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029-250-011
qPW s A [ A*, -AP 29-25-11 (Linda Thengvall SE corner of 4th St. & Lmndale Ave., Richvale Q contra Huggitt Elec., Chi Permit# 1813-75E( add light S AP 29-25-11 CONTR: Huggitt Elec., Oroville"'t�� Permit 1962-75E (s) - (for 1813-75) . .. s _ _ I _ AP _29-25=1 s DENNIS THENGVALL- t SE corwr 'Lindale & 4th St. , R,i/%vale j contr: T. Bragdon, Chic, G�� I Permit}_32.56 7,5B(deck_a �it.ion.,_coverea 1 wak way -trellis) 29-25-11 P� Eontr: Context us Corp, Chico'4 0 ���� Permit#962-81P(solar hot water sT#Af 29-25-11 Permit 201-81B(remodel/SF) �n�l �191Y� 029-250-011 01-0758 THENGVALL, DENISE & LESLIE 5296 CHURCH ST. RICHVVALL,E CONT: MCCLELLAN HVAC 029-250-011 01-1595 THENGUALL, DENNIS ' 5296 CHURCH ST. RICHVALE CONT: D & T ELECTRIC NEW ELEC SERV 029-250-011 04-1194 THENGVALL,,DENNIS 5296 CHURCH ST, RIC ALE Cont: OWNER REMODEL/ADD' 'BREEZEWAY LAND DEVELOPMENT SHEET ENCLOSED U B06-2491 029-250-011 MISCELLANEOUS Window/Glass Door; RETRO FIT 6 WINDOWS, STUCCO (1 f 5296 CHURCH S'T�u;, q -1Z'6 -07 THENGVALL, DENNIS E & LESLIE D ' E3o-c noo s a-nn�� CN C"l CN L�o COUNTY''OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County,Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT �jPERMIT NO. / ASSESSOR PARCEL NUMBER 91 ,�,-2- ,e) ZONING !� BUILDING PERMIT OWNER - A TELEPHONE SQ, FT. OCC. BUILDING VALUATION OWNER'S MAILING AJDDRESS AL CO NT R -AC- 'S NAME- TELEPHON ,E 7 'CONTRACTOR'S MAILING ADDRESS ' Fireplace C ONSTRUCTIO LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER f LICENSE No. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 �(l G/i Water piping LOT NO. I SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF E'J Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 ` of 1 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Instal lati Other G Describe work: QdJf.[���� �,/�+�`l to Ifni � C� :.y��..G�. OIl- — t'V{ a Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 0v OR LESS 10 100 AMP OR LESS 5.00 Main service EA. ADO'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.5i OR ADDNS. ACC. BLDGS. 2�sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. %� License No. 2QGG 26 Classification _f"i F . F11, 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 NEW CONSTR I.Ou LET 2,50 ea NO N.RESID BRANCH CIRCUITS) NEW CONSTR. 1POWER APPARATUSe NON-RESID. %SINGLE OUTLET CIR. / Ex. Oc50a@250 cup OUTLETS OR FIXTURES BAL 1 FIXED AP LNS. OR Ex. Occup.(OUTLETS (RESID,) EA. 2.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIirig Fee 10.00 WORKMEN'S COMPENSATION INSURANCE 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 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 S Contractor 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmles-§ the County of Butte against all liabilities, ju . ments cost,,.and xpe Vwhich may in any way accrue against said C • ty in segu-ence th g of this permit. ? X / Date _ Signature of Applicant — Owner ❑ Contractor Q Agent ❑ An OSHA permit is required for excavations over 5'0'N deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ Oc CUP. GROUP I TYPE OF CONST. F I PARCEL PD' I NO I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY � ��v ° �W _ PERMI,T--E-XPI'i;ES�,Df e Z the applicable provi- resolutions to do fees have been paid. WORKS ,T Date J' ZZ kZ _ Receipt No. �� U � � WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Mernorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and'Elliott Road, Paradise — Phone: 872-2961, Ext. 57 — CORRECTION-NOT1 CE BUILDING OR PROPERTY ADDRESS A routine Inspection Indicates that the fol!owing violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work Is completed. If you have any question pertaining to this matter, or need additional explanation, 'please contact this office immediately. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 9 1A APPLICATION AND PERMIT 4vvr"� ASSESSOR PARCEL NUMBER ZONING BUILDI G PERMIT OWNER TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING APDRESS CONT WC 'S NAME ITELEPHONE CONTRACTOR'S MAILING ADDRESS © Fireplace LEND ERV LER UNKNOWN LENDER'S MAILING ADDRESS Total Valuation $ Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER AJ� 77 LICENSE No. Plan Checking Fee Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDR S PLUMBING PERMIT Filing Fee 10.00 Each Trap ' 2.00 Repair drainage or vent piping 5.00 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 SFEr Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 24-00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilitie Installati Other_ Describe work: Rysl r 4— maP.��-�c i4,A \AJ&Zd- Ppmlt Fee $ Q, 0o Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service DOOV DR LESS 100 AMP OR LESS 5•00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.al OR ADDNS. ACC. BLOGS. _ 2¢sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business50@250 and Professions Code and m license is in full force and effect. . y License No. Classification El 1, 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 NEW CONSTR.'-OUT -OU LET 2.50 ea NON-RESID BRANCH CIRC TS NEW CONSTR. POWER APPARATUS D\\ NON-RESID. %SINGLE OUTLET CIR. 1 Ex. Occup OUTLETS OR FIXTURES BAL met FIXED APPLNS, OR Ex. Occup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): he permit is for $100.00 (valuation) or less. have placed on file with the County of Butte Building Department YaCertificate 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 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 k ep harml the County of Butte -against all liabilities, j ments, costs d xpe which may in any way accrue against said yin se c th of this permit. 7"kiThis X Date 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. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ o occuP. GROUP TYPE of CONST. PARCEL PD HD IseuE permit is hereby issued under is of the Butte County Code and/or work indicated above for which TOR OF PUBLIC B y PERM D e T_ the applicable provi- resolutions to do fees have been paid. WORKS 7 Date ✓—�✓��/ C Receipt No. 57 oO-3 e__ WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT �94'�—hoo/ PERMIT NO. 1201-81B PERMIT EXPIRES Denny Thengvall OWNER owner CONTR. 29-25-11 ASSESSOR PARCEL 5296 Church St., Richvale LOCATION i ,l Temp. Power Pole_ Called PG&E _ Temp. Elec. Service rr Called PG&E_ Temp. Gas Service _ Cal led PG&E -A JOB FINAL%l Signature = OK _ Not OK = Not Applicable MOBILEHOMES Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4, Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except b's 1. Zoning Requirements -Setbacks -Easements Date POOLS (Plans) OK except H's 1, Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval Card -BI 10. Plumb; Cir. Test -Water Supply Test Date Card -BI Date Card B -I Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) ' Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Fig. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-8lockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ft .-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 57. Smoke Detector _ 14. 