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030-170-079
`.. - ., \- - 79 Clifford Polston/ 55 • -fie;-Orovil�eI � • Permit 4791-75B oof)4F 030- 17-:0- -9 1 -4267, ` - `! .. .' x P.OLS'TON, MARY eEL 6ONTR: -BUTTE•LAND D55 CHERRY LN, OROV ILFIRE DAMAGE REPAIRS1 '?a 130 0 170-079- 94-0076E POLSTON, MARY , M 'n, , CONT; SHARP ELECTRIC ✓ zy 9� ��. 55 CHERRY LN. ,.OROVILLE UPGRADE -ELE SERVICE/SF V, 0 0 rk 0 t ra i. , 030-170-079 94-0076E �.71 P.OLSTON,.MARY " CONT: SHARPELECTRIC;a 55 CHERRY LN., OROVILLE ; UPGRADE ELE SERVICE/SF q3� 9 r ' i i �wlVns•. y ` Y j[ GAS Meter By 030-170-079 94-0076E �.71 P.OLSTON,.MARY " CONT: SHARPELECTRIC;a 55 CHERRY LN., OROVILLE ; UPGRADE ELE SERVICE/SF q3� 9 r ' i i �wlVns•. y ` GAS Meter By y Date ELECTRIC p _ 'Meter By ""� Date COUNTY,, OF.BUTTE - DEPARTMENT'OF DEVELOPMENT SERVICES- BUILDING DIVISION d..4" 7:County'Center Drive - Oroville, California 95965 - Telephone (9115)'538-75 PERMIT NO. APPLICATON AI DTERMIT ASSESSOR PARCEL NUMBER 30-17-79 I ZONING BUILDING PERMIT OWNER MARY TOLSTON r TELEPHONE SO. FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1010 • �iDDLE 'RM LANE * A ASI OROVILLE 95965 . CONTRACTOR'S NAME SHARP ELECTRIC i2'18 CONTRACTOR'S MAILING ADDPO BOX 1390 OROVILLE 95965 3y Fireplace CONSTRUCTION LENDER N/A UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS LN/A Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 55 (MERRY LN PERMIT FEE $ OROVILLE PLUMBING -PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE n SF AD Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W ` 20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describework: UPGRADE SERVICE TO 200 AMP PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 I Main Service ( BOOVORLESS 200A OR LESS ) 23.00 23-00 Main Service ( 200A TO 1000A ) 46.00 ' NEW CONST. DWELLING OCC UP. OR ADONS. ( & ACC. SLOS. ) SD 3.50 FT, - CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) /CQ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code a license is in full fo[Ae and effect. License No. Classification U • 0 ❑ 1, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON.RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BAL. @ 1.50 Ex. Occup.FIXED APPWS. OR ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 f± I WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. "!7+ I have placed on file with.tKe County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ I shall not employ any person iA any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or.this permit will be revoked. PERMIT FEE $ 66.00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. 1 also agre .too save, indemnify and keep harmless the County of Butte against all liabi�tiesjgme osts, and expenses which may in any way accrue against said Count i ons ue ce of the granting of this permit. t? X Date - �" / Si nature of Applicant - ❑ Owner ClAContractor ❑ 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. TYPETOTAL FEE $ 66.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSu This permit is hereby issued under the applicable provisions of the Butte County, Code and/or Resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC, WORKS By /''�K/I�' i Date /! /47 PERMIT EXPIRES ON / ID•fEl - Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR -..k PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PE MIT NO. APPLICATION AND PERMIT. ASSESSOR PARCEL NUMBER 30-17-79 ZONING BUILDING PERMIT " OWNER MARY POLSTON TELEPHONE SQ. FT. OCC. BUILDING VALU N / OWNER'S MAILING ADDRESS 1010 MIDDLE HUF LANE OROVILLE 95965 CONTRACTOR'S NAME SHARP ELECTRIC TELEPHONE 533-5218 CONTRACTOR'S MAILING ADDRESS PO BOX 1390 OROVILLE 95965 Fireplace CONSTRUCTION LENDER . N/A UNKNOWN Total Valuation is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS LN/A Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 55 CHERRY LN PERMIT FEE $ OROVILLE PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF A'1 Duplex O Mobilehome O Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition O Remodel ElUtilities El Installation Installation O Other O Describework: UPGRADE SERVICE' TO 200 AMP FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 111V OR 200AORLESS SS ) 23.00 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OUP. OR ADDNS. ( 8 ACC. BLDSCC. ) S0 3.50 FT., NEW CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 CONTRACTORS LICENSE LAW( I declare under penalty of perjury (check one) I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code a license is in full for a deffect. License No. Classification °' CJ ❑ I, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B20AL. @) 00 Ex. Occu FIXED APPWS. OR p' ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. O I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 66.00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. 1 also agre save, inde nify and keep harmless the County of Butte against all liabil• ' , Jud a osts, and expenses which may in any way accrue against said Co nt i ops a ce of the ranting of this permit. 9 X Date /'" Si ure of Applicant - O Owner OVContractor ❑ 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 $ 66.00 HAZ• D. FEES IMP FLOOD COF PARCEL PD HD ISSU This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been 4 /DIRECTOR -OF PUBLIC WORKS By f^6`"'K/ PERMIT EXPIRES ON IDat 1 provisions to do work paid. p D to ''11,� Receipt No. / 5-J / / I— WHITE-D.D.S.-B.D. CANARY -AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION V 7COUNTY CENTER DRIVE -OROVILEE; CALIFORNIA 95965.TE'LEPHONE(9:16)538-7541 PERMITAPPLICATION DATA SHEET OWNER /fit %° e� 45, IT�,.�% ' A. P. No. Proposed Building Us S (Peentl'G -O n ,' - Building Inspector Date 171Wy9"` At time of perm•t a plication, I was advised, the following data must besubmitted prior to permit processing and/or issuance: r DATE RECEIVED BY 1, All items have been submitted: ........:...................... 2. Plot plans, 3/4 sets, signed by preparer of plans. ... 1 .................... . 3, Complete plans, 3/4 sets, signed by preparer of plans i ........................ A. Engineered plans and calcs, 3/4 sets, with wet•signature on plans . ............. 5. Hazardous Material Form. ............:............................ . 6. Energy Design Compliance and supporting documentation. -w*:.. "; ......... 7. Statement of Intent for Non -Heated and A/C Buildings. ...'W. . 8. Engineered truss details and layout in duplicate (required prior to plan check). . . 9. Mobilehome data and manufacturer's installation instructions,x2, sets`. ........... 10.'. Fees of $ . ........................ ............... 11. Impact fees as shown on attached schedule . ............. ',; ................ . 12. California Department of Forestry plan approval/fees. ............,�.y ............ 13. Flood elevation letter (100 year flood) by California Engineer. ..:..----. 14. Sanitation and plot plan approval Health Department ............... 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy). . . 20. Pre -inspection for required. .. e� ���ada (Date) 21. Contractor's license'information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner _�: . •......... . 24. Recorded copy of Agricultural Acknowledgement Statement . ................... 25. Letter of signature authorization . ................................ . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ........................................ . 28. Mobilehome utility clearance. •................ . • 29. Documentation of legal access . ....................................... . 1'30. Documentation of 5.0% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ................ 31. Existing violations/expired permits . ...................................... 32. Plan check list. ..... ........................... . 33. [. •34. f t (C i f When you issue the permit, process as follows: Mail to owner. ail to contractor. Telephone and hold for pickup at o. ce -i ! eliver with inspector. Parcel Creation X Acreage Applicant Date",' Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date "` By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date ' Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by ' - Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works r•u :..d ,p��.,�J�ni7/'�1P �ti�.