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HARRISON, NED r
7895 PALERMO HONCUT HWY
PALERMO CONT: OWNER O
VAC, PROPANE, GAS LINE
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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.
BP052572
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: 09/23/2005 APN: 027-250-021-000
the Business and Professions Code, and my license is in full force and
effect.
License Class License Number:
:
Site Address: 7895 PALERMO HONCUT HWY PAL
Map Index:
Date: Contractor:
Description: NEW HVAC, PROPANE TANK & GAS LINE
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: HARRISON NED
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
7895 PALERMO HONCUT RD.
signed statement that he or she is licensed pursuant to the provisions of
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95966
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).):
❑ 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
Applicant: HARRISON NED
Cade: The Contractors' State License Law does not apply to an
7895 PALERMO HONCUT RD
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
OROVILLE, CA
provided that such improvements are not intended or offered for
95966
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 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
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.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date: 9 235 Owner: 212=2
License #:
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
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.
Valuation: $0.00
Policy #:
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, I shall
forthwith comply with those provisions.
Date:
� �(� � � • ' ,
vI /
Applicant:
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.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutions to do work indicated above for hich fees have been paid.}—
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
B . Date:
y
/(
PERMIT EXPIRES 01: �— 2.l— n(4
Date
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: 6_ S t7 /)/ Signature:'
Date: -- G
kOwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
OWNER INFORMATION
BUTTE COUNTY
o
DEPARTMENT OF DEVELOPMENT SERVICES
O
BUILDING PERMIT APPLICATION
0
AND SUBMITTAL REQUIREMENTS
>, r p
24 HOUR INSPECTION11: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
-_m o
OFFICE #: (530) 538-7541
Fax
A FEE WILL BE REO UIRED AT TIME OF APPLICATION
Planner
Website: www.buttecounty.net/dds
Class
"PLEASE PRINT CLEARLY"'
OWNER INFORMATION
Last Nae
Name
First Name
Address
L Eje m o
14 oV G u'L4 W
City CROY I L. k CSlate
C A
Zipq ,7d/
t�
Phone S30-- 93 3 ` V `� 3 2
Fax
E-mail
Fax
APPLICANT INFORMATION
CONTRACTOR
Name
City0
Address
Zip9S96
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City0
Address
Zip9S96
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name 1f C D /V
Address
7 `3 4 S /I i- 1.
City0
StaCte
Zip9S96
Phone 57 9G� 53.3_ g�2
Fax
E-mail
APPLICANT.SIGNATURE
X'
e"o7 ,
For office use only:
Zoning
Property AddressCity
% `lS "/41—IFnImo oNCvT YOI
Flood Zone
Cross Street
SRA I
Yes
%
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BP 5? -57
BIN #
PROJECT LOCATION
AP#
-
02'7- SO 09-1
Property AddressCity
% `lS "/41—IFnImo oNCvT YOI
C v N7rl y
o,,Tov1ti1, -
Cross Street
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:
C&IV7 L_ Ai r
d o F TAIV ! N -
-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.
Received by: K'6 , Amount: % I) D Bldg I I
Receipt #: � 38-74-7
WA: qqS5
SRA
Sheriff
SMIP
Other
Date:q . `L�j -O I I 1 dj Total
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 caics in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement:
❑
11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541. '
EXPIRATION OF APPLICATION _
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORM BUILDING F0RMS1BIdgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
_4
Butte County Department of Development Services.
NOTES
• ,: •' 7 County Center Drive, Oroville, CA 95965 0 -
,
(530) 538-7601 www.butteco.pnty neUdds ocouNta s
RESIDENTIAL'.-
AP": -+027-250-021--•-.. vcar.atf+o .-05-2572
Owner. ` HARRISON, NED -^
7895 PALERMO HONCUT HWY"` "
Site Address: -i PALERMO
CONT: OWNER
Contractor. 4_HVAC, PROPANE,: GAS LINE._-
e Type of Permit:
OFFICE COPY
Address?$9S yv-mica
GAS /J je
Meter By
Date 1
ELECTRIC
Meter By Date
SPECIAL CONDITIONS
CHECKED BY
SRA '
FLOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED •,
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
l'
OFFICE COPY
Address?$9S yv-mica
GAS /J je
Meter By
Date 1
ELECTRIC
Meter By Date
SPECIAL CONDITIONS
CHECKED BY
SRA '
FLOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED •,
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
+=OK
0 = Not OK
MANUFACTURED HOMES
MISCELLANEOUS
DATE LiPERMANENT FOUNDATION SOFT -SET
1 Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Loctn-Test; Fall/C/O-Concrete
4 Wtr; Loctn-Test-Easement Needed -Regulator
5 Elec Loctn-Clrncs-Grnd Amp -Concrete
6 Yard Gas; Loctn-Test-Wrap Nat or LPO
Inch Sz Ft Lngth
7 Blckng; SzSpacing-Marriage Line
8 Gas; MH Test-Demand-Valve-Cnnctr
9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -C/O to Grade
12 Gas and Electricity Tagged
13 Tie Downs ❑ Foundation ❑
14 Exits
15 Cert of Occupancy
16 HUD Label/Insignia Numbers Serial Numbers
DATE DECKS -COVERS -CARPORTS •GARAGE S
1 Zoning -Setbacks -Easements
2 Ftgs; Sol IsSz-Dpth-Spacing-CnnctrsSteeI
3 Decks, Girders/Joists-Dcking-Brcing
Stairs-Guard/Handrails
4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg
Frmg-Brcng
5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs
6 Carports; Wndws-Doors
7 Electric
8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof; Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnls
oa° m`4
DATE IPOOLS
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel -Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15 volts-GFI
6 Elec Enclsrs; Conduit Entries -Terminals -Listed
7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr
8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg
Boxes-Enclsrs-pniboards-Insultn to Main Conduit
9 Health Dept Apprvl
10 Plmb; Cir Test-Wtr Supply Test
11 Lt Niche
12 Enclsr; Fencing -Alarms
13 Bonding, Diving board or Slide
S 3 mac`
oam m ��' m
o
Pool Drawing
�=OK
0 = Not OK
RESIDENTIAL (Single•& Duplex)
