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027-360-142
_ 7 Gerald & Carol Crockett f `.-SYS Anderson Lane,app.3/4 mi - E - o Palemo Hcrcut Hwy, Palermo Permit #581-79B,P,E,M(new single family) AP 20 OP i4@ —'Gerald Crockett s/k private. road app. 1 mi. east of, ` ate'mo-Honcut Hwy., kZ mi. S. of Cox Laj,1, vOroville (AG �ILDG. EXEMPTION - 10/13/80) 027=360-142 02-0902 CLINE, JOHNNIE & MARGI (N 310 MELODY LN., OROVIL CONT: JIM CLANTON SF ADDITION 027-360-142 02-1579 CLINE, JOHNNIE & MARGIE 310 MELODY LN., OROVILLE DECK Wo" 027-360-142 B08-0843 MISCELLANEOUS Re -Roof RE -ROOF (34 SQ) 310 MELODY LN CLINE, JOHNNIE L & MARGIE J x ;027=360-142 03AGO62 CLINE; JOHNNIE ;310 MELODY, OROVILLE AG. BLDG (12'X 20') r A _. � ^ ; � j �cfli BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 310 MELODY LN Owner: Permit NO: B08-0843 APN: 027-360-142 CLINE, JOHNNIE L & MARGIE Issued Date: By Permit type: MISCELLANEOUS 310 MELODY LN Subtype: Re -Roof OROVILLE, CA 95966 Expiration Date: Description: RE -ROOF (34 SQ) (530) 534-5451 Occupancy: Zoning: A5 0( Contractor Applicant: Square Footage: CLINE, JOHNNIE L & MARG. Building Garage Remdl/Addn 310 MELODY LN OROVILLE, CA 95966 Other Porch/Patio Total (530)534-5451 FEE INFORMATION DBMSC Re -Roofing $204.50 Total Charged: $204.50 Fees Paid: $204.50 Balance Due: $0.00 Receipt No: B7279 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's Signature Date I Fn , 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: I HAVE AND the work himself or herself or through his or her own employees, provided that such improvements WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section need not a comted if the permit is or once hundred dollars($100) or ass. ple ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑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 to the subject workers' of X «� J U g 2!/O< compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those owpffes Signature Date provisions. X I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused arising out of, in any way connected with the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owner's behalf. CONSTRUCTION LENDING AGENCY JJ Cl I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Prin Date the performance of the work for which this permit is issued. (3097 civ. code) Mt -wrier ❑ Contractor OR; ElAgent for Owner ElAgent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. T • BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last NameL;1/� Firs Nam G e r -Pe; Mailing Address 31 City _ z f ir Stat eG ZiPz� Phone Sad - 3 V - Fax E-mail CONTRACTOR Name Address City State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone j. Fax E-mail APPLICANT SIGNATURE X duLme PROJECT LOCATION API C)�,—J ' O r I •Z Property Address t City ri r WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed 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: 44 Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning 1 Flood Zone SRA I Yes I No Occ. Type Const. Mitte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 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 government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PJLAt<TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. (YES R NO) I OV /HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: RE -ROOF (34 SQ) Reference Number: B08-0843 Applicant Name: CLINE, JOHNNIE L & MARGIE J Owner's Name: CLINE, JOHNNIE'L & MARGIE J AP # : 027-360-142 Signature of Property Owner: wyzce_,Date: 5���� PO 1? Received The Sum of For ��l �� Received: JqC� 0Q CASH ❑ CHECK OAVCO BUSINESS FORMS • (916) 7438511 )UNTY OF BUTTE rOF . ICIAL RECEIPT C E aEPARTMGSSUlNd-REC LZ C1 Received Bc� Title By 211' 37 022 IPT 11 20 f 1. BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 1 7 COUNTY CENTER DRIVE – OROVILLE, CALIFORNIA 95965 – TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT P RMIT NO. 6 (-) -3 —e&e?" /Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. ZONING A C � _ _ OWNERPHONE S-6 vvin;t NO. -530 -531/- 55151 OWNER'S ADDRESS 310 M-ttvsQ Ln Drzv,��'11c R�QGG LOCATION OF BUILDING 310 rn,ely Cn OMOI-) i Z It g5g1J6 USE OF BUIL,PING _l SIZE OF STRU URE 1a 'X �O = ��0 SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME °� STEEL CONCRETE OTHER (Specify) TYPE OF ROOF COVERING FLOOR TYPE UIN�GD t2 c ESTIMATED COSTCONST UCTION $ o Wcomply 0. p® AG Buildings shall with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: .- l"yREAR FRONT SIDES AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated about, and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date L'�1/–/92 20 3 Signature of Owner Permit Fee- $60.00 LfA The above describeG Building is exempt from a building per "it. F O PARC P. . ROOF G ISSN Receipt No. V Manager Building Division �✓ By Date White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant ti NOTES RESIDENTIAL ✓� .G PERMIT NO. . 027-360-142 _ _ 02-1579_w CLINE- _JOHNNIE & MARGIE 310 MELODY LN., OROVILLE - DECK C.OVSC— SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ,1 JOB FINALED (Date) .24 Signature t f t t t SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ,1 JOB FINALED (Date) .24 Signature il ✓ = OK 0 = Not OK - Act Applicable = Not Ready. MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 2. Soils; Special MH Support Sketch Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 3. Sewer; Location -Test -Fall -C/O -Concrete Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Frg-Bracing 4. Water; Location -Test -Easement Needed (Sketch) Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Carports; Windows -Doors 6. Gas; Location -Test -Wrap;-/ /" L'ft. / /'Nat. or/ /"L"ft./ /'LPG Electric 7. Well Clearance & Disconnect Frmg.; Sills -Anchors- Studs- Rttrs-Trusses 8. Utility Clearance Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 1. 4. Electricity; MH Test -Crossovers -Breakers -Clearances 2. 5. Drain; MH Test -Fall -Flex Connector 3. 6. Water; MH Test -Regulator -Connector 4. 7. Water and Sewer Connected -C/O to Grade -HD Approval 5. 8. Gas and Electricity Tagged 6. 9. Tie Downs -Type -Installation Cert. 7. 10. Exits; Insp.-Sketch 8. 11. Cert. of Occupancy 9. 