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HomeMy WebLinkAbout027-300-059I�I lO NIOI ' 027-300-059 PERMIT # 98-0371 SHETTLESOWORTH, HAROLD 2549 PALERMO ROAD, PALERMO CONT: UNKNOWN Me Y -HLI ELECTRIC GAS COMPAC TEST REQ S RT STRUCTURE REQS_ 651 1 3 t COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 ae, PERMIT NO. (Rev. 12/96) V . APPLICATION AND PERMIT Xg ���-- ASSESSOR PARCEL NUMBER 027-30-0-059 ZONING ARM14-1 BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS TI 103, OROVILLE 95965 CONTRACTOR'S NAME UNKNOWN TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'SMAIUNG ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILOII�fMD ES�ALERMO ROAD, PALERMO LL yy r Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ MobilehomeM Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 . Each as water heater or vent - 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities OX Installation ❑ Other ❑ Describe Work: 2 BEDROOM 24 X 52 Gas piping system 1 - 5 outlets . + 15.00 Building sewer 15.00 Mobile Home ISI GI W1 @20.0 .00 PERMIT FEE $ 80.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service p A OR LE:20O 23.00 3.00 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: gr 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 ,000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( d ACC. BUDS. s0 3.5¢FT. NE COSMULTL NON -R SNDT ,c OUTLET 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. EX. OCCU OUTLET OR FDCTURS zo @ I.00 BA 0 .50 Ex. Occup. O ELETS RLLNss OR, 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 20.00 Misc. Wiring 23.00 PERMIT FEE $ 63.00 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 Cooling Hood 6.50 Ventilation PERMIT FEE $ 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 if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. ' _ / X dam' Date _�_/ �_/C _ Si ature of Applicant - :, Owner [3 Contractor ❑ Agent `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 FE 166 •00 HA .� JTOTAL D. FESF .� O COF p EL pp — HD 6SUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date Date Receipt No. 231 £i92 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 Count Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) s APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER O *NTNG - BI LI IILDING PERMIT r BUILDINGPERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS CONTRACTOR'S NAME ' - URNOWN TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS I, Plan Checking Fee $ 23.00 BUILDINIC}t1f�f ESNLE 0 ROAb, PALERMO 4 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNIS„NS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE y� SF ❑ Duplex O MobilehomeX6 Other SPECIFY Each Trap 1 7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New r Addition ❑ Remodel ❑ Utilities 011 Installation O Other ❑ Descri a work: 2 BEDROOM 24 X 52 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W 920.00 •OO PERMIT FEE $ 80.00 ELECTRICAL PERMIT Filing Fee 20.00 OOOV OR UE Main Service 20.AORLE3 00 23.00 3.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commending 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: .-9 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. O 1, 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 OCCUP. ( SO. 3.52FT. NEW CONST. Mu�icrcOUTLEET NON RESID. T @7.50 POWER APPARATUS & SINGLE OUTLET CIR. Ex. Occu OUTLET OR FocruREs 2O @ ' °0 eAL @ .50 Ex. Occup. DUTL�rors REESSIp.OEp 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 0.00 Misc. Wiring 23.00 PERMIT FEE $ 63.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: O 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 Cooling Hood 6.50 Ventilation PERMIT FEE $ 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 if I should become subject to they workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. y/ _ X s�i� f1 4�vs�L __ Date _✓_�� ^ zC _ Sig ature' of Applicant - Owner ❑Contractor O Agent Anr&HA 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 166 00 TOTAL FEWf 6 ]I�Lr�jD M F cD p CEL This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. 