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'^.•'p.�y�!Ms+ i 1 i ffs i 030 462 007{�a�-;i•` �4`� 03-}0589 HOWARD, }RAYMOND* ,+ld�" l'e 1956 20TH ST OROVILLE. `REPLACE SERVICE PANEL OFFICE COPY Address GAS Meter By Date ELECTRICil Meter By ` - Da7t, . BUJ A •1 � • Q J F COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 �.. 31 (Rev. 12/96) APPLICATION AND PERMIT q. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDR SS .p - -•�' CONTRACTOR'S NAME-' � -• J TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS F�r�f• it � rj' i� � Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Pr�'LWE f l .,CTRI(, SERVICE PANNI A, U�5 4DI'' R"" 2?00/V-fP SLRVIC.E Gas piping stem 1 - 5 outlets 1 5.00 Building sewer 15.00 Mobile Home I S I G W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200A OR LESS 23.00 ^ Z LICENSED CONTRACTOR'S DECLARATION 1 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.PSINGLE 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: �J 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors td construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO ,000A 46.00 NEW CONST. DWELLING OCCUP. O OR ADDNS. ( a ACC. BLOS. 3.50' FT. PK1µRE081UT. MULTI -OUTLET 97.50 a OUfLEr COWER APPARATUS IR. zo ®,.� EX. OCCU OUTLET OR FIXTVREs BL @ .50 Ex. Occup. OUT ET5 RE�SID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ,re -1 nq,')ect i On r r; PERMIT FEE WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permitis issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars, ($100) or less.) I certify that in the perfrmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X L .._I Date ' (�_ Si gnnat a of Applicant - ❑ Owner ❑ Contractor ❑ Age An OSHA permit is required for excavations over 5'0"deep and demolition or constructionof structures over 3 stories in height MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 316 . n ) HAZ. D. FEES IMP FLOOD CDF PARCEL pD HD ISSUE ✓ This permit is hereby issued under the applicable provisions of the Butte County C e and/or Resolutions to do work inert d a v f r whi h fees have been paid141r- ByDate PERMIT EXPIRES ON `7.41(4 Defe Receipt No. '�'� i s' �`, t % /� WHITE-O.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 (Reve12/96) APPLICATION AND PERMIT 6 ASSESSOR PARCEL NUMBER 030-462-007 ZONING BUILDING PERMIT OWNER TELEPHONE . OWNERS MAIUNG ADDRESS ST- eA Sp, FT, OCC. BUILDING VALUATION CONTRACTOR'S M iOTH 9 TELEPHONE CONTRAC-rOkWAAUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1_956 2_0 Energy Plan Checking Fee $ tui -ST. , GROVI17LE $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REPLACE EL CTRTC' SERVICE UPGRADE TO 200AMP SERVICE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200A OR LESS 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. 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: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00NEW CONST. DWEwNG OCCUP. SO OR ADDNS. a ACC. S.3.5¢FT. t1Oµ.ESID MU.11 LTI.OUTLET 97.50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET oRFIXTURES 20@'.0°BAL @ .5o Ex. Occup. oFlxuntTs AFs DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 pre—inspection 0 PERMIT FEE $ �' 66.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. CQ Date natu7eof A plic� - ❑ Owner ❑ Contractor ❑ AgeAn OSHA permit is required for excavations over 5'0" deep and demolition or construction structures over 3 stories in height MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee is Occ CONST. TYPE TOTAL FEE $ 66.00 HAZ. D. FEES IMP FLOOD COF PARCEL PD HD ISSU This permit is hereby issued under the of the Butte County C de and/or inTid a v f r whi h fees have B PERMIT EXPIRES ON applicable provisions Resolutions to do been paid.Si Date D Te work n�jof Vim/ Af- Receipt No. �J- �� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PI -INSPECTOR GOLDENROD -APPLICANT Ga«`1�7��4�i'�'�!'�`r+tMti"a--a�f�YP.,�+avi+'r^7'.�1�•�>R'�v�`"TM'•^�r;s;),,�,,+w.-�rReo+s�.s''�7+i6�a.i�14�'�'�'''�o�i�*"'�r+*r•�1"ea�]'+b'��i' !j M1 4 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 > PERMIT APPLICATION DATA SHEET OWNER: C� ASSESSOR PARCEL NUMB Proposed Building Use: Counter Technici Date: Items required in orde o apply for a permit. All boxes MUST be checke O marked NA in order to apply. ❑ 1.. Plot plans, 3 or 4 sets, signed,�y the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit........................................................................I ❑ 18. California Department of Forestry plan approval ❑ paid. Sent. by: ...................... ❑ 19. Planning approval for (A) Use: (B)Parking: . (C) Parcel Check: ❑ 20. Contact Land Development about F Improvements, ❑ Drainage ............................... �l . Encroachment Permit fo drivewa e Pub cWoset. (construction approval prior to occupancy). 22. Pre -Inspection fo required ................ ❑ 23. Contractor's license information. (Number, N me Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization............`....................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. -Existing violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D ❑ 31. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for -obtaining a building permit. Date: 3 /31,07 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised cf the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was -advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date:. Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Buildine Division O.B.-1 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. I personally plan to provide the major laborf d materials for construction of the proposed property improvement: YES ❑ NO CV Q/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: PHONE: CITY: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated:' NAME ADDRESS PHONE TYPE OF WORK SI J 2Zg� s NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION Dear Property Owner: O.B.-1 An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. ;rely, el C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER OWNER.— LOCATION: WNERLOCATION: N, CONTRACTOR:_ PRE-IdSPETION FOR: DATE TO INSPECTOR: Building Description: PRE -INSPECTION REPORT .11 PERMIT DATE: 6z A.P. #• • L �� 7 BUILDING I NSPBCTOR'S REPORT CancnaciaWsage: - Residential/N of Units: Currently Occupied Abandoned/Vw4nt Electric: / Yes V No Condition of Electric Electric currently On Off Gas: Natural' D Propane None Currently On Off Obvious Problems:- SAnit.i ion: Plumbing Working Well Working Obvious SewageProblems. Comments: J Potable Water ON RECOMMENDED: ISSUE: �/ HOLDYOR ACTION RECOMMENDED: I CJs ` �� •— Inspector. Date _V,AC Sketch buildings on reverse and indicate location on properi 0