HomeMy WebLinkAbout030-461-008RP-SIDENTIAL
030-461-008 PERMIT#97-0771
BAKER, Paul D.
2116 Tehama Ave., Oroville
New Single Family
i.
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ICE COPY
DatDate
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GAS Date
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ELECTRIC � A15 Date Z y
Meter By
Address
GAS
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ELECTRIC
Meter By Dated§4�j�'j
J06 FINALED (Date) v —
Signature
r
y COUNTY OF BUVE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 Cdunty Center Drive - Oroville, California 95965 - Telephone (916) 538-7542' ,,P Rte NO/
(Rev. 12/96) APPLICATION AND PERMIT ,� „'�/
ASSESSOR PARCEL NUMBER
ZoN k
BUILDING PERMIT
'YHUL D BAKER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
1560 R 84,240
DWWrSCOURT, BERRY CREEK 95916
576 U 10,368
CONTRACTOR'S NAME
TELEPHONE
224 C 2,912
L
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $ 97,S20
ARCHITECT OR ENGINEER
LICENSE NO.
Fee
$ 20.00
—Filing
Permit Fee
$ 630.50
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 409.80
BUILDING ADDRESS
2116 TEHAMA AVENUE, OROVILLE
Energy Plan Checking Fee
$ 23.00
$
PERMIT FEE
$ 1,083.30
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF GX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
8 7.00 6.00
Solar or heat pump water heater
23.00
Water piping
15-0015.00
Each as water heater or vent
15.00 5.00
TYPE OF WORK
New ❑XAddition ❑ Remodel ❑ /Utilities ❑ Installation ❑ Other ❑
Describe Work: ems( Npd Wt
Gas piping system 1- 5 outlets
15-0015.00
Building sewer
15.00
Mobile Home IS I GI W1
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 2o0AORLESS
23.0023,00
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 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 I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service ( 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. (
SO
4,;
N CONS.
NON-RESIDT RANCH CI CET
UITS
@7,50
APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FucruREs
20 @ 1.00
BAS p .50
Ex. Occup. ouriEtDrs Aa o.) E
5.00
Temporary Service pol E
23.00 9,1 rin
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$ 140.79
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
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEt
$
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
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
orkers' compensation provisions of section 3700 of the Labor Code, I shall
I rthwith comply with those provisions.
X Date Z=f sZ _
Ignature of Applicant - Owner ❑ Contractor ❑ Agent /
An OSHA permit is required for excavations over 60" deep and de6U qr gn LIC i0 a
of structures over 3 stories in height. dd cc1� h� (O
Receipt No.21887=0 2 OO
Mobile Home Installation Fee
$
Energy Inspection Fee $ 46. U0
occ
R-3
CONST. TYPE
VN
TOTAL FEE $ 1, 46St. 55
HA_JDFEES
I
FLOOD
_(
CD
PAR
P
H
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
9y�
(�
HERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
ate
Date
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROFAPCANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 CountyrCenter Drive - Oroville, California 95965 -.Telephone (916) 538-75�- PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSEs80RPAR05.1,IUMBER V f-� _ y�
zOW
BUILDING PERMIT '
OwkmSO.
FT. OCC. BUILDING VALUATION
OWMER9 ADDRESS -
n
p�
:COWRACTOR-15 NAME
TELEPHONE
n ra
d•
COMPACTOR'S UPAING ADOR08
,.CoeTvarlw1.9MER
Fireplace
LMER's MAILING ADDRESS
Total Valuation S
-
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee S
2 0.0
Permit Fee - S
ARCHITECT OR ENGINEERS MALUM ADDRESS
Plan Checkina Fee S
BUILDING ADDRESS �) Lo 1
Energy Plan Checking Fee S
S
PERMIT FEE S
F C7
iatKXL
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each TrapPLJ
7.00 S
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each es water heater or vent
15.00
TYPE OF WORK
NewAddition C3Remodel❑ Utirities 13 Installation❑_ Other ❑
Describe Work:
Gas piping system 1 - 5 outlets
15.00
Buildingsewer
15.00
Mobile Home . S G W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 200" OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter
9 (commencing with Section 700C) of Divisicn 3 c! 'he Business and Professions Code,
and my license is in full force and effect.
License Class LIC. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for.the following reason:
❑ 1, 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
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.
Q I 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
(rhe 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, 1 shall
forthwith comply with those provisions.
X ______ Date _
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5' " deep and demolition or construction
of structures over 3 stories in hei ht.
Main Service 200" TO 1000A
46.00
NEN CONS �.OWELLMG OCCUP. sO
OR ADONS. a ACc. BLOB. 3.52 .
TLE
NOµ.7OFSID T.MULTI.OUCUT 0--7.50
POWER APPARATus
8 SINGLE OUTLET CXR.
Ex. Occup. OUTLET OR FIXTURES SAL Cg .So I
FIXED APPLNS. OR
Ex. Occu p. OUTLETS (RUID.) 5.00
Temporary Service p 23.00
Mobile Home Facilities 20.00
Misc. Wiring23.00
PERMIT FEE t
MECHANICAL PERMIT Fling Fee 20.00
Heating 3S
Cooling
Hood 6.50
Ventilation
PERMIT FEE S S
Mobile Home Installation Fee $
Energy Inspection Fee $
c
Z. 1 D. FEES
TOT FEE $
I FLOOD PAACE PO 6SUE
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
OaTGI
ReceiptNo. o -
WHITE •D.D.S.•B.O. CANAR - SESSOR NK -INSPECTOR GOLDENROD -APPLICANT
.. ,,✓. ,.y.... 'M �. -+isJX .t-''''. r v'r~.. rt. _Y;. ,^y-^•-.'�'t�'p,•;v.. '-' i-r�t 's":1* tx„},^''�" ^, •r1: -F -1 Zrt*Zf•'"'�9},•6�7ti.,:. _ r
COUNTY OF BUTTE '-t-DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE; CALIFORNIA 95965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: &ker— ASSESSOR PARC ER: — 14 ((j
Proposed Building Use: Building Inspector: Date:
At time of permit application, I was advised the following data must be submitted prior to permit pr4cessink and/or issuance:
Date Received By
❑ 1. All items have been submitted --------------------------------------------------------------------------------------
E32. Plot plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------
1:13. Complete plans, 3/4 sets, signed by the preparer of plans. ---------------------------------------------
❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.
.❑�
ergy Design Compliance and supgineered truss details and layout in duplicate (required prior to plan review) No faxes! -------------------
porting documentation:----=-----------------------------------------------
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
❑ 8. Hazardous Material Form.------------------------------------------------------------------------------------------
9. Manufactured Home data and installation instruc 'onps+iincluding Tie Down Specifications.------------------
gyFees of $ —--�-!--6\-_----------------------------------------------------�
Impact fees as shown on the attached schedule.
❑ 12. California Department of Forestry plan approval/fee§.--=-=------- --- — —--------------- -------------------
❑ 13 Flood elevation certificate. ----------------------------------------------------------------------------------------
DdLSanitation and plot plan approvalT LT He4th-�P.L -------------------------------------------
❑ 15. City of Chico plumbing permit.-----------------------------------------------------------------------------------
0'16. Plot plan and business license approval from the City of Biggs.
❑ 17., Planning approval for (A) Use: (B) Parking:
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.
1119: Encroachment Permit for driveway (construction approval prior to occupancy). ---
❑ 20. Pre -inspection for
required Request to Building Inspector on
❑21. Contractor's license information. (Number, Name Style, Classification). ----------------------
El 22. Workers' Compensation carrier and policy number. ---------------------------------------------
1:123. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - ------------------------
02 Letter of signature authorization. --------------------------------------------------------------------------------
Recorded copy of Agricultural Acknowledgment Statement. --------------------------------------------------
❑26. Letter of intent on building use.-----------------------------------------------------------------------------------
❑ 27. Manufactured Home utility clearance. -----
1128. Existing violations and/or expired permits.
029. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
E130. Other:
o
�D 1
(Date)
When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to frac or.
'Telephone Ci " 5 0? �03 and hold for pickup at 1, ffi . D liv with inspector.
— c
A licant: �J'--.. Date:
PP
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Departmen Date: By:
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building D' ision counter, by Da
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder.- Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
CERTIFICATE OF COMPLIANCE: Residential Page 1 CF -1R
-----------------------------------------='--------------------------------------
Project Title:- SFR FOR PAUL BAKER Run: 220 23 -Apr -97
Project Address: 2116 Tehama ave SFR -BASE
Thermalito, ca
Building Title: SFR 2160 s.f Buildin Pet #
Document Author: Larry J. Warner AIA y" -I rm/�
Tl
Telephone: 916-892-8008 Plan'Chec / Date
'J
Compliance Method: CALRES2 Version 1.31 Field Check / date
Climate Zone: 11
GENERAL INFORMATION
Conditioned Floor Area:
Building Type:
Building Front Orientation:
Number of Dwelling Units:
Floor Construction Type:
BUILDING SHELL INSULATION
1560 ft2
SFD Single Family Detached
180 deg (South)
1.00
Slab on grade r
Component
Insul Assembly
Type
---------------
R -value U -value
Location/Comments
Door f
----------------
0 0.330
----------------------------------------
Outside
Door
0 0.330
Unconditioned
Wall
13 0.089
Outside
Wall
13 0.088
Unconditioned
Ceiling
30 0.031
Attic
Floor,
0 0.295
Grade
Floor
0 0.722
Grade
FENESTRATION
Area U-
Interior Exterior
Overhang
Frame
Orientation
-----------------
(ft2) value Panes
----- ----- -----
Shading Shading
----------
and Fins
Type
Window South
104.0 0.650 2
----------
Std Drape Bug Screen
--------
None
--------
Metal
Window North
72.0 0.650 2
Std Drape Bug Screen
None
Metal
THERMAL MASS Area Thick
Type Exposed? (ft2) (in)
--------- -------- ----- -----
Floor No 1260 3.5
Floor Yes 300.0 3.5
HVAC SYSTEMS
Location/Comments
----------------------------------------
Grade
Grade
TypeEfficiency
----------------------
Furnace 0.78 AFUE
Air cond. -- central split 10.00 SEER
Duct Location
and R -value
-------------.