15. Water Ht.; Vent -Access -Combustion Air Water Pipe; Test & Anchors -Nail Protection 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except q's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72• Insulationin Attic E] Yes Foam -Looked 73. ) Guard Rails &Deck Construction -Post Caps _ 25. 2 Appliance Circuits in Kitchen & Conductor Size 74. Fdn. Vents &Crawl Hole Door -Drainage &Wood -Earth Clearance Looked under Floor ❑ Yes 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Followinginstld.: Drive E] Yes ❑ No; Walks ❑Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. 77, Stucco; Brown -Finish A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 29. Equip. Clearances; Panels-Motors-Mech. Equip. 30. Clothes Closet Light -Shower Light 78. Vents Above Root; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except q's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ 31. 32. 33. A.C. Ducts; Insulation & Support Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 85. Water & Sewer Connected -C/O to Grade -HD Approval 86. Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - Card -BI Date Card -BI Date Card -BI _ Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FRAMING Plans OK except q's Card -BI Date Card -BI Date Comments at Final: 36. Sills; Proper Material & Anchors 37. Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. _Walls; Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) _40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub -.!I.-Header 42. 43. 44. & Beam -Size & Bearing _ Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles _ 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT Or PUBLIC WORKS /E RMIT NO. 7 County Center Drive - NroVille, California 95965 - Telephone 916/534-4541 IkPPLIGATION AND PERMIT ASSESSORPARCEL NUMBER ZONING rQ _C� BUILDING PERMIT9 OWNS _. TELEPHONE i SQ. FT. OCC. BUILDING VALUATION TER MAILIN ADDRE S 10 3S- - C NTRACTOR• NAME 1A) eIr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation I $ Filing Fee - $ 10.00 LENDER'S MAILING ADDRESS _ Permit Fee $ , ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 16. 00 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS C PLUMBING PERMIT FiIIng Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 (.� 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 SF [F Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE QF WORK New❑ ❑ Additionemodellrf-iJ,/Utilities❑ Installation❑ Other❑ Describe work: — Ve—' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 {� T ( W Main service EA. ADO'L 100 AMP 2.50 NEW CONST. / DWELLING OCCUP.yl OR ADDNS. l ACC. BLDGS. 22 sq ft CONTRACTORS LICENSE LAW I declare under.penalty of perjury (check one): ElNON-RESID. 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 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR NON.RESID BRANCH CIRC I 5 NEW CONSTR. // POWER APPARATUS D %SNGLE OUTLET CIR. DO @ 250 OUT Ex. OCCUp LETS OR FIXTURES BAL�1 FIXED APLN5 Ex.-Occup.(OUTLETS P( RES(D )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 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 3 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep armless the County of Butte against all Iia ties, judgments ts, and ex es which may in any way accrue again s id County in, quence oft ranting of this permit. - n_�� X Date 77 Signature of Applicant — Ow r ❑ Contractor E]Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL.PERMIT FEE $ OCCUP. GROUP �� -zJ TYPE of CONST. V PARCEL C PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE 7R OF PUBLIC By P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date —f ter/ Receipt No. _5011;� 142Z WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT A.P. #�? Date of Inspection c Inspector Owner: AddresC14 OAt- Tenant: Building Locat ion : Type of Inspection requested: 1. Housing 1..1 2. Financing 3. Change of Occupancy to 4. Other (specify) Present use of building - A Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating'facilities: 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: ll.' Connection' to sewage disposal: 12. Connection to water -.supply: 13. Rubbish and garbage facilities: 14. Couments: B. Structural 1. Piers and footings: 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: C. Electrical 1. Service .—e ground:_ 2 Receptc c: 3. Fusing: - 4. Comments:_ D. Plumbing 1. Fixtures; connected and vented: 2. Gas water heater: 3. Cas heating vents: 4.. Comments E. Other I . Maintenance and repair: 2. Fire hazards: -A .--.- 3. Safety haz.rds:* 4. Weatl!er protection: 5. Und erfloor and attic ventilation: 6. Comnents: F. Commercial Buildings 1. Rcof covering:_ 2.. Distance to property lines: 3. Physically handicap -ped: 4. -Aest:-oom floors and walls: 5. Exits: 6. Improvements: 7. Zoning - 8. crmnelit -z: G. Field Problems or V ic-1 a'E io-ris 1. Problem -,- 1.violation (give nompleta. description):,W 11-7Z> �� AT 2. What action taken 4&ive complete --Jescripuion)! LJA3 AT- S5!!�.5 1. ,eg7. I -N I �&� So 4A_h Z I J,114 M C PW I- r'-IICIA,� A/'/) AAIa7 3. Whit an - Jon recommended: BC .4 /V&- U -J L- &F 1- 14 W17-14 dr De 9- w(/7;' A. -Infor.-.7tation only - f -L I o--� . - - S -7y Iq 7 A PV077E- W 771,',- 44C/;�f a B. Hold for tc-i (110.) days, then wri-e letter. -O(E> SOP .14Z -C - W644 jGd&X'La- Write letter. 11 -OK 7 D. Other: COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS,' 7 County Center Drive — Orovi Ile, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT aur represe rives or me county or butte to enter upon the o entioned roperty for inspection purposes. Date Signature of Pe76e or Agent 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 Receipt No. White-D.P.W. - Yello sor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date Date BUILDING Owner Dentis Then vall SQ. FT. OCC. BUILDING VALUATION Mailing Address Richvale Ca. Telephone No. Fireplace Contractor Cabrillo Builders Total Valuation Mailing Address P.O. Box 98 Permit Fee Plan Checking Fee &/or Penalty Paradise Ca. Telephone Na. Permit Fee $ $ Building Address /S N�gL PLUMBING No. @ FEE PERMIT FILING FEE $2.(10. 3, p O �— u Each Trap 1.50 / A "-le d s ` — Repair drainage or vent piping 1.50 Water piping 1.50 (J Lc___� Each gas water heater or vent 1.50 A. P. No. — s.�/ Zoning & Planning Gas piping system 1,- 5 outlets 1.50 Each additional outlet .30 Fees C Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel' Declaration Parcel Ma P 60R/W Im p Improvements Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval I Plans Approval Permit Fee C' ,Q ]' $ 2, S 0$ .2, NEW ❑ ADDITION ❑ UTILITIES ❑ OTHERX❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 © O Install elec. pumps Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures ba_lf� l Receps., switches & fix outlets 2 2b 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: Cabrillo Bldrs, Inc. Hood, Ex. FanorF.A. Furn. Motor 1.00 Evap. cooler, gar, lisp. or D.W. 1.00 Air conditioner or heat pump Water pump /,00 .2, BO Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. 