HomeMy WebLinkAbout030-200-06930-20-69
WILLIAM-R._FOX - - UPSHAW, Roy 5793E
1149 Roy Drive, Thermalito H. VENT - 4476P 444.4.P
Perm t #979-76P(inst. bldg. sew)--
I S F l �� -20-
9
h� 114.9 Roy Dr. (Lot 18, Upshaw dub. , Orovil..e
030-200-069 PERMIT#97-0966'. CONTR: John Voorhees,772 Biggs Ave.,OrovT -
FOX, William - (new single family)
1149 Roy Dr., Oroville . � ( .
Reroof/SF i 5/gv
r
030-200-069 06-1334
FOX, WILLIAM
1149 ROY DR, OROVILLE.
Cont: PAULS ELECTRIC «.K..
ELECTRIC PANEL
r
crl)oc�ao
I. NOTES
Butte County Department of Development Services u* a
7 County Center Drive, Oroville, CA 95965
(530) 538-7601—.byttecaunty.n@ydds °o
r
RESIP,�ENTIAL
- .,n _ _.
030-200-069 06-1334 .
APN: FOX WILLIAM--— -
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l I49 ROY DR, ORO VILLE
Owner. f . Cont: FAULS:ELECTRIC
Site Address: I ELECTRIC PANEL L�
Contractor.
Type of Permit: _
OFFICE COPY
Address 11�� ���►' a��.
GAS
Meter By Date
r ELECTRIC
y Meter By Date
r
i
CT�
r. SPECIAL CONDITIONS
CHECKED BY
D SRA
Q FLOOD CERTIFICATE EQUIRED
Q FIRE SPRINKLERS REQUIRED
0 SPECIAL INSPECTION ITEMS
Q VERIFY 5
Q USE PERMIT CONDITIONS "
Q SUBSTANDARD HOUSING LETTER
Q ENCROACHMENT PERMIT
Q REINSPECTION FEE PAID
Q ENV HLTH CLEARANCE
. a
s
DATE JOB FINALED:
SIGNATURE:
N
J 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.
1:W11-1IK*V
B. C. Building Permit 01-16.04 pg 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am licensed under
Issued Date: 06/05/2006 APN: 030-200-069-000
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.
Number:
Site Address: 1149 ROY DR ORO
License Class: License
QS 9"Tlet-d-
Map Index:
Date: 3 - (, Contractor:
Description: NEW ELECTRICAL PANEL
OWNER-BUILDER DECLARATION
I hereby affirm under penally 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: FOX WILLIAM R & SUE A
permit to construct, alter, improve, demolish, or repair any structure, prior
1149 ROY DR
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
OROVILLE, CA
the Contractors State License Law (Chapter 9 commencing with Section
95965
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
(530) 534-0440
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).):
O I, as owner of the properly, 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
Applicant: PAUL'S ELECTRIC
Code: The Contractors' State License Law does not apply to an
owner of property who builds or Improves thereon, and who does
625 MISSION OLIVE RD
such work himself or herself or through his or her own employees,
provided that such improvements are not Intended or offered for
OROVILLE, CA 95966
sale. If however, the building or improvements are sold within one
530-589-4100
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
sale.).
❑ 1, 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
Contractor: PAUL'S ELECTRIC
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.).
I 625 MISSION OLIVE RD
OROVILLE, CA 95966
❑ 1 am Exempt under Article 3 of the Business and Professions Code
530-589-4100
Date: Owner:
License #: 376492
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
Architect:
Labor Code, for the performance of the work for which this permit
is Issued.
Engineer:
❑ 1 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
Insurance carrier and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy #:
Census Code:
certify that in the performance of the work for which this permit Is
L
Issued, I shall not employ any person in any manner so as to
99�,
��
become subject to the workers' compensation laws of California,
and agree that If 1 should become subject to the workers'
compensation provisions of Section 3700;of the Labor Code, I shall
forthwith comply with.those provisions.
(n �j-(��
- --
Dale:
�`
Applicant: l
WARNING: Failure to secure kers' 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 applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolu Io s to do work Indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Dale:
Name:
By:
f
1XPIRES 5" 07
PERMIT ON: LI
Address:
Dare
❑ 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.
Cl 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 nefii� the d orized 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 s stance of a ficial form or document of Butte County. I hereby
authorize repre fives of Butte County to enter upon the above mentioned property for Inspecll purpos
(CJ
Print Name: �'— Signature:
Date:
O Owner Al Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16.04 pg 1
+=OK
0 = Not OK
MANUFACTURED HOMES .,
MISCELLANEOUS-.
