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HomeMy WebLinkAbout026-211-022 26-211-22 WADE HOUGH 2162 South Villa, Palermo Permit Permit #2161-78E(ele ser ch) SF 026-211-022 PERMIT#97-0947 STOUT, Glenn 2162 South Villa, Palermo Gas Line & Wall Htr/SF /L1 �'_ - 026-211-022 06-1375 THOMAS, JOHN 2162 S. VILLA AVE, PALERMO Cont: OWNER DEMO (HOUSE) 026-211-022 06-1846 THOMAS, CARL 2162 VILLA AVE, PALERMO Cont: GREENE ROOFING NSF/GAR L. 1' oZfl2._: I n ----C*q — ~ ' am I 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. BP061375 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS 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 Issued Date: 06/08/2006 APN: 026-211-022-000 the Business and Professions Code, and my license is in full force and effect. License Class License Number: : Site Address: 2162 SOUTH VILLA AVE PAL Map Index: Date: Contractor: Description: DEMO EX HOUSE (800) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires.a Owner: THOMAS, JOHN permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 591 FRUITVALE signed statement that he or she is licensed pursuant to the provisions of LINCOLN, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95648-9774 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).): lel, as owner of the property, or my employees with wages as their ediC ((((( sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: THOMAS, JOHN Code: The Contractors' State License Law does not apply to an 591 FRUITVALE owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, LINCOLN, CA provided that such improvements are not intended or offered for 95648-9774 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, 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 Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Art 3 the us d Professio s Code Date: 6 r 6 Owner: License #: WORKERS' CROPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of 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 u: Valuation: $0.00 Census Code: 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 the 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, l shall forthwith comply with those pr visions. Date: Applicant: WARNING: /F, e to secure workers' compensation coverage is unlawful, andubject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. e) „�J �✓ CONSTRUCTION LENDING AGENCY This permit is he is dYuJW the applicable provisions of the Butte Coun,y Code and/or` I hereby affirm that there is a construction lending agency for the' Resoluti Indic ted ab ve for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) tJ�p Date: Name: By: _ )),, V PERMIT EXPIRES ON: Address: Date ❑ ' I 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 subs?n-cZpf any offici ff rdo en of Butte County. I hereby authorize representatives of Butte County to e r pon the above mentioned property for inspection urpos s. Print Name: N 6' 1 ✓L!14 -r- glita Signature: /- Date: ner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND. SUBMITTAL REQUIREMENTS 24 HOUR NSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE N: (530) 538-7541 A FEE WILL BE REQUIRED AT. TIME OFAPPLICATION Website: www'.buttecounty.net/dds "PLEASE PRINT CLEARLY ­Y u OWNER INFORMATION (� Last Name Address Firsf Name City Address State Zip City t Statec44Zip Fax Phone >F/ax Uc. # E-mail DA 1L U u T SIGNATURE © MAN For office use only: CONTRACTOR Name LAG r Address SRA City No State Zip Phone Book Fax E-mail - Planner Uc. # Class T SIGNATURE © MAN For office use only: ARCHITECT/ENGINEER Name Flood Zone Address SRA City No State Zip Phone Book Fax E-mail Planner State License Number T SIGNATURE © MAN For office use only: APPLICANT INFORMATION Name Flood Zone Address SRA City No State Zip Phone Book Fax E-mail Planner T SIGNATURE © MAN For office use only: Zoning Properlyr�s 1D.� N Flood Zone Cily- SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. 1 ,I3' BIN # PROJECT LOCATION AP# _ b� I 1 vaD- Properlyr�s 1D.� N Cily- Cross Street Receipt #: She -1 s WORKER'S COMPENSAT40N 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. Other Total LENDING AGENCY Name Address Descriptio or cope of Work: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. Receiv d by.: Amount: 616� Bldg SRA Receipt #: She -1 s Sheriff SMIP Date: � � � Other Total V-\Pr)PhAC\RI III niNr: FnPhAC\RlrinAnnMithRnmtc rfnc Paae 1 of 2 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. ❑ 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,A/C 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 bldgs: (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 (534) 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 UFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 OWNER -BUILDER VERIFICATION Attention Ptoperty Owner: An '*owner -builder" building permit has been applied for in your name and bearing your signature. PleEse 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 material for construction of this proposed property improvement: YES ] NO [ ]. 