Attic R-4.2�,� 'J
Attic R-4.2
1
CERTIFICATE OF COMPLIANCE: Residential Page 2 CF -1R
Project Title: SFR FOR PAUL BAKER Run: 220 23 -Apr -97
WATER HEATING SYSTEMS
Distrib
Water
Water
# of
Energy
Volume
Wrap
System Name Type
------------
Heater Name
Heater Type
Htrs
Factor
(gal)
R-val
--------
Standard—Gas Standard
------------------------------
StandardGas
Storage gas
----
1
------
0.53
------
50
-----
12
WATER HEATING SYSTEMS MISC
System Name
---
Standard—Gas
Solar savings
fraction
-------------
Solar system
type
------------
WATER HEATER/BOILER DETAILS
Water Recovery
Heater Name Efficiency AFUE
---------------------- ----
StandardGas 760 --
Rated
Input
(kBtuh)
36.00
HYDRONIC DISTRIBUTION AND TERMINALS
System/Name Type Number
-------------- ------------- ------
None
SPECIAL FEATURES, REMARKS, AND NOTES
None
Wood stove Wood stove
boiler? boiler pump?
No No
Pilot
Standby Tank Light
Loss R -value (Btuh)
Pipe
run (f t)
Pipe Insul Insul
diam (in) thck (in) R -value
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance
specifications needed to comply with the Energy Standards in Title 24, Parts 1
and 6, of the California Code of Regulations, and the Administrative regulations
to -implement them. This certificate has been signed by the individual with
overall design responsibility. When this certificate of compliance is submitted
for a single building plan to be built in multiple orientations, any shading
feature that is varied isindicated in the Special Features, Remarks, and Notes
section.
CERTIFICATE OF COMPLIANCE: Residential Page 3 CF -1R
Project Title: SFR FOR PAUL BAKER Run: 220 23 -Apr -97
-----------------------------------=--------------------------------------------
--------------------------------------------------------------------------------
DESIGNER OR OWNER
Paul D. Baker
114 Shane Ct.
Berry Creek, CA 951116
916-589-5263
Lic #.
Signed
ENFORCEMENT AGENCY
Name:
i
Title.
Agency:
Telephone:
DOCUMENTATION AUTHOR
Larry J. Warner AIA
PHL Architects.
10-C Williamsburg Lane
Chico, CA 95926
916-892-8008
Date �Z6ned
Signed Date
to
COMPUTER METHOD SUMMARY ; Page 1 C -2R
--------------------------------------------------------------------------------
Project Title: SFR FOR PAUL BAKER Run: 220 23 -Apr -97
Project Address: 2116 Tehama ave SFR -BASE
Thermalito, ca
Building Title: SFR 2160 s.f Building Permit #
Document Author: Larry J. Warner AIA
Telephone: 916-892-8008 Plan Check / Date
Compliance Method: CALRES2 Version 1.31 Field Check / Date
Climate Zone: 11
ENERGY USE SUMMARY (kBtu/ft2-yr)
Energy Use Standard Design
Space
Heating
8.84
Space
Cooling
10.20
Water
Heating
13.82
Total
(ft2)
32.87
GENERAL INFORMATION
Conditioned Floor Area:
Building Type:
Building Front Orientation:
Number of Dwelling Units:
Number of Stories:
Proposed Design
---------------
8.30
9.41
13.82
-------- Complies
31.53 Yes
1560 ft2
SFD Single Family Detached
180 deg (South)
1.00
1
Floor Construction Type: Slab on grade
Number of Conditioned Zones: 1
Total Conditioned Volume: 12480 ft3
Conditioned Footprint Area: 1560 ft2
Ground Floor Area: 1560 ft2
BUILDING ZONE INFORMATION
Floor
Zone Area Volume
Name (ft2) ( f t 3) Type
------------ ------- -------- -------------
House , 1560 12480 Conditioned
OPAQUE SURFACES
Thermostat
Type
------------
CEC_Standard
Vent
Vent
Height
Area
(ft)
(ft2)
2'0"
17.6
Surface
Area
U-
Insl
Tru
Slr
Construction
Type
(ft2)
value
Rval
Azm
Tlt
Gns
Type
Location/Comments
----------
Zone —
------
House
-----
----
---
---
---
------------
--------------------------
Door
20.0
0.330
0
270
90
Yes
CEC_30-Wood
Outside
Door
17.8
0.330
0
270
90
No
2868-W
Unconditioned
Door
17.8
0.330
0
0
90
Yes
2868-W
Outside
Wall
326.2
0.089
13
0
90
Yes
W13.2x4SS
Outside
Wall
240.0
0.089
13
90
90
Yes
W13.2x4SS
Outside
Wall
312.0
0.089
13
180
90
Yes
W13.2x4SS
Outside
Wall
12.0
0.089
13
270
90
Yes
W13.2x4SS
Outside
Wall
206.2
0.088
13
270
90
No
W13.2x4.16
Unconditioned
COMPUTER METHOD SUMMARY Page 2 C -2R
Project Title: SFR FOR PAUL BAKER Run: 220 23 -Apr -97
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
OPAQUE SURFACES continued
Surface
Area
U- Insl
Tru
Slr
Construction
Type
(ft2)
value Rval
Azm Tlt
Gns
Type
Location/Comments
----------
Ceiling
-----------
1560.0
----
0.031 30
--- ---
-- 0
---
Yes
------------
R30.2x4.24
--------------------------
Attic
Floor
1260.0
-- 0
-- 180
No
S1ab140C
Grade
Floor
300.0
-- 0
-- 180
No
S1ab140E
Grade
PERIMETER LOSSES
Perimeter Length F2 Insul
Type (ft) Factor R-val
------------------- ------ -----
None
FENESTRATION SURFACES
Insul
Depth
(in) Location/Comments
------ ----------------------------------
GLAZING CHARACTERISTICS
Glazing
Charactr Glazing # of U- SC Gls Interior SC Int Exterior SC Ext
Name Type Panes value Only Shade Type Shade Shade Type Shade
clear Clear 2 0.650 0.880 Std Drape 0.780 Bug Screen 0.870
OVERHANGS
Fenestration
-------------- - ----------- Above Left Right
Name Height Width Depth Glazing Extension Extension
------------ ------ ------ ------ ---------- --------- ------=--
None
L
Glazing
Fenestration
Area
Tru
Open
Frame
Charactr
Name
--------------
Type
(ft2)
Azm
Tlt
Type
Type
Name Comments
Zone = House
----
-----
---
---
-------
--------
------------ ----------------
F-1
Wind
32.0
180
90
Slider
Metal
clear
F-2
Wind
24.0
180
90
Slider
Metal
clear
F-3
Wind
24.0
180
90
Slider
Metal
clear
F-4
Wind
24.0
180
90
Slider
Metal
clear
B-1
Wind
24.0
0
90
Slider
Metal
clear
B-2
Wind
6.0
0
90
Slider
Metal
clear
B-3
Wind
6.0
0
90
Slider
Metal
clear
B-4
Wind
12.0
0
90
Slider
Metal
clear
B-5
Wind
24.0
0
90
Slider
Metal
clear
GLAZING CHARACTERISTICS
Glazing
Charactr Glazing # of U- SC Gls Interior SC Int Exterior SC Ext
Name Type Panes value Only Shade Type Shade Shade Type Shade
clear Clear 2 0.650 0.880 Std Drape 0.780 Bug Screen 0.870
OVERHANGS
Fenestration
-------------- - ----------- Above Left Right
Name Height Width Depth Glazing Extension Extension
------------ ------ ------ ------ ---------- --------- ------=--
None
L
COMPUTER METHOD SUMMARY Page 3 C -2R
Project.Title: SFR FOR PAUL BAKER Run: 220 23 -Apr -97
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
FINS Left Fin Right Fin
Fenestration Exten Dist Exten Dist
-------------------------- Fin Fin above to Fin Fin above to
Name Height Width Depth Height glzng glzing Depth Height glzng glzing
------------ ------ ------ ----=- ------ ----- ------ ------ ------ ----- ------
None.
THERMAL MASS
SOLAR GAIN DISTRIBUTION
Fenestration
Name
------------
None
HVAC SYSTEMS
System Name
--------------
Zone = House
GasFurn.78
ACsplit10
Winter Summer Targetted
Fraction Fraction Thermal Mass Comments
-------- -------- ------------ ------- - ------------------------
Duct Location
System Type Efficiency and R -value
Furnace 0.78 AFUE Attic R-4.2
Air cond. -- central split 10.00 SEER Attic R-4.2
WATER HEATING SYSTEMS
Distrib
Water
Water
Vol
Cond-
Volume
Wrap
System Name Type
--------------------
Area
Thck
Heat
duct-
Construction
Insd
Mass Name
--------------
(ft2)
-----
(in)
----
Cap
----
ivity
-----
Type
------------
Rval Location/Comments
---- -------------------------
Zone = House
FLOOR -SLAB
1260
3.5
28
0.98
Slab140C
2.00 Grade
floor -ex
300.0
3.5
28
0.98
S1ab140E
0 Grade
SOLAR GAIN DISTRIBUTION
Fenestration
Name
------------
None
HVAC SYSTEMS
System Name
--------------
Zone = House
GasFurn.78
ACsplit10
Winter Summer Targetted
Fraction Fraction Thermal Mass Comments
-------- -------- ------------ ------- - ------------------------
Duct Location
System Type Efficiency and R -value
Furnace 0.78 AFUE Attic R-4.2
Air cond. -- central split 10.00 SEER Attic R-4.2
WATER HEATING SYSTEMS
Distrib
Water
Water
# of
Energy
Volume
Wrap
System Name Type
--------------------
Heater Name
------------
Heater Type
-----------------
Htrs
----
Factor
------
(gal)
------
R-val
-----
Standard_Gas Standard
StandardGas
Storage gas
1
0.53
50
12
WATER HEATING SYSTEMS MISC
Solar savings Solar system
System Name fraction type
------------ ------------- ------------
Standard Gas -- --
Wood stove
boiler?
No
Wood stove
boiler pump?
-------------
No
COMPUTER METHOD
SUMMARY ;
Page
4
C -2R
Project Title:
--------------------------------------------------------------------------------
SFR FOR PAUL BAKER
Run:
220
23 -Apr -97
WATER HEATER/BOILER DETAILS
Rated Pilot
Water Recovery Input Standby Tank Light
Heater Name Efficiency AFUE (kBtuh) Loss R -value (Btuh)
---------------------- --------------- ---------- ------
StandardGas 760 -- 36.00 -- -- --
HYDRONIC DISTRIBUTION AND TERMINALS
Pipe Pipe Insul Insul
System/Name Type Number run (ft) diam (in) thck (in) R -value
-------------- ------------- ------ -------- --------- --------- -------
None
SPECIAL FEATURES, REMARKS, AND NOTES
None
PROPOSED CONSTRUCTION ASSEMBLY: Residential Page 1 Form 3R
Project Title: SFR FOR PAUL BAKER 23 -Apr -97
Project Address: 2116 Tehama ave
Thermalito, ca Building Permit #
Building Title: SFR 2160 s.f
Document Author: Larry J. Warner AIA Checked By / Date
Telephone: 916-892-8008
Compliance Method: CALRES2 Version 1.31
Assembly Name:
Assembly Type:
Framing Percentage:
Framing Type:
W13.2x4SS
Wall Construction
15%
CEC_16ocW
LIST OF CONSTRUCTION COMPONENTS
Thickness Resistance Resistance
Note: Winter value used for outside air film.
