� U' 2 lQ ✓GGL.� -:&A2T f
Permit Fee
S
'Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1VOR L AMP OR 00LESS
10.00
Main service EA. ADO'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑NON-RESIO
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and' effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
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. OWE,LLING'OCCUP.�
OR ACDNS. ACC. BLOGs. )
/z¢sg ft
NEW CONSTR UTLET
BRRAANNCC.H CIRC ITS
2.50e a
POWER APPARATUS e
SINGLE OUTLET CIR. )
EX. Occup(OUTLETS OR FIXTURES
ezoesoe
ALO 30
FIXED
Ex. Occup. OUTLETS PIRESID ILISIS KEA)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of f,
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 liabiliti judgments, costs, a d expenses which may in any way accrue
against s d unty i conseque of h granting of this permit.
Q q
Xyy.. Date r�^ 30^ `�
` Signature of Applicant - Owner �J Contractor 11Agent❑
An OSHA permit is required for exec vvatipns over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ CONST TYPE
AL E
TOTAL FEE $ t9-7 7�
HAZ
CUA
PARK
PAR
PD
HD
ISSUE
This permit is nereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No.
WHITE-D.P.W., YELLOW-ASSE330R, PINK -INSPECTOR, GOLDENROD -APPLICANT
Z 32
r
COUNTY OF BUTTE - Department:,of Public Works
7 County Center Drive, Oroville, CA 95965
OWNER -BUILDER VERIFICATION
t
,,'Attention Property Owner:
Phone: 916-538-754].
An 'owner -builder" building Permit has been applied for i.n 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 or no)
2. I (have/have not)
for the proposed work.
signed an application for a building permit
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name_—
Address F.- _ Cityv_
Phone Contractors License No. �f2ri�
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address . Phone Type of Work
igned :
Property Ownere.
Social Security �
Date ?-,- 5d; 9e
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue.the permit.
wo
- set bf plans and
kapt on the job at all Um
make ahy Changes or al
written permission from
Works, County of Butte.
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OFFICE COPY
Address r
GAS
Meter'By Dat�e"s{��% r,
ELECTRIC
ji Meter By Date
a g
+" COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville,talifornla 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
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
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 ` r LJ
USE OF STRUCTURE
SF D' Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I G JW I
10.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel Utilities ❑ Installation ❑ Other ❑
Describe work:
69
Permit Fee
$ '.
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service OOOV OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
ElI am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
"Q 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-
ontract-
ors.(Sec. 7044)
ors.
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.� ,
A
NEW OUTLET ) Z¢sgft
CONSTR. U TI
NON-RESID BRANCH CIRC ITS 2.50 ea
/POWER APPARATUS 6
(SINGLE OUTLET CIR.
EX. OCCup(OUTLETS OR FIXTURES20@50 i/
FIXED APPLNS. 11
Ex. OCCUp. OUTLETS (RESID )REA.) 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.
❑ 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.
O 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
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 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.
4%/ -,
X —' /ci `� �'`-.'_ - Date �+ �`c
Signature of Applicant — Owner Q Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
iOn of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ y 0�
OCCUP.
CONST.TYPEJ
I
IFLOODIPARCELI
PD
I ND
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
—
By
PERMIT EXPIRES Date G
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date -' J
Receipt No.
WNIT!-D.P.W.. YELLOW-ASe1�3e R. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
- 7 County Center Drive - Oroville, Califbrnia 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMI %NO.
i/
ASSESSOR PA R CE,�. MBER
(/(f_
ZONING -
BUILDING PERMIT
O WNE /
G b
TEy�PHONE
� 3& l
S.Q. FT. OCC. BUILDING VALUATION
O ER'S MAILING ADDRESS
CONTRACTO�� ME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
VNKNOWN
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
$
BUI I G DDRESS
• �
V
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF;� Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel X Utilities ❑ Installation❑ Other ❑
Describe work: —
27&2 z2V:
Permit Fee
$ 619
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1100V OR LESS
100 AMP OR LESS
10.00
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.SINGLE
License No. 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)
F]1, as the owner, am exclusively contracting with licensed contract -Mobile
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUP.&) ,
OR ACDNS, C ACC. BLDGS. / /zQsgft
NEW CONSTRESID, ULTI.O TLET
NON•RESIO BRANCH CIRC ITS 2.50 ea
CIRCUITS)
POWER APPARATUS &)
OUTLET CIR,
Ex. OCCUp(OUTLETS OR FIXTURES ZO@30t
ewL030
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Home Facilities 15.00
Misc. Wiring
g 15.00
Permit Fee $ 1�z 4M
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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 Iia s, judgments, cost and expenses which may in any way accrue
again sai Coun y in cons ce of the granting of this permit.