2. I HAVE [ ] 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: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: DAME: _ p DDRES 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: DATE: ������ C NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. T'zis verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services -TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.net/dds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. 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 contractor is to secure an "owner -builder"' -building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321-CSLB (2752) or by accessing their website at www.CSLB.ca.gov. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Manager, Building Diviion NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. ... - nAv V r COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSE�SSORP NUMB t)Lb——UL� ZONING BU I iSING PERMIT O 61.�,1�w STOIJT TE532N-3391 SO. FT. OCC.' BUILDING VALUATION OWN llbl 1 NUMQTEtSSV111A. PALERMO CON[RAQTO S NAME U14,,p TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2162 SOUTH VILLA, PALERMO Energy Plan Checking Fee $ $ PERMIT FEE $ LOTNO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMITg Filin Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF F Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other M5 Describe Work: HOUSE GAS PIPING & DIRECT VMT e'1AL.L. HTR Gas piping system 1 - 5 outlets 15.00 15-00 Building sewer 15.00 Mobile Home ISI GI W1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( io nORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 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 Main Service 200A To I000A 46.00 NEW CONST. DWELLING OCCUR OR ADDNS. ( d ACC. BLDS. s0 3.50FT. NEW CONST. MULTI -OUTLET NON-RESID. RANCH@ 7.50 OWER APPARATUS 8 POW GLE OUTLET CIR. Ex. Occup.OUTLET OR FIXTURES @ I'50 eo PUNS Ex. OCCup. OUTIiTSPRESD.OEA. 5.00 ?23.00 Tem orary Service 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: ❑ 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 DIRECT VENT F 5. Cooling Hood 6.50 Ventilation PERMIT FEE $ 355.00 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ¢� 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 41 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. qq��I _ X i"L Date � 1 � r�' Signature of Applicant 0 -Owner ❑ 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 $ 70.00 HAZ. p, FEES IMP FLOOD CDF PARCEL I PD I HD I ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By ^ 1 -� PERMIT EXPIRES ON I / the applicable provisions Resolutions to do work been paid. Date Z7 r 7 De/e ReceiptNo,Z Z WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES - 7 County Center Drive - Oroville, ahlifornia 95965 - Telephone (Rev. 12/96) APPLICA•TIONAND PERMIT BUILDING DIVIS16 NZ (916) 538-7 4 PERMIT N0. ASS8RPEEI.NUf11 ZONING BUI ING PERMIT oW�LLLENNLL11l1STOOUT TE532 E3391 SQ OC BUILDING VALUATION OW21'6TILgbVffSVILLA, PALERMO C06RACTO 'S NAME TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS ' Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MA.WNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2162 SOUTH VILLA, PALERMO Energy Plan Checking Fee $ $ PERMIT FEE $ LOTNO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF &X 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: HOUSE GAS PIPING & DIRECT VENT WALL HTR Gas i in system 1 - 5 outlets 15.00 1 5 -no Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ . ELECTRICAL PERMIT Fling Fee 20.00 Main Service ion OR LEss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law fob the following reason:. [a' 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' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) U,-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 • workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. /c� ] / X Date �/ /1�� Signature of Applicant - P -Owner ❑ Contractor ❑ Agent —T An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. BLDS. 