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 -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills -Anchors- Studs- Rttrs-Trusses 9. Siding; Nailing -Veneer -Stucco -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 FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Liaht Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 .`� COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 PERMIT.PO. (Rev'12/96) APPLICATION AND PERMIT 1C22`f ASSESSOR PARCEL NUMBER 027-360-14.2. ZONING — BUILDING PERMIT OWNER CLINE JO TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 310 MELODY M. DROVE I E, Cr 504 6,552.00 CONTRACTORS NAME OVVL�TL�i. TELEPHONE CONTRACTORS MAILING ADDRESS - CONSTRUCTION LENDER Fireplace 6,552.00 LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 90.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS OROWTI.P. Energy Plan Checking Fee $ $ PERMIT FEE $ 168.50 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: 14' X 36' DECK Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 "OOVOR LIE Main Service 200A 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.FSINGLE License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law fir the following reason: V1, I, as owner of the property, or my employees with wages astheir sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation /of one hundred dollars ($100) or less.) !r, 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 fo wit ,comply with those provisions. // X i Date �(9 ,l"U, Signa ure of Applicant - 010wner ❑ Contractor ❑ Agent An HA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in h ight. Main Service TO 46.00so CCU000A NEW CONST. DWEWNG OCCUP. SO W: OR ADDNS. ( a ACC. BLDS. 3.50FT. NOµp.lp ' MULTI. CUTLET @a 7.50 GWER OUREi CIRAPPARATUS a . 20 @ 1.00 Ex. Occup. OUTLET OR FDnURES BAL O .50 Ex. Occup. oun TS REMnaE 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 FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 168.50 HAZ. - — D. F IMP D CDF — PARC MIy V ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By / ate CA/ e 2 - PERMIT EXPIRES ON I IDae Receipt No. , WHITE-D.D.S.-B.D. CANA - SSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT II 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 OWNEX 6 e–, o ' n o i e,� 1 1� I lei ASSESSOR PARCEL NUMBER v / 3 60 Proposed Building Use: ( corc � l ` Counter Technician: Date: —1�–y� Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 01. - Plot 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. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. ' Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... r— — ❑ 13. Other ` Remaining items needed to issue the permit. (May require additional plan review upon receipt of thvfollowing items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑� V. Statement of Intent for Non -heated and A/C Buildings ..............:.............................. !�1 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit........................................................................ ❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 19. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... 4Worker's Compensation Carrier and Policy Number ..............:.............................. ZOwner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone and hold for pickup. I have been infor ecd of the above items and requirements for obtai ing a building permit. Qvicant: te: 1. Index permit application for the above items numbered: 2. Additional items required Plan Check Letter Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ coun r, Date:_ Plans reviewed by: Date: Plans approved by: Date: Q'I1 Structural reviewed by: Date: Structural approved by: Date: A ie transfer by: Date: Yellow: Building Division TO: . FROM: SUBJECT: Building Department Environmental Health Sanitation Clearance 01, / S - e- . use a�u1r Slot Flan Attnchod Roos Plan Ahad _ Sent to 8.0.o ! `1 Lo 3 �, [q' q___ Owner Location/ AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Wel Clearance for dwelling. Other — DA AK Hold final for: Final clearance O.K. for: NOTE: A A, 17�'- j Environmental Heahfi Specialist Date APP ROVE dPW uwd). Y N (IN -)VA17 A "Kelp- -VIA ---------- 4 - JA -M ILDING- APP ROVE dPW uwd). Y N (IN -)VA17 A Map F•I•e /110. 10-01-oQy-CW''_--- Se;c 33 -r 1$. N RyE MDQ lye 3i o ME�oDY ud OQOUI ux . 85966 ASS•G55o7P�S /t1o, a�-�� A tj \F- NOTES i RESIDENTIAL >�� -- . _ - -i 027-360-142 02-0902 PERMIT NO. _ CLINE, JOHNNIE & MARGIE 1310 MELODY LN., OROVI LLE CONT: JIM CLANTON SF ADDITION -- - - w w �s.'S 7 Y t' t SPECIAL CONDITIONS CHECKED BY SRA i. FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS �4 VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER r OFFICE COPY f Address rI ` GAS ` Meter By Da /fie ' ELECTRIC 3� 1 Meter By Date !f JOB FINALED (D t t Signature ,• t = OK 0 = Not OK = Not Applicable ` = Not Ready (MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft.'' / P Nat. or / /"L"h./ /'LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date (MISCELLANEOUS Card B-1 Date Card B-1 Date Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 1. Zoning Requirements -Setbacks -Easements 5. 2. Footings; Size -Spacing -Marriage Line Carports; Windows -Doors 3. Gas; MH Test -Demand -Valve -Connector ~ Frmg.; Sills-Anchors-Studs-Rhrs-Trusses 4. Electricity; MH Test -Crossovers -Breakers -Clearances 10. 5. Drain; MH Test -Fall -Flex Connector Ext.; Steps -Doors -Landings 6. Water; MH Test -Regulator -Connector Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Gas and Electricity Tagged Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosure s-Panelboards-Ins. to Main in Conduit 9. Tie Downs -Type -Installation Can. Health Depanment Approval 10. Exits; Insp.-Sketch Plumb.; Cir. Test -Water Supply Test 11. Can. of Occupancy Light Niche 12. Permanent Foundation Only; License Decal Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 IR Date (MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rhrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric _ 8. Frmg.; Sills-Anchors-Studs-Rhrs-Trusses 9. Siding; Nailing -Veneer -Stucco -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 FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosure s-Panelboards-Ins. to Main in Conduit 9. Health Depanment Approval 10. Plumb.; Cir. Test -Water Supply Test 1t. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V= OK 0 = Not OK = Not Applicable RESIDENTIAL (Single & Duplex) = Not Ready ( � f�� Date Un eriloor (Plans) OK except #'s •• ,2!Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Fig., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth 4 4. Fig., Porches & Decks; Soils -Steel-/ /" Ftg. Depth ing. Joist-Rftr. Ties-Purlin-Rolf Brac.-Truss-Shting.-Ring. 5. Stemwalls, Main; Steel-Blockouts-Wrapped 4 6. Stemwalls, Garage; Steel- Blockouts-Wrapped Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 6a. Hold s and Special Anchors Slab, Steel -Wrapped -,I- / 8._-Piers- ' place Ftg.-Steel � .W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 64. 12. Electric Underground 1 Headroom- Rise- Run-Landinq-Fire Protection 13. Plenums & Ducts; Clearance -Material -Support -Ins. 76. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies Plb., Elec. & Mech. Equip. Listed for Location 15. Access & Ventilation 79. 16. Insulation Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Date Clearance Looked under Floor O Yes Card B-1 Date Card B-1 Date 83. Card B-1 Date Card B-1 Date A.C. Unit Disconnect, Electrical -Plumbing UMBING (Permit) OK except #'s Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. W ter Htr.; Vent -Access -Combustion Air Baffle 87. 18 ater Pipe; Test & Anchor -Nail Protection Ventilation Throughout House 1, . D.W.V.; Test Fittings & Anchor -Nail Protection 90. 20. Shower Pan; Test, First Floor -Tub Access Gas Test -Meters Tagged, Gas -Electric 21. Test Tub & Shower, Second Floor -Tub Access 93. 22. Gas Pipe; Sixe & Anchors Address Posted Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 23. Fixture & Transformer Clearance -Ins. Protection 24,-Llfec. Receptacles Spacing -Lights & Switches at Doors 25. S a Boxes & No. of Conductors Stapled Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 28. 2 Appliance Circuits in Kitchen & Conductor Size GF] 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI 30. Range Circle/ / ga Cu or AI -Oven Circ. / / ga Cu or Al Insulated Neutral ❑ Yes Q No Service -Riser Conductors & Ground Main Disconnect 32. Equip. Clearances Panels-Motors-Mech. Equip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 3 A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. F nace-Vent Access -Comb. Air -Return Air Vent 115 outlet 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 (Permit) OK except #'s ,, Sits Proper Materials & Anchors 41./Walls Studs -Nailing Spacing & Braces -Plates -Sound 4)Bearing Walls over Girders & Floor Nailing 43/ Draft Stop in Walls (rat proof) 4!Z Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs .Headers & Beams -Size & Bearing Date FRAMING (Continued) 4 ers-Post Caps -Anchors -Connectors 47. ing. Joist-Rftr. Ties-Purlin-Rolf Brac.-Truss-Shting.-Ring. 4 or Type A Flue -Fireplace Throat Clearance 4 .A ' Access; Size & Romex Protection -Draft Stop -Ins. Baffles Date Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions Date a ge Fire Protection Framing 63. perty me Firewall & Openings 64. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 5 1 Headroom- Rise- Run-Landinq-Fire Protection JV P wood on Roof Overhang -Attic Vents -Rafter Outriggers 60. g �� Siding -Nail' g Veneer to Mesh -Drip Screed -Fd. Vents-Underflr. Access zing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts Br nterior/Exterior Wall Panels Insulation -Walls -Ceilings �l 62. Infiltration -Walls -Windows 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 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 -Connector - In Garage; Above Floor-Ducts-Mech. 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 & Receptacles 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-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-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 O Yes 82. Following Inslld./Drive 0 Yes Q No/Walks ❑ Yes �] No/Planters 0 Yes ] 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 Throughout 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 94. Address Posted 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: Insulation Certificate BUILDING OWNER: BUILDING PERMIT #: L2:10 � BUILDING LOCATION- 3117 01-e,1aget, L) • ����� Lt�. � 9 5 9Gl� Description of Installation ROOF Material Thickness (inches) CEILING Brand Name Thermal Resistance (R -Value) Bau or Blanket Type 3017 Brand Name C -e94 -ate+ Teve— Thickness rutt:hes) I2 Thermal Resistance.(R-value) IQ 3Fs' Loose Fill Type Brand Name Contractor's minimtun installed weight/ft' lb _ Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) EXTERIOR WALL Material 13m4 - Thickness (inches) RAISED FLOOR Material Thickness (inches) SLAB FLOOR Material Thickness (inches) Width (inches) FOUNDATION WALL Material Thickness ('inches) Declaration Brand Name Thermal Resistance (R -Value) 13 Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) Brand Name thermal Resistance (R -Value) I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. UO kVL Ct l q,L Geacr_il Coneractor (Builder) Q- S ignarure and Title Sub -Contractor (Insulation InstaUer) Signature and Tide License Number Date License Number Dace THIS CERTIFICATE MUST -BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THF, BUILDING. JANUARY 1993 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 MainStreet e Chico, CA - (530) 8911-27511 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of workiis completed. If you have any questions pertaining to this matter, or need additional explanation, Please contact this office immediately. 