��,� '-P'_Ydi.+s"�',. ^3fg' i'+, .,Tlyt� '�T„A `°:"'•s' \`�''C, .�. acTF �,Ar�.g"_YW_•T.�'. �N '•'vgJT'i""^'. \ 7&'. 030=17-0-07g `t POLSTON, MARY 91-4267 , CONTR: BUTTE LAND DEVELOP• 55 CHERRY LN, OROVILLE FIRE DAMAGE REPAIRS I u.) 7 �e 4f�r 7 } r•�9aFrx J COUNTY OF BUTTE - DEkRTMENT OF PUBLIC WORKS; PERMIT RO. 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538.7541 ,., �=•�.� / APPLICATIONIAND-EERMIT ASSSE�SSOR PARCEL NUMBER ZONING.-- ]l - BUILDING PERMIT OWNER TELEP -ONE SO. FT. OCC. BUILDING VALUATION MARY POT lc;TON( t I MNTP,- 10.000 OWNER'S MAILING ADDRESS I � i 55 (MPRRY OROVILLE, 95965 ' ' CONTRACTOR'S NAM - TELEPHONE ANTI nV_WT,0 533-9323 CONTRACTOR'S MAILING ADDRESS - 1105 P R. C 95 Fireplace CONSTRUCTION LEND R UNKNOWN Total Valuation Is MAW Filin 15.00 g Fee $ LENDER'S MAILING ADDRESS Permit Fee $ 97.50 ARCHITECT OR ENGINEER LICENSENO.' Plan Checking Fee RI Ener Plan Checking Fee Energy g ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ _ � BUILDING ADDRESS Permit fee $ 112.50 55 rSFRRY IN. - O LR PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 X Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP f Water piping 7.00 Each qas water heater or vent 7.00 . • i USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 SF[K Duplex❑ Mobilehome❑ Other Mobile Home I S I G JW @ 15.00 SPECIFY I. TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities❑ Installation❑ Other °(] Permit Fee $ Describe work: -' REPAIR FIRE DAMAGED ROOF AND WALL _ Contractor *- STBUCPtIRAQ ELECTRICAL PERMIT Filing Fee 15.00 . - •' Main service soot/ OR LESS 18.50 200A OR LESS _ Main service 200A TO 1000A), 37.50 CONTRACTORS LICENSE LAW NEW''CONST. DWELLING OCCUPM 3.6Qsq.ft. I declare under penalty of'perj ury (check one): ( OR ACDNS. ACC. BLDGS. NEW CONSTRESID, @ 5.00 am licensed under'provisions of Chapt. 9, Div. 3 of the Bu$Ines$ RANCHLTI.OUTLET. NON•R ESID BRANCH CIRC ITS POWER APPARATUS & I. and Professions Code and my license Is In full force and effect. SINGLE OUTLET CIR. License .Jo.=i �i 3671ClassificationQ Ex. Occup( OUTLETS OR FIXTURES 20 76 ❑ I, as the owner, or my employees with wages as their sole( compen- Ex. Occup. OUT ETS P(RESIO )RE A.) I 3.00 sation, will do the work,and the structure is not intended or offered Temporary service 15.00 for sale. (Sec. 7044) El I, the licensed Mobile Home Facilities 15.00 as owner, am exclusively contracting with contract- Misc. Wiring 15.00 15.0(T ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ — Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): , I MECHANICAL PERMIT Filing Fee 15.00 F -]The permit is for $100.00 (valuation) or less`-' Heating 9= have placed on file with the County of Butte Building Department y a Certificate of Workmen's Compensation Insurance or a Certificate 'EVAP 1 DT— of Consent to Self -Insure. ' . f, Cooling p • ❑ I shall not employ any person in any manner so as to.become subject Hood 6.50 to the W. C. laws of California. Ventilation "• Notice to Applicant: If after making this statement, 'shouId-you -become subject -.such pemilt Fee ' $ to the W. C. provisions of the Labor Code, you must forthwith comply with provisions or this permit shall be deemed revoked. Contractor I certify that I have read this applicatioii'and•state thatithe above information Mobile Home Installation Fee S is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Energy Inspection Fee $ Butte to enter upon the above-mentioned property for inspection purposes. OCC CONST TYPE 177.50 I also agree to save, indemnify and keep harmless the County of Butte against TOTAL FEE $ all liagilities, judgments, costs, and expenses which may in any way accrue HAz DFEES IMP FLOOD CDF PARCEL PD HD Iss agaiinnsf said County ir-Lconsequence of the granting of this permit. t�.Date X�-CHA This permit is hereby issued under the applicable provi $;iae of A licant - ` Owner g pp ❑ Contractor ❑ Agent ©� yy,, sions o�#te . utte County ode and/or resolutions to do i Jf !