3.5Q FT. NON•RESIDT B AuNC CIRC @7.50 POWER APPARATus S SINGLE OUTLET CSR. Ex. Occu OUTLET OR FlxruREs gq0 p t.00 .50 11 Ex. Occup. OUTIEfSPPUNRES D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating DIRECT VENT HT Cooling Hood 6.50 Ventilation PERMIT FEE $ 35.00 Mobile Home Installation Fee Is Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 70.00 HAZ. I D. FEES IMP I FLOOD CDF PARCEL I PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMITE PIRES ON the applicable provisions Resolutions to do work been paid. Date S1'7 �7 7 fe ReceiptNO.Z`Z-Z,z>o WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER -BUILDER ,VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor ,and materials for construction of the proposed property imP3ovement :.YES l/ NO ❑ 2. I HAVE �/. HAVE NOT ❑ signed an application fora buildingpermit'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: PHONE: CITY: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER:_N-,_��:& Akz,-_�, SOCIAL SECURITY NUMBER: " DATE: t 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 r OWNER BUILDER INFORMATION 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 alsorequired by law to put their license number on all permits for which they.'. apply If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials . and other costs) is $300 or more for the entire project, and such persons are not licensed as.contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, - workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. i rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER .AW - COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — OroviIIe, California 95965 Tel ephone: 04-4§41 APPLICATION' AND PERMIT BUILDING Owner. /'71 r SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address f ., Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address ��„ �� �• izt jJ� Lr Plan Checking Fee &/or Penalty Permit Fee �. �..a n PLUMBING No.1 @ I FEE PERMIT FILING FEE $3.00 Each, Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. .r 1- .� �� — Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Fees W.C. •Sanitation Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Im r p ovements Each additional outlet .30 Building sewe?'—" 5.00 Bldg..Plans-Rec'd— I Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ I UTILITIES Q OTHER .Permit Fee $ $ - l •� i�t!tJ�� ��" c'1irtr;c- ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 , C'0 Main service 600V OR LESS loo AMP LESS 5.00 t� ,` C: Single Family it Duplex Mobil Home Others ❑ P ❑ ❑ ❑ -L Main service EA. ADD100 AMP 2,50 � � •� U OVER Main service 100 AMPso0v OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST DWELING OR ADDNS. ACCLBLOGSCCUP. S� 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: TLET 1 NEW RESID.CONSTBRANCH CIRCUITS NON.R ESI D, � BRANCH CIRCUITS/ 2.50ea NEW CONSTR POWER APPARATUS d NON.RESID. SINGLE OUTLET CIR. Ex. Occur)(OUTLETS OR FIXTURES 5 L 254 , Ex. OCCU FIXED APPLNS. OR P•�OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 E]II am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 the Workmen's Compensation Laws of California. MECHANICAL INo. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 Land Development Fee $ TOTAL PERMIT FEE $ w ...r,...,c,«.�.c� v. uic vvuniy vi ouuc W GIIIGI uNvn uic above-mentioned property for inspection purposes. X Date Signature of Permitee or Agent Receipt No. " White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. i DIRECTOR OF PUBLIC WORKS , r By ,'r/ �. ' ` Date Building permit expires Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS - 7 County Center Drive - Oroville, California 95965 Telephone: 5t"M4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property f r inspection purposes. X Date" i ature of Permitee or Agent Receipt No. % _// Z Tro White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above f r which feeshavebeen paid. . DIRECL A OF PIUBLIC WORKS BUILDING Owner w ►q—� ®%.3 SO. FT. OCC. BUILDING VALUATION Mailing Address s%�I�-stiL 0 Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address aZ 01 LL Plan Checking Fee&/or Penalty Permit Fee p PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. G �. G Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F T9arti•tatl�rT FireDept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EOA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 51,10 c Parcel A royal Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER