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HomeMy WebLinkAbout030-461-007030-46-1-007 00-0732 E CAFFEY, Zane 2127 Tehama Avenue, Oroville (reroo/SF) Alladin Roofing jgrlA-)R - `i /x-00 030-46)-007 CAFFFy, ZANF 06-1177 2128 TEHAMA AVE Cont: ERNESTN. OROVILLE DEA VOR SIDING 7:g �� S• Zb•06 lay B 030-461x'007' .,,,. c t>. - ac�;,k w3 .. 06-1177 IN O T C S 7 CAFFEY,' ZANE c.n == - .__< �s 2128 TEHAMA AVE, OROVILLE Cont: ERNEST N. DEAVOR ` SIDING L RrF-�ID APN: Owner. Site Address: Contractor. Type of Permit Permit No. SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDrnONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB.FINALED- J 6 SIGNATURE: OK o = Not OK MANUFACTURED HOMES DATE " PERMANENT FOUNDATION '" SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-DIrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat 0 or LPQ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Dnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-DIrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs 0 Foundation Q 14 Exits IS Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers 40 0 MISCELLANEOUS DEC KS•COVERS'CARPORTS`GARAGES 1 Zoning -Setbacks -Easements 2 Ftg3; Soils-Sz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnncfnsSplice-Decal-Enclsrs 6 Carptirts; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rffrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -landings 12 Braced Wall pnls Drawing POOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Dnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance -GR 5 Elec Pool Lting,-15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5-Crcltng Egp-Htr 8 Elec Gmdng; Egp*w/5' Crcltng Eqp-Pool Ightg Bokes-Enclsrs�pn1boards4nsultn 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 OK Not OK RESIDENTIAL (Single. & Duplex) DATE JUNDERFLOOR DATE IPLUMBING 1 ZoningSetbacks-Easemen ts-Fload-Slop e 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Fig Main; Soils-Elec Grnd Fig Opth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Fig Garage; Soils-Steel-Elec Grnd Fig Dpth" 55 DWV; Test Fittings & Anchr Nail Pctctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd flr - Tub-Acc 6 Stemwalls Garage; Steel-Biockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a1 Hold Downs and Special Anchrs 59 Fire Sprinkler, Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frpic Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test a lie °` 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgrnd DATE IMECHANICAL 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 61 AC Ducts Insulin & Support 14 GirdersSills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insulin 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16.Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic .�' , d� 4 r a` o` o' 0` DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 18 Walls Studs -Nailing Spacing & Braces-Plates•Sound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Watts over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-CIrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFl & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 71 GFl Arc Fault 25 Frpic Ties or Type A Flue-Frpic Throat Clmc 72 Elec Trim & Subpnl, Breaker Sts & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood PnI, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking Cimc 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrrn-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-CImc-Com Air Cnncir-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3' drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loon 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insults -Walls -Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes ❑No o'• m o'er °'� 87 Stucco Brown -Finish 88 AC Unit Dscrinct, Elec-Plmb 89 Wits abv Roof, Plmb-Appinc-Frpic-CIrnc to Opngs DATE JELECTRICAL 90 Wtr Well, Dscnnct, Elec, Plmb 40 Fxtr & Tmsfrmr Clmc4ns Prtctn 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntitn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Rornex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Gmd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Gmdng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C/0 to grade -HD Apprvl 46 2 Appinc Cirrs in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or ED AL 98 Address Posted AC Wire Sz ga ❑CU or❑AL 99 Fire Sprinkler 48 Range Circ ga ❑ CU or ❑AL 'Oven Circ ga ❑ CU or ❑ AL Insulated Neutral Dyes ❑No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clmcs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7.636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:.