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Home My WebLink About028-020-057-57 28-02-57 �� ° y 9° Lee S. Cash NIS Cent 1 Ho a Rd p :of Lo' vill Pe 2- B,E(new p v te- garage -2-8-02-57 TE �OIR RICHARDNTEESDALE NIS Centra" l House Rd, z mi E of Lone Tree Rd;�Oroville Permit##710-81,p il, 0 ELECTRIC 4-8-81 2'00A 100A- ,qAS 4-8-81 fi SUPPORT STRUCTUREfREf� 11 RE COMPACTION TEST Q O I » 28-02-57 M Permi-'529-81MHI ISS: ed�-ate-8�� 028=020-057 01-2393 TEESDALE ARD 739 CENT' _ L OROVI L CHANGE PANELS CC 1 r PERMIT NO.A. ?y PERMIT EXPIRES-T,I OWNER RICHARD TEESDALE CONTR. owner ASSESSOR PARCEL 2R—n2-57 LOCATION NIS Central House Rd, mi E 'T,nna Tref RA, Orn vi 1 1 P ,s } ;j i f Temp. Power Pole Called PG&E �7 / Temp. Elec. Service Called PG&E eplasa Ser ce r Cal led PG&E JOB FINALED (Date) Signature J = OK O = Not OK =•NotA-pplicable MOBILEHOMES = Not Ready 11 MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except Ws oning Requirements—Setbacks—Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements V-11soils; Special MH Support—Sketch ; 2. Footings; Size—Depth—Spacing—Connectors '3_-S�ewer; Location—Test—Fall-C/O—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 6/Wa r; Location—Test—Easement Needed (Sketch) t ( 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing lectricity; Location—Clearances—Grnd.—/7,001 Amp—Concrete 3 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures - — .Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft. "LPG ; 6. Carports; Windows—Doors Utility Clearance 7. Elec. s ^ Card-BIVA Date �' Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBI HOME INSTALLATION (P OK except q's Date POOLS (Plans) OK except q's ' Zoning Requirements—Setbacks—Easements 1. Setbacks—Easements Owings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability Ga MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining ricity; MH Test—Crossovers—Breakers—Clearances 4• Elec.; Receptacles and Lighting; Distances—GFI rat ; MH Test—Fall—Flex Connector. i 5. Elec.; Pool Lighting; 15 volts—GFI 6 a r; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7 ater and Sewer Connected—C/O to Grade—HD Approval ) 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Ele city Tagged ;. 8, Elec.; Grounding; Equip, w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. e+vfCs; Insp.—Sketch 10. Cert. of Occupancy + i 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date ;Card -BI Date Card -BI Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number -'�!� "� � for the following location: /�<v.a.'--1-'fi�.��.•Jz Owner 41 -7—y, �f��/• Owner's -Address Mobilehome Mfg. A;191"6-eK'1.� L-0 7- -Model Year Insignia No. 2-/� q 4 -2,3 Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director,of Public Works Date l .� —� gy •moi c _ �.� - THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE' DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-1241 , Ext. 70 7 County Center Drive. Oroville — Phone 5;94-4541 Skyvvay anis Elliott Road, Paradise — Phone 877-3435 CC")RRECT8®N NOTICE a LDING OR PROPERTY ADDRESS A routine inspection indicates that the following violalions+ of County Ordinande ' exist al the aboGe address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this malter, or need additional explanation, please contact this office immediately. C 5 f ��ids l_r,i..._L { �� 7 _ ham.—:Tr � t . AV 1�r LO I(Is pecco _ _ ___-- Date/ s` ' • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N V r 7 County Center Drive - Oroville, California 959ES - Telephone 916/534 41 9 �� APPLICATION AND PERMIT AA ASS SSOR PAIRCEL NUMBER ZONING mt�,� 1-/� BUILDING PERMI o N TELEPHONE S' SQ. FT. OCC. BUILDING VALUATION OWNE'R'S MAILING ADDRESS ' CNTR CTOR•S NA TELEPHONE ow CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee Permit Fee $ 10.00 $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee e� Penalty ,$' $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 0 BUILDI G DDR PLUMBING PERMIT Filing Fee 10.00 — Each Trap Repair drainage or vent piping 2.00 5.00 rb Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 _ Gas piping system 1 - 5 outlets USE OF STRUCTURE Building sewer Lawn sprinkler system 5.00 SF ❑ Duplex[] Mobilehome /Other SPECIFY TYPE OF WORK New❑ Addition ❑ Remodel Utilities ❑ I tallationIP Other ❑ Permit Fee $ Contractor Describe work: ELECTRICAL PERMIT Filing Fee 0 0. 