permit Fee $ $ �3Jl.e�trc�c� �G em ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 , 00 00V OR L Main service 100 AMP ORSLESS 5.00 ;100 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD -L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNS.r ( DWEACCLBLOGS.OCC UP. 7i)20Sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: NEW CONSTR.BRANCHMULTI-OCIRCUITS) NON-RESID. (BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & NON -RES ID. SINGLE OUTLET CIR. Ex. OCCUP(OUTLETS OR FIXTURES I6 L@; FIXED APPLNS. OR Ex. Occup. (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 .S I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 the Workmen's Compensation Laws of California. • PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property f r inspection purposes. X Date" i ature of Permitee or Agent Receipt No. % _// Z Tro White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above f r which feeshavebeen paid. . DIRECL A OF PIUBLIC WORKS BUTTE COUNTY ' DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds OWNER scant: CARL THOMAS 2162 VILLA AVE PALERMO, CA FEE INFORMATION Dwelling - Custom, Model $1,415.59 Fund 10 BLDG $943.72 SMIP - Residential $9.59 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires OWNER / I I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 10/03/2006 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Cartier: Policy Number. Exp. Date: (This section need not be completed if the permitis oris or one dollars ($100) or CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �l J ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of.P_Wif=ia-aFd-agreet4Mt if I should become subject to the workers' compa%ali _, o dons ofcoon 3XO-of the La brCpde, I shall forthwith comply with those V 0/03/2006 WARN G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND HALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU RED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Building Garage Remdl/Addn 1,280 528 Other Porch/Patio Total 1.808 $2,368.90 Balance Due: $0.00 Receipt No: OWNER /BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: 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 Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are notintended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). this 10/1 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte Co ty to enter the above mentioned property for inspection p ;es. I hereby certify that I am the ro ertypw a u aeg to act on the property t w ed beyialf. (�-r) J O 1� ✓� (ire rat it S 10/03/2006 game of Permittee [SIGN] Print Date E�Pwner 1:1 Contractor OR. DAgent for Owner DAgent for Contractor FILE COPY PROJECT INFORMATION Site Address: 2162 SOUTH VILLA AVE Owner: Permit No: 06-1846 APN: 026-211-022 JOHN THOMAS Permit type: RESIDENTIAL 519 FRUITVALE Issued Date: 10/03/2006 By KCG Subtype: SFD-Custom/Model LINCOLN, CA 95648 Expiration Date: 10/03/2007 Description: NSF/GAR (916) 645-8300 Occupancy: R-3 Zoning: OWNER scant: CARL THOMAS 2162 VILLA AVE PALERMO, CA FEE INFORMATION Dwelling - Custom, Model $1,415.59 Fund 10 BLDG $943.72 SMIP - Residential $9.59 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires OWNER / I I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 10/03/2006 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Cartier: Policy Number. Exp. Date: (This section need not be completed if the permitis oris or one dollars ($100) or CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �l J ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of.P_Wif=ia-aFd-agreet4Mt if I should become subject to the workers' compa%ali _, o dons ofcoon 3XO-of the La brCpde, I shall forthwith comply with those V 0/03/2006 WARN G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND HALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU RED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Building Garage Remdl/Addn 1,280 528 Other Porch/Patio Total 1.808 $2,368.90 Balance Due: $0.00 Receipt No: OWNER /BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: 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 Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are notintended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). this 10/1 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte Co ty to enter the above mentioned property for inspection p ;es. I hereby certify that I am the ro ertypw a u aeg to act on the property t w ed beyialf. (�-r) J O 1� ✓� (ire rat it S 10/03/2006 