HomeMy WebLinkAbout030-181-019A.
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1235 Biggs Oroville
Permit #1224-76P b ewer) SF
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1235
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outr: Pyramid Const., Oroville
/ Permit #2276-80B 8(ud�i�iou �o
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File No.
BUTTE COUNTY (For Action 1, 2, 31
Public Works Dept. (For Information w/ )
Director
Dep. Dir.
Sec.
Rd. & Br. Mtce.
Shop & Yards
Bldg. Insp. Admin.
Design Engr.
Bridge Engr.
Constr. Engr.
Surveys
Mapping
Transp.
Land Dev.
Drng. /S.I.
Sub. & Pcl. Maps
Permits
Addr.
l
February 11, 1987
Steve Shrock RE: Building,Permit
1235 Biggs Ave. A.P. #30-181-19
Orovill'e, CA 95965,
Dear Mr. Shrock:
With reference to the above subject and the residence you own at the sub-
ject address, ,we do not have any records in our files concerning the
existing back porch.
We therefore do not know when it was constructed or what codes were applic-
able at the time of construction.
Should you have any questions concerning this matter, please contact this
office.. '
Yours very truly,
William Cheff
Director of Public Works
Original Cloned by
J. F. G lander
J.F. Glander
JFG:ahb Chief Building Inspector
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PERMIT N0.
t
1224`76P
s
PERMIT EXPIRES 3/16/77
OWNER EDWARD HOWE
CONTR. owner
LOCATION (A.P. 30-181-19 )
1235 Biggs Ave., Oroville
}
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I
a
1 -
i
Temp. Power Pole/
Called PG&E/
Temp. Elec. erv.
Called G&E
Temp. s Serv.
C led PG&E
FINALED
(Date) �
(Signature)
' � �Sl�:r-.� �r;. �r. � •,y.• _�� . rr .r � � r � ..: r- ... ..=,'� �.l, `��.:�.t1r•:rt'�.{�-.��.��'..,�..,�.._. :.r.. •.'lr+r •Y•�•�.rr .l f'`
�- THERMALITO IRRIGATION DISTRICT ..,
410 GRtAND AVENUE
OROVILLE, CALIFORNIA 95965
TELEPHONE 533-0740
E
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: - Irk . , n o K
4,1v .
IJCJ
Owner's Name: je0/,)f-#.9T I•ln-
Date:
Address:
,,.-
Acct. No: 4 /D -,,S-
459 Sr
9s-W,
A.P. No.: --2n 19) - /9
Phone: -2 - A / V9
No. Units: I
Applicant/Agent: /a
Agents Proof: A) /
Address:
Fees:
Phone:
Application $
'
����-x� '�
Arrearage
Preliminary Review By:`�'� Date: /461-
CSA 26
Remarks:
SC -OR
1st mo. S.C.
Other
Total Fees ),,AM�
r
Collected By:
Date:
Field Review By: Date: .312-76
Remarks:
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
Date of TID approval of completed building sewer (early connection).
❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes
first ("existing construction", prior to Mar. 5, 1974).
❑ 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes
first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor.
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Pipin
Piers
Roofing
Sewer .
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwall
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
Roucih
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 r
Permanent
Door Closer
Final
Final
DATE
REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Orovi lie, California 95965
Telephone: 534-4541
/tea y/_
APPLICATION AND PERMIT
`^ •,' '..I+'�..ac��a.+a�roa vi uic Vvunly UI OULIC N tvm, UIJVn InB
above-mentioned property for inspection purposes.
X zf A � �� Date
Signature of Peer+mitee 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 < b
Aui ei-permit expires Date "'
BUILDING
Owner e
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Te a hone No.
'-
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
Building Address 14y,PERMIT
S
PLUMBING No. @ FEE
FILING FEE $3.00 , Q�
6/
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
O,� l q
A. P. No. / !
Zoning &Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W.C. I Sentat'i'ew
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
IParking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im r
p ovements
Lawn sprinkler system 2.00
t�1d�.-P�laos-Reo-d
Parcel Approval
Plans Approval
Permit Fee $ �.
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
OR L
Main service 10000 AMP ORSLESS 5.00
Main service EA. AOD'L 100 AMP 2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service OVER 600V 21.00
100 AMP OR
0 AM
Main service EA. ADD'L 100 AMP 1.00
NEW CONST OR ADDNS. ( ACCLBLDGS.LING CCUP. 92�sgft
NEW CONSTR. MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS) 2,50ea
NEW CONSTR. POWER APPARATUS &)
NON•RESID, (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the, provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. OCCup(OUTLETS OR FIXTURES) BALP1
Ex. OCCUP•(FIED APPLNS, OR
OUXTLETS (RESID.) EA) 2'��
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
1 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.1 @ FEEPERMIT
FILING FEE J$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
$
`^ •,' '..I+'�..ac��a.+a�roa vi uic Vvunly UI OULIC N tvm, UIJVn InB
above-mentioned property for inspection purposes.