_
Data!'/�iJ C�,LG
Si nature of Applicant - Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
OC CU P.
CON ST.TY P!
FLOOD
PARCEL
PD
NO
ISSUE'
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date -
Receipt No.
WNIT!-D.P.W., YELLOW-ASBl3SOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
Attention
An '
your sign
Plea
unnecess
will be
1.
OAP
3.
4.
5.
Sign
NOTE: Th
19
Th
mi
n
ary
issued
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965
Phone: 916-534-45
OWNER -BUILDER VERIFICATION
Property Owner:
'owner -builder" building permit has been applied for in your
name and bearing
ature.
se complete and return this information at your earliest opportunity
to avoid
delay in processing and issuing your building permit.
No building permit
until this verification is received.
I personally plan to provide the major labor and m terials
the proposed property imp ovement (yes or no)� '
for construction o
I (have/have not) signed an application for
a building permit
for the proposed work.
I have contracted with the following person (firm) to provide
the proposed
construction:
Name
Address \ City
Phone Contractors License No.
I plan to provide portions of this work, but I have hired
the following perso
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
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
ed:
Property Owne%y 4�
Social Securit umber
Date _
Sections 19831 an
is Owner -Builder Verification is sent to you as required by
832 of the California Health and Safety Code.
I
is verification must be completed and returned to our office
tted to issue the permit.
•
before we are pe
41
r-
F� Robert W. Babb
V_
Permit #2763-86B,E
' I
. 1
E
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville. California 95965 - Telephone 916/534-4541
r 1 APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
.f _ e C; _
ZONING
BUILDING PERMIT
OWNER 11 _ i
TELEPHONE
SQ, FT. OCC. BUILDING VALUATION
OWNER`S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
.$'
Energy Plan Checking Fee
$
ARCHITECT ORENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ ) /j
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF Fv Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation' ❑ Other E]
Describe work:
—{
+"0,
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
'SOOV
r t r
OR LESS
Main service 100 AMP OR LESS
10.00 f ,
Main service FA. 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.SINGLE
License No. Classification
El 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 OCCUPM '/zQsgft
OR ADDNS. ACC, BLDGS.
NEW CONSTR. MULTI -OUTLET 2.50 ea
NON•RESID BRANCH CIRC ITS
POWER APPARATUS h
OUTLET CIR.
Ex. Occu 20050e
p�OUTLETS OR FIXTURES eAL030
FIXED
EX. Occup. OUTLETS P(RESID.)REA.) 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc.lyiring 15.00 l'
:.- •: i `:
,Fee
Permit $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
a I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this. -application and state that the above information
is correct. I agree to comply to`�all Count�'grdinances and State Laws relating
to building construction, and her'elbysauthorlie 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 consequ4nge of the granting of this permit.
ti
?_ /c"`_f--,
✓ Date
-1
Signature of Applicaht_-\ Owner0 Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height. /// / { ,/ _
Mobile Home Installation Fee
$
Energy Inspection Fee i, /i/�
—
TOTAL PERMIT FEE $ �`- '7
OCCUP.
CONST.TYPEJ
I
IFLOODIPARCELI
PD
I No
I ISSUE
This permit is hereby issued under
Bions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
4'
By ;:1i
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date /
A-/
Receipt No. /
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK-INSPECTOR,OOLD�PPLI CANT
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
��
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 offi&e immediately.
— K.6Inspector_ �20Date
f
COUNTY OF BUTTE - DEP;IIRTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION IND PERMIT
PeaMlr No.
ASSESSr PARCEL MBER
_
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
X33 _J 9
SQ. FT. OCC. BUILDING VAL ION
OY(.pE 'S 1 G ADDRESS /
O/TRA TO 'S NAME
TELEPHONE
CONTR CTOR'S MAILING ADDRESS
Fireplace
NSTRUC TION LENDER
UNKNOWN
¢
Total Valuation $
Filing Fee
$ 10,00
'LENDER'S MAILING A DRESS
Permit Fee
$
MARC ITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 03
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
D 32 A*2 V
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF AA Duplex[ --I Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
0.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
`Main
service 600V OR LESS
100 AMP OR LESS
10.00 /Q, 0c)
Main service EA. ADO'L 100 AMP
2.50 S"O
CONTRA ORS LICENSE LAW
I declare under penalty of perjury (Check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
LJ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS. 1/21Csq ft
NNEW ON -RESIT R. BRANCH CTLETITS 2.50 ea
POWER APPARATUS &
_ SINGLE OUTLET CIR.