DATE PERMANENT FOUNDATION SOFT -SET
1 ZoningSetbacks-Easements
2 Soils; Special MH Support Sketch
3 Sewer; Loctri-Test; FalUCIO-Concrete
4 Wtr; Loctn-Test-Easement Needed -Regulator
5 Elec Loctn-Cirncs-Gmd 'Am -Concrete
6 Yard Gas; Loctn-Test Wrap Nat or LP❑
Inch Sz Ft Lngth
7 Blckng; SzSpacing-Marriage Line
8 Gas; MH Test-Demand-Valve-Cnnctr
9 Elec MH Cntnty Test-Crossovers-Breakers-Cimcs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -CIO to Grade
12 Gas and Electricity Tagged
13 Tie Downs ❑ Foundation ❑
14 Exits
15 Cert of Occupancy
16 HUD Label/Insignia Numbers Serial Numbers
---DATE D 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 ZoningSetbacks-Easements
2 Ftgs; SoilsSz-DpthSpacing-CnnctrsSteel
3 Decks, Glyders/Jolsts-0cking-Brcing
Stairs-GuardlHandrails
4 Wood Awn; Posts-Beams-RRrs-CnnctrsShthg.
Frmg-Brcng
5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs
6 Carports; Wndws-Doors
7 Electric
8 Fnng; Sills-AnchrsStuds4btrs-Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof; Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wali pnls
s' 41
DATE JPOOLS
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men-Uning
4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15 volts-GFI
6 Elec Encisrs; Con dult Entries Tenninals4lsted .
7 Elec Bonding; Metal w/5'-Crcltng Egp-Htr
8 Elec Grndng;.Egp w%5' Crcitng Eqp-Pool Ightg
6oxes-Enclsrs4nlboards4nsultn 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
.
o 41
rya kyr
Pool
Pool Drawing
0 - Nat OK
RESIDENTIAL
(Single
&
Duplex)
DATE JUNDERFLOOR
DATE
PLUMBING
7 coning-Setbacks-Easements-FloodSlope
2 Ftg Main; Soils-Elec Grnd Ftg DRth
3 Ftg Garage; SollsSteel-Elec Grnd Ftg Opth
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
5 Stemwalls Wain; Steel-Blockouts Wrapped
6 Stemwatls Garage; Steel-Blockouts Wrapped
6a Hold Downs and Special Anchrs
7 Slab, Steel Wrapped
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-RgitrService Test
12_ Elec Undrgmd
13 Plenums & Ducts; Clmc-MaterialSupport4nsultn
14 GirdersSilts-Anchr Bolts-Joists-Vnts-Cripples
15 Acc & Vntttn
16 Insulation
o� d 1
DATE FRAMING
17 Sills Proper Materials & Anchrs
18 Walls Studs-Naiiirig Spacing & Braces -Plates -Sound
19 Bearing Walls over Girders .8 fir Nailing
20 Draft Stop in Walls (rat proof)"
21 Fire Stops,'FUrred CeilingsStairs-Chasers-Tubs
22 Headers & Beams-Sz &Bearing
23 Hangers-P_ost Caps-Anchrs,Cnnctns
24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TnusShthg
25 Frplc Ties or Type A Flue*rplc Throat Clmc
26 Attic Acc; Sz &'Riaz .Prtctn-Draft Stop -Ins Baffles
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
28 Garage Fire Prtcth Framing -RC Channel
29 Prprty Line Firewall & Opngs'
30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Rund.anding-Fire Prtctn
32 Plywd on Roof Ovrhng AtUc Vnts-Rftr Outrgrs
33 Siding -Nailing Veneer
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc
35 Glazing Area -Glass PrtctnSkyLts-Plastic .
36 Shear Walls; Nailing -Bolts
37 Brace Int/Ext Wall pnis
38 Insultn-Walls-Ceilings
39 Infiltration Walls-Wndws
v
DATE JELECTRICAL
40 Fxtr & Trnsfrmr Clrnc4ns 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 ya ❑ CU or DAL
AC Wire Sz ya ❑ CU or DAL
48 Range Ciic oa Q CU or Q AL
Oven Circ ga Q CU or QAL
Insulated Neutral E] Yes E:] 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
53 Wtr Htr; Vent Acc-Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr. Nail POctn
56 Shwr Pan; Test, First fir -Tub Acc
57 Test Tub & Shwr, 2nd fir - Tub Acc
58 Gas Pipe; Sz & Anchrs
59 Fire Sprinkler; Test
60 Yard Gas Piping
up►rt MECHANICAL
61 AC Ducts Insultn & Support "
62 Vent Fan, Exhaust abv Insultn
63 Condensate Drain & Ovrflw, Sz & Grade
64 Furnace Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
66 Ext Steps -Door & SldeLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Clmc-Comb, Air-Cnnctr
In Garage; abv-flr-Ducts-Mach 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, Clmc-Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cirnc
