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HomeMy WebLinkAbout027-110-043- d 1t e 1=�f sr:�� j`e� ti:t �{f �N t - . �v `c;i�t�� t FRi ,•-i��"�¢,j -027-110-041 ',;04-1254 -12 D..Cont: OWNER ELEC FOR WELL r t i +I } tr• f o� . R4 _..t ? •ori, ' rt. 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.buttecbunty.net\dds 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Date: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of pedury that I am exempt from the Contractors' Stale License Law for the following reason (Sec. 7031.5 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 rile a signed statement that he or she is licensed pursuant to the provisions of 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 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).): FY 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 Contractors' State License Law does not apply to an 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 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.). ❑ 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 pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: Cl 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. O 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this pejmit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy W I certify that in the performance of the work for which this permit is issued. 1 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. I shall forthwith comply with those provisions. Date: S,— / Q U l PERMIT NO. BP041254 Issued Date: 05/06/2004 APN: 027-110-043-000 Site Address: Map Index: Description: ELECTRICAL SERVICE FOR WELL Owner: TRINIDAD & MERCEDES VERDUZCO 490 SPRUCE ST GRIDLEY, CA 95948 (530) 846-6750 Applicant: TRINIDAD & MERCEDES VERDUZCO 490 SPRUCE ST GRIDLEY, CA 95948 (530) 846-6750 Cili'ntractor: k License #: Architect: 'Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: Applicant: AUA). /4w(,un 4-"{ -genUe . Ito OU WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject 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. y CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the i3una uounry Godo. .1m,Vor I hereby affirm that there is a construction lending agency for the Resolutions lgdo ork indicated abov�'f011which fees have been paid. ycyiiuni&i ice of the -wort: for which this permit is issued (Sec 3097 Civ.) --^-� ` 1 �'�n1,n,�' �/. ,.��f���� - - - Name: By. [.�Yif%'j%�i Ger�.r°�� Oate: J -" L'U _Q % PERMIT EXPIRES Address: ❑ 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 representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name:��� 1. E c' c' t�t"C l P y' �'Q U c" .L Signature: Date: *Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. u I Ground work Setbacks Foundation/Footings Piers Grade Beams Eufer Ground Hold downs Stemwalls Do Not Pour Concrete Until Above Si ned Slab - Slab -Gars e Gas Test Yard Pipe 1 °` Lift 2 nd Lift Td Lift Final Lift Under Floor/Slab . Framing Shear Transfer Gas Piping Do Not Install Floor Sheathing or Slab CIS i Butte County Department of Development Services Inspection Card j 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX #: (530)538-2140 Visit our website at: www.buttecounty.net/dds ALL PLAN REVISIONS MUST .BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type Insp. Date Framing Rough Framing Rough Plumbing Rough Mechanical Rough Electrical Rough Gas Roof Sheathing Straps Shear Transfer Shower Pan . Rough Sprinkler Do Not Insulate Until Above Signed Insulation Wall Insulation Ceiling Insulation Do Not Cover Until Above Signed Shear Interior Shear Exterior Shear Braced Wall Wall Covering T -Bar Ceiling/RC Sheet Rock -1 layer Sheet Rock -2nd layer Separation/Location Framing/Openings Gas Test House Pipe Stucco Lath Scratch + Brown Finish Inspection Type Insp. Date NOTES Insp. Date F nal 0 Plumbing Final Mechanical Final Electrical Final Insulation Certificate i-- LU t i Final Sprinkler Swimming Pool Setbacks Pool Steel/Pre-Gunite Electrical Bonding Enclosures & Alarms Plumbing Electrical Gas Test Light Nitch UJ f Other Agencies Insp. Date Public Works Sewer Spec Inspection Fire Department Underground Final Sprinkler Fire Final Temp Elect Auth Elect Authorization Gas Authorization Permit Finaled 1 ' Uj LL � PERMITS BECOME NULL AND VOID I YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OF STATE LAWS B. C. Insp. Card 02-17-04 pg 2 0 Z W i-- LU -0 Uj IL UJ U Z Z Lul 0ZLIJZ Uj LL � 0 0 (� Z 0 J W UJ 0 Q VOA-Zt1! � Z0n-WIX WU) C0 oOaW�Za LLJ 5 �v0 WWLLW. ma.LU JZQ0 Z _LUJJ: � Q 0 B. C. Insp. Card 02-17-04 pg 2 BUTTE COUNTY 'DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (•DROVILLE) (530) 891-2834 (CHICO) + OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds r+ N PERMIT NO. BP041254 LICENSED CONTRACTORS DECLARATION I 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: 05/06/2004 APN•' 027-110-043-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: G� �� �(A ©� �� Date: Contractor. / M �:p Index: j Description: ELECTRICAL SERVICE FOR WELL OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the following reason (Sec. 7031.5 r Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: TRINIDAD & MERCEDES VERDUZCO 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 Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 490 SPRUCE ST she is exempt therefrom and the basis for the alleged exemption. Any GRIDLEY, CA 95948 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).): (530) 846-6750 10/ 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: TRINIDAD & MERCEDES VERDUZCO such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 490 SPRUCE ST proving that he or she did not build or improve for the purpose of GRIDLEY, CA 95948 sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed