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Home My WebLink About026-121-014026-121-014 PERMIT#9 32 POTES, Al F. 2134 Baldwin Ave., Palermo)a Iq j Cont: Dan Heal Plumbing 'J (relocate Gas Meter/SF) -026-121-014 PERMIT#98-2632., POTES, Al 2134, 4 Baldwi n Ave. Palermo Cont: Dan Heal Plumbing (relocate Gas Meter/SF) I. —77, OFFICE COPY —Address GAS Dat M6ter By ELECTRIC Meter By Date W Ji_,.w.COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 ERM N-0. (Rev. 12/96) APPLICATION AND PERMIT "f X ASSESSOR PARCEL NUMBER 26-121-014 ZONING BUILDING PERMIT OWNER POTESt AL TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS 2134 =4=12 BALDWIN AVE. PAL CONTRACTOR'S NAME DAN HEAL PLUMBING TELEPHONE CONTRACTORS MAILING ADDRESS 12206 MERIDIAN RD. CHICO CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2134 BALDWIN .AVE• Energy Plan Checking Fee $ $ PALERMO PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Rem !�❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ISM VIMPGE Gas piping system 1 - 5 outlets 15.00 • 15.00 —Buildingsewer Mobile Home S G W @20.00 pre inspection PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 OR Main Service 2D.A ROV OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i fu Orce and effect. 9 S y G License Class Lic. No. 1 -OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service To ioDDA 46.00so NEW CONST. DWELLM OR ADDNS. ( DW: W: ACCIO OCCUP. SO . elvs. 3.5¢FT; �N,pµq�lp. . MULTI.OUTLET 97,50 POWER APPARATUS 8 SMlGLE OUTLET CIR. Ex. OccU . CUTLET OR FDIURES BAL @ p A Ex. Occup. GPurELr-°rs 61D,OE ll 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ l have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers''Mmil2en§ationns nce cagier and policy number are: Carrier Policy Number AJ W C. - 7�ay (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the i ers' compensation provisions of section 3700 of the Labor Code, I shall , rwith comply with t��Date X _� S gna'6re of Applicant - Owner= ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and dem lition or construction of structures over 3 stories in height.. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 , Ventilation PERMIT FEE $ y Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD SS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. X41 f� /� , / / t, ly fi I T 41 b� s4 :4�/ Date , PERMIT EXPIRES ON ; / ' �i/U t� Data Receipt No. '-'.S�% %/ G% WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT •COUNTY OF BUTTE - DEPARTMENT OF DEVtL'OPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 RM (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 26-121-014 ZONING BUILDING PERMIT OWNER POTES, AL TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 2134 XX4NXNXX1XXXXtXXKX4R BALDWIN AVE. PAL CONTRACTORS NAME DAN HEAL PLUMBING TELE'NONE CONTRACTORS MAILING ADDRESS 12206 MERIDIAN RD. CHICO CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2134 BALDWIN AVE. Energy Plan Checking Fee $ PALERMO $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF 4 Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: METER RELOCATION PGE Gas piping system 1 - 5 outlets 15.001 Building sewer 15.00 Mobile Home I S I G I W @20.00 pre inspection 3.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i fu Orce and effect. `„� `�Ise License Class LIC. NO. J J 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 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' men ation ins nc�and policy number are: Carrier Policy Num er AZ .— - 26, (rhe above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' co pensation laws of California, and agree that if I should become subject to the r ers' compensation provisions of section 3700 of the Labor Code, I shall rt ith complywit tho provi ions. �) X Date b S gna LIre of Applicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and dem lition or construction of structures over 3 stories in height. Main Service zooA To ,000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. Blos. 3.50FT: NON-RESID. T. MULTI.OUTLET 97.50 POWER APPARATUS 6 SINGLE OUTLET CIA. 20 @ 100 Ex. Occup. OUTLET OR FUTURES SAL @ .50 Ex. Occup. OUTLEEDTSA .EESS,p.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP I FLOOD COF PARCEL PD HD ISSy2' This permit is hereby issued under"the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. �/ By )-t- / 110L PERMIT EXPIRES ON Dete rReceiptNo. –5091 9 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COU*Y OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE- OROVILLEI CALIFORNIA 95965 - TELEPHONE (916) 538-7541 f PERMIT APPLICATION DATA SHEET s , OWNER: A pr) ASSESSOR PARCEL NUMBER: Proposed Buirdirig Use: I — t A,vim C uilding Inspector: l Date: / l //�Z5 e, At time of permit applicati n, I was advised the following data must be submitted prior to permit proc s�and/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ 03. Complete plans, 3/4 sets, signed by the preparer of plans. ----------- ----------------------------------------- ❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.-------- 115. ------- ❑5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ ❑6. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- 0 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------ ❑ 10. Fees of $ ---- -------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ----------------------------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees. --------------------------------------------------------- ❑ 13. Flood elevation certificate. ------- -------------------------------------------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit. -------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. 1117. Planning approval for (A) Use (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- ❑,27 Pre -inspection for required. Request to Building Inspector on 112 1. Contractor's license informon. (Number, Name Style, Classification). ---------------------- -------------- ❑22. Workers' Compensation carrier and policy number. --------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). ❑24. Letter of signature authorization. ------------------------------------------ 025. Recorded copy of Agricultural Acknowledgment Statement. ----------- 026. Letter of intent on building use. — ------------------------------------------ 027. Manufactured Home utility clearance. ------------------------------------- ❑ 28. Existing violations and/or expired permits. ------------------------------- 029. 0433 A, ❑Grant Deed, ❑ M.E. Title, ❑ Check to H.C.D $ E130. Other: When you issue the permit, process as 3ollows ❑ Mail to owner, vlail to ❑ Telephone and hold for pickup ` Applicant: Copy of Haz-Mat form sent ❑Health Department, ❑Fire Department, ❑ A Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: _ 'ice. ❑ Deli er Pollution (Date) Date: By: Date: By: 1. Index permit application for the above: items numbered: 13 -,Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division coun�by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail,' ❑ Building Division counter, by Date: Contractor, designer, owner, was advises of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. I OWNER: LOCATI l PRE—INSPECTION,,: , DATE i A. P. # r. CONTRACTOR: f ZONING-- PRE—INSPECTION FOR: a f DATE TO INSPECTOR PERMIT HISTORY: NONE AS FOLLOWS: 1 TYPE OF OCCUPANCY BUILDING USAGE: TENNANT: [� OCCUPIED [] 0 HEATED—COOLED OTHER COMMENTS: FIELD — INFORMATION HAS ELECTRIC FD HAS GAS HAS SANITATION FACILITIES PERSON CONTACTED: ACTION RECOMMENDED: ISSUE HOLD FOR OTHER: BY DATE