77 Elec Outlets & Rcptcls at Ktchn Counter
78 Garage Fire Door; Swing -Landing -Closure
79 AC Duct in Garage -Damper.
80 Wtr Htr; Vnts-Cirnc-Com Air Cnnctr-PRV; abv fir
Mech Prtctn; LPG Appince Undr House 3" drain
81 Plmb; Elec & Mech Eqp Listed for Locin
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
83 Insultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth
86 Clmc Drnge Planters Q Yes Q No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, PImb-Appinc-Frplc-Cirnc to Opngs
90 Wtr Well, Dscnnct, Elec, Plmb
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
92 VnUtn thru House
93 Glass Prtctn
94 Corrections from previous Itispctns
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
o'�• o`er` d, �s
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.
BP061334
B. C. Building Permit 01-16-04 pg 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 06/05/2006 APN: 030-200-069-000
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.
, v License Number: �� ���
Site Address: 1149 ROY DR ORO
License class:
(> Contractor. LS 91 � , -
Map Index:
Dale:9 -
Description: NEW ELECTRICAL PANEL
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: FOX WILLIAM R & SUE A
permit to construct, alter, improve, demolish, or repair any structure, prior
1149 ROY DR
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
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95965
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
(530) 534-0440
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
Applicant: PAUL'S ELECTRIC
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
625 MISSION OLIVERD
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
OROVILLE, CA 95966
sale. If however, the building or improvements are sold within one
530-589-4100
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
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
Contractor: PAUL'S ELECTRIC
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.).
625 MISSION OLIVE RD
OROVILLE, CA 95966
O 1 am Exempt under Article 3 of the Business and Professions Code
530-589-4100
Dale: Owner:
License #: 376492
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
O 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ 1 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
insurance carrier and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy #:
Census Code:
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'
compensation provisions of Section 3700 of the Labor Code, I shall
�5 (60I
forthwith comply with those provisions.
y
Date: G7
Applicant:
WARNING: Failure to secure kers' 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,allorney's fees.
CONSTRUCTION LENDING AGENCY
This permit Is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolu !o s to do work indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.) `
Co_�(�
By Date: p',
Name:
C/1 -IS-07
Address:
PERMIT XPIRES ON:
Date
O 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.
O 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 or the d orized 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 s stance of a ficial form or document of Butte County. I hereby
authorize repro ' fives of Butte County to enter upon the above mentioned property for inspect! purpos
Print Name:Signature:
Date:
❑ Owner Contractor ❑ Agent for Owner O Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
-'APPLICANT INFORMATION
OWNER INFORMATION
Last Name
S
Fit Nat,
City
Fax
Add e
Zi
Cit . W
Fax
E-mail
Phone ^3
Z 0 v w
Fax
E-mail
-'APPLICANT INFORMATION
CONTRACTOR
Name
S
Add .es
City
Fax
State
Zi
Phone
Fax
E-mail
Lic. #
CI s
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
6
Name
-'APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Date Approved:
Fax
E-mail
State License Number
-'APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-Mai�-�
APPLICAJYT 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:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
BP0013
BIN #
Page 1 of 3
Description or Scope of l"k:.
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
required.
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.
Received by. Vh , Amount: `, b)Bldg
SRA
Receipt #: 155610 Sheriff
U1 L4g51 SMIP
Date: > S,Q(0 Other
Total
REV 8-12-05
PROJECT LOCATION
AP#
Properly Addre
City
Cross Street
G�
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Page 1 of 3
Description or Scope of l"k:.
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
required.
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.
Received by. Vh , Amount: `, b)Bldg
SRA
Receipt #: 155610 Sheriff
U1 L4g51 SMIP
Date: > S,Q(0 Other
Total
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.,
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. 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.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑ 4. NPDES Form.
❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7. Worker's Compensation Carrier and Policy Number.
❑ 8. Owner -Builder. Verification (if required).
1:19. Letter of Signature authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑ 12. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no .construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 3 REV 8-12-05
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030-200-069 "' PERMIT#97-0966
FOX, William
1149 Roy Dr., Oroville
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COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California. 95965 - Telephone (916) 538-7541—R,MIT, NO.