229772 Classification 8-010 Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit -Fee Aw $ ®t0 $ 0, 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. lecertify 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 Workmen's Compensation Laws of California. MECHANICAL N . @ 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 TOTAL PERMIT FEE $ aur represe rives or me county or butte to enter upon the o entioned roperty for inspection purposes. Date Signature of Pe76e or Agent 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 Receipt No. White-D.P.W. - Yello sor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date Date L. `PERMIT NO. 3256-75B P yE E } M MH UTIL. 'PERMIT NO. PERMIT EXPIRES OWNER Dennis Thengvall CONTR. Thomas Bragdon, Chico LOCATION (A.P. 29-25-11 ) se/corner Lindale & 4th St., Richvale { Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E VJOB � FINALED_ (Date) i (Signature) DATE REMARKS OR CORRECTIONS . ' A COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD L BUILDING BUILDING (Cont'd) PLUMBING Setback fj �`"^ Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwaII Sidinq To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. - Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — 'DEPARTMENT OF PUBLIC WO -7 -,) -Z" 7 County Center Drive. -' Orgi Ile, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. ate7,F45 Signature of Permitee or Ageat Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECT06t�OF'PUBLIC WORKS By .- N Date Cuild"ing permit expires Date 7—/ BUILDING Owner N. "S SQ. FT. OCC. BUILDING VALUATION o. od Mailing Address MIJP C 40 0 Telephone No. Fireplace Contractor Total Valuation 7 490 - Mailing Address Permit Fee Plan Checking Fee&/or Penalty ' / Telephone -No. J Permit Fee 00 1 T5_( Building Address �� Al C 10 PLUMBING No. @ FEE PERMIT FILING FEE J$3.00 '-' % Each Trap 1.50 Z / G• (� Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. - 2,5`41 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe ei FireDept. Fire'Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements p ovements Lawn sprinkler system 2.00 Bldg,' ons, ec'd d Par proval Plons Approval Permit Fee $ NEW ❑ ADDITION Eg UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 LJ -46712 (,)-14 VJA V Main service incl. 1 meter L Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) - Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 _Water Heater or Space Heater 1.00 Light fixtures b. %10 Receps„ switches & fix outlets 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: X h G VVX at Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 � 1 A License No. ��`+�' / c;� Classification�- Misc. wirings ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ is 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 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 TOTAL PERMIT FEE $ 0< authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. ate7,F45 Signature of Permitee or Ageat Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECT06t�OF'PUBLIC WORKS By .- N Date Cuild"ing permit expires Date 7—/ LAND DEVELOPMENT OROVILLE Lfkl BUILDING ENVIRONMENTAL HEALTH PERMIT CLEARANCE Build/ng Permit No. OWNERS A.P. n J NAME J 1 I �Yi E U (J L L. j P 0IJ P S NUMBER. Qq PRINT LAST NAME FIRST ADDRESS/LOCA COUNTY ZONING DESIGNATION: �'`-' FLOOD MAP: t) vs FLOOD ZONE: APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP DEED INFORMATION: DATE OF CREATION: DEED REFERENCE: - LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES -NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO COMMENTS/CONDITIONS: MAP INFORMATION: 777%e2V G V,4Z4 7 rL4CT DATE OF RECORDING: LOT_ BOOK 36 PAGE _Z2– COMPLIANCE 2COMPLIANCE WITH OLD SU (VISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES NO. IF YES, MARK APPROPRIATE ITEM(S) BELOW: A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BUILDING DIVISION UNLESS OTHERWISE NOTED. 1. Maintain a 50 ft. building setback from centerline of road. _ 2. Maintain a ft. building setback from right-of-way/centerline —3. Comply with Zoning code for building setback from road. —4. Maintain a 100 ft. leachfield setback from all ebsting wells. —5. Maintain a ft. leachfield setback from 6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. _ 7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. 8. Connect to a public water supply. —9. Connect to a public sewer system. 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications,`serves the parcel. _ 11. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ —12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) —13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010. - —14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated in the Oroville Area Traffic Mitigation Fee Agreement. 'Payment to be made to the Planning Division. —15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of the Uniform Building Code. - _ 16. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors. X 17. Pay school impact mitigation fees, X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article 11 of the Butte County Code. —19. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the Califomia Clean Air Act of 1988 as amended. —20. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person would then be able to assess the site significance and suggest appropriate mitigation measures. 21. 22. 23. 24. 25. 26. nl3108 40 kj%j)0D� sss� z z %nr a3r%1303*6 LD 6/98 FORMS\BLDG PERMIT CLEARANCE COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 5344541 APPLICATION AND PERMIT - authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Permitee or Agent 1 T ♦ r r Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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 Building permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address 1 _ 7 - ` Telephone No. Fireplace Contractor ,� '� �, ;- Total Valuation f Mai l i ng Address - J / �" - , , - 'I r. - t Permit Fee Plan Checking Fee &/or Penalty Telephone No. ( ?; --- ", Permit Fee Building Address- PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 zw -' 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. �- �— // Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees WCd Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 Bldg. Plans Recrd'�-, Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDIfION_Q-� _UTILITIES ❑ OTHER Q ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ' , ; • r- , , i - -' Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12or•less) (more than 12) - ♦, r Gt Single FarQly �i Duplexy❑ Mobil Home ❑ C - Others ❑ Range, Cook -top or Oven j 1.00 Water Heater or Space Heater / 1.00 Light fixtures . / /. b i /, Receps., swi ches & fix out -lets , ; 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. �� r Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE 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 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. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 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 TOTAL PERMIT FEE $ i authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Permitee or Agent 1 T ♦ r r Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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 Building permit expires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Tel ephpne: 534+4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Signature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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 Building permit expires Date ........................... BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 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. N0. Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W. C. Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EOA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval I Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 20P20 bo Receps., switches & fix outlets 2u 1112-1 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ ! % $ 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 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 $ $ 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 TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Signature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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 Building permit expires Date ........................... COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, California 95965 Telephone: 53`4-4541 APPLICATION AND PERMIT -- ...r....,I.,w.��w , u— vuuniy ui ouuc w cnicl upun tilt: above-mentioned property for inspection purposes. hX " Date 7 %S Signature of Permitee or Agents Receipt No./ � cn / White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DRECTO PUBLIC WORKS B� Date ;/__7 1-7 Building permit expires Date BUILDING Owner SO. FT. BUILDING VALUATION OCC. Mailing Address Telephone No. Fireplace Contractor Total Valuation /45::� Mailing Address //257 4 Permit Fee PI an Checki ng Fee &/or Penalty Telephone No. _-7Z3 Permit Fee $ $ Building Address,�p` V 5 PLUMBING No. @ FEE PERMIT FILING FEE $2.00 5 % Al ,Z 15;- alj Each Trap 1.50 C / _ L Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. S_// - Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 <SVA<Sanitation Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma P 60' R/W Improvements provements Lawn sprinkler system 2.00 Bldg. Plans Rec'd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 . 0-0 � �},�� G - Main service incl. 1 meter - /�IS ,"7 ! Additional meters, each 1.00 Single Family Lo Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (mor an 12) SQ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bal 20 , 6-o Receps., switches & fix outl 5-0 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: / ,(� �U94/ // Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar, disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No._.27G ©I bMisc. Classification C ' �O wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ 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. C have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. iecertify 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 Workmen's Compensation Laws of California. 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 MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE $ -- ...r....,I.,w.��w , u— vuuniy ui ouuc w cnicl upun tilt: above-mentioned property for inspection purposes. hX " Date 7 %S Signature of Permitee or Agents Receipt No./ � cn / White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DRECTO PUBLIC WORKS B� Date ;/__7 1-7 Building permit expires Date ,✓ COUNTY OF BUTTE -` DEPARTMENT OF PUBLIC WORKS 7 County Center Drive- - Oroville, California 95965 7J Telenfi'one- 5314-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. — X �e �i�^�J Date Signature of Permitee or Agent Receipt No. /yo '!S-" L,4Z White-D.P.W. - Yellow -Assessor -Pink-Inspector - Goldenrod -Applicant 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 By2e, 20 DI/� Date 3v 7,) Ing permit expires Date �3 %� BUILDING Owner a l SQ. FT. OCC. BUILDING VALUATION Mailing Address ff / Telephone No. Fireplace Contractor O �' �� Total Valuation Mailing Address Q f' �rJ!/� Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 jam" G.' Each Trap 1.50 Repair drainage or vent piping 1,50 Water piping 1.50 e gas water heater or vent 1.50 A. P. No.Gas Zoning 8 Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 FebEdW. Sanitation Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans I ParcelLawn I Declaration I Parcel Map 60R/W Improvements sprinkler system 2.00 Bldg. Plans Rec'd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 36-w fes'/Ca- - GY� - Main service incl, 1 meter Additional meters, each 1.00 Sub -panel (12 6r.f (more than 12) 45,01 - Single Family Duplex ❑ Mobil Home ❑ Others❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bol(d2 10 Receps., swi hes & fix o is , 7 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: y^ ri /'� !/ �Td5//,�., /��_Z25i L Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home -Facilities 5.00 - Temp. Power Pole 5.00 License No. a %�rClassification �- Misc. wiring ❑ 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE 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. rVr 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 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.$ PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 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 TOTAL PERMIT FEE $ 7r; 7 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. — X �e �i�^�J Date Signature of Permitee or Agent Receipt No. /yo '!S-" L,4Z White-D.P.W. - Yellow -Assessor -Pink-Inspector - Goldenrod -Applicant 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 By2e, 20 DI/� Date 3v 7,) Ing permit expires Date �3 %� 029-250-011 01-0758 JTHENGVALL, DENISE & LESLIE 5296 CHURCH ST. RICHVALE {CONT: MCCLELLAN I HVAC r -J COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT- �J SERVICES BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT I Z4a M ASSESSOR PARCELNUMB e� rJ, -O _ (Oil ..n CT 1 /` f BUILDING PERMIT OWNER TErNE SO. FT. OCC. BUILDING VALUATION OWN!;C7NG DRESS/ (� • ��� `--r r GO CONE iSs l �•4�/ TELEPHONE CO TOR MAID DRESS M 3 NuLo Y 5 CONSTRUCTION LENOER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ /� 6 ' st - BUILDING ADDRESS_—.� 96 c1 Energy Plan Checking Fee $ ( PERMIT FEE $ LOT NO. SUBONISpNS NAME I PWEL MAP - ....- PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF,k Duplex ❑ Mobilehome ❑ Other FY sP� Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping15.00 Each gas water heater or vent 15.00 TYPE OF WORK New 13 Addition ❑ Remodel ❑ Utilities 13Installation❑ Other ❑ Describe Work: /4 V Ac. nn ,�..qq (i ni Gas piping system 1 - 5 outlets 15.00" , Buildingsewer 15.00 Home I S I G W 920.00 —Mobile PERMIT FEE S 3 ELECTRICAL PERMIT Filing Fee 20.00 Main Service oa 'ss 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 1 C+uLic. No. 341" 1 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure -is .not intended or offered for sale. ❑ I, as owner of the property, am exclusively, contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BIDS. 3.5 QF°, NON•RESID. CONST.EW muLTI.OUTLET @7.50 PSOr AFPAMTUS a SINGLE oImET CIR. EX. Occup. ourLET OR FIXTURES SkL ®1.00 .50 Ex. Occup. o� Ro .° . 