00 _ Main service 800V OR LESS 100 AMP OR LESS 5.00 j -7X _ X (ej Main service EA_ ADD•L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.y) OR ADDNS. ACC. SLOGS. p¢ sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification NE w CONSTR TI-ou LET 2.50 ea NON-RESID BRANCH CIRCUITS) NEW CONSTR / POWER APPARATUS 6� NON-RESID. %SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES a �@1 FIXED APPLNS, OR Ex. OCcup.�pUTLETS (RESID.) EA. 2.00 Temporary service 10.00 I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered Mobile Home Facilities 15.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Misc. Wiring 7.50 Permit Fee $ ❑ I am exempt under Sec. , Business and Professions Code Contractor for this reason MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE Heating I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject Cooling Hood 3.00 Ventilation to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such Permit Fee $ Contractor provisions or this permit shall be deemed revoked. I certify that I have read this application and state that the above information Mobile Home Installation Fee $ ® . is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue OCCUP. GROUP I TYPE OF CONST. I PARCEL PD HD Issu agairj,st said County c equence of t e granting of this permit. This permit is hereby issued under the applicable provi- Bions of the Butte County Code and/or resolutions to do X v Ll Date � �j� Signature of Applicant = Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. work indicated above for which DIRECTOR OF BLIC < Q By e PERMIT EXPIRES Date fees' have been paid. WORKS `. Date �q(� / Receipt No. `A -776th WHITE-D.P.W.• YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY. DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. , PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1.. Owner's name: Qefs �� e 2. Installer's name: 41-7 C-1- 3. Is the site currently under permit? Yes 1).C/ No (If yes, furnish permit number lid ( ) OR Is the -site an existing site? -Yes No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of. all setbacks•and easements?sYes /�/ No (If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- ,--,QL-� /b 0 Amps 6. What is the mobilehome site service rating? ---------------------- :100_ Amps 7.. What is the mobilehome site circuit breaker rating? ------------- /Q(), Amps 8. Is there any other electric load to be served by the mobilehome siteservice? ----------------------------------------------------- Yes No TO (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of gas service? -------------------------=-=- Natural,/ / LPG / 11. What is the gas pipe length from meter or tank to th mo leh a?� 6 (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas . or less than 50 ft. on LPG.) MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. )&JC4 47,c_ furnish Setup Model No. Year Widt(ft.) Box Length V /O (ft.) Tagalong or Expando Size % ft. x 12— ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. - Footings (check one) l�.J (ft.)\(in:) Center support locations (ft.)(in.) I I (ft.)(in.) (ft.XiA-) (ft/.)) (in.) (in.) (in.) Center Supp rt footing si es (in.) x (ili.) (in.) Single *If center piers are other than drawn above, draw in. -locations, spacing,. and dimensions. ® 1. Wood either pressure treated or foundation grade. p 2. Other: (specify) Supports (check one). 1: Concrete block. LJ F-1-2. Other. (specify) n 4 --Tagalong or Expando,' show support details. ?0 -- Typical Support (in.) (in.) Footing Size (ft.)(in.) (ft.)