(Rev. 12/96) APPLICATION AND PERMIT
A EL NUMBEji
ZONING
BUILD G PERMIT
`OS�E�7ySgST�OTRP��RC_
OW�71 L�_lA/VYtfl��JOXX•(J7
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
D 1149 IIZOf DDR. , UROVII,l CA 959£ 5
- e I�f? �
CO RACTOR'S NAME
TELEPHONE '
CONTRACTOR'S MAILING ADDRESS
CON SOTWCTION LENDER
LENDER'SMAILING ADDRESS
Fireplace
Total Valuation $
RF N T OR ENGINEER
NONE
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Plan Checking Fee $
SULLQf4 �ODWy DR. , Op)VI1.I E
j j(�9 �U
Energy Plan Checking Fee $
$
PERMIT FEE $ .
IAT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑X Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each as water heater or vent 15.00—
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other EI
Describe Work: VE'E'R)~ W/CuIp
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S I G I W @20.00
PERMIT FEE S
ELECTRICAL PERMIT Filing Fee 20.00
Main Service coov, oR (Ess
2ooA oR (Ess 23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class LIC. NO.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law lor 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. SO
OR ADDNS. ( & ACC. SUDS. 3.5¢FT.
NEW CONST.MULTI.OUTLET
NON-RESID. ANCH I CUI S @7.50
8 SINOUPowERGLE APPARATUS
'LE CIR.
20 @ 1.00
Ex. Occup.OUTLET OR FIXTURES DAL @ .50
EX. Occup. pUTUETSPRESDOEA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with tho provisions.
Xi /' -' Date/ J _
S re of App can'� - 0 Ownet' ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 55.00
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
F N ..
%7 h_'&'ytl_Date 6
PERMIT EXPIRES ON
Date
Receipt No.
WHITE-D.D.S.75 . NARY' SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541_ Q 1 R IT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR
030-96-"W
ZONING
BUILD KG PERMIT
OWNER
WILIAM FOX
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
0 1440
OWNERS MAILING ADDRESS24
1149 ROY DR., OROVILLE CA 95965
CONTRACTOR'S NAME
OWNER
TELEPHONE '
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
NONE
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
NONE—Filing
LICENSE NO.
Fee $ 20.00
Permit Fee $ 35.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
1149 ROY DR. , OROVILLE
Energy Plan Checking Fee $
$
PERMIT FEE S 55,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF O; 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: REROOF W/COMP
Gas piping system 1- 5 outlets 15.00
Building sewer 15.00
Mobile Home ISI GI W1 920.00
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
Main Service soon OR mss 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.POWER
License Class Lic. NO.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law or 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.
O 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUP. s0
OR ADDNS. ( a ACC. DS. 3.5¢FT:
B
NEW CONST. MULTI -OUTLET
No NE ID.BRANCH CIRCUITS 97.50
APPARATUS
8 SINGLE OUTLET CIR.
20 Q 1.00
Ex. Occup. OUTLET OR FIXTURES BAL @ .50
Ex. Occup. ouT rs AFwSIOOEA. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.00
PERMIT FEE S
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
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
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.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with tho provisions.
Date
S169ru're—o'-f -App - caner O Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 55.00
:.AZ.
D. FEES IMP
I FLOOD
I CDF
PARCEL PD
I HD
I ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
/-Dat
-V
PERMIT EXPIRES ON
Dete
Receipt No.
WHITE-D.D.St.-B. NARY - -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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 iintil this
verification is received.
1. I personally plan to provide the maJpr labor and materials for construction of the proposed
property impr ement : YES 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: -
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.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTYOWNER:
SOCIAL SECURITY NUMBER:
DATE: s- — n
NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to issue the permit.
OVER
Ir O A 1
J .4
OWNER BUILDER INFORMATION
i
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements. specified: .
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
A permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit. in his or her name. .
Contractors are required by law to be licensed and bonded by. the State of California and to have a business
license fro_ m 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 worth the exception of various trades that you plan to subcontract, you should
be aware.of the followin ' ormation for your benefit and protection:
♦ If you employ/ otherwise engage any p rsons other than your immediate family, and the work (including materials
and other costs) is $300 or more for a entire project, and.such persons are not licensed as contractors or
subcontra ors then you may be an e ployer.
♦ If you are a loyer, you must gister with the State and Federal Governments as an employer and you are
subject to s ral o -at' luding state and federal income tax withholding; federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not cant' out these obliiations, and these risks are especially serious
with respect to worker's compensation insurance..
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to -secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
i rely,
Mic el C. Vi ira, C.B.O.