game of Permittee [SIGN] Print Date E�Pwner 1:1 Contractor OR. DAgent for Owner DAgent for Contractor FILE COPY 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 OF APPLICATION Website: � www.buttecounty.net/dds � **PIfASE PRINT CLEACRds*J*a�-� r� OWNER INFORM—AThoo� r CONTRACTOR Name 2 < r 6 `� Phone , For ffice use only: CONTRACTOR Name 2 < Address 6 `� City — p ILLS State FZI Phone 5 B a v Fax E-mail Date Approved: Lic. # Class For ffice use only: ARCHITECT/ENGINEER Name �i�tJv/L-- 7�0•� �S Address 6 `� City — p ILLS State ZiD S Pho e D 5 B a v Fa a 0 E -mail Date Approved: State License Number For ffice use only: APPLICANT INFORMATION Name I Address ❑ Structure Bu ithout Permits City Occ. State Zip Phone Page Fax E-mail Date Approved: For ffice use only: Zoning Flood Zone. I SRA ❑ Structure Bu ithout Permits WORKER'S COMPENSATION Occ. onst. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc A I PERMIT NO. 0(p.lI0` 0 PROJECT L CATION P# CProperty Address �5 ity �'L v l2sLLl7 Cross Street J /N G�c9-c— ilJ ❑ Structure Bu ithout Permits 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 Description or Scope of Work: I�- o Sq FT- Livingarage S� Open. Cov ❑ Structure Bu ithout Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. q q3 Recei d by: Amount: ?4;� Bldg le SRA Receipt #: j n l Sheriff SIL �`�' 1 SMIP 1 �(/ Other Date: 1 `7Y/' � J Total Page 1 of 2 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. ❑ 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 fazes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C 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). El10. 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-'tiA:n. -+ .K� .. -�r . �• A..`r � . �'S.'. .A. i-' S ...�-' . ;_.�:. .v.'. �r q,,�„, - tC _ . . .. . COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: A Proposed Building Use: w� T Mems required in order to apply for a permit. All boxes Mi ,[Y 1. Site pla;is, 3 or 4 sets, signed by the preparer ofd r 2. Complete plans, 3 or 4 sets, signed by the prepa 0 3. -Engineered plans, 3 or 4 sets, with wet signature 4. Engineered truss details and layouts in duplicate ❑ 5. Letter from Engineer or Architect for truss design .%? 6. Energy compliance design and supporting docun ❑ 7. Statement of Intent for Non -heated and A/C for � ❑ 8. Manufactured homes: (A) Installation manual, is plicate. dui ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Find plans ❑ 10. Flood Elevation Certificate, wet -stamped and ❑ 11. Hazardous Material Form 12. Acknowledgement of building permit applicati ❑ 13. Other ASSESSOR PARCEL NUMBER U ,�� �� (• U d Permit Technician: Date: %71' G(g 1ST be checked OR marked NA in o r to apply. .he plans. er of the plans. on plans AND 2 sets of stamped and signed calculations. No faxesl review. m in duplicate. ;idential Buildings. marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these , in duplicate. without required clearances. I aining items needed to issue the permit. (May require additional plan review upon receipt of the follo t ms 14. Sanitation and site plan approval from the Enlvironmental Health Department in ❑ Chico ❑ Oroville, s le 15. Fire Sprinklers............................................................................................ ❑ 16. Agridultural Buffer clr and site plan apr from the Ag Commissioner Sent by 17. Soil3 ❑ 18. Erosion and/or Engineered Foundation required ........................................... Report Control Plan Required ................... I................,.................................... 19,, Fees as shown on the attached Schedule ofiFees Due Sheet .............................. ❑ 20. City of Chico Plumbing permit...................................................................."" ❑ 21. Site plan and business license approval from the City of Biggs .............................. 022. California Department of Forestry plan approval ❑ paid. Sent by: .......... Wr 23. Planning approval for (A) Use: LAJ�_ (B) Parking: (C) Parcel Check:.. t ..... -A O�01 ❑ 24. Coitact Land Development about _ ImproIvements, -Drainage ........................ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... 26. NFDES Form ........................................ ........................ ....... :.... ................. a 27. Encroachment Permit for driveway from the! Public Works Dept ........................... 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ .29. Worker's'Compensation Carrier and PolicyJ'Number.......................................... 