14 Date-- = REV 10/92 3-6 lnsp'e( Date-- = REV 10/92 3-6 lnsp'e( COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 r•- 6� OWNER CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 6-4f- s'r- /- ry-)2 C COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT.,OF DEVELOPMENT SERVICES 4 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Orovllle, CA • (530) 538-7541 _ CORRECTION NOTICE OWNER PERMIT NO. Y, A routine inspection indicates that the following violations of butte county Ordinances exist at the ;above address and should be corrected. Please notice this office when correction of work is completed. II you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. ,r COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES --- 411 Main Street • Chico, C4 • (530) 891-2751 7 County Center Drive • Oroville, CA • (530)`'538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If y," have any questions pertaining to this matter, or need additional explanation, please contact tfrls office immediately. �2^C L REV 10/92 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Te`lephone (530) 538-75et;p P P,1! No• (Rev. 12/96) APPLICATION AND PER,,MIT �" ASSESSOR PARCEL NUMBER 027-360-142 ZONING I BUILDING PERMIT OWNER CLI%Z, J07AIINKE -_ MARGIE TELEPHONE 534-5451 SO. FT. OCC. BUILDING VALUATION 486 R 26 244.00 . OWNER'S MAILING ADDRESS 310 MELODY LN., OROVILLE CA 95966 216 C 2288 0C "'NI iIMMN TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAIUNG ADDRESS Total Valuation Is 29,052.00 ARCHITECT OR ENGINEER UCENSE NO. Fee $ 20.00 —Filing Permit Fee $ 284.50 ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee " $ 184.95 BUILDI G DRESS 1� MELODY LN. OROVILLE Energy Plan Checking Fee $ 23.00 $ PERMIT FEE $ 512.45 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 3 7.DD 21.00 USEOFSTRUCTURE SF 10 Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 1 5.00 15.00 Each gas water heater or vent 15.0 5.00 TYPE OF WORK New ❑ Addition M Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: SF ADDITION Gas piping system 1 - 5 outlets 15.00 Building sewer 15.0015.00 Mobile Home IS I G W 920.00 PERMIT FEE S ELECTRICAL PERMIT I Fling Feel 20.00 Main Service .0A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors license 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. I 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. S. SO 3.50x, 17, 00 NOµHEOSIU MULTI.OU C 97,50 POWER APPARATUS 8 SINGLE OUTLET M. EX. OCCu OUTLET OR FIXTURES BAL O 1.00 50 Ex. Occup. OFLIT IXED RES,p.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 37.00 WORKERS' COMPENSATION DECLARATION I h reby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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. /of , te y/6 - DW QSgn8ure mf Applicant -Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating 15.00 Cooling Hood 6.50 Ventilation PERMIT FEE s50.00 Mobile Home Installation Fee $ Energy Inspection Fee 1$46.00 Occ R3 CONST. TYPE VN 1T10tAL FEE $ HAZ. D. FE I P D CDF P C HD SU This permit is hereby issued under the Butte County Code and/or indicatedabove for Zhf es have By EXPIRES ON 1 the applicable provisions Resolutions to do work been paid. Date 4Defe Receipt No. 4 -a_ -PERMIT WHITE-D.D.S.-B.D. CANARY- SESS PINK -INSPECTOR GOLDENROD•APPLICANT 13 t COUNTY Cr- BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 SAI r,o �)c 12/96) APPLICATION AND PERMIT %» Z�6 A;SES.On PARCEL NUMBER ZONINO n BUILDING PERMIT owNER f ON T J�''�s r o SO. FT. OCC. BUILDING VALUATION _ O;;;l AS MA_ IUNGO ADDRESS - '0 % C TOR'S NAME TELEPHONE C RTORS MAILING ADORE CONS TRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ (� _ ARCHRECT OR ENGINEER LICENSE NO Fling Fee 20 0^J Permit Fee _ �-$- I $ ARCHITECT OR ENGINEERS MAIUNC. AnORESS Plan Checking Fee eV4oII,c ADD KESS 3 0 �� O � .. o uta v Energy Plan Checking Fee $ •O Cj $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME Pt.NCEt MAP PLUMBING PERMIT I Filing Feel 20.00 Each Trap 7.00 L2_Od USEOFSTRUCTURE Ci.`? -Is C SF Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heaterI 23.001 Water piping t 5.00• 0 Each gas water heater or vent 15 00 �� TYPE OF WORK New ❑ Additionr(i emodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: _ Gas piping system 1- 5 outlets i 5.00 S 0 Buildingsewer 1 5.00'/S-.. OQ Mobile Home S G W I 920.00' PERMIT FEE I S /0/`00 _ ELECTRICAL PERMIT I I Filing Fee; 20.00 Main Service '.O'A oa mss � ' , 23.00!, _ - Y I G) 9 C �% 7 � V L "PERAUT FEE PAID �_ � � � , f _D n . S" CL ! SHERIFF OTMPERM!T AAk6VNT RECEMb : 3 , 3Energy�� *Race" S w TO Is � � cowvm Main Service 200A TO I000A I 46.00j NEW CONST. DW:_ 11NG OCCUR SO ✓� OR ADONS. ( 6 ACC. OLDS. ) I 3.50FT.I Ii-I)r NEW CONST.MULTI.OUTLET NON-NON@7.50i POWER APPARATUS d SINGLE GIBLET CIR. _--__ OUTLET OR FIXTURES I Oo I Ex. Occup. BA! .� .so FlXE0 APPINS. OR I I 5.001 _ EX. Occup. OUTLETS REStO. EA �— Temporary Service I 23.00! — Mobile Home Facilities 20.00! Misc. Wiring I 23.00; I FEE s /To 0 MECHANICAL PERMIT Filing Fee I 20_0_0 Heating C ! IS -_17 U S'7-0 CoolingI Hood 6.50 ! Ventilation PERMIT FEE S v 0 Mobile Home Installation Fee $ Inspection Fee $ Y(n �O C7 �T_O AL FEE $ Z. D. FEES I FL000 OF P EL i HO i 25. This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON Ta Receipt No. WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT 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: ` ASSESSOR PARCEL NUMBER 6 3L Proposed Building Use 0cU Counter Technician: C 7` ' Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. !:�T1.. Plot 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. DL3. 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! ;�JZ--5" 'Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the en ing_eer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs ................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. Fees as shown on the attached Schedule of Fees Due Sheet :..................................... 5. Statement of Intent for Non -heated and A/C Buildings .................................. . . I Moll V0 16. Sanitation and plot plan approval from the Environmental Health Department in PJZ ❑ 17. City of Chico Plumbing permit ................................................... .. .41 1.8. California Department of Forestry plan approvalA paid. Sent by: 1 Ot El"....19. Planning approval for (A) Use: O 1t (B)Parking: (C) Parcel Check: ►-j—fLS— (�2, _0 20. Contact Land Development about ❑Improvements, ❑Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits ............................. ........................ ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Lette gal O ner, ❑ Check to Ij.C.D. $ Z31. Other: &a__ en issued Telephon and ofor pickup. I have been informed of theabove litems and requirements for obt ining a building permit. CA)licant: /air ce l.Y�,c�., Da y A6' ' d 1. Index permit application for the above items numbered: _ 2. Additional items required , Contractor, designer, owner, was advised of the above data by Contractor, designer, owner, was advised of the above data by Plans reviewed by: Date: Structural reviewed by: Date: Note transfer by: Date: Plan Check Letter ❑r phone, ❑ mail, ❑ counter, by Date: ❑ phone, ❑ mail, ❑ counter, by Date: _ Plans approved by:Date: _Structural approved by: Date: Yellow: Building Division I E.H. USE ONLY 'Slot Plan AltacMd PEmas Plan Attachad :Sant t* B.D. ! TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Locati n AP# Plan Approved for: Sewage Disposal Water Supply/ Public Priv to Well Clearance for dwelling. Other IA utanL� iy-I Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist 8/96 Date COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 �1 SCHEDULE OF FEES DUE OWNER l PROPOS ED BUILDING USE 1. BUILDING PERMIT FEES Balance Due ....................... $ Additional Fees Due ................. $ Additional Fees Due .......... :...... $ Revised Plan Checking Fee .............$ 2. SCHOOL DISTRICT FEES (paid at District Office) (Available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential ...................... x $360.00 = $ Units Commercial (sq. ft.) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... -x-=$ # Units Amt. Commercial (sq. ft.) ............ -X-=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES ' (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A. P. # It -,P -7 - -2, el f.) ;Z �/ DATE 1 AG RECEIPT # DATE REC. -af 3,2 i4 At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE Z -/ K- Q9 Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been. imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00) r School District A.P. Number Property Owner. Property Location/Address Subdivision BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One (form per BuildinBuilding) 6&a 'Building Department No. Jurisdiction: = city County Residential Development No of Living Units w ` Commercial/Industrials New 3/a Lot No. .......................................................................................... Sq. Footage Mobile Home Addition/ *Supplemental to (Group R) Installation Conversion Permit # "(No foundation inspection): z,«1„„'� w. "•_. J. }.rte= a ...,y a- 1,w _ ...Sq: Footage Addftiiin 1 (Including Exterior Roofed Areas) Irioor rians reviewea oy scnooi uistnct District Identification No. 092 013 5 nett'% 1 ie,� is / � • School District certifies that S I o 1) - (Street Address) (City) has complied with the requirements of Resolution No. representing, square feet. Lrl4tO District Representative Paid by Check N Remarks: (State) .-- Date (Applicant) (Phone Number) 9�5�01 (Zip Code) /� 90 by payment of $ AB 2926 / S FULL M GATION S Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeformAs (10/98)dmm B %u. 37, T, 1$.N R4E MD13 rya Rssrt�s�,e�s Map No, a-)-74 - -- -- E_./,q�LmDY .. IV --� S I 11 /r.*rI 11! w..-,^I/7r_- :210 3i0 MMODy W 0 2OUl L4.E e49- gS966- /3P�'D�7-360-112 YIQD' _Z£ -� 4 ,g• i. �� (oo6.�a�. APPROVE? Butte County ronmental Health 3v' ..41. APPROVE? Butte County ronmental Health APPROVED Butte Cou EnvironmentalnC alth Date 9 ue OWNER BUILDER INFORiti1ATION 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: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is S300 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 abouty our obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. IINtic rely, el C. Vi Ira, C.B.O. ger, Building Inspection NOTE: This Owner -Builder Information is required by Section 198.10 of the California Health and Safety Coda . OVER OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1 I personally plan to provide the major labor and materials for construction of the proposed property ' provement : YES'�C NO 0 2 I HAVHAVE NOT 0 signed an application for a building permit for the proposed work. I have contracted with the following Person (firm) to provide the proposed construction: , NAME: AD SS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide ons of this work, but I have hired the following on to coordinate, supervise, and provide a major work: NAME: ADDRESS: PHONE:R'S LICENSE NO. 5. I will provide some of the work bCO ave con cted (hired) the following persons to provide the work indicated: NAME ADDRESS PHO Q TYPE OF WORK SIGNED: PROPERTYOWNER• i l SOCIAL SECURITY NUMBER;� e DATE: NOTE: This Owner -Builder Verification is required by Section 19831 and 19833 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER E, . COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 27 _ ?00 ^ .� J ZONING n� {i_S BUILDING PERMIT OWNER Jb" cu /i �. �3 "E / SO. FT. OCC. BUILDING VALUATION OWNERTILING ADORES L 17"N 0 IW U l L� CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace " CONSTRUCTION LENDER /( /� UNKNOWN Total Valuation $ - Filing Fee $ 20.00 LENDER'S MAILING ADDRESS - Permit Fee $ - ARCHITECT OR ENGINEER N - - ucENSE NO. Plan Checking Fee $ -Energy Plan Checking Fee $ - ARCHITECT OR ENGINEER'S MAILING ADDRESS -- - - Penalty - $ SUwINGADDRESS / lLO n PERMITFEE S PLUMBING PERMIT Filing Fee 20.00 r4D (f-/ (� Each Trap J 7.00 LOT NO. SUBDNIS IONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel„ ❑ JofGli ties ❑ Installation 13Otherx V�1 /(J •'(t` b(� ,S�Y'LIG� l�(/^� Describe Work: � — Mobile Home ISI GI W @20.00 PERMITFEE S Contractor ELECTRICAL PERMIT Filino Fee 20.00 - Main ServiceOOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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-UPCLARATION — 1 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. ❑ I -am exempt under Sec.- Business and Professions Code for this reason -WORKERS' - - -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. -❑' 1 have. and will maintain workers' -compensation insurance, as required by -Section 3700 of the Labor Code, for the performance of work for which this permit is issued: My workers' compensation insurance carrier and policy. number are: Carrier Policy Number (rhe above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' 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 5'O" deep and demolition or construction of structures over 3 stories in height. NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BUDS. ) SO. 3.50 FT. NEW CONST. MULTI.OUTLET - NON"RESIO. ( BRANCH CIRCUITS ) 97.50 WER (GPs NGLE OUTLETTUS C R. ) EX. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 SAL - FIXED APPLNS. OR Ex. Occup. ( OUTLETS (RESID.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 - PERMITFEE S Contractor : PERMIT - Filing Fee 20.00 -- 9 Heating - _ - Cooling= Hood 6.50 - Ventilation PERMITFEE -_ S ' - Contractor Mobile Home Installation Fee Is Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HA2. D. FEES IMP FLOOD I COF PARCEL 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. WHITE-O.