FRAMING ADJUSTMENT CALCULATION
Cavity Framing . Total
----------------- ----------------- -----------------
U-value: (1./14.52 x 0.85) + (1./4.99 x 0.15) = 0.089 Btuh/ft2-F
Resistance: = 11.29 ft2-F/Btuh
NOTE
The values shown here are based on nominal data and do not include surface film
adjustments, crawlspace resistance, or other modifications mandated by the CEC.
Material
(inches) at
Cavity
at Framing
1
------------
FilmIn_90
--------- ----------
--
0.68
----------
0.68
2
GypBoard_HC
0.50
0.45
0.45
3a
Fir
3.50
--
3.47
3b
R13Batt
3.50
13.00
--
4
Felt
--
0.06
0.06
5
Stucco
0.83
0.17
0.17
6
FilmOutside
--
0.17
0.17
Total
Unadjusted
----------
Resistance (R):
14.52
----------
4.99
Note: Winter value used for outside air film.
FRAMING ADJUSTMENT CALCULATION
Cavity Framing . Total
----------------- ----------------- -----------------
U-value: (1./14.52 x 0.85) + (1./4.99 x 0.15) = 0.089 Btuh/ft2-F
Resistance: = 11.29 ft2-F/Btuh
NOTE
The values shown here are based on nominal data and do not include surface film
adjustments, crawlspace resistance, or other modifications mandated by the CEC.
MANDATORY MEASURES CHECKLIST : RESIDENTIAL
MF -1R
NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance
approach used. Items marked with an asterisk (*) may be superseded by more stringent compliance requirements listed
on the Certificate of Compliance. When this check list is incorporated into the permit documents, the features noted shall
be considered by all parties as binding minimum component performance specifications for the mandatory measures
whether they are shown in the documents or on this checklist only.
DESCRIPTION Designer
Building Envelope Measures
150(a): Minimum R-19 ceiling insulation.
150(B):Loose fill insulation manufacture's labeled R -value R-30
150(c): Minimum R-13 wall insulation in framed walls (does not apply to exterior mass walls). R-13
150(d): Minimum R-13 floor insulation in framed floors; Min. R-8 in raised concrete N/A_
150(1): Slab edge insulation -water absorption rate no greater than 0.3%, water vapor
transmission rate no greater than 2.0 perm/inch NA_
118: Insulation specified or installed meets California Energy Commission quality std's
116-17: Fenestration Products, Exterior doors and Infiltration/Exfiltration Controls
a: Doors and windows between conditioned and unconditioned spaces designed to
limit air leakage
b: Manufactured fenestration products have label with certified U -value, and
infiltration certification. Min. 0.65
c: Exterior doors and windows weatherstripped; all joints and penetrations
caulked and sealed.
150(G): Vapor barriers mandatory in Climate Zones 14 and 16 only. N/A
150(F): Special infiltration barrier installed to comply with 151 meets commission N/A
quality std's.
150 (e): Installation of Fireplaces, Decorative Gas appliances and Gas Logs
1. Masonry and factory -built fireplaces have:
a: Closeable metal or glass door
b: Outside air intake with damper and control
c: Flue damper and control
2. No continuous burning gas pilots allowed. X
Space Conditioning. Water Heating and Plumbing System Measures
110-13: HVAC equip., water heaters, showerheads & faucets certified by the commission X
150(l): Setback thermostat on all applicable heating systems X
1500): Pipe and Tank Insulation
1. Indirect hot water tanks to have blanket (R-12 or grater) or combined
interior/exterior insulation (R-16 or greater).
2. First 5 feet of pipes closet to water heater, non-recirculting systems, insulated
(R-4 or greater).
3. All buried or exposed piping in recirculating systems to be insulated (R4 or greater).
4. Cooling system piping below 55 degrees F insulated,
5. Piping insulated between heating source and indirect hot water tank. X
150. (m): Ducts and Fans
1. Ducts constructed, installed and sealed to comply with UMB sections 1002 and 1004;
ducts insulated to a min. Installed value of R-4,2 or ducts enclosed entirely within
conditioned space.
2. Exhaust fan systems have backdraft or automatic dampers.
3. Gravity ventilating systems serving conditioned space have either automatic or readily
accessible manually operated dampers. X
Enforcement
MANDATORY MEASURES CHECKLIST: RESIDENTIAL PAGE TWO MF -1R
Designer Enforcement
114: Pool and Spa Heating System and Equipment.
1. System is certified with 78% thermal efficiency, on-off switch, weatherproof
operating instructions, no electric resistance heating and no pilot light. N/A
2. System is installed with:
a: At least 36" pipe filter and heater for future solar heating
b: Cover for outdoor pools or outdoor spa. X
3. Pool system has directional inlets and a circulation pump time switch.
115: Gas-fired central furnace, pool heater, spa heater or household appliance
have no continuously burning pilot light. (Exception: Non -electrical
cooking appliance with pilot < 150 Btu.hr.) X
Lighting Measures
150(k): 401umens/watt or greater for general lighting in kitchens and rooms with
water closets; and recessed cueing fixtures IC (insulation cover) approved. X
THERMALITO IRRIGATION DISTRICT �T
410 GRAND AVENUE 2021
OROVILLE, CALIFORNIA 95965 -
TELEPHONE: (916) 533-0740
FAX: (916) 533-9243
SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: 2116 Tehama Ave.
Owners Name: Paul Baker
Date: 4/18/97
Address: 114 Shane Court
Acct. No.: 0702,9500
Berry Creek
A.P. No.: 30-461-008
Phone:
New Unit: one
Applicant/Agent:
Adding Units:
Address:
Fees:
Phone:
Permit: $_____L0 00
T.I.D.: 600 00
Preliminary Review By: Date:
Ext. Fees: •
Remarks: ' Connection fees will he those applicable at time
SC -OR: 900 00
of connection to the sewer collector system. Clean out
Lateral:
un to grade required at property l i nP _
Other:
Total Fees: 1530 JOQ
Amount Paid: $30.00
Collected By:
Finaled By: Date:
Location:
Size Line:
Signature of Owner/Agent:CV
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON COMPLETION
Date Billed:
Computer:
Paid SC -OR:
A.P. File:
(R.F.C.)
Blue Book:
Paid SC -OR:
Meter Book:
(S/C HG's)
Rev. 6/96
/a
RESIDENTIAL PLAN CHECKING GUIDE
SINGLE FAMILY, DUPLEX AND MISCELLANEOUS ONLY
OWNER: _ _ (r. BUILDINGPERMITNUMBER:
PLAN CHECKER: _ S A.P. NUMBER: ib O c -Y"-
GENER Ai.•
Zoning requirements: (side yards and number of permitted living units).
Valuation.
Plans signed by designer.
Proper description of work on application.
Existing violations on property.
Items on data sheet, (Impact Fees, Environmental Health, Developer Fees, etc.).
1-T Recorded notice of violation.
Complete parcel size and dimensions.
Setbacks, side yards, easements, etc.
Other buildings or structures.
Grading, fills and/or drainage.
/ Flood hazard.
Special conditions on creation map (Noise, S.R.A., Fire Sprinklers, Water Tender, Trees, etc.).
F.A.U. & F.A.S. road setback.
Building or utilities across lot lines (Record form).
Complete to scale plan with dimensions.
Required windows for light and ventilation (Section 1203).
Required windows for second exit (Section 310.4).
Skylights (Section 2409 & 2603.7).
Glazing in Hazardous Locations (Section 2406).
Required room sizes, ceiling heights (Section 310.6).
.G.F.C.I. in baths, garage, kitchen, wet bar and exterior outlets (N.E.C. 210).
Lights, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment.
Location of water heaters, heating and cooling equipment, other electrical or gas equipment.
Garage firewall, door size and closer (Section 302.4).
Minimum of one 3'0" exterior door (Section 1004.6).
Fireplace and wood stove location, alcoves and clearance.
Smoke detectors (Section 310.9.1).
Plumbing fixtures, water closet clearances and shower size.
Conventional Construction - Unusually Shaped Buildings (Section 2326.5.4).
Standard bracing or engineered design (Section 2326.11.3).
Clerestory requiring balloon framing and/or engineering.
Three story building requiring engineered calculations and plans.
Foundation plan complete enough to construct building.
Floor construction details complete enough to construct building.
Elevations and wall construction details complete enough to construct building.
Roof construction details complete enough to construct building.
&after ties or bearing ridge beam.
Fireplace construction details and calc. if necessary.
Garage door and/or porch header sizes.
Stud heights.
Adobe soils - special foundation design.
Retaining walls requiring design.
Special Inspection requirements.
Header size.
Sheetrock nailing inspection required?
July 1996
3.2
hESCELLANEOUS rMMS TO LOOK OUTFORO'
Stairway details: landings, rise and run, head clearance, handrails (Section 1006).
Guardrail details (Section 509).
Brick or stone veneer (Section 1403).
Exterior plaster - weep screeds (Section 2506).
per roof pitch for roof covering (Section 1501).
Roof covering type - (fire hazard).
Foam insulation - protection.
36" halls and stairways.
Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts.
Two exits on three - story dwellings (Section 1003).
Underfloor access and ventilation (Section 2317.7).
Attic access and ventilation (Section 1505).
_--Combustion air for fuel burning appliances - L.P.G. requirements.
Noise requirements on duplexes.
Energy design.
" f Flashing at all exterior openings.
C.D.F. responsible area requirements.
July 1996 3.3
.' ..� .. � ,� ' „.. � ; :. <� ., •r`i��•iY F.` '?k"�3�:�'#t/� ice- ��(�•r��'r��' ;�r�"'r'1'
r BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
{ (One form per Building)
School District
A.P. Number
Property Owner
Property Location/A
Subdivision
Dleoud�\o
—(410I Jurisdiction: Cit
Building Department No.
City E��County
M
Residential Development M Q
No of Living Mobile Home
Units Installation
Commercial/Industrial Q
I I New
Lot No.
