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HomeMy WebLinkAbout031-201-005.- ` ` . , . . . H.E. BARTON r 1035 Plumas Ave., Orovi-ii,iB"_ ' ` - 'L64 3. . -659 � ing CONTR: Weir Roof Oroville Co. KAFADEKTAMEL. V" (reroof and build up-sing 3 FAD ' 110 035r ' ^ . V'y7ySID�/ . ' ` ---- q . ^ . ^ . ' ^ . . . . . . ' ~ . . * . ^ . ,=====~~ . . . . ` . . . / . ^ , . . . � ~ . ~ ' . ^ - ^ , . . - . ` / . ~ ' . ` . . � � ` . , ' � BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING.PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP040593 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date' 03/02/2004 APN: 031-201-005-000" the Business and Professions Code, and my license is in full force and j effect. �7 License Class : /J License Number: yooit. C4,0 Site Address: 1035 PLUMAS AVE ORO Date: �(Contractor. .4!?4�,TS T'� h COZ7 Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW VINYL SIDING (1600 FT.) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior { Owner' KAFADER PAMELA M to its issuance, also requires the applicant for such permit to file a i 1035 PLUMAS AVE signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or ! 95965-3230 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the fit applicant to a civil penalty of not more than five hundred dollars ($500).): i ❑ I, as owner of the property, or my employees with wages as their it sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an t Applicant: KAFADER PAMELA M owner of property who builds or improves thereon, and who.does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of , sale.). ❑ I, as owner of the property, am exclusively contracting with. licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: PFISTER CONSTRUCTION and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 11358 AMALGAM WAY ❑ I am Exempt under Article 3 of the Business and Professions Code RANCHO CORDOVA, CA 95670 916-858-2024 Date: Owner: License #: 800290 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of corisent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit architect'- is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: 522 �; C—o,J Total Square Ft: 0 S. F. / Valuation: $0.00 C.� –, Policy #: �� S� 3 %CJ;�, 3 ? 'i - C� ❑ 1 certify that in the performance of the work for which this permit is Census Code: I issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California. and agree that if I should become subject to the workers' compensation provisions of Section 3700;of.the Labor Code, I shall forthwith comply with those provisions. Date: ^ 7 � � ^j�� C l7 • _50 Applicant: WARNING: Failure to secure workers' compensation coverage is1 u unlawful, and shall subject an employer to criminal penalties and one �� —` /&„ hundred thousand dollars ($100,000), in addition to the cost of // ` compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit!hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) R. -solutio o do work indicate abo a for which fees have been paid. Name: BYDate: to PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpose �I Print Name: ) % ' Signature: Date: S /.2 / 0 7 0 Owner ❑ Contractor 0 Agent for Owner <f4. 4.F --Contractor =,L COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street - Chico, CA - (530) 891-2751 s 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE ER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should becorrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this officemediate �) �r d+ y.. BUTTE COUNTY '' DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (ORO)/ILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#; (530)538-2140 WEBSITE: www.buttecounfy.net%dds PERMIT NO. BPO40593 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 03/02/2004 APN' 031-201-005-x300 the Business and Professions Code, and my license is in full force and ' effect. y7 License Class: %3 License Number: YOOA Site Address' 1035 PLUMAS AVE ORO Date: gcontractor. a��—' 'S Tc' `'C<'�GJ /1 Map Index: Description: NEW VINYL SIDING (1600 FT.) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: KAFADER PAMELA M to its issuance, also requires the applicant for such permit to file a 1035 PLUMAS AVE signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Cede) or that he or 95965-3230 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: KAFADER PAMELA M owner of property who builds or improves thereon, and who.does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: PFISTER CONSTRUCTION and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 11358 AMALGAM WAY ❑ I am Exempt under Article 3 of the Business and Professions Code RANCHO CORDOVA, CA 95670 9 16-858-2024 Date: Owner: License M 800290 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: h d Carrier. :166 "C —' Total Square.Ft: 0 S. F. — Policy #: 2, "- 3 %G 01 � ? 7 ?- - O Valuation: $0.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: ^ 7 _ 8 gsas 7 � ­50WARNING: Q 2 Applicant: Failure to secure workers' compensation coverage ise��r ped unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars L1 LL (!/ ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit'!hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutioroo do work indicate abo a for which fees have been paid. Name: BY Date: PERMIT EXPIRES ON: 3 oC Quo) Date Address: ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate :he storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpose" !� Print Name: U N Signature: Date: / 7 0 Owner ❑ Contractor ❑ Agent for Owner 411geat4er-Gontractor ,BUTTE COUNTY , -'I DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. ,-,,> -.5 DATE: 3 — /– . O LI -7 APN: /p v � ZONING NEAREST CROSS STREET: TRACT/LOT# SITE ADDRESS: I U S- ve - CRY, ZIP: i 1 c) OWNER NAME: l PHONE: y d� ie- YN30 - s 3 z- JJ7&I STREET ADDRESS: FAX: , CIN, ZIP:E-MAIL APPLICANT NAME:a �G J PHONE 71 r �- S 9 16 ''s8-'2vj STREET ADDRESS: FAX: CITY, ZIP: t A�e�© )a,a j E-MAIL CONTRACTOR NAME:PHONE: ��1 ��i►-�- f s 16� 8S� —10� STREET ADDRESS: � FAX: wi- �9- m � CITY, ZIP:E-MAIL' c. p ,rel C/144 cL - � S" 6 7 !J LICENSE NUMBER '90 e �. 9 v LICENSE TYPE: (3 ARCHITECT/ENGINEER NAME: PHONE STREET ADDRESS: FAX CIN, ZIP: LICENSE NUMBER E-MAIL: DESCRIPTION OR SCOPE OF WORK: 1'0 . I 1 sr , �< <s� C. ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION . Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: Application Received by: ' " Date: 3— Q Receipt number: � �y���� Amount Received: � �� , c5,0 P f4te r CovstracUo-w 11358 Amalgam Way Al, Rancho Cordova 95670 Phone: (916) 858-2024 Fax: (916) 858-2025 CCL# 800290 Date: To Whom It May Concern: 1?o6.P1- % 4 is authorized to obtain a permit and business license on (First Name) (Last Name) behalf of Pfister Construction. License Number: 800290 t� Sincerely, �6- Dani el Pfister President Pfister Construction 916/223-5038 AGORD„ CERTIFICATE OF LIABILITY INSURANCE DATE / 9/200 PRODUCER 916-361-9585 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY,AND CONFERS NO RIGHTS •UPON THE CERTIFICATE SKYLES INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 9840 BUSINESS PARK DRIVE SACRAMENTO, CA 95827 INSURERS AFFORDING,COVERAGE NAIC # INSURED PFISTER CONSTRUCTION' INSURERA: LINCOLN GENERAL INSURANCE CO. DAN PFISTER INSURERS: 11358 AMALGAM WAY SUITE Al INSURER C: RANCHO CORDOVA, CA 95670 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. --- — — Pow EXPIRATIONIMNSRD TYPE OF IPOLICYNUMBER LIMITS OENERALLIABILITY EACH OCCURRENCE $ 1,000,000 A COMMERCIAL MERCIAL GENERAL LIABILITY CLAIMS MADE I OCCUR 2537023772-0 12/01/2003 12/01/2004 PREMISES Eaoccurence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS) COMPIOP AGG S INCLUDED X I POLICY PRO' LOC AUTOMOBILE LIABILITY ANY AUTO COMBINEDSINGLE LIMIT $ (Esaccident) BODILYINJURY S (Per person).. ALLOWNEDAUTOS SCHEDULED AUTOS BODILY INJURY. .. $ (Peraccident) HIRED AUTOS NON)OWNED AUTOS PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY) EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY OCCUR FICLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ S $ DEDUCTIBLE $ RETENTION S WORKERS COMPENSATION ANDWC EMPLOYERS' LIABILITY •.. ANY PROPRIETOR/PARTNER/EXECUTIVE STA �U, OTH, E.L.EACH ACCIDENT S E.L. DISEASE , EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? H yes, desviba under SPECIAL PROVISIONS below t E.L. DISEASE, POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS PROOF OF INSURANCE *10 DAY NOTICE OF CANCELLATION FOR NON -PAY CERTIFICATE.HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION w. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ' *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SMALL PFISTER CONSTRUCTION IMPOSE NO OBLIGATION OR LIABILITY F ANY.KIND UPON THE INSURER -ITS AGENTS OR FOR INSURANCE PURPOSES UTMORIZEDREPRESEN �AREPRESENTATIVES. M/mat i��O�RPORATION ACORD 26 (2001/08) 1988 uCen..,A)e W1 rage i of z Caiitomia Home Monday, Judy 14, 2003 License Detail CALIFORNIA CONTRACTORS STATE LICENSE BOARD Contractor License # 800290 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before relying on this information, you should be aware of the following limitations: • CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject to public complaint disclosure, an icon will appear below. Click on the icon to obtain additional complaint information. • Per B&P 7071.17only construction related civil judgments known to the CSLB are disclosed. • Arbitrations are: not listed unless the contractor. fails to comply with the terms of the arbitration. • Due to workload, there may be relevant information that has not yet been entered onto the Board's license data base. Extract Date: 07/14/2003 * * * Business Information * * * PFISTER CONSTRUCTION 5837 PERMENTER CT ORANGEVALE, CA 95662 Business Phone Number. (916) 988-1349 :Entity: Sole Ownership Issue Date: 10/17/2001 Expire Date: 10/31/2003 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * Class Descri tion © GENERAL BUILDING CONTRACTOR * * * Certifications * * * Cert I Description HIC HOME IMPROVEMENT CERTIFICATION * * * Bonding Information * * * http://www2.cslb.ca.gov/CSLB LI1BRARY/License+DeW1.asp 7/14/2003 i,icc,se i�eiali Page 2 of 2 CONTRACTOR'S BOND: This license filed Contractor's Bond number 6046699 in the amount of $7,500 with the bonding company %jRETY COMPANY OF THE PACIFIC. Effective Date: 09/26/2001 * * * Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 1665168 Effective Date: 10/31/2001 Expire Date: 10/31/2003 Workers Compensation Historj Personnel List SalesPerson List License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesp�rson Name Request m 2002 $W. a of California. Gray Davis, Governor. Conditions of Use Prtvaw Polices http://www2.c' lb.ca.gov.CSLB LIBF.ARY/License+Detail.asp 7/14/2003 POLICYHOLDER COPY. SufATEP.O. BOX 420807, SAN FRANCISCO, CA 64142-0807 COMPENSATION INSURANCE. FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE OCTOBER 21,'2003 GROUP: POLICY NUMBER: 1665168-2003 CERT -If ICATE I D: 63 EXPIRES: 10-31-2004 .. .... iO-31-2003/10-31-2004 CONTRACTORS 7"8T -BOARri-.:'! WORKERS':,' COMPEk9kTION UNIT P 0 BOX -2-6000"" #800290 SACRAMENTO CA 95826 10-31-03 LOS ANGELES DISTRICT N'tic This is to 66ftity that We hove Workers Compensation' iinsUtance , i�. I JbOm :by the tmgdi�ii Insurance CommIssiQ"ner to the --employer harned. below for the policy:,ppriod Ind This policy" is.,n*'bt,.s.ubject,t6caricelikon by*:.thefund except upon:-.10-...-day.s.,adr ante wkMen!:noticetot he employer. We will also,:gj,.v days:.ad4ance notice should this pollcy.:be canpalled-pO I expiration. This certlfick6 ofinsurin' is not an Insurance ipotby..and does . not ' " the coverage afforded by the policies listed herdih. N6tykhStancing any requIrement,-tens ,or condition of any co'httidtd -dither document with respect to which this certificate of insurance may be issued or may pertain, the Insurance afforded by the -policies described herein is. subject to all the terms, exclusions, and conditions, of such policies. FROG;'"' RLLSTRTE PHONE NO. 9167897148 Jun. 14 2002 10:35RM P3 Q)AIISt . Vou're In good henda. ALLSTATE INSURANCE COMPANY HomE° Office . Northbrook. Illinois Calendar Date 06/14/2002 CALIFORNIA BUSINESS NAME DANIEL PFISTER BUSN ADDRESS 5837 PERMENIER CT CITY ORANGEVALE HOME;PHONE ( ) CUSTOMER SERVICE REQUEST COMMERCIAL AUTO POLICY Policy Number: 048601685 04/24 ST: CA ZTP- 95662 BUSINESS PHONE : ( 916 ) 223 - 5038 ---------------------------- CHANGE COVERAGES These are the coverages that apply.to your vehicle(s) after your requested change has been made. ITEM 001 ITEM 002 AB Combined BI & PD 1000000 1000000 SS UM Bodily Injury. 300000 300000 DO Collision (Ded) 500 500 HH Comprehensive (Ded) 500 500 SUPPLEMENTAL.COVERAGES ITEM NO: 001 Include waiver of collision deductible:N SUPPLEMENTAL COVERAGES ITF_M NO: 002 Include waiver of collision deduct.ible:N -INTERESTED PARTY ADD ITEM On Item: 2000 F150 1FTZX1723YNC22272 Certificate of Insurance Holder Name: WALTER PFISTER Address: 110A HARDING BLVD Exp Year: City; ROSEVILLE State: CA Zip: 95678 Dir Code: 000000 ADD ITEM INTERESTED PARTY On'Item: 2002 F350 1FTSH31F92EC22300 Certificate of Insurance Holder Name: WALTER PFISTER Address: 110A HARDING BLVD Exp Year: City: ROSEVILLE State: CA Zip: 95678 Dir Code: 000000 Page. 1 of MORE R21IM-1 T V y r 1 1 t PlolumasAve r• - 03 201=00 ti r t it • 4 Butte Av! t ;r PERMIT N0. 