► work i dic ed aboveo which fees hive been An"permit is required for excavations over 5'0" deep and demolition or construct- paid. N ion of structures overstories height. DIREC:I BLI(1�j1N/( RKS 12%11 41 f3 tiinn Receipt No. iJK��J / 1 By A /t Date /11/9 p WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date L� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT 0. 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 ' APPLICATIOWAND' PERMIT _' If 27z ASSESSOR PARCEL NUMBER 030— 7 — ZONING BUILDING PERMIT OWNER TELkPF{ONE SO. FT. OCC. BUILDING VALUATION CONIR.10.000 OWNER'S MAILING ADDRESS OROVILLE. CA 95965 Lq-mg CONTRACTOR'S TELEPHONE .533-9323 CONTRACTOR'S MAILING ADDRESS 01ROVILLE., CA 95966 Fireplace CONSTRUCTION LEND R UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 97..50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS SS MERRY TN_ OROVILLF Permit fee $ 112.50 PLUMBING PERMIT Filing Fee 15.00 , Each Trap 1 5.00 Solar or heat pump water heaterE17.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water pipingEach qas water heater or ventUSE OF STRUCTURE Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outletsSF© Building sewer Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other K] Describe work: REPAIR FIRE DAMAGFD ROOF AND WATT. _ (NO STRUCTURAL) Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LESS 200A OR LESS 18,50 _ Main service 200ATO100DAI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): �. �� UyI 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. o�36 Classification R ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUPM OR ADDNS. l ACC, BLDGS. / 3.64sq.ft. NEW CONSTR.ULT'-OUTLET NON-RESID BRANCH CIRCU, TS @ 5.00 I POWER APPARATUS &) %SINGLE OUTLET CIR. EX, Occup(OUTLETS OR FIXTURES 76 FIXED APNS.20 Ex. OCCUp. OUTLETS P(RESID IREA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 1.5.00 Permit Fee $ 30.00 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling EVAP 11.00 Hood 6.50 Ventilation permit Fee $ 3.5.00 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 harmless the County of Butte against all Iia ilities, judgments, costs, and expenses which may in any way accrue agai said County irkcon equence of the granting of this permit.9 Date bl gn tore of Applicant Owner ❑ Contractor ❑ Agent P� An OSHA permit is required for excavations over, deep`. d d m it' n or construct- ion of structures ove3 stories in height. /C/ Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES 177.50 HAz 0FEES IMP FLOOD F PARCEL PO rID Is E This permit is hereby issued under the sions of a utte County ode and/ work d' ed ab o hich fe L By IRE I I PERMIT EXPIRES Date /// applicable provi- r r olutions to do ve been paid. RKS Date 12/11/91 2/11/92 t� Receipt No. Vc z i� t/ O ©,(7 WHITE-D.P.W., YELLOW -ASSESSOR, P NK -I NsPECTOR, GO ENROD I 6T COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916,538-7541 APPLICATION°AND 'PERMIT PERMIT NO. ASSESSOR PARCEL NUMB —17 ZONING BUILDING PERMIT OWN Eft �� TEL&RHONE S0. FT. OCC. BUILDING VALUATION OWNE MA NG ADORE S C r--1 L�(/ CON.TRACCTO NAME TELEP NE 4AI-V-42S CON T MAI AD RE33 (p Fireplace CO&STRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING S ADDRESS _ G �y Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W 615.00 TYPE OF WORK New ❑ Addition ❑ RReemodel ❑ Utilities ❑ Installation Other Describe work: — _ PE CE{Z �i f�� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LESS 200A OR LESS 18.50 Main service 200A TO 1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 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 th(Sece owner, am exclusively contracting with licensed contract- 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ! DWELLING 0CUP.y\ OR ADDNS. l ACC. BLDGS. // 3.6090t. NEW CONST FL ULTI.OUTLET NON.RESID BRANCH CIRC ITS) @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 764 FIXED APLNS. Ex. OCCUp. OUTLETS P(RESID )REA.1 I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ — 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 Seif-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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating rQ Cooling Hood 6.50 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Si nature of Applicant - Owner _ 9 PP ❑ Contractor ❑ Agent ❑ An OSHA ion of structures tover required soin excavations ions over 5'Q" deep and demolition o. construct- Mobile Home Installation Fee S Energy Inspection Fee S occ CONST TYPE TOTAL FEE $ HAz I DFEES I IMP FLOOD CDF PARCEL PO HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR- --r-n-APPLICANT LOCATION: uS Cil r r CONTRACTOR: bf �`E d 0. / ! CL t� i� l 1 n PRE -INSPECTION FOR:"i �� DATE ho A / A. P. # 0130 ZONING .DATE T0' INSPECTOR 1�I .PERMIT HISTORY: NONE_( AS FOLLOWS i f 1 TYPE OF OCCUPANCY 0 its eGf1© h j FIELD - INFORMATION BUILDING USAGE: TENNANT: 25'0CCUPIED LZE[�HAS ELECTRIC �TED-COOLED �GAS [ffM!�S—SANITATION FACILITIES PERSON CONTACTED. OTHER COMMENTS: _r c�/9-�L f�l��%- I;�U62/1%�J'-v�¢�.v� P CooLoge io N i2&64 J? a C oy I.- ,,22 xl d 7- 4 Z:Z-i L ACTION RECOMMENDED: ISSUE 0 HOLD FOR OTHER: DEPARTMENT OF SOCIAL SERVICES AL PAYMENT AUEST kGAINST YOUR CASH AID AND THAT INCOME HAS DROPPED OR STOPPED. afore or after. iat the county is counting income that has dropped or stopped against your cash aid. I p ng days after the date this completed form is received. ` J this month we expect the S •t Cost $ COUNTY USE ONLY DATE POSTMARKED: CASE NAME AND NUMBER: Supp. Month ' Est. Earned Income ' $ W/E Disregard — Dep. Care Disregard — Net Earnings = S Total Aid Before O/P Adj. + _ OWNER COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORyIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. A. P. No. Proposed Building Use Building Inspector Date At time of permit application, I was advised.the following data must be submitted prior to permit processing and/or issuance: 1. All items have been submitted. 2. Plot plans in duplicate/triplicate, signed by preparer of plans. 3. Complete plans in duplicate/triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Hazardous Material Form. 6. Energy Design Compliance and supporting documentation. 7. Statement of Intent for Non -Heated and AC Buildings. 8. Engineered truss details and layout in duplicate (required prior to plan check). 9. Mobilehome installation data including manufacturer's installation instructions. 10. Fees of $ 11. Chico Urban Area fees paid. 12. Park fees paid. 13. School District fees paid. 14. Sanitation approval from Health Department. 15. City of Chico plumbing permit. 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be required. Contact Land. Development Section of DPW. 19. Driveway permit (construction approval required prior to occupancy). 20. Pre -Inspection for required. 21. Contractor's license information (No., Name Style, Classification). 22. Certificate of Workmans Compensation Insurance. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑). Recorded copy of Agricultural Acknowledgment Statement. ___(25.,j,ette9ofT signaturg,au�hori ti ""'Cr --0 ,Arc 26. 27. A .L Pee m; r— When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant Date GENERAL INFORMATION BUILDING DEPARTMENT OFFICES HEALTH DEPARTMENT OFFICES Chico. . . . 196 Memorial Way Chico. . . . 196 Memorial Way Phone: 891-2751 Phone: 891-2727 Hours: 8:00 a.m. - 12:00 a.m. Hours: 8:00 a.m. - 9:00 a.m. Orovi I le . . . 7 County Center Drive Phone: 538-7541 Hours: 8:00 a.m. - 5:00 p.m. Parad i se . . . 747 Elliott Road Phone: 872-6307 Hours: 8:00 a.m. - 12:00 a.m. Oroville . . . 7 County Center Drive Phone: 538-7281 Hours: 8:00. a.m. - 10:00 a.m. Paradise. 747 Elliott Road Phone: 872-6308 Hours: 8:00 a.m. - 9:00 a.m. PLANNING DEPARTMENT — 7 County Center Drive, Oroville — Phone: 538-7601 — Hours: 10:00 a.m.-- 3:00 p.m. Original — Applicant • ... i .. .. .. ...fit. .; �: -y..• � �,. • ... . yr,�n. a,a.�.p!,�j'qui-��`�.,..;.,.+'_��il(',t'E�'; COUNTY OF BUTTE - DEPARTME•NT-Op PUBLIC WORKS - BUILDING DIVISION! . 