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. ,Wirin 23.00 ' 3.CO PERMIT FEE $ L4(A� 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. Tidy workers' compensation insurance carrier and policy number are: Carrier C .A i (1�✓ Policy Number !I I.1!i (The above section 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 pr visions of section 3700 of the Labor Code, I shall forthwith comply with thos iprovisions. X 7'7'/ Date V Signature of Ap ca - ❑ Owner ❑ Contractor El Agentl, An OSHA permit is required for excavations over 60" deepnnd,demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Foe 20.00 Heating 1 90-W Coolin ) I Hood 6.50 Ventilation PERMIT FEI: $ (n Mobile Home Installation Fee $ Energy Inspection Fee $ c _ 3 gQNST nPE TOTAL FEE $ 1-3 8 , 00 HAZ. Dy FES MP 1/ FLOOD CDF PARCEL Po HD suE This permit is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate above for which fees have been paid. Byt %% Date PERMIT EXPIRES ON y �' to Receipt No. WHITE-D.G.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT WFA COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION V 7 County Center Drive • Oroville, California 95965 • Telephone (530)• 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT C, ASSESSOR PARCEL NUMB Ip G BUILDING PERMIT OWNE HTE aONE c, ' �' TO�� SO. FT. OCC. BUILDING VALUATION . OWNE$$� \�YC$r CONT TELEPHONE) CO TOR5MAILI DRESS ^ - 9S-c1!%3 Y CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS n St - i Energy Plan Checking Fee $ % Q FJ (OdC19 $ PERMIT FEE S LOT NO. SUBDNISIONS NAME I RAVEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF)( Duplex ❑ Mobilehome ❑ Other SPECIFY Each Tra 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 ❑ Installation [3 Other ❑ /C ��J/J(, Describe Work: T -i VL�t (,�Q [ .. Gas piping syste!9 1 - 5 outlets 15.00 � Buildingsewer 15.00 Mobile Home I S I G I W Q20.00 PERMIT FEE t 3 -60 ELECTRICAL PERMIT Fling Fee 20.00 Main Service z'so.OV 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 ' full force and effect. License Class C-ZQic. No. 3`'15- 1 -L1 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 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' comnsation insurance carrier and policy number are: Carrier A p Policy Number _1z:_>q (The above section need not be completed 0 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' com nsation laws of California, and agree that if I should become subject to the IN rs' compens n pr visions of section 3700 of the Labor Code, I shall fo ith comply it thos provisions. 8' X Dat 8/01 Si ature of Apptcan'b Owner ❑Contractor 9 Agent An OSHA permit is required for excavations over 60" deke and_ddrnolition or construction of structures over 3 stories in height. Main Service TO IUOOA 46. 00 DWE200ALLING so NEW cortsr. owELUNo occuv. 3.SQF°; OR S' & ACC. I CQ LET NON.RESID, BRANCH CIRCUITS �%O 7.50 POWE APPARATUS 8 SINGLE OUTLET CIR. 20 EX. Occup. OUTLET OR RMAES BAS O I.SO Ex. Occup. oU TS AEsID.LNS Den 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23,60 PERMIT FEE S 3. (� MECHANICAL PERMIT Fling Fee 20.00 Heating tI A0 160 010, OD Cooling Hood 6.50 Ventilation PERMIT FEi= $ Mobile Home Installation Fee $ Energy Inspection Fee $ cC3!.AI. �� TOTAL FEE $ 138,00 p FE P FLOOD I CDF PARCEL I Po I HD I ttUE This permit is hereby Issued under the applicable provisions of the Bu County Code and/or Resolutions to do work indicate above for which fees have been paid. By Date at PERMIT EXPIRES ON ` / —o,,,-'- ReceiptNo. 31 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD-APPLICANT(Date) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 01 -1595 - ASSESSOR PARCEL NUMBER 0 ' ZONING BUILDING PERMIT OWNER A TELEPHONE SO. FT. OCC. BUILDING VALUATION .OWN ZMI� ;ADDRESS /� h/i CONrRACTOR'S E �� ffTrELEP;HONE (i CONrR� TV / G.. ADX; _ s� C- 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 2,71/ Energy Plan Checking Fee $ /� C. ✓� PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF;k/Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Ne—, %CetitL _1x-,�/ Gas piping sy2tem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W Q20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class ..0 �� Q _ / O Lic. No. � �� OWNER -BUILDER DECLARATION— I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 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 I one hundred dollars ($100) or less.) X-10certify 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 d I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. '�j X �Date 6 a / `— �� Signature of Applicant - ❑ Owner WContractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO L000A 46.00so NEW CONST. DWEWNG UP. SO V OR ADDNS. ( a ACC. BUDS. 3.50FT. NoµaEOSIU T. MULRANCTI-OUTLET @7.50 PowER APPARATUS a CIS. OUTLETR FIXTURES EX. OCCU OUTLET OR FIXTURES BAL �';� Ex. Occup. GLiiEE°TsEsID.Gew 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE 10 TOTAL FEE $ {� HAZ. I D. FEES IMP FLOOD CDF PARCEL PO 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. 7 Date 2 Z— efe Receipt No. _22 . ®� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT u..':a:., „ .�;n.}s,.rr;.::r:�: ane'.: „r': .,�.`v°!': ��:x4 �.apl'�••":wew�.a-�".. 029-250-011 01-1595 THENGUALLjDENNIS 5296 CHORCH ST. RICHVALE CONT: D & TELECTRIC NEW E=EC SERV 41 ti_ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 7 9_ 2 ,,,, v / r ZONING BUILDINGPERMIT OWNER / TELEPHONE SO. FT. OCC. BUILDING VALUATION OWN5 MA�; ORESS / r /4 CONTRACTOR'S ME TELEPHONE G.._ CONTRACTOiJ; U ADOF ((��fl✓� riL„ TJ ,J I CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS �C�/ L, Energy Plan Checking Fee $ fil C 2 1' PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF,;/ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping Water 15.00 gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: %✓C��fi� r C s�if- L l GC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800V OR LE Main Service 2o0.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)xof Division 3 of the Business and Professions Code, and my license is in full force and effect.POSINGLE r� ^� License Class G �- ! % Lic. No. ti a / •!.7 . 1 f!r OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 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 Main Service 200A TO 1000A 46.00 NEIN CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLpS. SO 3.5QFT; NEW CONST. -OUTLET NON-RESID. @7.50 WER APPARATUS 8 OUTLET CIR. OCCU OUTLET OR FIXTURES aq0 p •S0 1.00 OR Ex. Occup.. DUTLEEDTS R=.)11 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 2. PERMIT FEE $ (� MECHANICAL PERMIT Fling Fee 20.00 Heating —Cooling Hood 6.50 Ventilation PERMIT FEt $ 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 �I- 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. ry �f�j X � YI Date (.a)- /0 7" 0 _ Signature ofiAAppTlicant - ❑ Owner PContractor ❑ 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 $ S HAz. I D. FEES IMP I FLOOD CDF PARCEL PO HD ISSUE ` This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have Lr By r 00*1 PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. / Date a1B Receipt No. fI 73/ • 400 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT CLAIMANT: ADDRESS: CITY & STATE: r)ATG nG rl AMA- County of Butte Oroville, California GENERAL CLAIM Leslie Thengvall P.O. Box 305 Richvale, CA 95974 nta/mms BUTFE COUNTY SEP 2 8 2005 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELA AMOUNT Refund Claim - See attached calculation sheet APN: 029-250=011 Permit No.: 044194 PAID RETAINED REFUND Development Services $ 852.34 $ 736.87 $ 115.47 THERM DRNG $ - $ - $ - SMIP $ - $ - $ - SHR $ - $ - $ - SRA $ - $ - TOTAL $ 852.34 $ 736.87 $ 115.47 > %i:::::< :BREA)EtDOWNi::' : sUb J T'::AecOUNT. ':AMOUN.T,* 101001 DVLPMNT SVC 440-001 4210500 $ 115.47 1011822 THERM DRNG 18001 280 $ - 1011430 SMIP 1001 280 $ - 1011811 SHR 1800 280 $ - 101001 SRA 0100 4617240 $ - TOTAL $ 115.47 $ 115.47 I, the undersigned, declare under penalty of peryury that the services or articles claimed nave been pertormed or delivered, and [nar this claim is true and correct as stated. Dated this ;,)ed e Tri day of2005, at r . Calif. Signature of Clai nt I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specked above have been performbd or delivered and that there is a Budget Appropriation or Speck Board Approval (Checkthe same. Dated this day of , 2005, at Oroville , Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY EPT & SUB PROJ SUB. OBJ CLAIM NO...., . INV NO. INV. DATE ENCUMB. GROSS AMT. CULATION SHEET LAIMANT: Leslie Thengvall DDRESS: P.O. BOX 305 ITY & STATE: RiChvale, CA 95974 ATE OF CLAIM: 09/02/05 APN: 029-250-011 RECEIPT INFORMATION ` NUMBER: 395393 4/27/2004 DATE: ISSUED TO: Leslie Then vall 0112 CHECK #: $852.34 AMOUNT: 04-1194 PERMIT #: Yes No Yes No Yes No X PRIOR REFUNDS: X FEES VERIFIED REFUND BREAKDOWN{ Title BLDG THRM DRNG AUD SUSP HER DEVV FEE }A FI � F1RE Fund Dept Accnt Cashl 0010 440001 4210500 101001 1800 rHRMDRN 280 1011822 1001« (SMIP) 280 1011430TU11811Y 1800 �+(SHR) 280x{ 0100-. �(SRA)A& 4617240 1010011, DETAIL PAID RETAIN REFUNDr�. BLDG Time 109.96 ....... .. :: ::: Filing from Plan Check 0.00 1 0.0010.00 »»>::: ............................... >::::::: %::::: < > >:' .......... Plan Check/Filing0.25 27.50 681.88 681.88 0.00 0.00:: Inspection 0.00 170.46 1 170.461 170.46 .......... :•:•:::::::::::•:::•:•:•:•:•::•:•:•:::::::• .......... .......... .......... ..........: BLDGFEES OTHER BLDG . 0.00 0.00 : ::::::::::::::::::;:::::::::;:::;:::: :::::::::::::::;:;: ; 0.00 0.00 REFUND PROCESS FEE 54.99 54.99 54.99 54.99 .......... >::: >:::::::.................... .......... .......... . .......... BUILDING TOTAL 852.34 .. 736.87::,:.:. ,,.115.47. �,,,--.,:115:47 ::.:..:.:.:.:.:.:.:.:::::::::::"'>:>>::':::::: ""::>;>: :::::::::::::::::::: : :•:•:•:::•::: :::•:•:•:•:•:: THERM DRNG 0.00 0.00 .......... .......... .:.:.:.:.:.:.:..:. SMIP 0.00. SHR ' (� � �'� �a�.�� ,rrL� . ss; *�. �: I;r iS!oo �. t tk Yrv� W6 w iAl�i'�' tE SRA,+�`'r�+s44VU-W,% x���• WjS-e'. "W-x,..X0.00- $ 852.34 $ 736.87 $ 115.47 APPROVAL CHECK: $115.47 Date Reviewed 10/3/2005 DIFFERENCE: $0.00 Scott Rutherford (Should be blank) Chief Building Inspector .a 0 0 0' 0 Butte.. County Department of Development Services www.bUttecountv.net/dds 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538.7785 Facsimile . ADMINISTRATION * BUILDING * PLANNING 9/2/2005 / { Pj{ Leslie Thengvall Pl- 13 P.O. Box 305 r Rich.vale, CA 95974 ` RE: .Permit No. 04-1194 APN#029-250-011 Owner: same On 4/27/2004 a deposit was made in the amount of $852.34, of which $736.87 was retained.- Please sign, date, and return the enclosed claim form to this office. Once we receive the claim form, we will then process your refund in the amount of $1.1.5.47. Should you have any questions, please contact this office Monday through Friday, 8:00 a.m. to 4:00 p.m., at 538-7601. Sincerely, Diane Lewellen Account Clerk, Senior Administrative Division enclosure Al 04-1194.1tr CLAIMANT: ADDRESS: CITY & STATE: DATE OF CLAIM: NUMBER: ( I DATE: ISSUED TO: CHECK #: AMOUNT: PERMIT #: PRIOR REFUNDS: FEES VERIFIED DETAIL REFUND CALCULATION SHEET Leslie Thengvall ' P.O. Box 305 Richvale, CA 95974 07/27/05 APN: 029-250-011 04/27/2004 Leslie Then vall 0112 $852.34 04-1194 $ 852.34 I $ 736.87 I $ 115.47 APPROVAL CHECK: $115.47 Date Reviewed 08/16/2005 DIFFERENCE: $0.00 Scott Rutherford (Should be blank) Chief Building Inspector No 0j o�UTrF0 Butte County Department of Development Services G Building Division O O 0 7 County Center Drive c�UNty Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on t he receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees aid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Development Services for oavment eracesssfie. CLAIMANT'S NAME: E MAILING ADDRESS: PHONE: (S^3D)$2 X21 0z — ASSESSOR'S PARCEL NO.: _ � _.. �..�� _'.., �.L L✓: [Please use one claim form per permit.) BLDG PERMIT NO.: .� .. D Receipt No. 1 Receipt No. 2 Receipt No. 3 -'a Pi 9 . RECEIPT NO.: RECEIPT DATE: �.� Z,.. _•.. RECEIPT AMOUNT: _. REASON FOR REFUND REQUEST: o07CO Check those fees which you wish to have considered for refund: Building Permit Fees =Sheriff Fees =SRA Fees (CDF Fire Planning) =Other (specify): (Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may pick them up prior to that time. Signa re Date K:/Forms/Refund Application 0822 3 B TT' COUNTY DEPARTMENT OF DEVELOPMENTSM9(CH BUILDING PERMIT APPLICAT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (5 ) OFFICE #: (530) 538-7541 3yd . N PERMIT NO. BP jjq4 ®k DATE: n -o APN: v q- Sd�- of (- ©Pa ZONING: OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE: I Les l « £2Z Vf- - S 71 RPsS l/1 ` (/l �L IP X FJS�_ FOZ �U C ' ,c t,,—/I 7 E-MAIL: j ( G SITE2 D S: rGt� C V. V 5-q7q- N EST C SS $TREET: TRACT/LOT 9. Aa I IICANT N E• V,1. 14,e+1 va, l PHONE 2E2-, z�Q STREET ADDRESS: . b G u r - F � L' CIP: c�lvaIe- , -1 s Z E-MAIL -9'-rL me— CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CRY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE A HITE,CT/ENGINEER AM PHONE: '7/3-6 - 13ralv�l' iS3o r s 12D-71 CRY,AP:LICENSE �SI�t 95'9&Z NUMBER IL• Qfi DESCRIPTION OR SCOPE OF WORK/ mod�L " CODs Odd `4 AA :s4,4 S� ❑ Structure Built without perm's 7 7 7 ❑ Proposed Change of Occu ncy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit h not been issued will expire one year after the date of application. In order to renew action on an a plication after ex (ration, a new application, plans and fees will be required. REQUEST FOR REFUNDS written request by the person who paid the fee. Refunds can only be madeVn The request must be made prior to the expiration of the permitno construction work has been done. Filing fees, plan check fees for work plan checked and other de artmosts are not refundable. For office use only: Notes: d Application Received by: ate: Receipt number: ��jAmount Received: S75"07,3 v1- PAI U—f— anuli -6— :i-d11d 1 A t r � L a��a-C �In r sus COUNTY OF BUTTE -DEPARTMENT OF � V LOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA '95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: (-� r^ �,' ✓1 Y`I L �� �1 _-ASSESSOR PARCEL NUMBER Proposed Building UsMod EL Counter Technician: TIP Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. a 1. Site p16ns„3 or 4.sets, signed by the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. �. ��� 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxes! 5. Letter from Engineer or Architect for truss design review. �1 6. Energy compliance design and supporting documentation in duplicate. D 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. O 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. - El 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13': Detached Accessory Building Form filled out by the owner ) 014. Hazardous Material Form / _ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ � ico d�/, Ae s applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑/ 17. Fire Sprinklers............................................................................................ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by O l 19. Soils Report and/or Engineered Foundation required ........................................... ......... '0 i 20. Erosion Control Plan Required........................................................................ ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit........................................................................ t 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... RK 29. Contractor's license information. (Number, Name Style, Classification) ........ :.......... 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... C3'35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.1-14 Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant -A Date: / �Dr 1. Index permit, pplication for the above it ms n tiered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: Date: Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Yellow: Building Division Date: Date: Date Date: COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER A.P. # /���� PR PROSED BUILDING USE-Adi e DATE RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ J --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES / Gy .(�f�l I >C; .eel (paid at School District Office) (form avallaille after Plan Check) IMM! 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ _ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg.. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ft ......... — $ Sq. t . Amt. n 10. OTHER L�� At time of permit application, I was advised the abov ees are required to be paid prior to issuance of the permit. These fees may be changed durig the plan checking process. APPLICANT DATE �Y Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 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 -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) National Pollutant Discharge Elimination -Systern (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement MESS THAN 1 ACR9Z Project Title: ar that a construction By signing below, L the project ownerlowner's agent, certify that I am aw e r more of land requires a Construction Storm Water Permit from the project that disturbs I acre o In State Water Resources Control Board and that it is my responsibility to submit a Notice of tent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700-00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs I acre or mo . re of land. L furtherp certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provided by law., Signed: Title: Date: O.B.-1 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 improvement: YES D NO �( 2. I HAVE( 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: IVi>-V of 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: CITY: PHONE: CONTRACTOR'S LICENSE NO. S. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: I J SOCIALSl✓C tTI'YNUASER: DATE: NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Coda Thu verification mast be completed and returned to our office before we are permitted to issue the permit OWNER BUILDER INFORMATION Dear Property Owner. An application for a budding 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 party ofrecord on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself; you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are repaired by law to be licensed and bonded by the State of California and tui 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: 0 Ifyou employ or otherwise engage ray Persons other than your immediate family, and the work (mchuiing materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation bsmance, disability insurance costs, and unemployment compensation conhzbutions. There may be financial risks for yon ifyou 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, coact the Internal R evenne Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Lzw. contact the Depattment 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 peank, eaoneoursiy 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 obiamed by contracting the Contractors State License Board in your community or at 102014 Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so chat we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Iy. Mi I C. Vi ira, C.B.O. Building Inspection NOTE.• ars Owner -Builder Information is required by Seaton 19830 of the California Health and Safety Codes OVER 13 ' a3 L �6 Butte County Department of Development Services 0 03TTFo YVONNE CHRISTOPHER, DIRECTOR o 0 0 0 7 County Center Drive o ~'9'': = o Oroville, CA 95965 c�U N'�y (530) 538-7601 Telephone (530) 538.7785 Facsimile TO: LP2A ' FROM: Scott Rutherford (530) 538-7160 srutherford(a7buttecountV.net SUBJECT: Plans Transmittal For Review Per Contract O DATE: 6/10/2004 Applicant: Then vall, Dennis & Leslie Permit04-1194 Project Type: Remodel/And'l Breezeway APN: 029-250-011 100°.o-----� 70% Plan Check Fees $ 340t;- $ 94.E $ 238.66 34$ 238.66 LP2A Fee $ 238.66 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans _ Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other 4z cka�� 94 S�d � 4o ��U tl old Butte County Department of Development Services NOTES 7 County Center Drive, Oroville, CA 95965 a r_ eCOUNSyo /� (53o)538-7601 www.buttecounty neUdds w --- RESIDENTIAL i APN: Owner: _ Site Address: Contractor: o Type of Permit: Cr Permit No. 029-250-011 -THENGVALL; DENNIS& 5296 CHURCH ST, RICHV CONT: OWNER .�ELEC SERV I OFFICE COPY C 7 4 Address GAS Meter By Date � ELECTRI. Meter By Da�''��-2 SPECIAL CONDITIONS CHECKED BY i R Q SRA ❑ FLOOD CERTIFICATE EQUIRED ❑ FIRE SPRINKLERS REQUIRED =` ❑ SPECIAL INSPECTION ITEMS `❑ VERIFY ❑ USE PERMIT CONDITIONS ❑ SUB -STANDARD HOUSING LETTER K -❑ ENCROACHMENT PERMIT N ❑ REINSPECTION FEE PAID ❑ ENV HLTH CLEARANCE M DATE JOB FINALED: D -SIGNATURE: �=OK 0 = Not OK._ T MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test -Crossovers -Breakers -Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancyo9�, 16 HUD Label/Insignia Numbers Serial Numbers DATE ID E C K S -C O V E R S'C A R P O R T S'G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-Dpth-Spacing-Cnnctrs-Steel 3 Decks, Girdets/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnis 0\41 DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes -Enclsrs-pnIboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide '$` oill 400 Oa 0 Pool Drawing �=OK 0 = Not OK r RESIDENTIAL (Single. & Duplex) - DAIt JUNDERFLOOR UAtt IPLUMBING 1 ZoningSetbacks-Easements-Flood-Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Sol Is -Steel -Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd flr - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test , 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs -Rgitr-Seryice Test 12 Elec Undrgrnd DATE IMECHANICAL 13 Plenums & Ducts; Cirnc-MaterialSupport-Insultn 61 AC Ducts Insultn & Support 14 Girders-Sills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic FRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & flr Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration-Walls-Wndws o' ELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or ❑ AL AC Wire Szga ❑ CU or ❑ AL 48 Range Circ _:aa ❑CU or F-1 AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 0`S 400 0�� FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv flr Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 lnsultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Pimb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptci-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR. INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO52579 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/23/2005 APN: 029-250-011-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 5296 CHURCH ST RIC License Class: License Number: Map Index: Date: Contractor: Description: ELECTRIC SERVICE & MISC WIRING OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: THENGVALL DENNIS E & LESLIE D CP 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 pursuant to the provisions of 5296 CHURCH ST the Contractor's State License Law (Chapter 9 commencing with Section RICHVALE, CA 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 95974 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: E & LESLIE D CP owner of property who builds or improves thereon, and who does owner such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 5296 CHURCH ST sale. If however, the building or improvements are sold within one RICHVALE, CA year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of 95974 sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ADVANCED ELECTRIC & SOUND ❑ I am Exempt under Article 35 the Bus' ss and ofessions Code Date:y_:ow2& 3881 G BENATAR WAY CHICO,CA 95928 WORKERS' COMPENSATION DECLARATIOW 1 hereby affirm under penalty of perjury one of the following declarations: 530-891-7597 ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the License #: 623540 Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are:' Engineer: Carrier: Policy #: ❑ I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY - This permit is hereby issued under the cable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to dywork indicatgd aboy16 for hich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) 9 qs /j 5 Name: By: Date: / O) t�_� Address: PERMIT EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection puZ,"Q1 (� `�Z4AaV,41J JL'i't Print Name:` Signature - g� Date: % '66 XOwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B06-2491 Issued: 10/23/2006 Address: 5296 CHURCH ST RICHVALE APN: 029-250-011 Permit Subtype: Window/Glass I Owner: THENGVALL, DENNIS E & LESLIE D Applicant: WHEELER JOHN CONSTRUCTION Description: RETRO FIT 6 WINDOWS, STUCCO (180) MUST BE ON JOB SITE JOB SHALL BE READY PRIOR TO CALLING FOR INSPECTION. THE INSPECTION CARD AND APPROVED PLANS MUST BE AVAILABLE FOR EACH INSPECTION OR THE INSPECTION WILL NOT BE MADE AND A RE -INSPECTION FEE MAY BE ASSESSED. ALL PLAN REVISIONS MUST BE APPROVEI) BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DA' Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Sign Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Roof Nail 129 Shower Pan/Tub Test 408 Fire Sprinkler 702 Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Gas Test 404 Stucco Lath 142 Stucco Scratch 143 Stucco Bro 144 �a Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Project Final 801 JrhKMl1'N I5hUUMh NULL A1ND VUll) 1 Y COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy 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: 5296 CHURCH ST Owner: Permit NO: B06-2491 APN: 029-250-011 THENGVALL, DENNIS E & LES Issued Date: 10/23/2006 By KEJ Permit type: MISCELLANEOUS 5296 CHURCH ST Subtype: Window/Glass Door RICHVALE, CA 95974 Expiration Date: 10/23/2007 Description: RETRO FIT 6 WINDOWS, STUCCO (530) 882-4217 Occupancy: Zoning: ARMH Contractor Applicant: Square Footage: WHEELER JOHN CONSTRUCTION WHEELER JOHN CONSTRU( Building Garage RemdUAddn P O BOX 5262 P O BOX 5262 OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530)534-5449 (530)534-5449 FEE INFORMATION Siding/Stucco - Stone / Brick $110.00 Window/Door - Replacement $220.00 Total Charged: $330.00 Fees Paid: $330.00 Balance Due: $0.00 Receipt No: B611 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 WHEELER JOHN CONSTRUCT CSLB-586797 / B / 01/01/2008 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 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 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 �ct. X 10/23/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: CO actors Signature Date El1, 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: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND 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 Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors 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 State Fund 229-0004521 01/01/2007 Policy olicy Number: 6cp. Date: Contractors License Law.). (This section need not a completed if the permit is oror on�llars ($100) or ess. ❑ 1 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 subject to the workers'X 10/23/2006 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. X 10/23/2006 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 Signatuor Date WAR G: 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 AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( ) 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 use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. Count t enter the above m ntioned property for inspection purposes. I hereby certify that I am the pr own or aut rized to act on he property owners b alf. H A ,!>r yv 10/23/2006 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for ame of ermittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) rrrccc--Y�� Owner Contractor OR; 0Agent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net7dds "PLEASE PRINT CLEARLY" --- OWNER INFORMATION Last Nae �` l irst ame Mailing Addrefs S civi) State i1 Stat Zip Phone Fax Fax E-mail Lic. , --- CONTRACTOR Name �` l Address Q D City / State i1 Zi Phone_5-_,,4 — Fax E-mail State/ Lic. , Class --- ARCHITECT/ENGINEER Name ) �cj t 2�� v Address /" City Address State Zip Phone City Fax E-mail State/ State License Number --- - APPLICANT INFORMATION Name -1 /" Page Address Planner D City 3 G v / State/ Zip Phone If hiring anyone other than license contractors, a certi rcat of worker's compensation must be shown at the time of permit issuance. _� Fax J E-mail LENDING AGENCY Name f APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. 6G.;q-9 BINN Descri ftion or Scope of Work: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. RV': i' Amount: ✓ Bldg SRA Sheriff SMIP Dater 0 3 other j� _� Total PROJECT LOCATION AP# D� Property Address r City Cross Street WORKER'S COMPENSATION Policy Number O fO Carrier ► ^ f If hiring anyone other than license contractors, a certi rcat of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name f Address ' \� N' Descri ftion or Scope of Work: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. RV': i' Amount: ✓ Bldg SRA Sheriff SMIP Dater 0 3 other j� _� Total