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. El 33. E;isting violations and/or expired permits..l...................................................... ❑ 34. Deed Restriction........................................................................................... 35. C Legal description, ❑ M . Title title earch, regi ration or MCO. ....................... 36. CRlter: ❑ 37. Cther. When issued Telephone I have beenvn= Plot Plan Attaolted jkttdi Floor Plan Attaedfff111 �.H. U3E ON�v Sent to BD/DS / TO: Building Division = Development Services FROM: Environmental Health SUBJECT: Sanitation Clearance L)�g �-b));� Owner Location AP# Plan Approved for: Sewage Disposa Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Building Clearance 912005 Supply: Public Date ON Well BUTTE,COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner THOMAS, CARL & JOHN APN No: 26-211-022 Permit Type: Subtype: 4 App Date: 8/1/2006 Permit No: BP 06-1846 Permit Desc: BUILDING PERMIT,FEES ESTIMATED AT APPLICATION $2,359.31 Plan Check portion of Permit Fee $943.72 $1,415.59 Balance of Building Permit Fee 2 FEMA RYes Flood Elevation Review $109.98 0 SRA* Yes Fire Plan Check - Non -Refundable $95.00 0 (State Responsibility Areal Building Inspection $109.98 0 1 - $204.98 NON-REFUNDABLE portion of fees due at application $943.72 RECEIPT .PATE Te h/ sst FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $943.72 FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT $1,425.1 _ 1—N At the time of permit ap lication, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan cess. checking pro Applicant: Date: Pursuant to Gover enc cion 66020, you are h6rebyS9UfiaEKhose Items followed by an "*" may have been imposed on your project. You have 90 days f-om the date of p4,proval of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are specified in Go Ment Code Section 66020(a). K:/Building/F pms/Schedule of Receipt Fees Residential 041506 BUTTE COUNTY SCHOOLS IMPACT -FEE CERTIFICATION FORM (One form per Building) School District JI I Building Department No. olj rJ « A.P. Number Q _ ! — U v d` Jurisdiction: City County Property Owner ,4 C Property Location/Address Subdivision Lot No. ......................................................................................., G Residential Development © Q Q Sq. Footage �0 j No of Living Mobile Home Addition/ 'Supplemental to (Group. R) Units Installation Conversion Permit # *(No foundation inspection) .........................................................................................� iw Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial 0 New Addition District Identification INo. 070034 School District certifies that PI)h 14) V1, I I OL 0 A)4 (Street Address) (City) / (State) has complied with the requirements of Resolution No. / 12- PC) square feet. �tvi-4—ac-41 District Representative G Paid by Check # K) I iii" Remarks: Sq. Footage (Including Exterior bnofe/,d,Areas ) V fes' Date (Applicant) (q1&)6Vr—.ffav (Phone Number) (Zip Code) by payment of $ e zs2s $ ULL MITIGATION $ 6_ 2445L. Date Nodes: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with Government Code Section 66020(a), within 00 days from the date fees an paid. Fatiure to submit a timely written protest will prohibit you from challenging On imposition of the fees In any court sedan. it, subsequent to the School District Representative signing this Butte County Schools Impact Fee Cw Matlan Foran, the, School District Is notified by the applicable Local Planning Agency that this project Is being nvlswed under the California Emrkonmantal QuaRtii Act (CEQA), this orated mar be subled to additional school fess to futir n dilate Its lrrrosd on the school d"Ws schools. White (school districtX Yellow (building department), Pink (applicant). feeformift (305W= BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM YFEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) , O CHICO AREA RECREATION AND PARK DISTRICT (CARD) D PARADISE RECREATION AND PARK DISTRICT (PRPD) D DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Nwnber (s)� oZ� Building Permit Number Property Owner (s) , Project Location JAddress a �p C Subdivision Name Assessable Sq. Ftge f Type of Residential Development (check one) New Development ✓�Single Family -Detached Single Family -Attached Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile. home Mobile home replacement verified by Assessor Department Demo Permit (d to issued ) verified by Bu'lding Department Comments:.,4 �a Aing ALADepa-trnentRe tati a Date 0 FRRPD ❑ CARD ❑ PRPD 0 DRPD certifies that: Appl scant Name Mailing Address Phone Number City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ Square Feet @ $ _ Remarks: per unit for a total of $ . 