(in.) -- Max. Pier Spacing -- Max. Overhang 5Z9_91 BUTTE COIk1T1' BJtLDING DEPARTMENT APPROVED Z/v COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT O. WU 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-454/O•— / APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER -OZ S ZONI G r s' BUILDING PERM% OWNER /ChW )eID TCESDfq L& TE EPHONE 846_531/ SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ApD�RIE33 GAO v�� CA fs 9k (/j CONTRACTOR'S NAMEE/f/ /, //( TELEPHONE CONTRACTOR'S MAILING ADDRESS } Fireplace CONSTRUCTION LENDS UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGIN LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ eu�p s ADDRESSJ� PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Q�Qu�LL� Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each gas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeQ--'Other SPECIFY Building sewer Lawn sprinkler system TPOO TYPE OF WORK ,�/ New ❑ Addition ❑ Remod `❑ Utilities L� Installation❑ Other ❑ Describe work: ��S Permit Fee $ Zp,o,6 Contractor ELECTRICAL PERMIT Filing Fee 10.00 001 OR Main service 100 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2-.50 NEW CONST'( DWELLING OCCUP.y) OR ADDNS. \ ACC. BLDGS. 20 sq ft CONTRACTORS LICENSE LAWNEW I declare under penalty of perjury (check one): F-1NON-RESID. I am licensed under provisions of Chapt. 9, Div. 3 of the Business50@zg¢ and Professions Code and my license is in full force and effect. No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason CONSTR I.Ou LET 2.SOea N.N-RESID BRANCH CIRC TS NEW CONSTR I POWER APPARATUS 6 %SINGLE OUTLET CIR. Ex. OCCUp OUTLETS OR FIXTURES BAL@100 Ex. Occup.(APP FIXEDLicense P(RESID )LNS.REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 SOU Misc. Wiring 7.50 Permit Fee $ ZS. 00 Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 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 for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs and expenses which may in any way accrue against aid C t1'nty in conk�ce of the gran Ing of this permit. . X %C� c �Date Signature of Applicant — Owner ❑ Contractor ❑ AgeneD An OSHA permit is re wired for excavations over 5'0" deep and demolition or construct- ion -of structures over stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $_O0 occuP. GROUP ��— I TYPE OF CONST.PARCEL (/ Al PD HD IssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE TOq OF P LIC By. PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS / Date Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT This set of plans and specifications Mi1ST'+e kept on the job at all times, and '+.t is unlawf"1 fo make any changes or oltera+ions on same without written permission from the Department of Public Works, County of Butte. A pe; mlt will ergmobileh installation of the NOTE.—All Materials & Workmanship Shrill Be" in', Accordance with Recognised Good Practices and of a quality prescribed for the Specified use in the Uniform Building, Plumbing & Machanical Codes and the National Electrical Cod is shall be within ehome, either ir within the rear ide (left) of the 1 �r__; lei shDP A setback of 5 ft. from the property lines and'a setback of 50ft. from t be° ear �of centerline shall structures or equipment except for a 2 ft. eave overhang. 'BUTTE .COUNTY BUILDING DE?AMAFNT .APPROVED- h A setback of 5 ft. from the property lines and'a setback of 50ft. from t be° ear �of centerline shall structures or equipment except for a 2 ft. eave overhang. 'BUTTE .COUNTY BUILDING DE?AMAFNT .APPROVED- e"d,v of Jquw OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: Lee S. Cash ADDRESS: P.O: Box .1857 Ma 'll CA 95901 CITY & STATE: rysvi e, IMPORTANT: DATE OF CLAIM, Aug. 9, 1977 SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Decided not to build. (Permit Appin. #2602777B,E - Receipt #161927 - AP 28rO2-57) Building permit fee ------ $52.00 �fee - Retain 113 ot --- 17.33 Amount.of refund, due ------------ $34.67 - Electrical permit.fee --- $49.05 Retain i i.ng. fee--- ---- Amount, of refund due -------- TOTAL REFUND DUE ---------------- $80.72 $80.72 I TOTAL $80 72 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this 8thday of Aug77 Oroville .................................. ............................ 