231892' WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .A. -- A r COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT �'— ASSESSOR PARCEL NUMBER ,YONING BUILDING PERMIT OWNER TEUePH6N9 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS r u 05965 CONTRACTOR'S NAME i TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS d Plan Checking Fee $ Bu1LOI c�gD�Es �,_, , W ROADPALERMO J�44 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. S UBDNIS ION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ MobilehomeXg 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 ITYPE OF WORK New 0 Addition ❑ Remodel ❑ Utilities ❑X Installation ❑ Other ❑ Describe Work: _ 2 BEDRWM 24 X 52 1 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.06 3.00 PERMIT FEE S 80.00 ELECTRICAL PERMITff�� Filing Fee 20.00 w LE Main Service 200A OR LE200 1 23.00 3.00 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. DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: -• !� I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service ( 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. SO 3.5,s TDS. NON -RES D? ANTI OUTLET H CIRCUITS 97.50 POWGLER APPARATUS 8 SINE OUTLET CIR. EX. OCCU OUTLET OR FIXTURES 2u � I'00OWNER-BUILDER BAL Q .50 P Ex. Occup. D ELETSRES,15.) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 0.00 Misc. Wirina 23.00 PERMIT FEE $ 63.00 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 Cooling Hood 6.50 Ventilation PERMIT FEE S 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.) .+ ,JI 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. f X "�'l'.1./ _"t�'_T Date .. �� ' q,5," _ Signature of Applicant - X 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 166.00 TOTAL FElf HA2 D. EEs Imp- Y c rEL PD,- HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid. Date Date Receipt No. 2311392 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ! •' 2 04' .-r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538 -7541 -,,JP PERMIT NO. (Rev. 12/96) ' APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 70N;1NG 027-30-"5 4 BUILDING PERMIT �Y� OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME ��-,j, \ s TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ • 00 BUILDIw�ragITSP �n' PA vmy� j6�,.�7{��1yy j'_AL`['�EL1tR_J J'L Energy Plan Checking Fee $ $ ' PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE XX SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New �j Addition ❑ Remodel ❑ Utilities ❑x Installation ❑ Other ❑ Describe Work: 2 BEDROOM 24 X 52 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ • ELECTRICAL PERMIT Fling Fee 20.00 Main Service AORLEF 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.POWER 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, 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 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ( a ACC. BLDS. SO 3.5¢Fr: CNS. NEW NON-RESNDT MULTI -OUTLET @7,50 APPARATUS a SINGLE OUTLET CI R. Ex. Occup. OUTLET OR FIXTURES 20 Q 1.00 BAL @ .so FIXED APPLNS. OR Ex. Occup. OUTLETS RESID. EA 5.00 ;- Temporary Service 23.00 Mobile Home Facilities 20.00 tUXU Misc. Wiring 23.00 PERMIT FEE S r • 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 1 Cooling Hood 6.50 Ventilation PERMIT FEE $ 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.) •` W 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 if I should become subject to the workers', compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X '-1 a:-rar/ :_ {%�'Z P_s- * rZ Date •- �� '_� _ Signature of Applicant - Owner ❑ Contractor ❑ Agent 4 -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. TYPE00•Ul) TOTAL HRIS H� D. FEES IM F c PAijCEL r Pp, HD ISSUE 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. L By Date PERMIT EXPIRES ON Defe Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT V115 "J_410.t f COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICA TION DA TA SHEET OWNER: /tel . J h.o ,1We c ,Aj Ai,AL ASSESSOR PARCEL NUMBER: 02 -7 — 3 C) Proposed Building Use: M_U jJ Building Inspector: A)S Date: At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All iiems have been submitted .------------------------------------------------------------------------------------- ❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans. ------ E13. ----- ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. 0.4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- El 6. Energy Design Compliance and supporting documentation. ------------------------------------------- 07. Statement of Intent for Non -Heated and A/C Buildings. ----------------------------------------------- ❑ 8. Hazardous Material Form.