0, per sq foot for a total of $ Paid by Check No: Paid by Cash: Receipt No: i OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. i 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [] NO [ ]. 2. I HAVE [X] 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: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan .to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: 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 i 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. Rev'd 11/4/2004 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.net/dds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is . $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. 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 contractor is to secure an "owner-builder"=building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321-CSLB (2752) or by accessing their website at www.CSLB.ca.gov. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, -kip elKwFy Scott Rutherford Manager, Building Divi NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. ®epartme'nt C o u n t y J. Michael Crump, Director National Pollutant Discharge Construction Storm Water Pei Plan (SWPPP) Acknowledgeme Project Description: of Public Works o f B u t t e LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 limination System (NPDES) Phase .II it and Storm Water Pollution Prevention [LESS THAN 1 ACREI Project Location and/or Parcel Number: By signing below,' I, the project owner/ow 1 acre or more. of land and that I,' theref Permit. from. the: ,State of California Reg contain mulf_ple site build -outs of less tha more than one acre of disturbed soil will 1 California Regional Water Quality Control (. 2!1 0Zz x's agent, certify that this.project WILL NOT DISTURB 'e, do not need to apply for a Construction Storm Water nal Water Quality Control Board. Phased projects that one acre but when combined with subsequent phases total luire a Construction Storm Water Permit from the State of oard. I am aware -that :submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of C �liforilia Regional Water Quality Control Board for a project that disturbs one, acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: I-a=than 1 Acre NPDES & SWPPP Compliance Certification Butte Co unlyDepartmentofDevelopmentSer ices °�vrr��.0 :. 7 County Center Drive , t. Oroville, CA 95965 0ate' (530) 538-7601 Telephone (530) 538-7785 Facsimile OUHY (BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: ° I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained a I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. ' . Within one year from the date of application for a building permit, all other required permits and clearances from other. entities' must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: vj o APN: 0 X (0 Building site address: V Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIG TUBE OF APPLICANT DATE SHEET OF NAME d as,`� BUTTE C O U N -T Y ./ti.- PROPERTY / ,' ^ RECORD PARCEL NUMBER Book Page Block Parcel Code NAMEy� - - esu rvo u ^� y PROPERTY LOCATION /" 9 ^ L ► F — 160 5 160 ZONING Assessment Year 19 ,7 1993 4,9. 19 19 19 UTILITIES -SITE IMPS. Date • 05-2-10 -9% 12- = 26 20 124 Electricity: Ye Tel one ❑ _ r'1 0r 11 fl Appraiser c.. _ _ A _ 162 _ - L r1 162 b� 162 '� 162 fG I-1 r-1 n 162 162 n u esu rvo u i es LJ rvo U Sanitary Swr.: Public ❑ Ind'iv. Use Code 160 5 160 R S 160 160 160 160 Storm Swr.: Public ❑ Natural Transfer Code 124 % 124 I l d % 124 % 124 % 124 % 124 Street: Conc.