Sq. Footage
Addition (G oup R)
.�G
Sq. Footage
Addition (Including Exterior
Roofed Areas)
Date
reviewed by School District Personnel)
Identificati No.1070129
I School District certifies that
(Applicant)
(Street Ad9Il'es§)\
W1�
(City)
has complied with the requirements of Resolution No.
representing
School District Representative
Paid by Check #
square feet.
I
(Phone Number)
(State) (Zip Code)
Oby payment of $ x
1�11; 2926
[FULL MITIGATION $
*—r V
/ Date
Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the Imposition of the fees in any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls (2/97)dmm
And when recorded mail to:
Building Division
#7 County Center Drive
Oroville, Ca. 95965
R 2.11991
"97-014228
NOT COMPARED W>N
ORISINAL DOCuMEW7
AGRICULTURAL STATEMENT OF ACKINOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code requires this,acknowledgment to be recorded prior to issuance of a building permit. The
property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this
property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including. but not limited to
herbicides. pesticides, and fertilizers: and from the pursuit of agricultural operations including, but not limited to cultivation.
plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise. and odor. Butte County has established
agricultural purposes and 'residents within said zones and on adjacent property should be prepared to accept such inconvenience or
discomfort from normal. necessary farm operations.
All that real property situate in the County of Butte. State of California. described as follows:
/,�- //S, O f- e rt" 0 1= --t-"k e . So
l o� l {'� 13LOc291 G% I 2 1�+ m aL �� aCCai- J i r�
o Tlti a T G -e �- T1 o f i- e r_ C k
e- c- .e�. 0 1�G.�e eco �� off' 1.3c�Z-C co
J
C a; Cc a �. in ; a �-+ . J u e / 8 7
Date: �7 =Ors.
State of California )
County of (3o,,�z\,e_ )
On y- before me,
personally appeared 1 Cain _ r�kF (� E \1 C\ \ Ke- personall%-
known to me (or proved to me on the bans of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacitv(ics), and
that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted,
executed the instrument.
WITNESS my hand and official seal. DENISEiE►�IAH
Commission 0 1073963 Mfr CPSI o•'` •�': ' ��•
otcl tO Coury Public
Signature C , "e MI MYCommh County, a.e
gyp. SEPT, 30. 1999 ._
CERTIFICATION OF INSULATION
ADDRESS OR TRACT
SACRAMENTO INSULATION CONTRACTORS
LOT #
n'
❑ P.O. BOX 854, WEST SACRAMENTO, CA 95691 LIC. #202026
`
1453 GARDEN HWY., YUBA CITY, CA 95991 LIC. #202026
I
P.O. BOX 9651, FRESNO, CA 93793-9651 LIC. #202026
�' �P "' '��
❑ P.O. BOX 11631, RENO, NV 89505 LIC. #10675
❑ 3326 A PONDEROSA WAY,
vc J,c( lei
LAS VEGAS, NV 89118 LIC. #10675
DATE INSULATION COMPLj-
( SQUARE FEET)
( SQUARE FEET)
( SQUARE FEET)
TYPE OF INSULATION
TYPE OF INSULATION
TYPE OF INSULATION
MATERIAL
MATERIAL
MATERIAL
FIBERGLASS
FIBERGLASS
FIBERGLASS
FORM
FORM
FORM
BATTS
BATTS & BLOW
BATTS
MANUFACTURER'S PRODUCT I.D.
MANUFACTURER'S PRODUCT I.D
MANUFACTURER'S PRODUCT I.O.
MANUFACTURER
MANUFACTURER
MANUFACTURER
OCF
OCF,
OCF
BAGS
R - VALUE
APPLIED
R - VALUE
APPLIED
MIN. INSTALLED
R - VALUE
APPLIED
INSTALLED
THICKNESS
INSTALLED
THICKNESS
WEIGHT PER
SQUARE FOOT
INSTALLED
THICKNESS
'31
�c
KNEE WALLS IF R -VALUE IS OTHER THAN WALLS ABOVE
MATERIAL
FORM
R VALUE
MANUFACTURER
FIBERGLASS
BATTS
OCF
AIR INFILTRATION SEALANT
MATERIAL
MANUFACTURER
y�
W R GRACE
THIS IS TO CERTIFY T INSULATION AND/OR SEALANT HAS BEEN INSTALLED IN CONFORMANCE WITH APPLICABLE CODES,
MATERIAL ND D AND REGULATIONS.
•
SIGN -INS LA ONTRACTO
TITLE
MANAGER
DATE
SIGN URE G ERAL RA OR
TITLE
DATE
REMARKS:
6,42v�ct c- S joV"l 2-30
t�w lz, 3
SIC -303 BUILDER COPY
COUNTY OF BUTTE
• BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
CORRECTION NOTICE
OWNER PER IT N o _
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If u have any questions pertaining to this matter, or need additional explanation,
please co ct this office immediately.
!A -
Date
Date Inspector
REV 10/92
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street, Chico, CA'f (916) 891-2751
7 County Center Drive, Oroville, CA (916) 538-7541
CORRECTION NOTICE
k"&"- 9--�- 0 77 /
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact thjs office immediately.
i
d,
Date Inspector
REV 10/9
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (91 6) 872-6307
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
Date Inspector
REV 10192
V=OK
O = Not OK
Not
=NotRealldyyble MOBILE HOMES `
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch.
3. Sewer; Location -Test -Fall -C/O -Concrete
4. Water, Location -Test -Easement Needed (Sketch)
5. Electricity; Locabon-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap; / /'Uft.
/ /Nat. or/ / L'ft./ /LPG
7. Well Clearance & Disconnect
8. Utility Clearance
t J
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand VaKe-Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs-Type4nstallation Cert.
10. Exits; Insp.-Sketch
11. Cert of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rttrs.-Connectors
Shthg.-Rfg: Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date 'Card B-1
Date Card B-1 Date Card B-1
''v
's
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rttrs.-Connectors
Shthg.-Rfg: Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date 'Card B-1
Date Card B-1 Date Card B-1
''v
✓ = OK
O = Not OK
= Not Apf
* = Not Re.
RESIDENTIAL (Single & Duplex)
Date .-*UNDERFLOOR (Plans) OK except #'s JA r&-_., / C) I
Ft , ain; Soils-Elecjermd.-/ !�f' Ftg. Depth
F . arage; Soils-Steel-Elec. Grnd// •-7" Ftg. Depth
Ftg. rches & Decks; Soils -Steel-/ 1.2.4' Ftg. Depth
to IIs, Main; Steel-Blockouts-Wrapped
to IIs, Garage; Steel-Blockouts-Wrapped
owns and Special Anchors
ilSlab, Steel -Wrapped
8. P'- ireplace Ftg.-Steel
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Pienums & Ducts; Clearance-Mater:al-Support-Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date a f -G�, Card B-1 Date Card B-1
Date Card B-1 Date Card 6-1
Date PLUMBING,4KeroOK except #'s
QjkVaLer Htr.; V t -A ss om ustion e
14-1%%ter Pipe; Test & Anchor -Nail Protection
.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Tes2b & Shower, Second Floor -Tub Access
as Pipe; Sixe & Anchors
Date /40,- s Card B-1 Ile4 Date Card B-1
Date ?` Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
23. Fixture & Transformer Clearance -Ins. Protection
ec. Receptacles Spacing -Lights & Switches at Doors
ize xes & No. of Conductors Stapled
ZoOl�oq2pyAffstallecl Close to Edge of Studs & C.J.
qui round made up w/Mech Fastners-Bond Gas & Water
2 Appliance Circuts in Kitchen & Conductor Size GFI
ga. Cu or AI-A.C. Wire Size / / ga Cu or AI
3 a 7 / ga Cu or Al
Insul 'd Neutral 0 Yes 0 No
Service -Riser Conductors & Ground -Main Disconect
32. Equip. Clearances Panels-Motors-Mech. Epuip.
3 . lothes Closet Light -Shower Light -Spa Light
34. _ moke Detector
Date/0-.3--17 Card B -1/j Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
35, A G at en & Support
34,V011it Fan, Exhaust above insulation
37. Condensate Drain & Overflow, Size & Grade
Hance -Vent Access -Comb. Air -Return Air Vent 115 outlet
39-AUw-AQeen-6 2' F rnace in Attic
Date ja_a -C1-2 Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date I.RA LAING (Plans) OK except #'s
Materials & Anchors
44!WgAyrBtGds-Nailing Spacing & Braces -Plates -Sound
_ gZ/Searipq Walls over Girders & Floor Nailing
p in Walls (rat proof)
s, Furred Ceilings -Stairs -Chasers -Tubs
& Beams -Size & Bearing
Date AMING (Continued)
Ha ost Caps -Anchors -Connectors
41e<ling. Joist-Rftr. Ties-Purtin-roff Brac.-Truss-Shting: Rfng.
ace ies or e A Flue -Fireplace Throat clearance
c Access; Size & Romex Protection -Draft Stop -Ins. Baffles
wr,�&T_Windows or Exiting Doors -Sill Hgt. & Dimensions
541�-iarage Fire Protection Framing
5i�-PrepeLine Firewall & Openings
Doors -One 3' -Check Garage 3rd Story, 2 Exits
N. room -Rise -Run -Landing -Fire Protection
ood on Roof Overhang -Attic Vents -Rafter Outriggers
Vents-Underflr.
fiFtc/ 58. lazing Area Glass Protection -Skylights -Plastic 42
_102Shear Walls; Nailing-Bolts
_nft_ 60. Brace Wall Panels
62. Infiltration -Walls -Windows
Datt� _� Card B-1 Date Card B-1
Dat�_� Card B-1 AZ,, Date Card B-1
Datel FINAL (Plans) OK except #'s
63. Ext Steps -Door & Sidelight Protection -Landings
64. Smoke Detector
6 nace; Vents -Clearance -Comb, Air-Conector-
jn.Oarage; Above Floor-Ducts-Mech. Protection
66.room Exiting
67 G F1�& Bath Fixtures & Tub Access -Spa
68. Elec. Trim & Subpanel, Breaker Sizes & Labels
-'-69796irs & Rails
70-Fireptace or Stove, Clearance -Hearth
L_ i i. clef. Outlets ood Panel, Int. & Ext.