19....... at................................. Calif..................................................................................... Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriationa•or Specific Board Approval (Checkone) for the same. Aug.7 Oroville Dated this .........9ttl............................. ....... day of 19....... at .............................. . Calif..................................................................................... Department Head or Authorized Deputy Dept. Exp. Code ............................................ Code ................................................PAYABLE FROM.......................................................................................... FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY VENDOR CODE DEPT. & SUB. PROD• SUB. _ 0BJ. CLAIM NO. INVOICE NO. INVOICE DATE DISC. GROSS AMOUNT ENCUMB. SUB -DIST. INSTRUCTIONS -10 -CLAIMANTS, All claims against the county must be itemized, giving dates and character of service rendered or 'work performed, quantities, de-'• scription and unit prices of article6' furnished or .delivered. Claims must be ceriified by the ctaimant. and -submitted to the De- partment head for approval. Upon approval the Department head will forward claim to County Auditor for payment procedure. Do not file with the County Auditor first. Claims should be presented to off:: ials for approval immediately upon completion of services requested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's office before preceeding Wednesday noon. Compliance with above will expedite payment of claim, failure to do so may delay payment considerably. 1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County center Drive — Oroville, California 95965 ' Telephone: 534-4541 APPLICATI6N AND PERMIT 77 X — EERY ( A Date S 7-77 Signature of Permitee �Ag Receipt No. / . 9;9 White-D.P.W. — Yellow-Assessorf— Pink -Inspector — Goldenrod -Applicant the Isuiie county Uode and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Building permit expires Date Date BUILDING Owner S_ SQ. FT. OCC. BUILDING VALUATION Mailing Address �?v.jyox elephone No. Fireplace Contractor Total Valuation 2(y d Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee $ 2 Building Address S 2 14. lkrl� -e PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 397-1 JQAVI 1 _ Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No., 2 .2 ` Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fee W. . Sa on Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declar on Parcel Ma P 5Z 60' R/W 1P Im rovements Lawn sprinkler system 2.00 Bldg. Plans Recd Par pproval Plans Approval Permit Fee ,$ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEEPERMIT FILING FEE $3.00 Main service 600V OR 100 AMP ORLESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others. Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD -L 100 AMP 1.00 ,. NEW CONST. DWELLING O OR ADDNS. ( ACC. BLOGS- Q 21tsgft NEW CONSTR MULTI-OUTLET BRANCH CIRCUI SJ 2.50ea .JS) NEW CONSTPOWER APPARATUS &) NON- R. RESID. (SINGLE OUTLET CIR. 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: Ex. Occup(OUTLETS OR FIXTURES) BAL@�1 Ex. Occu P -( FIXED APPLNS. OR OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ D S WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this ri permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentinn P.rt nrnn Prty fnr ineno Linn ni imnccc TOTAL. PERMIT FEE I$ 0� This permit is hereby issued under the applicable provisions of X — EERY ( A Date S 7-77 Signature of Permitee �Ag Receipt No. / . 9;9 White-D.P.W. — Yellow-Assessorf— Pink -Inspector — Goldenrod -Applicant the Isuiie county Uode and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Building permit expires Date Date PERMIT AtPLICATION WORK SHEET OWNER A 4e -.e_ Zoning_ Use Proposed Permit fee based upon: - 1. Complete contract price. 