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ry -_ COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER 0044 P. No.o`- Proposed Building Use Building Inspector 6M Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 1. All items have been submitted. �2. Plot plans, 3/4 signed by preparer of plans. 3. Complete plan 4 sets, signed by preparer of plans. 4. Engineered plan and calcs, 3/4 sets, with wet signature on plans. 5. Hazardous Material Form. 6. Energy Design Compliance and supporting documentation. 7. Statement of Intent for Non -Heated and A/C Buildings. 8. Engineered truss details and layout in duplicate (required prior to plan check). 9. Mobilehome data and manufacturer's installation instructions, 2 sets. 10. Fees of $ 11. Impact fees as shown on attached schedule. 12. California Department of Forestry plan approval/fees. 13. Flood elevation letter (100 year flood) by California Engineer. 14. Sanitation and plot plan approval Health Department. 15. City of Chico plumbing permit. 16. Plot plan and business license approval from City of Biggs/Gridley. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. 19. Driveway permit (construction approval required prior to occupancy). 20. Pre -inspection for required. 21. Contractor's license information. (No., Name Style, Classification). 22. Certificate of Workmans Compensation Insurance. 23. Owner -Builder Verification (Given to owner , Mail to owner �. 24. Recorded copy of Agricultural Acknowledgement Statement. 25. Letter of signature authorization. 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. 27. Letter of intent on building use. 28. Mobilehome utility clearance. 29. Documentation of legal access. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. 31. Existing violations/expired permits. 32. Plan check list. 33. 34. When you issue the permit,rocess as follows: Mail to ner. Mail to contractor. Telephone S and hold for pickup at !rov ° office. Deliver with inspector. Other Applicant Date EXPIRATION OF APPLICATION Applications for which a permit has not been issued, will expire by limitation 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. FEE REFUNDS Refunds can only be made upon writtten request by the person who paid the fee. The request must be made within one yearfrom the date offee payment on permits not issued, and one yearfrom the date of permit issuancefor permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan checking fees for work plan checked and other department costs are not refundable. Original - Applicant �r' 'Y/'��..ox ..n,ti.7 �^r1.-..�........--.•<...rl-�^+-F'«rt:r....•i,.n'..'_�i,-.�,�4.J••�.�F'�_r '� ..s �y,.c-,-�.� •r..f�...�.n.RJ+� 1�.r�y '� � ,-_ �- COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILE-E, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER o � P. No. 64 / �6 f ` Proposed Building Use Building Inspector 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 items have been submitted......................................... Plot plans, 3/4 signed by preparer of plans . .......................... 3. Complete plan Al sets, signed by preparer of plans. . 4. Engineered plan and calcs, 3/4 sets, with wet signature on plans . ... .......... . 5. Hazardous Material Form . ........................................... . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy)... •Pre-Inspection..req. .u_e_sT- 20. Pre -inspection for required. .. to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner ) ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . ............................. :............ 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When you issue the permit, process as follows: Mail too ner. Mail to contractor. Telephone 5, and hold for pickup at v ' JZe office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date's Plans checked by Date Plans approved by Date' Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works s PERMIT NO. 58.1-79B,P,E,M 9 PERMIT EXPIRESOA k ;,OWNER .RALD & C'ARDT, C`�$Clf'KETT 'I" CONTR. owner 4' OATON 'A -P. 27-22-117 1nderson Ln, app,3/4 mi.. E of Palermo �Honcut Hwy, Palermo I� VA ers zit :5- A clOvIeYisth d Temp. Power Pole Called PG&E emp. lec. Serv. al led PG&E Temp. Gas Serv. — Z Called PG&E JOB FINALED (Date) (2 (Signature) 443--/ 7,ec--E A)or 1A) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD ' Scratch BUILDING BUILDING (Cont'd) I PLUMBING Setback - ���5 9 Firewall Soil Pipin Interior Lath S Forms Permanent Parapets 1st Floor Final Elec. Pedestal Main Bldg. Sewer Restroom Finish '—"-`-"' 2nd Floor Support Footings Water Piping Windows 3rd Floor StemwaII Sidina To out - Slab — Roof Sheathing Water Piping '7 0f Piers �S - `7r-�' Roofing ..�(' -'y Sewer Garage Fdn. Vents Fixtures Footings Garage Vents (/ 4 Water Htr. Stemwa I I Insulation Heaters Slab Carport Footings _/ Prov. for phsicalit -- handicapped Conformance of ex, t structure Appliances Gas Piping Temp. Gas ' r /Test 2,,,,., , Slab Final Sanitation Patio I FIREPLACE Final r Footings Footing ELECTRICAL MasonryWalls Throat Rough - Reinf. Steel Final 42 -1 Fixtures - Bond Beam FIRE SP KLERS Motors -- Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole -------- Finish Ducts Underground Interior Lath S Ventilation Permanent Door Closer MOBILEHOME UTILITIES ------------------ Final Elec. Service Final Elec. Pedestal Water Piping Sewer Gas Piping E ME INSTALLATION -------------- Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS Tot LE?s lo prop✓ 1aE iri✓•S @ s RL.tGES otil Cr/�DC2S P aV17),e 5-04-17> 8t_o c -K /Au.