(530) 538-7541 PERMIT NO. BP061177 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/18/2006 APN: 030461-007-000 the Business and Professions Code, and my license is in full force and effect.' r o,s--7&]j License Class: License Number: Y Site Address: 2128 TEHAMA AVE ORO Date: 5 r Contractor: Cfl7t }� �.i�Jal Map Index: I D@SCrtlOn: SIDING 4 SQ.'S p 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 permit to construct, alter, improve, demolish, or repair any structure, prior Owner: CAFFEY ZANE G & JUSTINE to its issuance, also requires the .applicant for such permit to file a 2128 TEHAMA ST signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95965 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: ERNEST N. DEAVOR owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 203 SHADY OAK DR provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one OROVILLE, CA 95966 year of completion, the owner -builder will have the burden of .530-589-5348 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 not apply to an owner of property who builds or improves thereon, Contractor: ERNEST N. DEAVOR and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 203 SHADY OAK DR ❑ 1 am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 530-589-5348 Date: Owner: License #: 405782 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 Architect: 1� is issued. SSI I have and will maintain workers' compensation insurance, as Engineer: 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: �U Carrier: �. w-� Total Square Ft: 0 S. F. 7 % Policy #: Valuation: $0.00 ❑ 1 certify that in the performance of the work for which this permit is Census Code: 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 forthwith comply with those provisions. S - Date: Applicant: - - WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. // CONSTRUCTION LENDING AGENCY This per,,;i'Lis hereby issued under the p •cable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions to L ork indicated abo e f which fees have been paid. I BY Dater Name: /7 PERMIT EXPIRES ON: �� D % / Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & SafetyCode is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. 1 acknowledge it is unlawful to alter the substance of any official f or document of Butte County. I hereby . authorize representatives of Butte Cq/unty tonter upon the above mentioned property for inspection purposes Print Name: ►'>7 (/c t l/l b h Signature: / Date: ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 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. PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/18/2006 APN: 030-461-007-000 the Business and Professions Code, and my license is in full force and '— � effect. c7�/ �J License Class : License Number: Site Address: 2128 TEHAMA AVE ORO Date: S " - Contractor: G�77��f %� �J� Map Index: Description: SIDING 4 SQ.'S OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the p Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: CAFFEY ZANE G & JUSTINE to its issuance, also requires the .applicant for such permit to file a 2128 TEHAMA ST signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95965 she is exempt therefrom and the basis for the alleged exemption. Any 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 property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: ERNEST N. DEAVOR owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 203 SHADY OAK DR provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one OROVILLE, CA 95966 year of completion, the owner -builder will have the burden of 530-589-5348 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 not apply to an owner of property who builds or improves thereon, Contractor: ERNEST N. DEAVOR and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 203 SHADY OAK DR ❑ 1 am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 530-589-5348 Date: Owner: License #: 405782 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 Architect: 1� is issued. aSl I have and will maintain workers' compensation insurance, as Engineer: 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: �U VV-� Carrier: /����, -7 ��_ O 607�� Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 ❑ 1 certify that in the performance of the work for which this permit is Census Code: issued, 1 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 forthwith comply with those provisions. Date: 7 b Applicant: - WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit,is hereby issued under the p cable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutio s to ork indicated abo e f which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: �jl Date: PERMIT EXPIRES ON: r D Q9 Address: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official f or document of Butte County. I hereby authorize representatives of Butte Cgninty to enter upon the above mentioned property for inspection purposes Print Name: �► 1') //(� Vl � Signature: .S. _ Date: G ❑ Owner Contractor ❑ Agent for Owner ❑ 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 OFFICEt<: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buffecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION CONTRACTOR Last Name irst Name Address 7 Address City City State Zips y Phone Fax Fax E-mail i For office use only: CONTRACTOR Name ro e Address 7 /� r City � Stat--)' 6 Phon Lot # Fax E-mail Lic. # i For office use only: ARCHITECT/ENGINEER Name � �� r" �1 / �'►� � G Address I Yes City Type Const. State Zip Phone Lot # Fax E-mail State License Number i For office use only: APPLICANT INFORMATION Name � �� r" �1 / �'►� � G Address I Yes City Type Const. State Zip Phone Lot # Fax E-mail i For office use only: ZoningI 4R I Flood Zone I SRA I Yes Occ. Type Const. Subdivision Name Map Book Page- Lot # Planner Date Approved: uv cm rum auomi I I AL KtUUIREMENTS K:\FORMS\BUILDING FORMSM3IdgApplSubRgmts.doc Page 1 of 2 PERMIT NO )4177 BIN # PROJECT LOCATION AN Property Address . Cit e Cross Street Sheriff 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 Descripf)on or Scope of Work: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: G J Bldg SRA Receipt #: Sheriff SMIP Date: Other GG Total REV B-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 faxesl ❑ 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). ❑ 9. 