Ex. OCCup(OUT.LETS OR FIXTURES 20®DO¢
eAL(P30
FIXED APPLINIS
Ex, OCCUp. OUTLETS (RESID.)REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. �Yirin 15.00
g
PZE —
Permit ee $ rj
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
1 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.
LIalso agr save, indemnify and keep harmless the County of Butte against
Iiab' (ties judgments, co andexpenses which may in any way accrue
ns said ount in cons n e the granting of this permit.
1 �� &)
Date `
Si ature of Applicant — Ownerjj��N Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" de nd e�I'tigaor construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $WA 9(11
TOTAL PERMIT FEE $
OCCUP*J
CONST.TYPC
FLOODPARCEL
PD
ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRE R OF ELIC
�o
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
r
Receipt No.1�nll M
WNITC-D.P.W.. YELLOW•A88[380R, PINx•INSPECTOR, LDENROD-APPLICANT
COUNTY OF BUTTE - DEPARTMENT'OF'PUBLIC WORKS - BUILDING DIVISION �
7 O
OWNER
CUNTY CENTER DRIVE - OROVILL CAL�ORNIA 95965 - TELEPHONE. 916/534-4541 ,
PERMIT APPLICATION DATA SHEET
Permit No.
PDLIA2� fel ,Q Y A. P. No.
Proposed Building Use_
Permit Fee Based Upon:
.w1"14
'Complete Contract Price DPW Valuation
Other ( •)e ain) '
Building Inspector Date
r
At time of permit application, I was adviskahe following data must be submitted prior to permit processing
and/or issuance: DATE RECEIVED APPROVED
1. All items.have been submitted. . . . . . . . . . . .
2., Plot plans in duplicate/triplicate. ... . . . . . . .
3. Complete plans in duplicate/tri.plicate. . . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD ''Fees Paid" Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
9. Letter of signature authorization. . . . . . . . . .
10. Sanitation approval from Health Dept. . .
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ )
15. Improvements may be required. . . . . . . . . . . .
d
0&�l16. Mobilehome Installation Data
• Pre-Inspec. request to of
7. Pre -Inspection for �� Required. Building Inspector
18. Recorded copy of Agricultural Acknowledgment Statement . . .
19. Other
When you issue the permit, process as follows:_ Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
Applicant
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to 'permit issuance.
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone -' Mail Other
Byr Date
Plans checked by Date/
Plans approved by Date
Other:
r'
Copy—DPW
�Y
l Nu��ct3'� w-�C •,
@� �/: a 6tl c c_ /`lo ewe c
COUNTY OF BUTTE - DEPARMUEWT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASS E�SSOR PARCELMBER
_
ZC.i lff�
BUILDING PERMIT
OWNER
ILd W. r
TELEPHONE
X33-9
SD. FT. OCC. BUILDING VALUATION
O E 'S I NG ADDRESSCq /
O AL O 'S NA M Er.. f
TELEPHONE
CONTRA'CTOR'S MAILING ADDRESS
Fireplace
NSTRUCTION LENDER
UNKNOWN
d@
Total Valuation Y
Filing Fee
$ 10.00
ENDER's MAILING A DRESS
Permit Fee
$
APCFITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCOR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
7032 a r—L b2U
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF r'VDuplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationEl Other ❑
Describe work: _
Permit Fee
$
Contractor
'
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1011 OR LESS
100 AMP OR LESS
10.00 77��
��• QV
Main service EA. ADD'L 100 AMP
2.50 sO
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑NON.RESID
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
Q 1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST.(DWELLING OCCUP.N\
OR ACDNS. ACC. BLDGS. I
/zQsgft
NEW CONSTR. MULTI -OUTLET 2,50 ea
BRANCH CIRC ITS
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup( OUTLETS OR FIXTURES 1A ®130
FIXED APPLNS. OR
Ex. Occup. OUTLETS IRESIO.) EA.) 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.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
*cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agr save, indemnify and keep harmless the County of Butte against
all liabi (ties judgments, co , and expenses which may in any way accrue
again s said ount in cons n e the granting of this permit.
Date �_/� J' �
Si oture of Applicant — OWnedii� Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
OCCUP,
CONST.TYPEJ
IFLOODIPARCELI
PD
ND
�9UE
This permit is hereby issued under
Bions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable to do
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.
WN,TE-D.P.W.. YELLOW-ASIC»OR, PINK -INSPECTOR. GOLDENROD -APPLICANT