2050-76P A • PERMIT EXPIRES 4/26/77 OWNER H _ E RARTON CONTR. owner LOCATION (A.P. 31-201-05 ) 1035 Plumas Ave.; Oroville rI • t' } k J 1z " 'l • f t /p.Gas Pole &E erv. plied&E rv. E L FINALED (Date) (Signature) Stucco COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS r BUILDING INSPECTION RECORD Subpanels Mesh BUILDING BUILDING (Cont'd) Grd. Fault Pr PLUMBING Setback Firewall Soil Piping Cooling Forms Parapets 1st Floor Under roup Main Bldg. Restroom Finish 2nd Floor Door Closer Footings Windows 3rd Floor REMARKS OR CORRECTIONS Stemwall Siding To out _ Slab Roof Sheathing Water PI In Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov, for physically handicaped Conformance of ex. structure Appliances Gas PipingTest Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat I Rou h Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Pr Scratch 'Heating Service Brown Cooling Temp. Pole Finish Ducts Under roup Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) THERMALITO ,IRRIGATION DISTRICT 306 410 GRAND'AVENUE OROVILLE, CALIFORNIA 95965 - TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: Owner's Name: X/ 7 .a,?`�„ _ Date: ' �, Address: Ar- �' �..�-,- �� ,r.�� - Acct. No, A. P. No.:3/-.;?e./ Phone: ? _ / . No. Units: Applicant/Agent: .r/%1 Agents Proof: N114 Address: ' MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: 0 --Date of TID approval of completed building sewer (early connection). ❑ -30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). ❑ 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID Fees: Phone: Application $ ,r f Preliminary Review By: f r Datea4' % Arrearage y �.i�.�'�i_��r CSA 26 f Remarks: SC -0 R 1 st. mo. S.C. Other Total Fees Collected By: Date: Field Review By: / Date: Remarks: CA A MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: 0 --Date of TID approval of completed building sewer (early connection). ❑ -30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). ❑ 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID J COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Orovi lie, California 95965 _ -} Tetephone: 534-4541 APPLICATION AND PERMIT r vi,., ,roa u,c wun,y vi Quilt to CIIICI uNun u1e above-mentioned property for inspection purposes. X,a� -�Date Sig notur of Permitee or AgeQnt L Receipt No. / s� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions )f the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. (RECTO OF PUBLIC WORKS 52 By Dat Building permit expires Date BUILDING Owner le- 71)N SQ. FT. OCC. BUILDING VALUATION Mailing Address ?� Zv�p�d' v-(2 [ TeJgphone��, Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee ' $ Building Address L D / v �, PLUMBING No. @ FEE PERMIT FILING FEE $3.00 dry Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 f _ ! S� A. P. No. l Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. J ftn4i m 1 Fire Dept. Fire Zone Use Permit Building sewer 5.00 S.C-4 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 ans ec Parcel Approval Plans Approval Permit Fee $ $ o'L NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ©� ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 /� \�J I J�(�(/P/v' "'� o Main service 600V OR LE55 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service 1100EAMP OR LESS 25.00 Main service EA. AOD'L 100 AMP 1.00 NEW CONST. DWELLING OCCUP, & OR ADDNS, ACC. BLDGS. 2¢sq ft NEW CONSTR. (MULTI -OUTLET NON-RESID, BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & NON -RES,D, (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: • Ex. Occup(OUTLETS OR FIXTURES) BAL� Ex. ccu FIXED APPLNS. OR O P• ( OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 A ® I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ®I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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 MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE 81 al $ r vi,., ,roa u,c wun,y vi Quilt to CIIICI uNun u1e above-mentioned property for inspection purposes. X,a� -�Date Sig notur of Permitee or AgeQnt L Receipt No. / s� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions )f the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. (RECTO OF PUBLIC WORKS 52 By Dat Building permit expires Date