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 KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 ..i � i. �Ic•:.y..is.r,yM.7((.Y'«r.KwF a e..h.st;., r +�. a a �. ter.. .� .. � t �'—�r-y i�'4 •Y• -:.—vi.i: ..:,iy-- '..i..r_ y.t �i;.«� Y+.. . _ 030-46-1-007 00-0732 B CAFFEY, Zane 2127 Tehama Avenue, Oroville (reroo/SF) Alladin Roofing COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 5 X7541 . PERW NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-46-1-007 ZONING R ILDING PERMIT OWNER nn TELEPHONE SO. FT. OCC. BUILDING VALUATION R OWNERS MAILING ADDRESS 2129 tnharna croville05066 CONTRACTOR'S NAME nIlmdAin rnnfing4Q_7QZ TELEPHONE CONTRACTORS MAILING ADDRESS 1 Q1; ar pl, rd orairille 05,065 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ • LRT -- ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS ' Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑XDuplex ❑ 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 ❑ Unities ❑ Installation ❑ Other ❑+X Describe Work: reroof /comty Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G - W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee - 20.00 000OR LESS Main Service OVA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i full force and effect. _ 7 License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, 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 TO 46:00 CCU000A NEW CONST. OWELI.ING OCCUP. DWE200ALLING OR ADONS. d ACC. BUDS. SO 3.5¢FT. NON gQID. EW OT.MULTI.OUTLET 97,50 POWER APPARATUS 8 SINGIE OUTLET CIR. Ex. Occup. OUTLET OR F=URES 20 aAa'. o UNS Ex. Occup. ourEiE s RESID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION I 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 Ste *,e iC �, ., Cl Policy Number -11w1- - I C77 (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 Uply with those provisions. X ,/�/ A_Q� Date — ,�� Signaturof Applic tt ❑-'`Owner �R) Contractor ❑ Agdnt An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood . 6.50 Ventilation PERMIT FE15 $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE w 47.00 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. / _/� _© rr '� Datd—/; PERMIT EXPIRES ON Date WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING VISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 5 -7541 /RMNQ- (Rev.12/96'T Y APPLICATION AND PERMIT ��(( ASSESSOR PARCEL NUMBER 030-46-1-007 ZONING ar ILDING PERMIT OWNER TELEPHONE Sp. Fr, OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS 2128 fphama araiul-1e 95966 CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑x Duplex ❑ Mobilehome ❑ Other sPECIFv 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 ❑cx Describe Work: reroof /comp Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 600VOR LE Main Service A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i full force and effect. S ,� License Class — Lic. NO. L( OWNER -BUILDER D CL RATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service To M 46. 00 WEL200A NEW CONST. DWELLING OCCUP. U OR ADDNS. & ACC. sLDS. SO so 3.50 FT. NEW CONST MULTI.OUTLETRCUITS @7.50 POWER APPARATUS S SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FDRUREs 2L@''0° BAL p .so Ex. Occup. DFlxurLEEDTs AE�ss oR� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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 permitis issued. My workers' fpTp Wfionlnsurance carrier and policy number are: Carrier J 74 /- cc.vt Policy Number JJ3- (The above sections n ed 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 forthwithom ly with those provisions. X Date — ��o Signatu of Applic t - [3 Owner Contractor ❑ Ag t An OS A 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 FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 47.00 HAZ. I D. FEES IMP I FLOOD I CDF PARCEL PD I HD I ISSLkF This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for w ' ees have been pai % PERMIT EXPIRES ON�� Date Receipt No. 289524 WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. .ev.12/96) -' APPLICATION AND PERMIT ASSESSORPARCELN"MRRO� zoNNo BUILDING PERMIT SO. FT. OCC. BUILDING VALUATION OWNERS CONSTRUCTION LENDER LENDER'S MMUNG ADDRESS ARCNRECT OR ENGINEER LICENSE NO. ARGfTECT OR ENOWEER9 MALJNG ADDRESS ButDWG ADDRESS . IDT NO. SUBDNEi ION'S NAME PARCEL MAP USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other sPEcsv TYPE OF WORK New ❑ Addition ❑ R5tmodel ❑ UdGties ❑ Installation 177or ❑ Describe Work: W Fireplace PERMIT FEE f Total Valuatlon is Fling Fee 20.00 Main Service Filing Fee $ 20.00 Permit Fee S NEW CONST. Plan Checking Fee $ OR ADONS. Energy Plan Checking Fee $ NEWCONST. NIO_ ( ,e L.; y° ) S PERMIT FEE _ PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I WT- @20.00 OVTLE'r OR FDnURES Ex. OCCU C, r&. EA PERMIT FEE f ELECTRICAL PERMIT Fling Fee 20.00 Main Service p°orA o'R ==' 23.00 Main Service 200A TO 1000A 46.00 NEW CONST. DwELLNG OCCUP. 3.5Cso OR ADONS. BIDS. NEWCONST. NIO_ ( ,e L.; y° ) @7.50 OVTLE'r OR FDnURES Ex. OCCU C, r&. EA 5.00 Temporary Service 1 23.00 Mobile Home Facilities 1 20.00 Misc. Wiring 1 23.00 I PERMIT FEE I i 0 MECHANICAL PERMIT Filing Fee 1 20.00 1 Hood 1 1 6.50.1 1 PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ AIIAZ O. FEES W/ FL000 COf PARCEL FO ND ESSU This permit Is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutions to do work Indicated above for which fees have been paid. By Date PERMIT EXPIRES ON