X zf A � �� Date
Signature of Peer+mitee 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 < b
Aui ei-permit expires Date "'
*PERMIT NO. 2276=80B,E
PERMIT EXPIRES
OWNER XH Steve Shrock'
CONTR. Pyramid -Const., Oroville
30-181-19
LOCATION (A.P. -
1235 Biggs Ave., Oroville
Temp. Powrer Pole
Called PG&E
Temp. lec. Serv.
Called PG&E
Tem.. Gas Serv.
ailed PG&E
JOB
FINAL ED
(Date)
I
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback Firewall I I —qA r 25 Soil Pi 1.
Forms
Parapets
P 9
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings 2 D AtalWindows
3rd Floor
StemwalI /
Siding r— ---
To out
'Slab
Roof Sheathing —
Water Piping
Piers
Roofing r- r
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwal I
Garage Vents
Insulation
Water Htr.._
Heaters
Slab
Carport
Footings
Prov. for ph sically
handica ed
Conformance of ex.
structure
Appliances
Gas Piping & Te
Temp. Gas
Slab
Final '—
Sanitation
' Patio
FIREPLACE
Final
ELECTRICAL
neint. steel Final Fixtures v
Bond Beam FIRE RINKLERS Motors
Framing Test Water Htr.
Stucco Final Subpanels
Mesh MEC NIC Grd. Fault Prot.
Scratch Heatino Service
Brown Cooling r Temp. Pole
Finish Ducts Underground
Interior Lath Ventilation Permanent
Door Closer Final Final 61i—t'
MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal
Water Piping Sewer Gas Piping
OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE p- REMARKS R CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE
f� EPARTMENT OF PUBLIC WORKS
01 der Avenue, CRico — Phone 343-4211, Ext. 70
ounty Center Drive, Oroville — Phone 534-4541
Skyway and Elliott Road, Paradise — Phone 877-3435
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that -the following 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 his office immediately.
rn I e .. 1 f'/1�-
1
0r_�
Inspector
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-454
APPLICATION AND PERMIT
PERMIT N0.
cza< 767
iflol
ASS SOR PRtEr NUMBER
_ (hhl
ZONING
BUILDING PERMIT
OWNER
F -v Cil
TELEPHONE
S0. FT. _OCC. I BUILDING VALUATION
- Q`
OWNER'S MAILING ADDRESS
CO T ACTOR'S NAME A) -S%.
#LEp-'Vo6
CONTR TOR'S MAILING ADDRESS
2� 7 v�,�r�ov� �
CON R UNI NOWN
Fireplace
Total Valuation $7iOO
i O V1
ER'S MAI /�R ES S
UAM8J)•120VI_
Permit Fee ,
$
ARCHITECT OR ENGINEER
LICEN E NO.
Plan Checking Fee
$ 00
Penalty
$
ARCHITECT OR INEER'S MAILING ADDRESS
Permit fee
$ &Cdo
BUILD 7s /
/ 5 r7 J / 1 n '
7
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
!
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE �
SF [:1Duplex❑ Mobilehome❑ Other /� ,, 4I� E
SPECIFY
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
New ❑ Addition L!P' Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 3.00
Main service 100 AMP OR00V OR LESS__5.00
Main service EA. ADD'L too AMP
2.50
NEW CONSDWELING OR ADDNST ( ACCLBLDG &) 20sgft O
CONTRACTORS LICENSE LAW
I declar nder 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.ad I 163 6 Classification
�
sole compen-
F] 1, as the owner, or my employees with wages as their sole
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 ULTI-OUT E 2.50 ea
NON-RESID BRANCH CIRCUITS
'NEW CONSTR. POWER APPARATUS &
NON-RESID. (SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
50L�
BAL@tOQ
Ex. Occup.FIXED APPLES, OR
(DUTLETS (RESID.) EA,) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $ 70
Contractor PETS Wul
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
Q The permit is for $100.00 (valuation) or less.
Ell'I have placed on Jile 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.
MECHANICAL PERMIT
FiIingFee 3.00
Heating
Cooling
Hood
2.00
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 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 liabilities, judgments, costs, and expenses which may in any way accrue
agai id Co ty in conseq nce o. he granting of this permit.
X ate�S "S' 00
Signature of A p I nt — Owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $ S, %a
o GROUP
s /
``
TYPE OF CONST.
I
PARCEL
�
PD
ND
,/
/�
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR 0 PUBLIC
By
PE T EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
r� p
Date (S-
y 17,-af/
-3
Receipt No. 37372-
WHITE-D.P.W., YELLOW- ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
....-: ;;;�
File No.