� /4-" pd7- /LLS Gil171t(A) iZ`� dF :i)8S'. K cop "AQ4 V � 1 s (NOTE: An entry must be made on this form each time you visit the job site.) Permi t# INSULATION CERTIFICATION Anderson Number and Street ; City County z,uouivision Lot Number DESCRIPTION OF INSTALLATION ROOF Material Brand Name Thickness (inches) Thermal Resistance (R Value) EXTERIOR WALL Material:Nlber lass Brand Name ` Certainteed u Thickness (inches) 2 Thermal Resistance (R Value) 11 CEILING Batt or Blanket Type,,"' Fiberglass 'Brand Name- Certalnteed y. Thickness (inches) Thermal Resistance -(R Value)' 19 _ Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags Weight per bag Ib Area Covered Ift2► Thermal Resistance (R -Value) FLOOR, ELEVATED,' Material d � „Brand Name Thickness (inches) — Thermal Resistance (R Value). FLOOR, SLAB Material Brand Name . Thickness (inches) Thermal Resistance IR Value) Width (inches) " FOUNDATION WALL Material "Brand Name ' " g: Thickness (inches) 'j ThermaFhesistance- (H Value) HEATING SYSTEM -Gas Furnace e - ' . - - - - e Make Model Description - Rated Bonnet Capacity DECLARATION hereby certify that the above insulation was installed in the building at the above location ir, conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24.of the California Administrative Code). General Contractor (Builder) •� License Number Signature and Title Date Hawkins Insulation Co.a Inc. 215925 Sub -Contractor (Insulation Applicator) License Number Owner 23/79 Signature and Itle o Date CERTIFICATE REVIEWED BY Date BIN-029Bui ing-Inspet on Office) ��. % RES IDENT IAL ENERGY CONSERVATION STANDARDS ��- CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT Anderson Lane Oroville, California (location) BUILDING PERMIT NO. 58179BPEM A;P. NO. 27-22=117 THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge. Fdn. Walls Floors Walls (Eg rc -%,r i Ceiling/Roof Ducts Circulating Pipes APPROVED HEATER��_ APPROVED WTR. HTR. GLAZING: N) Single Glazed Special (Insulated) CERT. & LABELED WDS.�// & SLIDING DRS. WEATHERSTRIPPED DRS. AJA BACK DAMPERED FANS 4 INTERMITTENT IGNITION DE ICES CERT. APPLIANCES Al M I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH_THE ENERGY.CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. /� Insulation Applicator Name N(l,i,) jns T'lSca �(a [-,ion On, T � o-, /. (please print) Signature of Insulation Applicator h.1/hr),. State Contractors License No. 3 79'0 9 General Contractor/Owner Name G. R. & Carol. Crockett pl e se print) Signature of General Contractor/Owne��'-_2. �cZT State Contractors r J License No. THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL -BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. 4m 'o 0 -It Z/O COUNTY OF BUTTE — DEPAF TMENT OF PUBLjC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT 167/— / BUILDING Owner �,� d �' SQ. FT. OCC. BUILDING VALUATION g a2 Mailing Address y e,a, ` 8'6 e Telephone No. Contractor Mailing Address Fireplace�� Total Valuation 3f�Q Telephone No. Permit Fee �( Building Address e,a Plan Checking Fee&/or Penalty - Permit Fee / $/ 0 c .,, r, PLUMBING No. @ FEE r W ` PERMIT FILING FEE $3.00 10c-'> Al, l,IP ,,,Al Each Trap 1.50 1-3,5-0 epair drainage or vent piping 1.50 P. No. .� ,� �.� �//� _ ZarAAg & Planni Water piping 1.50 !', 5'> Each gas water heater or vent 1.50 -� Fe W. San tion Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 /, u'e_-i' EQA Parking Plans Parcel Declaration to t" ��- parcel ap 60' R/W Impr ements Each additional outlet .30 Building sewer 5.00 Bldg. Pla I Rec'd ParceLrA`pprovol Plans Approval Lawn sprinkler system 2.00 NEW R] ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ $/ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 °•0r) Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service 600v OR LESS 100 AMP LESS 5.00 Main service E4. ADD -L 100 AMP 2.50 OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L loo AMP 1.00 NEW CONST DWELINGOR ADDNS. ACCLBLDGS.0 P. �) 20sgft q CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: NON-RESID NEW CONSTR.MULTI.OUTL T BRANCH CIRCUITS) 2.50ea NEW CONSTR /POWER APPARATUS 8 NON.RESID. SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTIIRES 50L259� BAL@1 Ex. Occu FIXED APPLNS. OR P•�OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 a'I'am exempt from the Contractors License Laws of the State of California. Permit Fee $ q ,70 WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. M. -i- certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner eli so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL INo. @ FEEPERMIT FILING FEE $3.00 rj, crt) Heating J®,© Cooling 7— Ventilation Hood 2.00 0-0 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above -mentioned -property CX_ for inspection purposes. , Date Sianatu re of Pwrm�f.., Land Development Fee $ TOTAL PERMIT FEE tr 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. DIRECT PUBLIC WORKS Receipt No. j �� By Date_ —1J -7f ��� White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date z- - / 3- ?d To: Building Department From: Enviro=ental Health P.egardi:g: Sewage and/or Water and/or Addition Clearance(s) 21__24��� 014 MR LOC ION A.P. No. Plans are approved for: Sewage Disposal .-Water Supply Hold up Final for: Water Supply Final Ciearance OK for: Water Supply Clearance is for a bedroom oma'or mobile home). Other Tia addition(s).will be 061 .. w Date r COUNTY OF BUTTE —DEPARTMENT OF PU13LIC WORKS —BUILDING DIVISION 7 County Center Drive — Oroville, California 95965 — Telephone: 534-4541 OWNER (NP Y-0 Proposed Building Use d. PERMIT APPLICATION DATA SHEET / Permit fee based upon: Uomplete Contract Price Other (explain) Building In Attime of issuance: Permit No. A. P. N o. 2.7'—--• �� DPW Valuation ;pector , 0 Z �, Date ./— '� / --- -Z j permit application, I was advised the following data must be submitted prior to permit processing and/or 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14 15. 16. DATE RECEIVED APPROVED All items have been submitted................................................................... Plot plans in duplicate/triplicate............................................................... Complete plans in duplicate/triplicate................................................... Complete engineered plans and calcs..................................................... Plans with Energy Design Compliance Statement ............................ State Energy Forms No. .................... Statement of Intent for Non -Heated & AC Buildings ................... Fees of $ Letter of signature authorization............................................................. Sanitation approval from Health Dept.... Planning approval for ............. Certificate of Workmen's Compensation Insurance Contractors License Information (no., name style, classification) ............................... Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. Pre -inspection for required. Pre-inspec.request to Other bldg. -inspector (date) -,When you issue the permit, process as follows: Mail to owner Mail to contractor. Telephone S'3-3—(.155 and hold for pickup at office. Deliver w/inspection. Other �a//d iy \ 1 ��..._,�. Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by N. Plans checked t Plans approved OTHER: Copy/DPW Date Date Telephone Mail Other Date RESIDENTIAL PLAN CHECKING GU IDE w (S.F., DUPLEX, & MISC. ONLY) � Bldg. /� OWNER /�!-� ' '�' VAQ-01.. �-OL ILC-T`.r A. P. A. GEMRAL K. Zoning requirements (sideyards and parking). Valuation. - 3- Signature by R.C.E. or Architect (if required). B. PL.OT PLAN ; Af. omplete parcel size and dimensions. etbackq, sideyards, easements, etc. ---3-. Other buildings or structures. _. � '""`Grading, fills, drainage. Permit # 5%'1-7q # Z7-22:117 C FLUOR PLAN Complete to scale plan with dimensions. Required windows for light and ventilation (Sec. 1405). /• Required windows for second exit.(Sec. 1.404). Allowable glazing for energy requirements (20% max. per.State law). Human impact glass (Sec. 5406). Required room sizes, ceiling heights (Sec. 1407). /7oo" G.F:C.I.'s in baths and exterior outlets (Sec. 210-8). Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. Locations of water heater, heating & cooling equipment, other electrical or gas equipment, and plumbing fixtures. 1<- Garage firewall, door size, and closer.(Sec. 503(d)(4)). 1 - 3'0" exterior exit door (Sec. 3303d). ddl.07__Fireplace location. ., Smoke detectors (Sec. 1413). D. STRUCTURAL DETAILS o -T. Foundation plan complete enough to construct building.' .� Floor construction details complete enough to construct building. Elevations and wall'construction details complete enough to construct building. Roof construction details complete enough to construct building. .5v ' replace construction details and calcs if over one-story in height. �f'ficient data and -details to satisfy energy insulation requirements (State law). E. M.TSCELLANEOUS ITEMS TO LOOK OUT FOR 'I. CCX plywood on exposed locations and overhangs. -2-.----Stairway details (Sec. 3305). ,3v ---Guardrail details (Sec. 1716). ick or stone veneer (Chapter 30). Exterior plaster - weep screeds (Sec. 4706 & 4708). �. Proper roof pitch for roof covering (Chapter 32). er ties or bearing ridge beam. 'fV.A�SSES t� arage door or porch header sizes'. F3! Adequate bracing. 1te-.--b4ving area over garage - complete 1 -hour separation required including supporting walls and posts, etc. 11v--JTwe-(-2)' exits'on three-story dwellings (Sec. 3302). r COUNTY OF BUTTE = DEPARTMENT'OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. 95965 PHONE: 916-534-4541 G. With reference to the above subject: Attached is: Application for permit Building Plans Engr. Calcs Labor Code Information OT DATE RE: /"- yV A. P. # Mobilehome Utilities Installation Sheet Mobilehome Installation Information Shee Typical Plan Sheet List of Codes Enforced We need the following information: Permit app lication•signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractors License Law information or check exemption statement. Letter authorizing signature of Complete plans in including plot plans. Plot plans in Structural details in Complete plans in prepared by registered civil engineer or architect. Engr. calcs. sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 695 Oleander Ave.,.Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, ` Oroville, for Copy of recorded parcel declaration. Recorded copy of deed- showing 754 OTHER a�/Nl _7 6�7.Q Should you have any questions concerning the above, please contact this office. Yours very truly, Clay Castleberry Director of P,ubli Works Glan er JFG:dd Chief Building Inspector RES IDENT IAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INST ED CONFORMANCE( WITH CURRENT ENERGY CONSERVATION REGULATIONS AT.`C� ��-a�1, !� cin __S location BUILDING PERMIT .NO.C-1 1.. 0 M A -;P. NO.99 r THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION• Slab Edge Fdn. Walls Floors - Walls Ceiling/Roof Ducts ✓ Circulating lJff APPROVED HEATER t/ APPROVED WTR.HTR. GLAZING: Single Glazed Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. WEATHERSTRIPPED DRS.` BACK DAMPERED FANS INTERMITTENT IGNITION DEVICES CERT. APPLIANCES ✓ I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO, THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator NameiT�`1��1��n� Signature of (please print) Insulation Applicator State Contractors General Contractor/Owner Nam, Signature of General Contractor/c ease print). ecCkc•��� Date State Contract License No. n THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. PARCEL SPLIT WORK SHEET Comb.M Bound. Rev.l New Parcel Maint. Code 119 Retire 901 Delete etals Parcel Number 0 7 / - 7 7 - `) _, / -,, �- " r 001 Status Code YC 002 Code Area > ? _ ` I Page Change0 Code Area Split Q Date ' Mapper �. J 003 Assessed Owner c.� r r '-, - , /,J A •' CB 004 c% Owner 005 Street Address 006 City and State 007 Zip Code 008 Property Location r'1 �/• :'. %�' �" i ���. fir �. �_ 023 Book & Page Recorded Date Y ! Maint. Code Code Owner Maint. Code e t a 1 n a m e Maint. Code Fractional Interest Tax $ Deed of Trust First Second Benf. Benf. SEE OTHER SIDE FOR ADDITIONAL INSTRUCTIONS COPY — PUBLIC WORKS AGRICULTURAL BUILDING Exemption from Permits , owner of the property located at ,/ (please print) S�S �"e ✓�� ��Li , of— I'nnalovwelAnml-7� J, z44 Assessor Parcel # 7 ' a "' Z-L;� , intend to construct an agricultural building on this property that is not subject to permits. Agricultural building is defined as follows: Agricultural building is a - structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place i of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. I understand that if I change the use or occupancy of this building in the future, that I will be subject to the necessary permits, inspections, and approvals from the.Butte County Building Department. Signature of Property Owner Date Py ,a- it 11 ! j i. L. I I I ! �' lb • I .. I .I .. I t f i .I A i , .I � .; i ,i fA- 7 T 7. - Jt - b t G) r7 co � i II1(I' t � I�I �i_ --I---..i._....;.. l.. _._..f. .....�.. j.. I.: i .I... .. ..!.. - ... ... .. I ! I I 1 ! 1 ! .. ! - �----! i I L. j i 1 1 1 I I Zt- I 1 I.. II;i�I !►li IlliI I I i. i L L.. 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