2. Partial contract price (eXVlain) 3. DPW Valuation (show): -� Permit No A.P. No. 29 ^62- Approved Not approved At time of permit application, the applicant was advised the following data or information must be submitted prior to permit processing and/or issuance: By Date Received 1. . All items have been submitted. ------------------------------ 2. Plot plans in duplicate/triplicate.------------------------- 3. Complete plans in duplicate/triplicate.--------------------- Complete engineered plans and calcs. Fees of $ ------------------------ . Letter of signature authorization. -------------------------- 7. Sanitation approval. ---------- =----------------------------- 8. Planning approval for -- 9. Workmen's Compensation Insurance Certificate. _______________ 10. Contractors license information. ____________________________ 11. Parcel declaration, recorded copy. -------------------------- 12. Access declaration. _________________________________________ 13. Aunt Minnie information. ------------------------------------ 14. Deed of access, recorded copy. ----------------- ------------- 15. Deed of parcel creation, recorded copy. --------------------- 16. Parcel map, recording data. --------------------------------- 17. Pre -inspection request for 18. Improvements - plans required & DPW approval. --------------- 19. Other Bldg. Inspector During plan checking process, the following data or information must be submitted prior to permit issuance: 1. Index permit for items above and in addition the - ollowing: Date 5-22- r� Before permit issuance, all of the following items must be signed or marked NA: 1. Zoning use 2. Legal parcel 3. Envir. Health Plans Sent A. Sanitation 4. 2. Applicant advised by Telephone Mail _-*----Ot r c0q,,tier Y- 3. Plans checked by Date014'-79 5. 4. Plans approved by Date When pe t is issued, process as follows: i' 1. Mail to owner. 2. Mail to contractor., 3. Deliver with inspection. 4. Telephone and hold for pickup. 5. Other 1.2 B. Restaurant C. Other Public Works Plans Sent A. Street Imp. B. Drainage C. Permits & Fees D. Other Planning A. Use Permit B. Variance C. Other Other Agencies Plans Sent A. Fire Dept. B. Other 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 8 - OZO, --Ds 7 ZONING - BUILDING PERMIT OWNER TELEPHONE _ 094 6' r SQ, FT. OCC. BUILDING VALUATION .94 OWNER'S MAILING ADDRESS 7� 5 Cesv f/1 D I& CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNIwOWN Total Valuation $ LENDER'S MAILING ADDRESS Fling Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS 4 051 Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS /(% /r 72 PERMIT FEE $ PLUMBING PERMIT Fling Fee 20.00 Each Trap 1 7.00 Solar or heat pump water heater1 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SFO Duplex O Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New ElAddition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main ServiceBOOV OR LESS ( 200A OR LESS ) 23.00 �O Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( d ACC. BLOS. ) SO. 3.5C FT. CONTRACTORS LICENSE LAW declare under penalty of perjury (check one) ❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON RESID. ( BRANCH CIRCUITS ) @7.50 ( POW ER APPARATUS ) 8 SINGLE OUTLET CHR. Ex. Occup. ( OUTLET OR FIXTURES ) 2001.00 BAL. .50 Ex. Occup.FIXED APPLNS. OR ( OUTLETS IRESID.I EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 e .OD WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ ConSractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT.FEE $ Contractor certify that I have read this application and state that the above information is correct. agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONSr. TrIE TOTAL FEE $ HAZ- 0. FEES I IMP FLOOD I COF PARCEL PD Ho 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. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES ON (Dere/ Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 731 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 73 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER D 1-� (' O� O Q O( j' VC— ZONING BUILDING PERMIT OWNER %� TELEPHONE B� �- 5,3 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDR SS 5 AJ - e CONTRACTOR'S NAME N TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 3AJPERMIT vU E FEE $ 72S 09VU/l E PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE ,� �r SFf Duplex ❑ Mobilehome ❑ Other \ SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ClUtilities ❑ Installation ❑ Other ❑ Describe Work: PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service` OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( 6 ACC. BLOS. ) So. 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O I, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON -REBID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS 1 6 SINGLE OUTLET CIR. / Ex. Occup. ( OUTLET OR FIXTURES ) BAL. 2 . @ 100 Ex. Occup.FIXED APPLNS. OR ( OUTLETS IRESIO.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S 3 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ �l Do HAZ. 1 D. FEES I IMP I FLOOD I CDF I PARCEL PO I HO I 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. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES ON lDetel Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT /�L0 -- 0£Z - L Z 0 CLAIMAN' ADDRESS CITY & S1 COUNTY OF BUTTE Oroville, California GENERAL CLAIM DATE OF CLAIM: Jb - �X- O/ SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERV/CES IMPORTANT.• SEE INSTRUCTIONS ON REVERSE SIDE DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT OWNER DECIDED NOT TO BUILD: AP# 028-020-057, BP# 01-2393, RECEIPT# 3322Z9, OWNER: RICHARD TEESDALE DATED: 9.21-:0 TOTAL AMOUNT PAID: N REFUND PROCESSING FEE: 8920 99 00 EErAINELECTRICAL PERMIT FILING FEE: 20 00 AMOUNT RETAINED: 45.00 TOTAL AMOUNT TO REFUND: 44.00 TOTALI 4 44.00- 00the theundersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as st ted. , 1 Gated this a`ZJ� �ay of , 19at ✓ Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or c s specified abov e n performed or delivered and that there is a Budget Appropriation I I or Specific Board Approval ( I (Check one) r Dated this 8 day of OCT , 19 01, at OROVILLE , Calif. D artment Head or Authorized Deputy Dept. Code 440-002Exp. Code 4210500 PAYABLE F OM RUTi,DTNG Dept. Code Exp. Code PAYABLE FROM Dept Code Exp. Code PAYABLE FROM DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY PFRMTTS FUND FUNC FUN DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. REFUND CLAIM APPLICATION g1l c ' 'JCLAIMANT S NAMEVG �� MAILING ADDRESS ASSESSOR PARCEL #: RECEIPT NUMBER(S) Request a refund of fees paid on the above receipt number(s) for the following reasons: i Please refund any applicable fees in the following categories: (Check those. categories which you wish to have. refunded.) ` (Vf Building Permit Fees ( ) SRA Fees (CDF Fire Planning) Disposition of Plans: ( ) Plans returned to me at counter ( ) Sheriff Fees • ( ) Urban Area Fees '.4 ( ) Please mail plans to me at above address. (VrPlease. dispose of plans. SIGNATURE r • • J Z DATE l ` PLEASE DATE AND SIGN THE ATTACHED COUNTY OF BUTTE GENERAL CLAIM FORM. DO NOT COMPLETE ANY OTHER INFORMATION ON THAT FORM!,,' FOR BUILDING DIVISION USE: Receipt Information: G Number:. 3 1 Date: Issued To: Amount: Fees Retained: t/ g Processin Fee: $ Q 5, I Bldg Filing Fee: $ PPl�lbg Filing Fee: $ ✓Elec Filing Fee: $� Mech Filing Fee Energy PIC Fee: Plan Check Fee Inspection Fee: Pjre SRA Fee: Total Amount Retained TOTAL REFUND DUE COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Orovilie, CaliYornia 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 01-2393 ASSESSORPARkEf�MO-057 UL UG ZONI t15 BUILDING PERMIT OWNER RICHARD TEESDALE TELEPHONE 846-5361 SO. FT. OCC. BUILDING VALUATION . OWNERS MMUNG ADDRESS 725 CENTRAL HOUSE RD, OROVILLE 95965 CONTRACTOR'S NAME OWNER 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 Plan Checking Fee $ BUILDING ADDRESS 739 CENTRAL HOUSE RD OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome IN Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities XJ Installation ❑ Other ❑ Describe Work: C ANCE TWO 200 AMP MIN SERVICE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A OR LESS 23.00 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 DECLARATION I hereby affirm under penalty of perjury that 1 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 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 9 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 foowith comply with th provisio s. X+ Date Q �/ _ SigTiature of Applicant - Owner ❑ Contractor ❑ Ag nt An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELUNG OCCUR OR ADDNS. ( ; ACC, BLnS. SO 3.5QFT: NO CONST. OUTLETTS @7.50 FSINGLOwERE OUTLET APPARATUS CR. 8 OUTLET OR FUTURES 20 @ 1.0O Ex. Occu BAL @ ,50 Ex. Occup..GF»L„T AFLsin.) A. 5.00 Temporary Service 23.00 Mobile Home'Facilities 20.00 Misc. Wiring 23.00 23.00 PRE INSPECTION PERMIT FEE : $9.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI: $ Mobile Home Installation Fee Is Energy Inspection Fee Is Occ CONST. TYPE TOTAL FEE $ $9.00 HAZ, I D. FEES IMP I FLOOD I CDF PARCEL I PD I 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. By Date PERMIT EXPIRES ON ate Receipt No. IN 332249/$89.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �I ��,.'`.� -«q 1`q'i`Ty! �S►„"�.rs�7'i`G,,�+�TwnK.'u�."`"�Y9�'r�'IiY+ji'v"-L:tVh.:""j.,rr'K'+1YY'^r'�"'�..i'�'e.^M1^"'er'I^'7�.r�.v-r-.'�1i�4.w*ryN't5..+'sr-v,,, COUNTY OF BUTTE - DEPARTMENToOF'DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER:V6mdASSESSOR PARCEL NUMBER: t(/ _ Proposed Building Use:2W Building Inspector: Date: At time of permit app cation, f was ad ' ed the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted .-----------------------------=------------------------------------------------------ ❑2. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. 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! ------------------ 06. Energy'Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. 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 ------------------- El10. Fees of $ ------------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule.----------------------------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees. --------------------------------------------------------- ❑ 13. Flood elevation certificate.---------------------------------------------------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit. --------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. --- 1117. -- ❑17. Planning approval for (A) Use:\ (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑,19. Encroachment Permit for driveway (cons ct'on approval prior to occu��jj cy). ---------------------------- v 20. Pre -inspection for 0 required Request 4kgbspector on 112 1. Contractor's license information. umber, Name Style, Classification). ------------------------------------ ❑22. Workers' Compensation carrier and policy number. e24 . Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). . Letter of signature authorization. ------------------------------------------ ❑25. Recorded copy of Agricultural'Acknowledgment Statement. ----------- 026. Letter of intent on building use "---------------------------------- ❑27. Manufactured Home utility clearance. -------------------------- ❑ 28. Existing violations and/or expired permits. --------------------- 029. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ 1130. Other: (Date) When you issue the t, p ocess%as follows ❑ Mail to owner,�Vlr ontractor. Telephone '7 ( / and hold for pickup at office. ❑ Deliver ith ins ector. Applicant:(IL O Date: / Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, 0 Fire Department, ❑ Other: 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 ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division 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: VAl-, Onno _ llA„o.+...o.,r.,fTlo..ol.......o..