to the (Sec. 7044, Business (530) 846-675 i / contractors construct project Professions Code. The Contractors' State License Law does E Cop"( t and not apply to an owner of property who builds or improves thereon, Or'VA Jam/ _ r) j J� for licensed �n�" and who contracts such projects with a contractor(s) pursuant to the Contractors' State License Law.). Contractor' i Address ) 1 O ' O I am Exempt under Article 3 of the Business and Professions Code Oate%n[L vl Date: Owner: GPS Meter 13 _ - GS RtG WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of peryury one of the following declarations:- ❑ 1 have and will maintain a certificate of consent to self -insure for Meter 6y _ 0cense #: 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: g insurance carrier and policy number are: Carrier: Policy #: Total Square Ft: 0 S. F. lY I certify that in the performance of the work for which this permit is issued. 1 shall not employ any person in any manner so as to Valuation: $0.00 e, become subject to the workers' compensation laws of California, Census Code: F �/�1)I 1 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 with those provisions. Date: C�` / V `-- / ^ P�I1 -IT `10,5&66 Applicant: /,LAI: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject 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: — ..-- ------- — �-- — •r ,, _ �._ '�• -. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Coda ?nrvor I hereby affirm that there is a construction lending agency for the Resolutions t do ork indicated abov which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) By: L�/�� e� Date: S�IU�O Name: PERMIT EXPIRES ON: S' l0 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 representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: ��1 t C ey t A yrci U e .0 0, Signature: h19��5 �lY YCt Z� �F2— Date:' C9)Owner 13 Contractor ❑ Agent for Owner O Agent for Contractor 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.netkdds PERMIT NO. BP041254 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: 05/06/2004 APN: 027-110-043-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: Date: Contractor. Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: ELECTRICAL SERVICE FOR WELL Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: TRINIDAD & MERCEDES VERDUZCO 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 State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 490 SPRUCE ST 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 GRIDLEY, CA 95948 applicant to a civil penalty of not more than five hundred dollars ($500).): (530) 846-6750 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: TRINIDAD & MERCEDES VERDUZCO such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 490 SPRUCE ST proving that he or she did not build or improve for the purpose of sale.). GRIDLEY, CA 95948 ❑ I, as owner of the property, am exclusively contracting with (530) 846-6750 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 pursuant to the Contractors' State License Law.). Contractor: O I am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION 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 License #: 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: 9 insurance carrier and policy number are: Carrier: Policy #: Total Square Ft: 0 S. F. GY 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 Valuation: $0.00 become subject to the workers' compensation laws of California, Census Code: 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. Date: �— �/Q -- 0 / ���Letp1 4- Applicant: /U1�1%:j�h�T�BeeIV(.(� WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject 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. - y L CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Bette County Coda ?ncyor I hereby affirm that there is a construction lending agency for the Resolutions 1 do rk indicated abov which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) L�/� �Ze� Name: B y �1 Date: PERMIT EXPIRES ON: S' !Q Date Address: ❑ 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 substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: M e V C E' _C J) P C d— u ej O Signature: (R— Date: S" / Q IlOwner O Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT.SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. 1. BPo 4-► a54 DATE: APN: ZONING: OWNER'S LAST NAME: �'-c uZC OWNER'S FIRST NAME: tr�` yt� 6(0 c5 PHP�o - 7t3 - asa5 -YS�6 -STREET AOORESS:— FAX CITY. ZIP: � C ` � � � � � C E-MAIL: SITE ADDRESS: ry 6 s PaY(�� � CITY, ZIP: NEAREST CROSS STREET: TRACT/LOT If: APPLICANT NAME: /4ebceke.S Vec aozco PHONE: STREET ADDRESS: 90 E Pr0 ce FAX CffY, ZIP:G C�1 Irt / q �� G EMAIL CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE- ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER: E-MAIL DESCRIPTION OR SCOPE OF WORK: ❑ 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 fees will be required. 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. For office use only: Notes: Application Received by: Date: 5.4.0 4 - Receipt Receipt number: �p�� ��S Amount Received: $ I Master application 3-4-04 O.B.- i OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner-buildee' 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. )(L I personally plan to provide 4e major labor and materials for construction of the proposed Property improvement: YE NO ❑ X2. I HAVE .❑ HAVE NOT a signed an I have contracted with the following person (firm) to provide the proposed construction: proposed work. 