--------------------------------------------------------------------------------- ❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications .--------- ❑ 10. Fees of $---------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ------- ❑ 12. California Department of Forestry plan approval/fees. 013 - 13. eazfielevation certificate. --------------------------------------------- 4. Sanitation and plot plan, approval l earth Department. ❑ 15. City of Chico plumbing permit. --------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. --- ❑ 17. Planning approval for (A) Use: (B) Parking: 01 1 - QKrntact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. 9. Encroachment Permit for driveway (construction approval prior to occupancy). 020. Pre -inspection Pre -inspection for required Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 0 22. Workers' Compensation carrier and policy number. ---- I Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- 024. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- 0 26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- 030. -------------- ❑30. Other: / ------- When you issue the permit, process as follows QMail to owner, ❑Mail to contractor (Date) ❑Telephone and hold for pickup at office. ❑ Deliver with inspector. Applicant: `� '� hfe- Date: 'Copy of Haz-Mat form sent ❑ Health Department, 13Fire Department, ❑ ollution Date: By: Cop vy of plans sent o Health Department, ❑ Fire Department er: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by o phone, o mail, o Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by o phone, o mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by o phone, o mail, o Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by o phone, o mail, o Building Div 'sion counter, by Date: Plans reviewed by: Date: Plans approved by: Date: � — Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signal me. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuirig your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide theajor labor and materials for construction of the proposed property impr ement : YES, NO E32. I `HAVE HAVE NOT ❑ signed an application for a building permit for the proposed wotk.'; 3. I have contracted with the following person (firm) to provide the proposed construction:.:._; :- v^ ADDRESS: My.. 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: r,,Jk,.T,,.,") / -<- ADDRESS: ADDRESS: CI Y: PHONE: CONTRACTOR'S LICENSE NO. It 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: PROPkkTYOWNER:ZJZ-t x SOCIAL SECURITY NUMBER: DATE: 3- — / / r 98 -" '-NOTE: -Thu Owner -Builder Verification is required by Section I98.3J-an-jT798J2 of?ha, California Health and Safety Code. This verification must be completed "i returned to our office before we are permitted to issue the permit. _1 I OWNER BUILDER INFORMATION I 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 parry 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 you plan to subcontract, you should be aware of the following information for your benefit and protection: ti .. ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 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 contrac!grs 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. IMirely, X U� el C. Vi iia, C.B ger, Building Inspection NOTE. This Owner -Builder Informatlon is required by Seellon 198.10 of the California NealNr and Safety Coda OVER (Rev. 12/96) ®,w1ci? o,r©vt, UV VIE , COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER, ZONING BUILDING PERMIT pyyNEq / r d 2- 5h P .,Z[ /,e5 cod y Aa LL TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADORES ' ,q' g `/,r &4� �/v\11,11 J U V CONTRACTOR'S NAME J/ TELEPHONE CONTRACTORS 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 MAILING ADDRESS Plan Checking Fee $ 19-1E, BUILDING ADDRESS �L(� / Energy Plan Checking Fee $ U 1>J -W D $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ MobilehomeA_ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation ❑/ Other ❑ Describe Work: p` , J/L o2 6a)L1 �[7 a K J! �- Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S G W Q20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A 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.POWER 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, 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 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 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.) ❑ 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. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3stories inheight. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. so OR ADDNS. ( a ACC. BLnS. 3.52FT. NO gOI.T. MULTI -OUTLET @7.50 APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 2L0 .50 ant w EDLNS Ex. Occup. ofluxT APP A D.°FEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE / TOTAL FEE $ ,/ HA2. p. FEES IMP I FLOOD I CDF I PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date (Da te Receipt No. 93/,q'? -2_— WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION NOTICE Post this job card In a safe conspicuous place. Do not remove until all required inspections are made and building is approved for occupancy. Plans must be available A. P. No. _ 027-300-059--`' -'PERMIT-#'98-0371' _ SHETTLESOWORTH, HAROLD- - Owner _ 2549 PALERMO ROAD, PALERMO - CONT: UNKNOWN— Contractor _ MH Permit No. Expires PERMITTEE MUST CALL FOR INSPECTIONS Footings Piers Underground Conduit Pre-Gunite Underfloor Electrical Underfloor Mechanical Underfloor Framing Rough Plumbing Rough Electrical Rough Mechanical Framing Shower Pan uo:Not.insuiai9:unu1:A0ove=bi9nea is Insulation Do of over Until.ove ne Fireplace Footing Fireplace Throat _ ........... _. -9, o.: Not. Continue Fire place:Untit:Atiove:S Scratch and Brown ..Do Not Cover. Until Above SigneiJ ..... . . Sewer Service Water Service Pool Final Plumbing Final Electrical Final Mechanical Final Building or M.H. Final DO NOT OCCUPY UNTIL ALL THE ABOVE IS SIGNED AND THE BUILDING OR MOBILE HOME IS APPROVED FOR OCCUPANCY Addresses ..Information 24`=Hr lns Oroville 7 County Center Dr. 538-7541 538-7636 Chico 1469 Humboldt Rd. 891-2751 891-2834 Revised 7/94 i RESIDENTIAL PERMIT NO. 027-300-059 PERMIT # 98-0371 SHETTLESOWORTH " HAROLD PERMIT EXPIRES 2549 PALERMO ROAD, PALERMO CONT:'-UNKNOWN'-- OWNER ONT:'-UNKNOWN'--OWNER �� MHt - CONTR. ASSESSOR PARCEL LOCATION 027-300-059 PERMIT #98-0371 SHETTLESWORTH, HAROLD 2549 PALERMO ROAD, PALERMO MHU { II Y 1 1 Temp. Power Pole Called PG&E— Temp. Elec. Service Called PG&E _ Temp. Gas Service _ Called PG&E — JOB FINALED (Date) Signature V=OK O = Not OK ble • = Applicable NotReMOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 9. Siding; Nailing VeneerStux)-Mesh 1. Zoning Requirements - Setbacks - Easements 10. Roof; Shthg-Roofing 2. Soils; Special MH Support Sketch 11. Ext; Steps -Doors -Landings 3. Sewer, Location -Test -Fall -C/O -Concrete 12. Braced Wall.Panels 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp-Concrets Card B-1 Date Card B-1 6. Gas; Location -Test -Wrap; / MfL / /Nat or/ /`L'fL/ /LPG Card B-1 Date Card B-1 7. Well Clearance & Disconnect POOLS (Plans) OK except #'s 8. Utility Clearance 1. Setbacks -Easements 2. Soils;Compaction-Structure Stability Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 1. Zoning Requirements- Setbacks Easements 7. Elec.; Bonding; Metal w/3 -Circulating Equip. -Heater 2. Footings; Size -Spacing -Marriage Line 8. Elec.; Grounding; Equip, w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards4hs. to Main in Conduit 3. Gas; MH Test )emand-ValoeConnector 9. Health Departrnent Approval 4. Electricity; MH Test -Crossovers -Breakers -Clearances 10. Plumb.; Cir. Test -Water Supply Test 5. Drain; MH Test -Fall -Flex Connector 11. Light Niche 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged Card B-1 Date Card B-1 9. Tie Downs -Type -Installation Cert. Card B-1 Date Card B-1 10. Exits; Insp.-Sketch 11. Cert of Occupancy 12. Permanent Foundation Only: License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-DeplhSpacing-ConnectorsSteel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beamr Rttrs.-Connectors Shthg.-Rfg.-Bracing, 5. Alum. Awn.; Columns-ConnectionsSplice-Decal-Enclosures 6. Carports; Windows -Doors 7. Electric 8. Fnng.; Sils-AnchorsStuds-Rttrs-Trusses 9. Siding; Nailing VeneerStux)-Mesh 10. Roof; Shthg-Roofing 11. Ext; Steps -Doors -Landings 12. Braced Wall.Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils;Compaction-Structure Stability 3. Pod Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pod Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/3 -Circulating Equip. -Heater 8. Elec.; Grounding; Equip, w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards4hs. to Main in Conduit 9. Health Departrnent Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 0 = No OK RESIDENTIAL (Single & Duplex) - = Not Ap I'cable * = Not Ready Date UNDERFLOOR (Plans) OK except: *Is 1. ZoningSetbacks-Easments-FloodSlope 2. Ftg., Main; Soils-Elec. Gmd. / /Fig. Depth 3. Fig. Garage; SoilsSteel-Elec. Gmd/ /' Ftg. Depth 4. Ftg. Porches & Decks; SoilsSteel-/ /' Fig. Depth 5. Stemwalls, Main;'Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors . 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF. Gas Pipe; Size Anchor: - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts- Joists Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sae & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 23. Fixture & Transformer Clearance -Ins. Protection 24. Elec. Receptacles Spacing -Lights & Switches at Doors 25. Size Bares & No. of Conductors Stapled 26. Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water 28. 2 Appliance Circuts in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al 30. Range Circ. / / ga Cu or Al -0v n Circ. / / ga Cu or AI Insulated Neutral 0 Yes 0 No 31. Service -Riser Conductors & Ground -Main Disconect 32. Equip. Clearances Panels-Motors-Mech. Epuip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector Date Cana B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Fumance-Vent Access -Comb. Air-Retum Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except Nt 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing 1 - • - Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-roll Brac.-TrussShting: Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Hgt & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits 54. Stairs; Width-Headroom-Rise-Run4 ending -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior / Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace; Vents -Clearance -Comb, Air-Conector- In Garage; Above Floor -Ducts -Meth. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int & Ext 72. Kit Fixt. & Appliance; Ground. -Air Gap -Cooking Clearance 73. Elec. Outlets & Recepticales at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr: Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. In Garage; Above Floor -Meth. Protection 77. Plb., Elec.'& Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (G.F.O-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 82. Following Insdd./Drive 0 Yes 0 NoANalks 0 Yes 0 No/Planters 0 Yes 0 No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throught House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: m c. . E HIM! MINE IN MEN IN ommom IN mommommom Mill 10MINEEN I *; N1,3506, 0 IMENESON WAR MOVXXUMMIEENNEEWE IN MEN SOMME IN WINE IN IN IN Wt lz -.T-7-57- "AG E I S 14 I All E, Sm NMI on, H MESH MEN ===MEN 1 hiMmmmm _=__ iM r. mo qrrT ii�Y� •' • .: • 7?cE is r�o ' �1 as li •* • t tlt t� ■ •f,�� •-. ,� ,.' �; / t. _ ILI_ _,ys • 7 . it �1 is � - ♦ .. ����� lam= 0 ® ■■■■M■ s■ MM:- i - MEN■ Mn wEN i "' Z\ —-7— =-J LAND DEVELOPMENT BUILDING / ENVIRONIV E TAL HEALTH - PERMIT CLEARANCE Building Permit No. OWNER,dee NUMBER: ( ��Q� D 59 PRINT LAST NAME FIRST ADDRESS / LOCATION: o?S y_ &Z'L /emo ��Qr COUNTY ZONINIiM / DESIGNATION: ��// FLOOD ZONE: FLOOD MAP:'r-Zd 16 APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP DEED INFORMATION: DATE OF CREATION: 2/Z 8/-I DEED REFERENCE: I %2 3 o%L 60 LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO COMMENTS/CONDITIONS: PV14S 2 7 3D'S3 MAP INFORMATION: DATE OF RECORDING LOT BOOK PAGE COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES NO . IF YES, MARK APPROPRIATE ITEMS) BELOW: A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BU/LD/NG DIVISION UNLESS OTHERWISE NOTED. 1. Maintain a 50 ft. building setback from centerline of road. 2. Maintain a ft.building setback from right-of-way/centerline of _ 3. Comply with Zoning code for building setback from road. 4. Maintain a 100 ft. leachfield setback from all existing wells. 5. Maintain a ft. leachfield setback from _ 6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. 7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. _ 8. Connect to a public water supply. _ 9. Connect to a public sewer system. _ 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the parcel.