Rt. Fixt. ppliance; Ground. -Air Gap -Cooking Clearance
I e utlets & Rece ticales at Kit. Counter
ara a Fire Door; Swing -Landing -Closure
75. A.C. Duct in Garage -Damper
7 Fttc; V s -Clearance -Comb. Air Connector-P.R.V.
In age; Above Floor-Mech. Protection
lec. & Mech. Equip. Listed for Location
78. Elec. Receptacles in Garage (G.FI.)-Romex Protection
Insulation -Foam -Looked in Attic
C,_ 6nard rails & Deck Construction -Post Caps
Bents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
o lowing Instld /wive 0 Yeso/Walks 0 Yes g�IQo/Planters 0 YesglGo
/41-2— 83. Stucco n-Fi
,---.84-A-C. Unit Disconnect, Electrical -Plumbing
L,-85—Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
4* --Water Well, Disconnect, Electrical, Plumbing
exterior Elec. Trim, G.F.I. Receptacle -Underground
ventilation Throught House
1,-99. Glass Protection
90. Correction om Previous Inspections
91. G ti t -Meters Tagged, Gas -Electric
Water & Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
Date Card B-1 Date Card B-1
Date ._? and B-1 Date Card B-1
Date Card B-1 Date Card B-1
Co is Fi
• * " THERMALITO IRRIGATION DISTRICT
410 GRAND AVENUE
OROVILLE, CALIFORNIA 95965
TELEPHONE: (916) 533-0740
FAX: (916) 533-9243
K0
! —
SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: 1116 letter a Avg:.
Owner's Name:
Date: 4/13/9?
Address: J l 4 t,1 -1:w
Acct. No.: 0202-121)
b -c ,, ry Cre:
A.P. No.: J4) -
Phone:
New Unit: uta:
Applicant/Agent:
Adding Units:
Address:
Fees:
Phone:
Permit: $ -� J
T.I.D.:
Preliminary Review By:
Date:
Ext. Fees:
Remarks:' t,cz-r-cL.L`us' ft2 ; c -di M tao.;O
n.mlicriAL At titin
SC -OR:
to t.m Clean uut
Lateral:
u to ur"Cf(-t rcY.ui rs ft 'It 'trn'Lft;-ty
Other:
Total Fees: 1.5.30 Gj
A.v
—
Amount -Paid: -Zbo.i:U
r
`
Collected By: S.
Finaled By:�� ae�--
Date:
Location:
Size Line:,
42
L
•
Signature of Owner/Agent:
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON COMPLETION
Date Billed:
Computer: •�
Paid SC -OR:
A.P. File:
(R.FC.)
Blue Book:
Paid SC -OR:
Meter Book:
(S/C HG's)
Rev. 6/95
BUILDING DIVISION
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE — OROVILLE, CALIFORNIA 95965 — TELEPHONE: (530) 53 7541
AGRICULTURAL BUILDING EXEMPTION PERMI
r
PERMIT NO.
Agricultural building is defined as follows: Agricultural building is a structure detigned and constructed to house farm
implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human
habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a
place used by the public.
ASSESSOR PARCEL NO. D 2 � / f . ®6 '�
�Cd
ZONING A -O
+�
OWNER
PHONE NO.
OWNER'S ADDRESS
Il M
LOCATION OF BUI NG
USE OF BUILDING
'A
SIZE OF STRUCTURE
ply—M X Z = SO. FT.
TYPE OF CONSTRUCTION:
WOOD FRAME —.X,— STEEL CONCRETE OTHER (Specify)
TYPE OF SIDING
ROOFPOVERINGf-�
FLOORNE
ESTIMATED COST OF CONSTRUCTION
AG Buildings shall comply with the minimum front, side, .and rear yard setback requirements of the applicable County
Ordinances as follows: ` 1
FRONT 551 SIDES REAR
AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a
mobilehome, and 23 feet from a commercial building.
AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a
mobilehome, and 40 feet from a commercial building.
AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation
USGS Datum.
I declare under penalty of perjury that the building will be used as stated above and the purposed use confirms with the
AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and
obtain any necessary permits, inspections, and approvals to complyyTh the requirements in effect at that time and before
occupancy.
Date - —:22 Signature of Owner
Permit Fee - $60.00 The above described AG Building is exempt from a building permit
Receipt No.�B
FLVCgt I PARCK I P.D. ROOF G I ISSU
Manager Building Division
By Date
White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant
NO. 5417-79B,P,E
PERMITEXPIRES, 8/31/An
C 7V wo
OWNER F�AN f Q:F :F A
CONTR. owner
LOCATION (A.P. 30-036-21
2116 Tehama Ave, Orovill
Temp. Power Pole
Called PG&E
Temp. Elec. Serv..
Called PG&E
Temp. Gas Serv.
Called -PG&E
JOB/,
FINALED
(Date)
(Signature)
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
StemwaII
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwal I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
p
Footings
Prov. for physically
handicaped
Conformance of ex.
structure
Appliances
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
MOBILEHOME UTILITIES ---------•----•--- Elec- Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
M 1 EHOME INSTALLATION
- - - - - - - - - - - - - - Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
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
Telephone: 534-4541
APPLICATION AND PERMIT
67��lf79
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
7� X t t t to
Signature of Permiteeor Agent
Receint Nn_
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
tte County Code and/or resolutions to do work indicated
above for which fees have been paid.
D R'�CTOR OF PUBLIC WORKS
B Date—
Building
ate
Building permit expires Date O -3/-01,P
BUILDING
Owner %RIA AJO S 14 a(_L�A AJ D
SQ. FT. OCC. BUILD G .VALUATION
EST. '7!50
t� _
Mailing Address 8/6- MOAJ140 60 S'/
CJ,C o Vl �G C4957��
33 na
Contractor 0 60 AJ E6--
/LMailing
MailingAddress
Fireplace
Total Valuation '75-0 - 00
Telephone No.
Permit Fee fj , pp
Building Address 2 U% 7_040MA AtIE
Planng Fee&/or Penalty
Permit t Fee 9.00
EAG
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 r00
Each Trap 1.50
V!
Repair drainage or vent piping 1.50
D _ D ` r
A. P. No. 1p /
Zoning &Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fps]
WIPd
Sa444Hett-
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 -5 outlets 1.50
EGA
Parking
Plans
I ParcelEach
I Declaration
I Parcel Map
1 60' R/W
I Improvements
additional outlet .30
Building sewer 5.00
B
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION'❑ UTILITIES ❑ OTHER 0----
permit Fee $ .Ott
$ ®Fr
CO"_bc-T oAJ,5 Abe- k54. liC%Sp. 0,47-Eb
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 3.002
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family Er Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONST DWELING
OR ADDNS. ( ACCLBLDGS.CCUP, S\ 20sgft
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:
NEW CONSTR MULTI.OUTL T
NON -REBID (BRANCH CIRCUITS) 12.50ea
NEW CONSTR. POWER APPARATUS e
NO N.R ESID, (SINGLE OUTLET CIR.
Ex. OCCUP(OUTLETS OR FIXTURES BAL50 @21
FIXED APLNS.
Ex. Occup.( OUTLETSP(RESIDIRE A) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring Z 6.25 12,50
t✓ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ S, So
$ s 5Z
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
y� 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.
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
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
t2.00
Hood
Permit Fee $
Land Development Fee
$
$
TOTAL PERMIT FEE
$Z SC
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
7� X t t t to
Signature of Permiteeor Agent
Receint Nn_
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
tte County Code and/or resolutions to do work indicated
above for which fees have been paid.
D R'�CTOR OF PUBLIC WORKS
B Date—
Building
ate
Building permit expires Date O -3/-01,P
... ...... Eatte Counig
LAND OF NATURAL WEALTH AND BEAUTY
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
Address ❑ 695 Oleander Avenue, P.O. Box 1100 IN 7 County Center Drive ❑ 747 Elliott Road
Roply to Chico, California 95927 Oroville, California 95965 Paradise, California 95969
Telephone: 916/343.4211, Ext. 62 Telephone: 916/534.4281 Telephone: 916/872-2961, Ext. 58
Francis B. and Frances B. Holland
815 Montgomery Street
Oroville, Cali foi-nia. 95965
Dear Mr. and. Mrs. Holland:
April 3, 1979
Re: 2116 Tehama Avenue, Oroville
.AF# 30-03.-6-21 -
On July ll, 1978, this department mailed you a letter itemizing
several violations of California State Housing Law, existing on. the
above premises for which you are the assessed owner.
A second complaint has been received concerning overflowing
sewa7e on theproperty. Our inspection revealed a pool of standing
se4•raJe and/or wastewater at the north west corner of the dwelling.
Tn addition, there was no visible evidence of an. effort to correct
the conditions listed in the July 11, 1978 letter. You previously
stated that you are in the Process of repairing the dwelling.
This letter is a. second notice directing you to correct all
Housing Law violations existing on. the property. in ad.dition, you are
directed to discontinue the illemal discharge of sewage and/or waste-
water onto the ground surface anal to provide legal and sanitary sewage
di snosal.
A reinspection will be made within JLC days to determine if you
have corrected the sewage problem and a reinspection will be made
30 days to ascertain compliance with California State Housing
Laj,r. Failure to comely may result in legal. action_ by this Department.
if you have any questions concerning this letter or the July 11, 1-978
Letter, please contact me at the above address and telephone number.
Yours truly,
Thomas Reid; R.S.
Sanitarian
TR/jr
Certified #622670
11 July 1975
Butte
®ut
t. -',1,D OF NATU RAL 'WEALTH AN D BEAUTY
DEPARTMENT OF HEALTH
PUBLIC HEALTH SERVICES
DIVISION OF ENVIRONMENTAL HEALTH
Address ❑ 695 Oleander Avenue, P.O. Box 1100 IM 7 County Center Drive ❑ 747 Elliott Road
Reply to Chico, California 95927 O►oville, California 95965 Paradise, California 95969
Telephone: 916/343-4211, Ext. 62 Telephone: 916/534-4281 Telephone: 916/872-296.1, Ext. 58
rrancis H. and Frances 3: Holland
815 :Montgomery Street
Orovil?a, CA 95965
Dear 1,1r. and i;rs. Holland:
On a recent date an inspection was made of the premises located at
2116. -Tehama Avenue, Oroville, Cali_fornia.. The property is identified as
_,ssessor's Parcel No. 30 -03 -6 -21 -and you are listed as the assessed owner of
tine property.
At the time of inspection, the following conditions were observed that are
violations of the California State Housing Law:
1. There were bare electrical wires, missing.electrical outlet and svitch
box covers, inoperative switches and other deteriorated and hazardous
portions of the electrical.system.
2. The hot water heater was improperly installed. It was improperly vented,
lacked an approved press -are and temperature relief valve, lacked proper^
clearance from combustibles and was not provided with an approved source
of combustion air.
3. Portions of the interior walls and ceilings were deteriorated, broken
ardor damaged. Areas of ceiling plaster were in danger of falling.
CD
.There was evidence of a leaking roof.
4. . Portions of the floors were deteriorated. Some flooring materials
were deteriorated and ancleanable. There was.a hole in the kitchen floor.