♦ ca.....,.,.., n..:u:__r�:_._____ 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. 01- I personally plan to provide the major labor and materials for construction of the proposed property imprpvement : YES NO 0 2. I HAVE 0` HAVE NOT ❑ signed an application for a building permit for the proposed work. have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: DO A PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide - the work indicated: NAME ADDRESS PHONE TYPE OF WORK SI PROPERTYOWNER: NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER OWNER BUILDER INFORMATION Dear Property Owner: i 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 yoirself 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 $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95.814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. I+Mage'rC,2uii1diirng Va, C.B.O. Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7, County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 �ev.t2/98j APPLICATIOW AND PERMIT a�-� PERMIT NO. A. �essoll PAA(.•d w.eeT OWN" BUILDINC.i PERMIT JOCC. owNeT� Ao ,-� S0. FT. BUILDING VALUATION WY OONTMGTOWS Tei.S110NC OONTIU610 , "'"o11478 OONe T111,00" Lzmel 1AND61•e WI AWARM Fireplace AACNrKCT 001 eNOFNM e No. Total Valuation s Filin Fee s 20.00 �E� 0" 06011140711�� A00011122 Permit Fee _ s srnc.aADoacas Plan Checkin Fee s 1. nergy Plan Checking Fee s s °T NO• s'e°Ns°r,swwe PAAca MAP PERMIT FEE S BING PER FUng Fee 20.00 USEOPSTRUCTURE Each Tr 7.00 >F O Duplex O Mobilshome O Other Sola' um w ter heater 23.00 suet Water i i 15.00 TYPE OF WORK Each as wn h or event 15.00 Waw O Addition O smodel O UY4 ies q Instalntion O Other O Gas 1 in stem - 5 outlets 15.00 Buildin sewer 15.00 describe Work Mobile Home G W 020.00 PERMIT FEE S ELECTRICAL PERMIT _ELtq Fee 20.00 - - — --- Main Service IOOOV OR II 200A On ;;; 23.00 Main Service 200A TO 1000A 46.00 CONS ADON2.TDWHLlA! OOCUP. 80.a Act. eine. 3.50rT. O ND FSIO. MULTFOtJT1.ET Q7.50 J 1�// rowfa APPI t ! O CtR EX. Oc ot/TtET OR fDR1AlEY .� 1 eA� .so Ex. Occu 5.00 em orar rvice 23 00 bile Home cilities 2000 -- _1Nirin _ 23.00 *PER�IAIT' P/ap MECHANICAL P MIT Fling Fso 20.00 SRA - - Heatin t amCoolie SHERIFF Hood 6.50 OTHER ventilation PERMIT FEIr s Mobile Home Installation Fes s Energy Inspection Fee i 0I C►6T TYPE T AMOUNT RECEZVEb �� I NAZ OTAL FEE SD. Ra MAP I FT This permit is hereby Issued under the appkable pro f 'ons Of the Butts County Code and/or Resolutions to do work *R " "ER Indicated above for which fees have been paid. * TO BE PVT INTO comm TER By Date PERMIT EXPIRES ON COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive a Orovillb, California 95965 • Telephone (530) 538.7541 APPLICATION AND PERMIT PERMIT NO. AeesswrlrAilednlil� r - 'DMNO -C� BUILDING PERMIT aw1�r♦ - F / Q SO. FT, OCC. � dim 4 i,�1 _ l BUILDING VAlUAT10N o0Wft&cTorrs �..� . •ver. w1w �iJft01 LANDC 11 WANG Z -0—A euaoslo AOoilps LOT NO. I $uaoaUM ww! USEOFSTRUCTuRE 5F O Duplex O Mobllehome O Other TYPE OF WORK *PERT FEE PAID SRA SHERIFF $ OTHER MOUNT RECEIVEb *RECEI" NUM IER * TO 9E PVT INTO COMPV M rue iece Total Valuatlon S Permit Fee Plan Checkino Fee Energy Plan Checking Fee PERMIT SING PERMIT Each T�pn Soler or heel pump water Water piping Each As water heater or Gas piping system 1 .5 a Building sows Mobile Home SIG V Main Service Mein Service OR A00M. NOr+r10i0. EX. Occup, ! EX. Occup, 1 1 i emPlOr4rY Service i bile Home Facilities PERMIT FEE I tl 2ERMIT sow oft use MMA ON urea 20oA TO 1000A a AOC. exits. MU�TLOVTxlT /OYMOI AF'►AMTxle t eNOIF atm w .a- i OVTtET Oil FUTma 1 Heatin MIT 20.00 20.00 7.00 23.00 15.00 15.00 15.00 15.00 W20 60 19 Fee 20.00 23.00 46.00 3.Str�T. 97.50 5.00 23.00 20.00 23.00 95 I e 20.00 8.50 IPERMIT FEI2 S Mobile Home Installation Fee i LEnergy Inspection Fee i e ooNCT. TriTOTAL FEE _ IML O. Ftes W► "W .AAcd Fo 10 ",4 s permit is hereby Issued under the applicable provhions Of the Butts County Code and/or Resolutions to do work Indicated above for which fees have been paid. I By Date PERMIT EXPIRES ON