BUTTE COUNTY (For Action 1, 2,3)
Public Works Dept. (For Information �)
Director
Dep. Dir.
Sec.
Rd. & Br. Mtce.
Shop & Yards
Bldg. Insp. Admin.
D&C / Traffic
Const.
Rd. Des.
Br. Des.
Sur. & Loc.
Transp.
R/W
Mapping
Land Dev.
Ref. Disp.
Drng. / S. 1.
Sub. & Pc I. Maps
Perm its
Steve Shrock
1235 Biggs Ave.
Oroville, CA. 95965
Dear Mr. -Shrock:
May 20, 1980
RB: Special Inspection #29-80
(AP -30-181-19)
With reference to the above subject and your proposal to convert the residential
garage located at the above address into an auto detail shop, the requested inspec-
tion was made on May 19', 1980.
The inspection revealed the following items which must be done or resolved:
1. Provide one (1) 30 exterior exit door, preferably on the front of the
building, and usable by the physically handicapped.
2. Provide an approved electric f6eder from the residence to the auto detail
shop.
3. Verify adequacy of the circuits and grounding of the system to the service
ground.
4. Provide a one (1) hour occupancy separation wall between the detail shop
and the residential garage with all openings protected for 1 -hour, or
deleted.
5. If you decide to include the residential garage as a portion of the auto
detail shop, you may delete Item #4. In addition, you must provide a 1 -hour
.firewall from the foundation to the roof sheathing, including the eave over-
hang, at the exterior wall along the west property line. All openings must
be protected for 1 -hour, or deleted.
6. Provide attic ventilation.
7. If you add heating, air conditioning, or lighting, you must comply with the
applicable sections of the State of California Non -Residential Energy Require-
ments.
It is now in ordeVior you to submit complete floor plans, plot plans, and structural
details of the building as you propose to use it, apply for the required permits, and
pay the appropriate fees.
Should you have any questions concerning this, please contact me.
Yours very truly,
Clay Castleberry
Director of Public Works
JFG:dd Cl WififidIng Inspector
� v '
�� ..
��
� v '
'
BUTTE COUM-DEPARTMEM OF
PUBLIC WORKS
'SPED' SAL INSPECTION REPORT
Owner:— �v_2.-_- �� ��
A. P. #
Address:_
Date of Inspection
Tenant: p
r
Inspector
Building Location:�� 3 1� 6
Type of Inspection requested:
CD
1. Housing / / 2. Financing / 3.
Change
of Occupancy to ��
4. Other (specify)---
use ofbuilding:
J%®Present
A. Sanitation 11ouiijg
A
"9�'
c
1. Vater closet:_
2. Lavatory.-,
Bathtub OY S1iOlJP-r: _
-
4. Kitchen sink:___
a• Hot and cold Water to fixtures:
6. He ,ting facilities: /L.oMQ
_
7, Natural light and ventilation: ✓
8. Rocs•.n and space requirements: e�
9. Bedroom window or door for second exit--
10.
xit:10. Infestation of insects, vermin, or. rod;:.nts:_---- _
11. Connection to sewage disposal.:
12. CornecG ion to grater supply
13. Rubbish and garbage facilities:
14. Comments: --
S
- S M '*_V 1-1 1 '11� 0 C. _1_j
1. P.1-ers and footings:
0
2. Floor ronstnrction:_5- G
3. Wall construction: w�m a. V_
4. Ceiling and roof constructio:-L:— 1
v
5. F';,rr.places :__�_�..r��_�Ge
6. Comments: ��-
C. Electrical
L. Sezvic:: ^nd wound:-4/�?s. _o ' %-�-
2. Receptncles:_ .. %.✓�.. a ;i �-u vc-� -
3. Fusing:it
D. P11 bin .
1. Fixtures c:��o,,:�nzc.t(,d and vented:___pc)-, ._
2. vzuter
.3. Czts z:cTtrg Ear:as;sW`._._._��_,_,...,.�_... --
4. Ccziments:
E. Other k
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protectio.. _
5. Underfloor an attic
• vent ilat-1.o„✓
6. Comments: - —
F. Commercial Buildings
Roof covering: Cp,
d- .,Distance to property lines:
Physically handicapped: 712
Restroom floors and walls.
�b.