5. There was evidence that the space heater was not in proper operating
condition.
and Mrs. HollanO
4' .1 m Jr.:ly 19178
J
ao_. -
.e Two
'
1'o--orIPly with the California Stat H(L si:� -Law you are directed to correct the
v.4 clatiO,nS in t'-,--fOtlow?ng nne-r .within 30 days upon receipt of this
I e t --er
i. Repa'r or repla:!e hazardous portions of the electrical system in�ludi.2
providing a safe electrical system in proper working con3i tion
?. Provide a properly installed hot water heater with an approved vent,
pressure an -34 temperature relief valve, clearance fron combustibles and
an adequate source of. combustion air.
3. Repair.or replace deteriorated and/or damaged interior walls and ceilings.
Correct any roof leaks and otherwise make the dwelling weather -tight.
!: Repair or replace the damaged floors and floor coverings.
5• rrovide a safe, adequate space heater in proper working -condition.
Permits are required for the above repairs. These may be obtained from- the
-Butte County Department of Public Works, 7 %County Center Drive, Oroville,
California.
Please direct inquiries to meat the above address and telephone n1wrber.
Very tr-aly yours,
1— mas Reid, R.S.
Sanitarian'
TR:d.sd
.Ref: L -159 -HC
cc: .Building Dept.
Address
Reply to
BEAUTY
DIV IbIUN Uh' tNVIHUNNItIV IAL MI:ALIH
❑ 695 Oleander Avenue, P.O. Box 1100 EX 7 County'Contor Drive ❑ 747 Elliott Road
Chico, California 95927 Oroville, California 95965 Paradise, California 95969
Telephone: 916/891-2727 Telephone: 916/534-4281 'Telephone: 916/ 872-2961, Ext. 58
December 111 1980
Mrs. Ginger DeLozier
2116 Tehama
Oroville, CA 95965
Re: Rental - 2112 Tehama
Orovil.le, AP#30-03--6-21
Dear Mrs. DeLo.ziere
On December 10, 1980 I made an inspection of the rental unit at
the.above listed address at your request. During the_inspection
the following conditions were observed which are in violation of.
the State dousing Law Regulations, and the Uniform Housing Code,
1976 edition. These conditions render the structure substandard
and unsafe for human occupancy.
1. 'There are no shut-off valves on the gas service lines to the
range, waterheater or space heater.
2. The hotwater heater lacks'a temperature -pressure relief.valve.,
and the space heater flue is in poor. condition.
3. There is unsafe electrical wiring and fixtures on -the exterior
of the dwelling, in the storage shed, and.rear porch, and numerous
extension cords in use.
.4. There is evidence of a roach and rodent infestation.
- 5. The front and kitchen entry doors are in poor repair and not
weatherproof. There is evidence of a roof leak.
6. The ceiling is cracked in the living room, and there'is a hole
in the bathroom wall.
7. Floor til.e is missing in kitchen.and bathroom.
8. The dwelling is not being maintained in a .sanitary manner and
items are stored in a manner creating a fire hazard.
These conditions shall be corrected within THIRTY (30) DAYS or the
structure vacated and not reoccupied until all repairs are completed
.as listed below. Permits will be required for items 1,2 and 3 from
the Butte County Department of Public Works.
page 2 of 2
,K
1. Provide shut-offs.on gas lines for range, water heater and space
heater.
2. Provide a properly installed hotwater heater with a temperature-.
pressure valve and discharge line
3. Repair or'replace all unsafe electrical wiring and fixtures on
the exterior and interior of the housed
.4. Eradicate roaches and -rodents from the house. Rodent -proof
the structure.
5.. Replace or repair front ana kitchen entry.doors. Repair the
roof leak..
6. Repair .the cracked ceiling. and hole in the bathroom wall.
7. Replace missing floor tile in kitchen and bathroom..
8. Clean the dwelling, remove junk and debris, eliminate all fire
hazards..
These items shall be completed as indicated, or the dwelling vacated
at once. If. you have any questions.please contact me at the above
listed address or telephone number.
Very truly yours,
Howard J. Snyder, Jr., R.S.
Division of Environmental Health
HJS/lld
c c : "aPub:l.cMWo rrk s
Tenant - 2112 Tehama, Oro., 95965
Z,
n
r- -Ito Co
LAND OF NATURAL WEALTH AND BEAUTY
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
Address ❑ 695 Oleander Avenue, P.O. Box 1100 7 County Center Drive O 747 Elliott Road
Reply to - Chico, California 95927 Oroville, California 95965 Paradise, California 95969
Telephone: 916/891-2727 Telephone: 916/534-4261 Telephone: 916/ 872-2961, Ext. 58
July 22, 1980
Francis B. & Frances B. Holland
815 Montgomery Street
Oroville, California 95965
Re: 2116 Tehama Avenue, Oroville
A# 30-03-6-21.
Dear Mr. & Mrs. Holland:
This department has again received a complaint concerning a sewage
failure and other .substandard conditions at the above located.
property. The Butte County Assessor's records indicate your are
the owner of the property.
On July 15,,1980 an inspection of the property revealed an open
trench and pipeline at the rear of the house, running raw sewage
onto the ground surface and onto adjoining properties. This condi-
tion is in violation of Chapter 19, Sections 19-3, 19-4,. and 19-.14,
of the Butte County Code. Section 19-14 requires that any building
with an existing sewage disposal system creating an insanitary
condition shall be connected to a public sanitary sewer.i% the
building is within two -hundred and fifty (250) feet of a public
sanitary sewer.
A sanitary sewer line is available in Tehama Street in front of
this building. This letter is an official notice to connect the
house sewerage to the public sewer.
Work shall begin and permits shall be obtained within five (5)'days,
and all work shall be completed.within fifteen (15) days from receipt
of this notice. Permits may be obtained from the Butte County
Department of Public Works, 7 County Center Drive for the sewer line
installation. Fees and connection permit may be obtained from the
Thermalito Irrigation District, 410 Grand Avenue, Oroville.
page 2 of 2
Francis B. & Frances B. Holland
Oroville; CA 95965
In addition to the above, we have been advised that the space
heater'.for this.dwelling has been tagged as unsafe by the
Pacific, Gas and Electric Company. This condition.is a violation
of the California Housing haw.
To comply with this law,: remove the unsafe space heater and
replace it with an approved, vented, and properly installed space.
heater under permit and inspection of the Butte County Department
of Public Works. Replace the.heater within thirty (30) days of
receipt of this notice.
.Very truly yours,
oward J.der
:.S.
Y > >
Division of Environmental Health
HJS/lld/ _
cc: blic Works
BUTTE COUNTY
DEPARTMENT OF PUBLIC HEALTH
Division of Environmental Health
7 County Center Drive
Oroville, CA 95965
(916) 538-7281
-.June 2, 1987
." CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Ray and/or 011ie Robertson
P.O. Box 933
Oroville, CA 95965
RE: Housing Complaint - 2112 &.2116 Tehama, Oroville, CA
AP# 30-4-6-1-008
Dear Mr. or Mrs. Robertson:
This department has received a complaint alleging health and safety
hazards in the above listed dwelling units. The Butte County Assessor's
records indicate you are the owners of the property.:
On May 27, 1987, I visited the property and was unable to find anyone
occupying the two dwelling units. I did observe evidence of sewage on
the around, unsafe wiring, and broken doors at 2116 Tehama. The dwelling
at 2112 Tehama had a large accumulation of discarded furniture, a stove,
trash and garbage, broken windows, and apparent roof damage.
These conditions are in violation of the Butte County Code, Chapter 19,
Section 19-3, 19-4, and Chapter 31, Section 31-8; and the California
Health and Safety Code, Section 17920.3 (a)(13)(14)(15), (d), and (g)(2),
and which render the buildings substandard and unfit for human
habitation.
To comply, take action within SEVEN (7) DAYS from receipt of this notice,
and as indicated, to make the following corrections. Obtain any required
permits from the Butte County Department of Public Works, 7 County Center
Drive, Oroville, CA, prior to making repairs.
1. Repair or replace the defective sewerage plumbing under the house at
2116 Tehama, and confine all sewage to the Thermalito Irrigation
District sewer.
2. Repair or replace all defective, unsafe, unprotected electrical
wiring and fixtures in both dwellings (221 and 2116 Tehama)
eliminating open splices and hazardous wiring within THIRTY (30)
DAYS.
3. Repair or replace all broken doors and windows in both dwelling units
within THIRTY (30) DAYS.
r
Ray and/or 011ie Robertson
June 2, 1987
Page 2
4. Remove all refuse including rubbish, trash, garbage, old furniture,
stoves and junk and dispose of this material at an approved disposal
facility.
5. Contact this department and arrange for a complete inspection of the
interiors of both dwellings.
A followup inspection will be made. Failure to comply will result in the
Franchise Tax Board being advised of your noncompliance. You will then
be prevented from claiming state tax deductions for taxes, depreciation,
amortization, or interest expenses connected with the property as long as
it remains substandard. This notice is given to you pursuant to Sections
17299 and 24436.5 of the California Revenue and Taxation Code.
Contact me at the above listed address or telephone number if you have
any questions concerning this notice.
Sincerely,
I,oward Gskr R.S.
Supervising Sanitarian
Division of Environmental Health
HJS/mlf
cc: Public Works - Jim Glander
COUNTY OF BUTTE - DEPARTMENT�OF,PUBLIC WORKS. PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
ry APPLICATION AND PERMIT
A S!J5,SO�j.SAI�C� L NUMBER
�3��'-•�•L��11��)�a
ZONING
BUILDING PERMIT
OWNER _
Francis Holland
TELEPHONE
589 w� 101,
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
Riverview Dr., Oroville 95966
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
'
$Nona
. Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.SUBDI
VISION NAME ___JPARCEL
MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF.� Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
0.00ea
TYPE OF WORK
New❑ Addition ❑ Remodel❑ UtilitiesInstallation❑ Other .19
"Describe work: demo ?'louse _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty p l y (check one):
email of perjury
ElNON-RESID
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
lcense No. Classification.
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. (DWELLINGOCCUP.ei)
OR ADONS. ACC. BLDGS.
, /2(Zsgft
NEW CONSTR. UL I.OUTLET
BRANCH CIRC ITS
2,50 ea
POWER APPARATUS e
(SINGLE OUTLET CIR. )
Ex. Occu
Occup(OUTLETS OR FJ
200030
zAL@30
Ex. Occup. OUTLETS PFIXED APLNS. R
(RESID.)EA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
&a,"l 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
l 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 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
agains a Coun in con quence of a granting of this permit.