7 COUNTY CENTER DRIVE - VILLE, Q;ALIFO%.IA 95965 - TELEPHONE: 916/538-7541 Ile for PERMIT AP"PLIC"ATION DATA SHEET Permit No. OWNER A. P. No. Proposed Building Use Building Inspector Date At time of permit application, I was advised the following data must'be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans .. y 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions..... .......................... .. .................. 10. Fees of $ 11. Chico Urban Area fees paid .......... .............................. 12. Park fees paid ..................... .'.... . A. ..... . 1 . 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... -16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre-Inspectio.n for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications "... 22. Certificate of5Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner 0). . Recorded copy of Agricultural Acknowledgment Statement ......... 25. tter of signa ure uthoriz ti9n / 27. 46,c_ Ocic. M I— When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant Date Copy of dz-Mat-form sent ' HHealth Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. S 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone---mail" counter by ..date Contractor, designer, owner, was advised of above required data by_phone=mail I &counter by ' date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet- ,t AP folder •r, .' Copy—DPW OWNER: PRE -INSPECTION DATE / k - K I LOCATION: r S�S ✓- 1� A . P . #-30-/7 ' 7 CONTRACTOR: Al -w 4f Q r �r �► ZONING PRE -INSPECTION FOR: /- c, e c DATE TO INSPECTOR /Z - `T- Tj PERMIT HISTORY: NONE AS FOLLOWS: 9 -19 - 75- TYPE 5 TYPE OF OCCUPANCY FIELD - IMFORMATION BUILDING USAGE: TENNANT: [� OCCUPIED �� HAS ELECTRIC S GAS ga6s SANITATION FACILITIES HEATED -COOLED .�--ff�rPERSON CONTACTED` OTHER iMTS: i� 6i► mimpo- WA i �' 50 ACTION RECOMMENDED: ISSUE 0 HOLD FOR OTHER: �i - PERMIT NO. 4791--75B P E M MH UTIL. PERMIT NO. PERMIT EXPIRES OWNER Clifford Polston ONTR. owner. OCATION (A.P. 30-17-17 j Oroville MS'S CLi e, low r- t Temp. Power Pole Called PG&E Temp. Ellec. Serv. Cal'l'ed PG&E Te p Gas Serv: Called PG&E JOB FINALED (Date) / _ �I 6 f (Signature) i COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILD NG BUI ING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. N Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathigo Water Piping Piers Roofing / (.j Sewer Garage Fdn. Vents V Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped j Heaters Appliances Carport Footings Conformance of ex structure Gas Piping & Test Temp. Gas Slab Final `�il� Sanitation Patio FIREPLACE Final Footings Footing Walls Throat Rou h Reinf. Steel Final JEMasonr Fixture Bond Beam FIRES R NKLERS Motors Mesh Scratch Brown Finish Interior Lath Door Closer DATE ©����7 L ME NICAL Grd. Fault Prot. t Heating Service j Cooling Temp. Pole Ducts Under round ' Ventilation Permanent Final Final REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ' 7 County Center Drive - Oroville, California 95965,411 J� ,-- Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte•to enter upon the above-mentioned property for inspection purposes. Date i re of P a tee 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 pN'd. DIRECTOR OF FIU13LIC WORKS By Date wilding permit expires Date !j—? BUILDING Owner SQ. FT. OCC. BUILDING VALUATION ®-d Mailing Address Q Ilre%phone No. , Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee.&/or Penalty Telephone No. Permit Fee 610 bC Building Address L PLUMBING No. @ FEE PERMIT FILING FEE $3.00 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. No - 3 '-' 7 7 / Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet - .30 F s -Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 ci a 'a Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 10 ELECTRICAL No. @ 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 p2 Light fixtures yalain 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: Hood, Ex. Fan or F.A. Fun. 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 $ C authorize representatives of the County of Butte•to enter upon the above-mentioned property for inspection purposes. Date i re of P a tee 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 pN'd. DIRECTOR OF FIU13LIC WORKS By Date wilding permit expires Date !j—?