DATE JUNDERFLOOR
DATE IPLUMBING
1 Zoning -Setbacks -Easements -Flood -Slope
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
2 Ftg Main; Soils-Elec Grnd Ftg Dpth
54 WV Pipe; Test & Anchr-Nail Prtctn
3 Ftg Garage; Soils-Steel-Elec Grnd Fig Dpth.
55 DWV; Test Fittings & Anchr Nail Prtctn
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
56 Shwr Pan; Test, First fir -Tub Acc
5 Stemwalis Main; Steel-Blockouts-Wrapped
57 Test Tub & Shwr, 2nd fir - Tub Acc
6 Stemwalis Garage; Steel-Blockouts-Wrapped
58 Gas Pipe; Sz & Anchrs
6a Hold Downs and Special Anchrs
59 Fire Sprinkler; Test
7 Slab, Steel Wrapped
60 Yard Gas Piping
8 Piers-Frpic Ftg-Steel
9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
11 Wtr Pipe; Test-Anchrs-Rgltr-Service Test
DATE M E C H A N I C A L
12 Elec Undrgrnd
61 AC Ducts Insulin & Support
13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn
_ 14 GirdersSills-Anchr BoltsJoists-Vnts-Cripples
62 Vent Fan, Exhaust abv Insultn
15 Acc & Vntitn
63 Condensate Drain & Ovrflw, Sz & Grade
16 Insulation
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
0�41
FRAMING
17 Sills Proper Materials & Anchrs
18 Walls Studs -Nailing Spacing & Braces -Plates -Sound
19 Bearing Walls over Girders & fir Nailing
20 Draft Stop in Walls (rat proof)
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
22 Headers & Beams-Sz & Bearing
23 Hangers -Post Caps-Anchrs-Cnnctns
24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-TrussShthg
25 Frpic Ties or Type A Flue-Frpic Throat Cirnc
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
28 Garage Fire Prtctn Framing -RC Channel
29 Prprty Line Firewall & Opngs
30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
33 Siding -Nailing Veneer
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrfir Acc
35 Glazing Area -Glass Prtctn-SkyLts-Plastic
36 Shear Walls; Nailing -Bolts
37 Brace Int/Ext Wall pnls
38 Insultn-Walls-Ceilings
39 Infiltration-Walls-Wndws
ELECTRICAL
40 Fxtr & Trnsfrmr Cirnc-Ins Prtctn
41 Elec Rcptcls Spacing-Lts & Switches at Doors
42 Sz Boxes & No Of Cndctrs Stapled
43 Romex Installed Close to Edge of Studs & CJ
44 Eqp Grnd made up w/Mech Fstnrs
45 Grndng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
47 Subfeed Wire Sz ga E] CU or ❑AL
AC Wire Sz ga ❑ CU or ❑ AL
48 Range Circ ga ❑ CU or ❑ AL
Oven Circ ga ❑ CU or ❑ AL
Insulated Neutral E) Yes E::] No
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp Cirncs pnls-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
o c`
o A o
FINAL
66 Ext Steps -Door & SideLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr
In Garage; abv-flr-Ducts-Mech Prtctn
69 Bedroom Exiting
70 GFI & Bath Fxtrs & Tub Acc-Spa
71 GFI Arc Fault
72 Elec Trim & Subpnl, Breaker Szs & Labels
73 Stairs, Guard/Handrails
74 Frpic or Stove, Cirnc-Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cirnc
77 Elec Outlets & Rcptcls at Ktchn Counter
78 Garage Fire Door; Swing -Landing -Closure
79 AC Duct in Garage -Damper
80 Wtr Htr; Vnts-Cirnc-Com Air Cnnctr-PRV; abv fir
Mech Prtctn; LPG Appince Undr House 3" drain
81 Plmb; Elec & Mech Eqp Listed for Loctn
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
83 Insultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Cirnc Drnge Planters ❑Yes ❑No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Pimb
89 Vnts abv Roof, Plmb-Appinc-Frpic-Cirnc to Opngs
90 Wtr Well, Dscnnct, Elec, Pimb
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
92 Vntitn thru House
93 Glass Prtctn
94 Corrections from previous Inspctns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99 Fire Sprinkler
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