I
X ` Date C ^-1=/ %
Signature of A licant — owner
g pp Contractor ❑ Agent l�'
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.Receipt
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
E
TOTAL FE $
E
-
2%.$d
HAz
cuA PARK SCHL
FLD
PAR
Po
I Ho.
Iss
This permit is hereby issued under the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for which fees have been aid.
p
UBLIC WORKS
D7KX)
B ,1 �% Date
PERMIT EXPIRES Date
No. 89048-27.50
WHITE-D.P.W., YELLOW-A9e931011, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovllle, Callfornla 95965 - Telephone: 916/538-7541
APPLICATEONAD PERMIT
ASSJ6S?4V11AFUgL NUMBER
LL}}VV ��JJjjjj
ZONING
.0
BUILDING PERMIT
OWNER
Franris, Hol Iqnd
TE'LECHONE
589-1101
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
107 Riverview Dr., Oraville 95q66
dpmr)
CONTRACTOR'SNAME
Ownpr
-
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
Nnnp
UNKNOWN
Total Valuation is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 17-50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT FiIingFee 10.00
a
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SFf2 Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other 29
Describe work: demo house
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
Fcense No. Classification.
as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.e,)
OR AODNS. \ ACC. BLDGS.
yzQsgft
NEW CONSTR. MULTI.OUTLET
NON-RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. Occu p OUTLETS OR FIXTURES
20@50t
SALO 30
FIXED APPLNS.
Ex. OCCUp. OUTLETS IIRESID IREA.1
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
I Consent to Self -Insure.
L>/f ' 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
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 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
agains I County in co7quence of granting of this permit.
1�"r �'
X �(� ' Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
-
27.50
HAZ.
I CUA
I PARK
I SCHL
I FLD
CDF
PAR
PD
I HD.
Issu
This permit is he issued unoer the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for whi h fees have been paid.
ql R OF LIC WORKS
By Date
PERMIT EXPIRES Date
Receipt No. 89048-27.50
WHITE-D.P.W.. YELLOW-ASSF330R, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEP RTMENT•rOFt'PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE 66 x - IFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT A►PPLI ,A-T10N DATA SHEET
Permit No.
OWNER C (S
A. P. No. -3C�
Proposed Building Use pQAA tE' •—'Building Inspector Date ,5-- 2' 9/,
At time of p mit application, I was advised the following data must be submitted prior to permit processing end/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . ....................................
2. Plot plans in duplicate/triplicate, signed by preparer of plans ........
3. Complete plans in duplicate/triplicate, signed by preparer of plans ..
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation ......... -'
7. Statement of Intent for Non -Heated and AC Buildings ..............
---- •-8d-E-n—gmeerec'r'f'russ details and layout in duplicate (required prior to plan check)
Te) W§tolation data including manufacturer's installation
Instructions.......................................................
10. Fees of $
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from -Health Department
15. City of Chico plumbing permit ..............
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
—� 22. Certificate of Workmays Com en tion Ins r N cc
23. Owner-Builder-qg cat�o�i� ven owner b, IVlaiI to owner .....
-- -24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ................................... I Q /
26.
27.
When u issue the permit, process as follows: Mail to caner. Mail to contractor.
Telephone '539— 761eand h to d for'pickup at ��poffice. Deliver w/inspector.
Other 5`38--'7^72(
Copy of Paz -Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new iteni\not checked above).
1. Index permit for above items No. a3 1 \
2. Addi.tional items required:
Contractor, designer, owner, was advised of above required data by_phonifLinaF%counter bys�!date���
Contractor, designer, owner, was advised of above required data by—phone —mal l_counter by date
Plans checked by
Sets of plans on hold in
Copy—DPW
Date Plans approved by
File cabinet AP folder
Date
:.
TO: Butte County Public Works Dept,
FROM: Francis B. Holland, owner
SUBJECT: Demolition of 2116 Tehama St.., A.P. 030-461-008
DATE: May 2t 1991
My son., Fred Holland, also signing as F.B. Holland, has my authorization to
apply for and receive a demolition permit for the above referenced property.
Sincerely,
/ L? I A a -
Francis B. Holland
cep
COUNTY OF BUTTE - Department of Public Works
7 County Center'Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement yes r no)
G`2. I(have have not) signed an application for a building permit
fo a proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors 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 Contractors 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: /J
Property Owner
Social Security Number
Date —Z-91
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
Demolition Permits
d
n
Asbestos Notification Statement
Date
AP#
Pursuant to section 19827.5 of the California Health and Safety Code, all
demolition permit applicants are required to fill out this form.
"19827.5. A demolition permit shall not be issued by any city, county,
city and county, or state and local agency which is authorized to issue
demolition permits as to any building or structure except upon the receipt
from the permit applicant of a copy of each written asbestos notification
regarding the building that has been required to be submitted to the United
States Environmental Protection Agency or to a designated state agency, or
both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to that part. The.permit may be issued without the applicant
submitting a copy of the written notification if the applicant declares that
the notification is not applicable to the scheduled demolition project. The
permitting agency may require the applicant to make the declaration in writing,
or it may incorporate the applicant's response on the demolition permit appli-
cation."
Attached is a copy of my written asbestos notification to the United States
Environmental Protection Agency for the demolition project located at
Signature of Applicant
OR
I hereby declare that a written asbestos notification to the United States
Environmental Protection Agency is not applicable to this demolition project.
Sig ature of Applicant
2/19/91
MAIL TO
ASBESTOS NOTIFICATION
EPA/NESHAPS Region IX
1235 Mission St. A-3-3
San Francisco, Ca. 94103
DATE:
PROJECT JOB #
(Please see reverse side)
Ag—cies A1'M Notified:
❑ ZMf i
❑ Califoraia Air Aosouxcas Board
❑ C.1 osaA
❑ Building Dapart=ant
INSTRUCTIONS ON REVERSE S
ASBESTOS DEMOLITION/RENOVATION
NOTIFICATION
OPERATOR: -
¢.r
EPA USE ONLY
Please check one:
DateRec
Pstmrk
Renovation
CITY STATE
School
Demolition requiring
ZIP PHONE( )
10 day notice
Del/ND
Demolition requiring
ADQUTE?
20 day notice
ADDRESS
Code#:
Revision of Original
CITY STAT_
,(Form on reverse side)
Doc#:
IDE—PLEASE READ BEFORE USING THIS
FORM
1.
OPERATOR: -
3. FACILITY NAME:
(Contractor)
ADDRESS
STREET ADDRESS
CITY STATE
CITY STATE
ZIP PHONE( )
COUNTY ZIP
2.
OWNER
4. FACILITY DESCRIPTION
ADDRESS
AGE --_._ SIZE
CITY STAT_
ZIP PHONE( )
PRIOR USE
5.
Project Start Date: Completion Date:
6'.
Estimate of Friable Asbestos: ON PIPE: Linear Feet
SURFACE OF OTHER COMPONENTS: Square Feet
Nature of Materials:
7.
DESCRIBE METHODS OF REMOVAL:
8.
PROCEDURES USED TO COMPLY WITH 40 CFR 61.147 6 152:
9.
NAME & LOCATION OF DISPOSAL SITE:
ANY FURTHER PERTINENT INFO CAN BE INCLUDED BY ATTACHING ADDITIONAL SHEETS
QUESTIONS??? FOR FURTHER INFORMATION CALL (415) 556-6415 8am/4pm M -F
INE_TAUCTIONS FOR -USE OF ASBEgTog DEMOLITION/RENOVATION NOTT T aTION FORM
RENOVATION: means altering in any way one or more facility components.
NOTICE MUST BE POSTMARKED AS EARLY AS POSSIBLEBEFORE PROJECT
DEMOLITION: means the wrecking or taking'out-of load -supporting structural
members of a facility together -with any related handling operations
10 Day notice for MORE than 160 sq.ft.or 260 linear ft. asbestos
20 Day notice for LESS than 160 sq.ft.or 260 linear ft. asbestos,
includes facilities which contain no asbestos.
FACILITY: means any institutional, commercial -or industrial structure
installation, or building. Renovations on single family residences
and apartment buildings with 4 units or fewer are exempt from
notification to EPA. -
PROJECT JOB #: Your OWN -IN-HOUSE T D for a specific jobsite. Optional,
but expedites communication -concerning notifications.
LOCAL AGENCY: Most areas in Region 9.have local NESHAP delegated agencies.
In these areas notice must be provided to both EPA and the
local agency.
1. OPERATOR/CONTRACTOR: Full information concerning person doing the work.
2. PROPERTY OWNER: Complete in full.
3. FACILITY NAME: Must have complete address OR directions to the jobsite.
4. FACILITY DESCRIPTION: Current use of building. Project location in the
facility. Other descriptive information as necessary.
5. START AND COMPLETION DATE: Provide month, day and year. Must be revised
if dates change. .(see revision form below)
6. Estimate of amount to be removed (must be in square or linear feet).
Revisions(see form below) must be made for additional amounts uncovered.
7. Examples of methods: glovebag, scrape, remove in sections, etc.
8:'Examples: Adequate wetting prior to and during work, double bag, etc.
DRY REMOVAL MUST RECEIVE PRIOR WRITTEN APPROVAL FROM EPA
OR THE LOCAL DELEGATED AGENCY
IF MORE SPACE IS NEEDED THAN PROVIDED, ADDITIONAL SHEETS SHOULD BE ATTACHED
TO REVISE A NOTIFICATION ALREADY ON FILE WITH EPA, USE FORM PROVIDED BELOW
PROJECT NAME PROJECT JOB I
ORIGINAL NOTIFICATION DATE Revision Notice #1 2 3 4 5
please circle
This is to advise that the above referenced notification presently on file has
been revised. Please note the revised portion listed.
CHANGES FOR THIS REVISION: PROJECT ( )
CANCELLATION
1. NEW Location
2. NEW Scope of Work
3. ADDITIONAL Quantity of Asbestos
4. -NEW Start Date
5. NEW Completion Date
6. NEW Disposal Site
COUNTY OF BUTTE' OF PUBLIC WORKS PERMIT NO.
7 County Center Drive-:Orovllle, Callfmrnla 96885 - Telephone: 918/538-7541
APPLICATION AND PERMIT
ASSESSOR PA C&L NUMBER
—0GQ
Z jVIN
-
BUILDING PERMIT =
OWNER
c cis
Ts ¢ HDNs
s�q-��o�
SO. FT. OCC. BUILDING VALUATION
OWNER'! MAILING ADDRESS
107 2t'uecuiew 420
�
0
CONTRACTOR'r'S' NAME
OWlV ��
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
R
CONSTRUCTION,VIr
UNKNOWN
Total Valuation Is
LENDER'S MAILINC ADDRESS
Filing Fee $ 10.00
Permit Fee$ ,
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
1,07 �f 11 QiQ�'l2.(,1J or qgWqG o2�j
Permit fee $ OC 'J5—O
,27
PLUMBING PERMIT Filing Fee 10.00
G �lsp
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF)Z Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
0.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ ytilitiesO Installation ❑ Other le
Describe work: A9I?ln & ffoo-s e_
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
Main service ;$o AMP OR LESS
RSLESS
10.00
Main service EA. ADD'L too AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license Is In full force and effect.