Ma ger, Building Inspection
NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code
OVER
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT.QF,PEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSORPARCEL NUMBER
zOI`NG
BUILDING PERMIT
OWNER L&
NnA
TELEPHONE
SO. FT OCC. BUILDING VALUATION
P C?'�77
OWNERS MAILING ADDRESS / / D y
Lfl-
CONTRACTOR'S NAME
TELEPHONE '
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
Energy Plan Checking Fee
$
PERMIT FEE
S S
LOT NO. SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF uplex ❑ Mobilehome O Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New O Addition ❑ Remodel ❑ Utilities ❑ Installation O Other ❑
Describe Work: Aezu-
Gas piping system 1 - 5 outlets
15.00
sewer
15.00
—Building
Mobile Home S G W
T§"
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service �'oYt oa LEss
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.20
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
O I, as owner of the property, or my employees with wages astheir sole compensation,
will do the work, and the structure is not intended or offered for sale.
O 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:
O 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.
O 1 have and will maintain workers' compensation insurance, as required.by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X Date
Signature of Applicant - ❑ Owner O Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0' deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. owEUING OCCUP. s0
OR ADONS. ( a ACC. BLDs. 3.50FT.
NEW
NON -RES D. STI CIRCTUITS@7.50
PSO APPARATUS
& SINGLE OUTLET CIR.
@ 1.00
Ex. Occup. OUTLET OR FDMREs SAL @ .so
Ex. Occu . oFurEitTs A o� 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE S
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ S�S
Z. I D. FEES IMP I FLOOD
I CDF PARCEL ( PO NO ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
(Delo)
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I
i n �
PffRMIT NO. 979-76P
s ,
PERMIT EXPIRES 3/5/77
OWNER .WILLIAM R. FOX
CONTR. owner
LOCATION (A.P. 30-20-69
1149 Roy Dr., Oroville
i Temp. Power Pole
Called P &-E
Temp. Elec/Serv.
r Calle PG&E
f Temp. as Serv.
r
alled PG&E
OB. r 4zz�
FINALE,
(Date)
(Signature)
THERMALITO IRRIGATION DISTRICT
410 GRAND AVENUE
OROVILLE, CALIFORNIA 95965
TELEPHONE 533-0740
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: 1A we
Owner's Name: Date:
Address: Acct. No:
y
A.P. No. r 2 r'
Phone: No. Units:
Applicant/Agent: IQ ,/A Agents Proof:
Address:
Fees:
Phone: Application $+
Arrearage
Preliminary Review By: -7-Date: - �''� CSA 26
Remarks: SC -OR
1 St mo. S.C.
Other
Total Fees v1 v1
Collected By:
Date:
Field Review By: Date: 3
Remarks:
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
Or 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 - TIO, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECGRD
BUILDING I 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 Piping
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
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
(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 — Oroville, California 95965 Q _
~ Telephone: 534-4541 7
APPLICATION AND PERMIT
7(1:9
authorze le)JIesentativeS of the County of butte to enter upon the
above-mentioned property for inspe purposes.
Xel. Date ✓
Signature of Permitee or Agent
Receipt No. 'z6k2 &!�—
White-D.P.W. — Ye lol w -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.
TOR 9F PUBLIC WORKS
Da
permit expires Date
BUILDING
Owner
SQ. 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 $
11
Building Address a
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 �rQQ
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. Q a v—
Z
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
lbk
Sawi>aieN-
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00 S cQ_ Q
EQA
Parking
Plans
Parcelparcel
Declaration
Ma P
60' R/W
Improvements
Lawn sprinkler system 2.00
.FILL. PI___ a__,4.
Parcel Approval
Plans Approval
Permit Fee $ —
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER r"2'
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
e�o zdze
Main service 600V OR LESS 5.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 2.50
SinSingle Family Duplex Mobil Home
9 Y P ❑ ❑ Others ❑
Main service OVER 600V
10o AMP OR•LESS 25.00
Main service/ EA. ADD•L 100 AMP 1.00
DWELLINGNEW CONST.
OR ADDNS. ( ACCBLDGOCCUP. &) 21tsgft
NEW CONSTR. MULTI -OUTLET
NO N.RESID. ( BRANCH CIRCUITS) 2.50e4
NEW CONSTR. (PO%YER APPARATUS &)
NON -RES,D. 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) BAL0e
Ex. Occu P•(FIXED APPLNS. OR
OUTLETS (RESID.) EA) 2.00
Temporary'service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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
authorze le)JIesentativeS of the County of butte to enter upon the
above-mentioned property for inspe purposes.
Xel. Date ✓
Signature of Permitee or Agent
Receipt No. 'z6k2 &!�—
White-D.P.W. — Ye lol w -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.
TOR 9F PUBLIC WORKS
Da
permit expires Date