❑Asph. [� Dirt Gravel ❑ Acreage 178 178 178 178 178 178 Street Lights: Yes ❑ No Incomplete 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 C & G: Yes ❑ No ,X Building Class 167 14 167 167 167 167 167 Sidewalks: Yes ❑ No (� Bedrooms 168 168 168 168 168 168 SITE TOPOGRAPHY Baths 169 169 169 169 169 169 Level Rolling ❑ Other❑ Effective Year 170 170 170 170 170 170 Slopes Up [I Down❑ S -S ❑ Area of Residence 171 171 171 171 171 171 At . ❑ Above ❑ Below ❑Grade Land Type 172 Lol*omcsite❑ 172 LotDHomesite❑ 172 Lot❑Homesite❑ 172 Lot❑ Homesite❑ 172 Lot❑fJomesite❑ 172 Lot❑Homesite❑ View ❑ Of: Car Shelter 173 Yes ❑ No,>K 173 Yes ❑ No ❑ 173 Yes ❑ No ❑ 173 Yes ❑ No ❑ 173 Yes ❑ No ❑ 173 Yes ❑ No ❑ WATER Pool 174 Yes ❑ No� 174 Yes ❑ No ❑ 174 Yes ❑ No ❑ 174 Yes ❑ No ❑ 174 Yes [-] No ❑ 174 Yes ❑ No ❑ Quantity: Quality: Partial Complete % Complete % Complete % Co lete % Complete % Complete % Complete Public ❑ Well ' Ditch ❑ P.P. Acct. Checked Yes ❑ No ❑ Yes ❑ No ❑ Yes No Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Supplier t L 0u Aerial Photo Year Topo. Map Year MARKET DATA Soil Name Index Acres Comparable 1 02_(z, 14 1 13 Comparable 2 c9 -to - o ec) Coo Comparable 3 p 24m"� �� 1,S Sale Date/Price 1.0 a- /Z 02)'-J1 711.7_ 4_i 1,0!1� _45 J IPW Yf ` PRIMARY BASE SECTION Base Year 140 140 9 !Z 14U 6(19z 140 140 140 Event Date 186 1 0 -•?. `� tom, 186 j,,y -7 186 -5--0504 186 186 186 ' Land 109 '� ^ � 109 L� 00 109 _q62� 109 109 109 Avg. Soil Rating Improvements 110 110 ^4,.., ©�Q 110 {� 110 110 110 LAND REMARKS: Trees and Vines ill u 111 111 111 111 111 Personal Property 112 112 112 112 112 112 Keyed By: SECONDARY BASE SECTION Base Year 240 240 240 240 j 240 240 Event Date 286 286 286 286 286 286 Land 209 209 209 209 209 209 Improvements 210 210 210 210 210 210 Trees and Vines 211 2111 211 211 211 211 Keyed By: PRIMARY LAND VALUE COMPUTATION SECONDARY ASSMT. PRIMARY LOT H/S YEAR BASE YEAR VALUE SQ. FT./ ACRES UNIT VALUE VALUE ADDED TAXABLE VALUE ASSMT. SECONDARY LOT H/S YEAR BASE YEAR VALUE SQ. FT./ ACRES UNIT VALUE TAXABLE VALUE ADDED VALUE PARTIAL OWNERSHIP CHANGE ASSMT. YEAR EXISTING BASE YEAR EXISTING VALUE PORTION RETAINED RETAINED VALUE EXT. % 1 EXTENDED I VALUE TO YEAR TRANS. DATE VALUE PORTION TRANS. TRANS. EVENT DATE VALUE VALUES LAND COMPUTATIONS X = X = X = LAND IMPROVEMENT COMPUTATIONS X = X = X = IMPS. LAND COMPUTATIONS X = X = X = LAND IMPROVEMENT COMPUTATIONS X = X = X = IMPS LAND COMPUTATIONS X = X = X = LAND IMPROVEMENT COMPUTATIONS X = X = X = IMPS. LAND COMPUTATIONS X = X = X = LAND ' IMPROVEMENT COMPUTATIONS X = X = X = IMPS. LAND COMPUTATIONS X = X = X = LAND IMPROVEMENT COMPUTATIONS X = X = X = IMPS. RB5ID�NTIAL BUILDING NBCORD T/ ir`:- :n.,J �a�•:r, ADDRESS c2 2 5• �%%L /�� PARCEL 7. c+ ' a/ _7� 177 SHEET OF SHEETS ' — Reinforced /it r "X > - M - DESCRIPTION OF BUILDING -T6—m Com) - no Brick CLASS@'SHAPE CONSTRUCTION STRUCTURAL EXTERIOR ROOF LIGHTING AIR CONDITION X. Sub Floor Stone Shake ROOM AND FINISH DETAIL �y _ .-. T° light_ Sub-Slondard J� Frame — 7 `V Z—//_ Stucco o� Flot / Pitch Goble .14 Wiring X.T. Conduit h'ecting Conlin Forced I Cleoni ROOMS FLOORS BI/ 2 FLOOR FINISH Moteriol Grode TRIM Walls I FINISH Cei/in s ARCHITECTURE X Stondord Sheathign Siding Hip / '15X. Cob/e Gravity Humid. All •, Automofic Firep/ace Kitchen ✓nits Above-Slondard CohereAeBloc k f%- Shed / Fixtures NO// Unit _ CONSTRUCTION RECORD EFFEC. APPR. NORMAL % GOOD Permit A YEAR YEAR Remoing Toole /o No. For Amount Dole ge Life RATING `E G, A;F P) Cond. Arch. Func. Con- Jfore espace Work- Fl. No Affr. Plan form. upb'dCloset hship FINISH Floors I Wol/se- ' % Stories specio/ B.8 B. 1 f. 8 G. / Cut Up Few Cheap Ent. Noll USE TYPE Bnch Shingles Dormers A . Medium floor Unit I Living FOUNDATION Adobe Shakes Many I ISpecial Zone Unit I Dining Double `� Concrete Floor.Joisf: 8.88. 1 f T. 's 6. Gu Hers Centro/•• r' -- Duplex— -- — Reinforced /it r "X > - M PLUMBING Bed -T6—m Aportmenl Brick 2"4: "X - Brick Shingle Poor ` Goad Bed Unit 1 Cost nil Cost nil Cost Unil Cost sl osf os Flol Wood X. Sub Floor Stone Shake Oi/Burner �y 17 /%/y� Court WINDOWS Tile Fixtures Mote/ DH. Casement _—, Trim ?( GYoterHeoter M-B.T.U. _ Insulated Ceilin s '( Steel Josh Composition •, Automofic Firep/ace Kitchen ✓nits Lighf I Heovy Insulo/ed'Nolls-7Screens . Compo. Jhin le -:16a E)ect. I I DroinBd. Moterio/: _ CONSTRUCTION RECORD EFFEC. APPR. NORMAL % GOOD Permit A YEAR YEAR Remoing Toole /o No. For Amount Dole ge Life RATING `E G, A;F P) Cond. Arch. Func. Con- Jfore espace Work- Fl. No Affr. Plan form. upb'dCloset hship FINISH Floors I Wol/se- BATH DETAIL FIX TUI Lo. ubj Type F/ l _' + %r' off' �i o ,- b /9 i-� d� sa �1 / , ; / Fin sh J, z- -e "g. 9k- I I I SPECIAL FEATURES lL , T j Book Cases Built -fn Beds lrenefian Binds Shutlers MICROFILMED r).4 A COMPUTATIO11q-1_i1(Ja &.-f I Appraiser 8 Date G,-�", 1 y/_ T lye I o` 1 1,�, i60 -T6—m Unit Area Unit Cos/ n+l Cost Cost Cost Unit Cost Cost l�nil Gosf Cost Unit 1 Cost nil Cost nil Cost Unil Cost sl osf os C� �y 17 /%/y� � 1 �P vef I - _ T07AL r' NORMAL % GOOD R. C.L.N. D. 4,3 C. c D :;) `�y•.$ '"a.c^'d tom, nu sin_n dV' __� sr•',-. 'J i -- .n (ftv - -