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: CONTRACTOR'S LICENSE NO. • I willprovide 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: DATE: NOM This Owner -Builder Ver<. fication is required by ,lection 19531 and 19532 the . California Health and Safety Code This verificatiof must be completed *and.. -returned to .our office before we are permitted to issue thepermit. OVER 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" youare the responsible party ofrecord 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 apply. put their license number on all permits for which they ifyou plan to do your own wort, with the exception ofvarious 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 finily, and the work (including materials and other costs) is $300' or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, p workers compensation insurance, disability insurance costs, and unemployment compensation contriibvdions. h ♦ 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. u + For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if yon 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. 6 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 perm.% 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 ,1C. Vi ira, C.B.O. C. Building Inspection q, NOTE: Thu Owner Builder Infomwtion it required by Section I9$30 of the California Health mrd Safely Code p OVER p k 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:b2-7Z ASSESSOR PARCEL NUMBS Proposed Building Use: Counter Technician: Date: V / Items required in order to apply for erm!t. All boxes MUST be checked OR marked NA in or er t apply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. • Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Site plan and business license approval from the City of Biggs. ❑ 12. Letter of intent for non-residential buildings. ❑ 13. Detached Accessory Building Form filled out by the owner. ❑ 14. Hazardous Material Form. ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.). ❑ 17. Fire Sprinklers ❑ 18. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office 0 19.. Soils Report and/or Engineered Foundation required. ❑ 20. Erosion Control Plan Required. ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet. ❑ 22. City of Chico Plumbing permit. ❑ 23. California Department of Forestry plan approval ❑ paid. ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _Drainage. ❑ 26. NPDES Form ❑ / 27. Encroachment Permit drivewa from the ublic Works D (construction approval prior to occupancy). p� 28. Pre -Inspection for required. ❑ 29. Contractor's license information. (Numbe ificati , ame Style, Clas on). 0 30. Worker's Compensation Carrier and Policy Number. 31. Owner -Builder Verification (_ Given to owner, _ Mailed to'owner). ❑ 32. Letter of Signature authorization. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement. ❑ 34. Manufactured home utility clearance. ❑ 35. Existing violations and/or expired permits. ❑ 36. Deed Restriction. ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H:C.D. $ ❑ 38. Other: ❑ 39. Other When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining'a building permit. Applicant: Date: 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. Original -Applicant COUN�jY 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: 112 V-4 b 2 ASSESSOR PARCEL NUMBE LJ, Proposed Building Use: Counter Technician: Date: _ V Items required in order to apply fora ermit. All boxes M ST be checked OR marked NA in or er t apply. ❑ 1. Site plans, 3 or 4 sets, s ned by the preparer of the plans. . ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered, plans,.3 or 4.sets, with wet signature on plans AND 2 sets of stamped and. signed calculations. 0 , '" 4°'"ere Engined ossrdetailsand layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner O 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. O 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ a ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ O 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. O 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the ublic Works De ........................... 28. ,Pre-Inspection'for. required....... ❑ 29. Contractor's license information. (Numb ame Style, Cla sification)................... O 30. Worker's Com pens ation�Carrier and Policy Number .......................................... 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 32. Letter of Signature authorization......................................:............................. O 33. Recorded copy of Agricultural Ackri6Wledgment Statement ................................. ❑ 34. Manufactured home utility clearance................................................................. ❑ 35. Existing violations and/or expired permits.......;.................................................. O 36. Deed Restriction........................................::::............................................. ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, O counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, O mail, ❑ counter, by Date: Plans reviewed by: Dale: Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division PO+ I aS¢ PRE -INSPECTION REPORT r OWNER: VELD +-Lz ca DATE: 5.4 04 - LOCATION: 0-0 A.P. # d>�7. i �o• 0-�3 CONTRACTOR: ZONING: A-5 REASON FOR PRE -INSPECTION C—L_C—e SVC- FoQ wE-L� DATE TO INSPECTOR: 5.5 •64- PERMIT HISTORY (NONE (SEE ATTACHED BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: _ Residential # of Units: Currently Occupied AbandonedNacant: ( ) Yes ( ) No Electric: Electric Currently ( ) On ( ) Off Condition of Electric Gas: Currently ( ) On ( ) Off Condition Sanitation: Plumbing Worldng () Yes ( ) No Obvious Sewage Problems ( ) Yes ( ) No Mobile home # of Units: ACTION RECOMN[ENDED: ISSUE ( 4)- ei� s ( ) No Hold for permits or verify: Inspector: �7 Date:. �KFTC'H RTTTT,T)TN(T4 ON REVERSE AND INDICATE LOCATION ON PROPERTY: 2� -- LL� `' `1° M. 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