License No. Classification.
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ 1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.aI
New CONSTR.( A CC. BLOGS.
, hLsgft
ULTII.OUTLET
YN'O ;RESID BRANCH CIRC ITS
2.50 ea
-• POWER APPARATUS e
SINGLE OUTLET CIR.
OCCUp�OUTLETS OR FIXTURES
20@50Ex.
DAL03t
aALo7ot
Ex. OCCUp. OUTLETS FIXED P(RESID .1 EA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
9
t5.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
Permit Feer
$
Contractor
1 Certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit..
X Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ 1
An OSHA permit is required for excavations over 5'0" deep and demolition olconstruct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
—
I CONST TYPE
TOTAL FEE S
HAL
CUA PARK scHL
FLD I cDF
PAR PD
1 Ho.
Issue
This permit is hereby issued unser the applicable provi-
sions 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
PERMIT EXPIRES Date
Receipt No. FrT0_/
`Fy `r -a-7. 1S p
WNITC-O.P.W.. YELLOW-ASSCSSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (ye or no)
2. I (have)kave noQ signed an application for a building permit
for the proposed work.gy ►.�y �,�, , FQr� MOwg,.�r�� s�toiu�u� ,&S
FPS• Ho��.q�D ,, Pt:p+ Hwy wJ2#7-r'E*.0 ANrrro�4Ancw .
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4
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 Contractors License No.
h►Ow E
5. I will provide sof the work but I have (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
So„ i
50.+ ® 7'�cF Hp��a►,.� i o -z �Qi V E�V�'�w C)Gt mal i � �t � GLMcuri o,iv
Signed:
Property Owner
Social Security Number
Date5-
-'/0 —!2/
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
a
June 22, 1987
Pacific, Gas, and Electric RE: Substandard Housing
2150 Bird St. A.P. #30-461-08
Oroville, CA 95965
Attn: Ron Severson
Gentlemen:
The residential buildings located at 2112 and 2116 Tehama, Oroville, have
been inspected and declared substandard pursuant to the provisions of the
California Health and Safety Code. The owner, Ray Robertson, has been
notified to rehabilitate or demolish the structure.
Due to the unsafe conditions found, and since the building is presently
vacant, this office hereby requests that you disconnect the gas and electric
services at the earliest possible time.
Your timely cooperation concerning this request would be,appreciated.
Should you have any questions concerning this matter, please contact this
office.
JFG:ahb
cc: Health Department - Oroville .
Yours very truly,
William Cheff
Director of Public Works
Origin®I -Sgo by
y F. Glerods,
J.F. Glander
Chief Building Inspector
■l
File No.
BUTTE COUNTY ';;F(3—raction 1, 2, 3)
Public Works Dept. (For Information / )
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. & Pci. Maps
Permits
Addr.
0
G
`In� �\
star-Departmis _Memorandum
TO:
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SUBJECT:
DATE: 0547
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30-461-08 ! it ' 92-1792B
�• ��
4 • �� HOLLAND, Francis , '
E 2116 Tehama St`,Oroville
demo house _
} L
2�
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovllle,Calllorgla 95965 - Telephone: 916.538.7541
APPLICATION AND PERMIT
PERMIT NO.
A03E ' R PARCEL NUMBER
030--461--098
ZONING
AR
BUILDING PERMIT
OWNER
Francis Holland
TELEPHONE
589-1101
SO, FT. OCC. BUILDING VALUATION
Est. 1000.00
OWNER'S MAILING ADDRESS
140 Ward Blvd., Oroville 95966
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING1ArRES5
' 11
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 11000.00
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee $ 22.50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Permit fee $ 3%.50
PLUMBING PERMIT Filing Fee 15.00
2116 Tehama $L .. OrOvillf3
Each Trap 1 5.00
Solar or heat pump water heater 1 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 1 7.00
Each qas water heater or vent 1 7.00
USE OF STRUCTURE
SF ® Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 1 5.00
Building sewer 15.00
Mobile Home S I G I W @ 15.00
TYPE OF WORK
New ❑ Addition _ Remodel C Utilities ❑ InstallationC Other [
Describe work: Demo House
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 600V OR LESS 18.50
200A OR LESS
Main service 200A TO 1000A1 37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license IS In full force and effect.
License No. Classification
LW"as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUP, f\ 3.54 sq.ft.
OR ADDNS. l ACC. BLDGS. /
NEW CONSTR.MULTI-OUTLET 5.00
NON-RESID BRANCH CIRC ITS
(POWER APPARATUS 6)
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20 @ 754
A
Ex. OCCUp. OUTLETS FIXED IR ESIDLN S. IREA.) I 3.00
Temporary service j 15.00
Mobile Home Facilities 15.00
Misc. Wiring
g 15.00
Permit Fee $
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
�l shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 15.00
Heating
Cooling
g
Hood 6.50
Ventilation
Permit Fee $
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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�aiCoun;y isequence of the granting of this permit.
Xu-'""'"'7u�/�� Date 5 -2S -4=1Z
9 PP ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ CONST TYPE
TOTAL FEES 37 . 50
HAz
I DFEES I
IMP
I FLOOD
I CDF
PARCEL
PD
HD
Issu
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
�- DIRCT OF PUBLIC WORKS
By j� Dater//- 52
PEI IMIVEXPIRE Date
�' '
116160
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
/ COUNJY 10F`"BUTTE - DEPARTMENT OF PUBLIC WORKS
v 7 County Center Drive - Orovllle, Cdllfbrnia 95965 - Telephone: 916.538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
030-461-008
JnNIIpA'
AR
BUILDING PERMIT
OWNER
Francis Holland
TELEPHONE
589-1101
SQ. FT. OCC.1 BUILDING VALUATION I'
Est. 11000.00
OWNER'S MAILING ADDRESS
140 Ward Blvd., Oroville 95966
CONTRACTOR'S NAME
Owrier
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is 1,000.00
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$ 22.50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ 37.50
PLUMBING PERMIT
Filing Fee 15.00
2116 Tehama%''__ . n ovi 1 le
Each Trap
1 5.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
7
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF X❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G JW I 1@
15.00
TYPE OF WORK
New L 1 Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other [3
Describe work: Demo THLouse N_
10 !A e e - f -91
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200AA 00OR LESS
2OR LESS
18.50
Main service 200ATO10ooA1
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license Is In full force and effect.
;J
License o. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
El i, as the owner, am exclusively contracting with licensed contra
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.8j
OR AODNS. ( ACG. BLDGS. /
_37.50
3.60 sq.ft.
NEW CONSTR. ULTI-OUTLET
NON-RESID- BRANCH CIRCUITS)
la 5.00
/POWER APPARATUS 6
\SINGLE OUTLET CIR.
Ex, Occu p OUTLETS OR FIXTURES
20 7s
EX. OCCUp. OUTLETS FIXED PRESID )LNSREA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00ct-
Misc. Wiring
g
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
�ishall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIirig Fee 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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
againai Coun. y in consequence of the granting of this permit.
X Date —2-
Si nature of Applicant – Owner
g pp ❑ Contractor ❑ Agent
An OSHAwork
permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee
$
occ CONST TYPE
TOTAL FEE $ 37.50
HAz
1 11 FEES
IMP
FLOOD
I CDF
I PARCEL
I PD
HD
ISSU
T.
This permit is hereby issued under the
sions of the Butte County Code and/or
indicated above for which fees
DI CT OF PUBLIC
By
PE IT EXPIRE Date
applicable provi-
�
resolutions to do
have been paid.
WORKS
Date6--0—`Z2—
6 �f
Receipt No. 116160
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
I
f
�. Ak
COUNTY OF BUTTE PARTMENT44F PUBLIC WOR BUILDING DIVISION
.r
Y
7 COUNTY CENTER DRIVE - OROVIILLE, �,.ALl 6RNIA 95965 - TELEPHONE (916) 538-75A V7-1
-
� 4,;
PERMIT APPLICATION DATA SHEET
OWNER/ ! ,✓VCIS 1,14 NO A. P. No. 30` /--w62
Proposed Building Use 45e/,o �414fr-� nspector Date 2 -
At
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ....................................... .
2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... .
3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... .
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............ .
5. Hazardous Material Form . ........................................... .
6. Energy Design Compliance and supporting documentation . ................. .
7. Statement of Intent for Non -Heated and A/C Buildings . .......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ . ..........................................
11. Impact fees as shown on attached schedule. ..............................
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . .............
15. City of Chico plumbing permit . ..........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) I rovements (B) Drainage. .......... .
19. Driveway pe mit (construZio ppr va �j� fired prior to occupancy). . .
20. Prel i _ � tii dca S 1 to Buispedion requeT
S� required. . . to Building Inspector (Dale)
21. Contractor's license information. (No., Name Style, Classification) . .............. {
22. Certificate of Workmans Compensation Insurance. .
23. Owner- ¢uild'er Verification (Given to ownerMail to owner ............
24 -Recorded copy of Agricultural Acknowledgement Statement . ................. .
X25. Letter of signature authorization . ........................................
26: Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
-27. Letter of intent on building use . ......................................
28. Mobilehome utility clearance.
29. Documentation of legal access . ........................................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements. ...... `....... .
31. Existing violations/expired permits . ........................... ..............
32. Plan check list. .
33. Gyt D S t0 S -::17r ' .e
34. 1 /UD «,47'/6
When d'issue the permitgrcress as follows: Mail Mail to contractor.
�Telepho e ( W-xa' and hold for pickup at t � office. Deliver with inspector.
Other
Parcel Creation 2
Acreage Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date • By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ p mail Counter
Contractor, designer, owner, was advised of above required data by _ phon _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive,_ Oroville, CA 95965 Phone: 916-538-75.41'
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your.earliest opportunity to avoid
unnecessary delay. in processing and issuing your building permit. No building permit
will be issued until this verification is received..
1. I personally plan to provide the major labor and materials for —&C4-tiie�f
the proposed property improvement (yes or 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 Contractors 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 Contractors 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: �1
Property Owner ✓/%/jL'►'lZ4�
-Social Security Number �.
Date �B— Z -
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted o issue ther�nit.