Exits:-
6.
xits:6, Improvements •
7. Zonirg: �--Z -- -
8. Comments:
Jxe
S o�
G. Field Problems or Violations N
1. Problem or %Aolation (give complete description):
2. What action taken (give complete description)
3. What action recommended:,
7-7A. nfonaation only
B. Hold for tea (10) days, then writ.: letter,
C. Write Letter.
77D. Other:
a it YN .. Y`..., r ^ J , VIA)al �•~.H'i`s-w,; r .� �� Rt++.. .i4 �� y` �.4 .itnr d �.� yi}�;�`:�t l r
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
Telephone: 534-4541
APPLICATION FOR SPECIAL INSPECTION
Owner A. P. No./�
Mailing AddressVIZZ, C Telephone No. ..5 j�%-9
�S�6S
Applicant Telephone No.
a� r
Mailing Address
Building Location / � --
I
I hereby request a special inspection of the following building:
/ Vl' 1. Dwelling (if only a portion, specify)
/ / 2. Apartment House (if only a portion, specify)
/ / 3. Commercial (specify present occupancy)
/ / 4. Other (specify)
I am requesting a special inspection for the purpose of:
/ / 1. Moving the building.
2. Financing (specify agency)
/ V1 3. Change of occupancy to
/ / 4. Other (specify)
Case No.
t/ A!JW 5f/ WAY 7-e- ..
I hereby certify that I will obtain the necessary permits and make any necessary corrections,
alterations, or repairs required by the County of Butte, as a result of this inspection, to comply
with building and housing code requirements. I also certify that prior to the use or occupancy
of this building, I will complete the above required corrections, alterations, or repairs, or,
if the building is presently occupied, I will complete the above required corrections, alterations,
or repairs within thirty (30) days.
I certify that I have read this application and state the above information is correct and hereby
authorize representatives of the County of Butte to enter upon the above-mentioned property for
inspecti n urposes. �t
Date � �� ��✓
Signature of Owner
Fee paid $ 541100
1st -DPW - 2nd -Inspector - 3rd -Applicant
Receipt No.
John Perry
Gordon Keetes
Paul Norman
Givard
Frank H. Boatuvight
V ask Moore
Dawid Poeeseic
>3ill iat'n `.ghee ack
Donald R. Chambers
Z_aaky Ivey
V-nck Kirk
�ii: �.4a&A s SGSB.i
Phillips
Wright
Lincoln H. Norman
J4hn Bereeck
Aamea Felix
Ruse Bates
Frank Bl fzai-m
Robe,- poach
f'QCa1ard Johanson
,.I "1
rte''
oro.-4mUer sales, Jago.. 49 Distrs
^�rxo.Tip �,.�.,�cc:ller Sales,0ro. s/sa lriextt
(g�$
.e row
1.0660 Nisi
W/S Jazc"
0,X,I
Fames WalsAnjuba My 224 Teha
SS/S speee
Wayne & Cab's. 230 sRc
1.71.5 E11
55 Colter
Sierra iii Seer., Para. 20 Wood I
Gari Mul.lania:9 11'aradise 6379 Luc!
'50 Creenk
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stephe6 C. Burton'chlco
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COUNTY OF BOTTE — DEPARTMEN-T QF PUBLIC WORKS — BUILDING DIVISION
7 County Center Drive — 0roville,.'California 95965 — Telephone 534-4541
PERMIT APPLICATION DATA SHEET
Permit No. -)e�_ 0
OWNERA.P. No.
Proposed Building Use 42
Permit fee based upon: Complete Contract Price DPW Valuation
�jOther (explain) '-��� � 1 �y— Z�ZZ^T 1
Building Inspector /_/� �J �,��� Date-/�-�sz'7�
At time of permit application, I was advised the following data must be submitted prior/to per(nit processing and/or
issuance:
DATE RECEIVED
APPROVED
__�,_'.
All items have been submitted...................................................................
2.
Plot plans in duplicate/triplicate...............................................................
3.
Complete plans in duplicate/triplicate...................................................
4.
Complete engineered plans and calcs.....................................................
5.
Plans with Energy Design Compliance Statement ............................
6.
State Energy Forms No. ....................
7.
Statement of Intent for Non -Heated & AC Buildings ...................
8.
Fees of $..................................................
9.
Letter of signature authorization.............................................................
10.
Sanitation approval from Health Dept....
11.
Planning approval for .............
12.
Certificate of Workmen's Compensation Insurance ........................
13.
Contractors License Information (no., name style,
classification) ...............................
14.
Improvements may be required. Contact Land
Development Section of Dept. Public Works (see
addressbelow).................................................................................................
15.
Pre -inspection for required. Pre-inspec. request to
bldg.inspector
(date)
16.
Other
When you issue
the permit, process as follows: t all to owner Mail to contractor.
__4_, -Telephone SSG — V'04e and hold for pickup at office.
Deliver w/inspection.
Other
Applicant , Date
Copy of plans sent Health Dept., Fire Dept., Other
Date
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time of application, circle item.)
1.
Index permit for above Items No.
2.
Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone
Mail
Other
By Date
Plans checked by Date
.Plans approved by Date
OTHER:
Copy/DPW
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