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HomeMy WebLinkAbout031-201-008057 031-201-008 PERMITN97-0531 OLRY, Scott 1963 10th St., Oroville Ele Ser Ch & Rewire/SF AlAl cl- 031-201-008 OS -2166 OLRY, SCOTT & JANIE 1963 10TH ST, OROVILLE CONT: OWNER RE ROOF 031-20 1 -008 05-2787 OLRY, SCOTT 1963 10TH ST, OROVILLE Cont: OWNER WINDOWS0111 a5 - BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: '(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Date: Contractor: 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 to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 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 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article,2"df the Busineskalr d. r2�essions Code Date: LiG_� WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy ❑ 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 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: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. PERMIT NO. BPOS2787 Issued Date: 10/10/2005 APN: 031-201-008-000 Site Address: 1963 10TH ST ORO Map Index: Description: REPLACEMENT OF 5 WINDOWS, NEW SIDING( 900 SQ) Owner: OLRY SCOTT D & JANIE 171 M KAREN CLOVIS, CA 93612 (530) 370-1092 Applicant: OLRY SCOTT D & JANIE 171 M KAREN CLOVIS, CA 93612 (530) 537-1092 Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte Count} Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indica ed above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) ` Date: � 10— 10-0 5 Name: By: � /'' PERMIT EXPIRES ON: i 1 (� I` i 1— n In Address: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely 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 t duy authonzd agent of the owner. I ag:ee to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of a y official form o5' o utle County- I hereby authorize representative. of Butte County toupon the above /mentioned property for inspection purposes. Print Name:_ ` ��"� Signature: Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHLCO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION **PLEASE PRINT CLEARLY** OWNER Last Name/ /J First me _l— Address (��- r City l/l State .14 A i� C�� -70_ ( D q � Fax ( _ ARCHITECT/ENGINEER Name Address City State Zip Phone Fax E mail State License Number CONTRACTOR Name ,- i Address SRA City State Zip Phone Fax E-mail Lic. # Class ARCHITECT/ENGINEER Name Address City State Zip Phone Fax E mail State License Number ..,Ig 11a 'jq Ir For office use only: APPLICANT NAME Name .T� /j`� t 1 ct� Address SRA City ('�?l ^ State�� Z hone Fax E-mail Page ..,Ig 11a 'jq Ir For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: n%/Co CnD CIIQIUIITTAI RF(1111RFMFNT5;, PERMIT NO. BP() 5277'67 BIN # LENDING AGENCY Name Address Description or Scope of Work: r i+n i &% i Sq. Footage S {- 1:711— ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are riot refundable. r- n rr O Received by, K G Amount / J, O Bldg SRA Receipt #:�l 5 Sheriff SMIP Date: (0 - O5 n Other SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ .5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed. by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION ...�..... ....... ... .....'. rr.r,uc�o�_n__c..�D_�._ ..... D...... o s7 RFS/ R_I r_nA 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 material for construction of this proposed property im rovement: YES [("I\]. 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: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: ' DATE: 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. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your naive listing yourself as the builder of the 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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. o There may be financial risks for you if you do not. carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact 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 perfonn 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 contractor 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 contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT " 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP052166 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 08/12/2005 APN: 031-201-008-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I Site Address: 1963 10TH ST ORO License Class : License Number: Map Index: Date: Contractor: OWNER -BUILDER DECLARATION Description: re roof 15 Squares I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: OLRY SCOTT D & JANIE permit to construct, alter, improve, demolish, or repair any structure, prior 171 M KAREN to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of CLOVIS, CA the Contractor's State License Law (Chapter 9 commencing with Section 93612 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applic to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not . intended or offered for sale (Sec. 7044, Business and Professions Applicant: OLRY SCOTT D & JANIE Code: The Contractors' State License Law does not apply to an 171 M KAREN owner of property who builds or improves thereon, and who does CLOVIS, CA such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 93612 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 Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors'' State License Law.). ❑ I am Exempt under Articles of the Busin and ro ssions Code Date: _ 1 �-"SOwn r. WORKERS' COMPENSATION DECLARATION License #: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Architect: Labor Code, for the performance of the work for which this permit is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft:. 0 S.F. Valuation: $0.00 Poli�'Icertitv Census Code: that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall I forthwith comply with those pr visions. Date: C9 r v Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one vvv hundred thousand dollars ($100,000), in addition to the ,cost of compensation, damages as provided for in Section 3706 of the Labor, code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is herebyAr§ued undei;pe appncab rovisibns of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to P119ork indi ateove for ich f s have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Date: Name: By. PERMIT EXPIRES ON: Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. am the owner or t drly authorized agent of the owner. I agree to comply with I hereby certify that I have read this application, that the above information is correct, and that I all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of 4ny official form gr document of Butte County. I hereby authorize representatives of ButteCountyto enter upontheabove mentioned property for inspection purposes: Print Name: t5" TT f DI � Signature: Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor e. C. Building Permit 01-16-04 pg BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE 9: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER Last Name&1 First Kime Address 1 ,, r 'V' reAl `1 t�-/T/ City L V/ StateC �I fi?- /� Zip % 2 l Phon -1, O /f Fax E-mail APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name © �� Address City State Zip Phone Fax E-mail IrAPPLICANT ;' mo rAtIN For office use only: Zoning I Flood Zone F_0`_SStreet SRA Yes — —No Carrier Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. 216 BIN # LOCATION �j �,� AP#©U 3/— — Property Address / C� r'0 S% City F_0`_SStreet WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage 0 Structure Built without Permits 13 Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received byAmount: V Bldg SRA 1 VI Receip`t,�#: I)� Sheriff - ` ` . SMIP (Z�S. Date: �, ` Other Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor. Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 71F7 UWAAVW&y 0561A LV UWAY locate your residence. We have received a serves as access to along your road (see proposed road i your property attached patitiol Please advise If this road name is - si hear from you within 14 days from t assume the name is satisfactory and wl if you have any convenience, Phone Oroville, CA 95965. DA: so Att. questions, pleasq No*. 915/538-7331 03P-201--,-008 w iPERMIT#97-0531, .OLRY, Scott. 1963.1Oth St.; Oroville El•e Ser Ch & Rewire/SF L' 1 IJ r- 111 ..' Y OUNTYOF BUTTE -.DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center'Drive - Oroville, California 95965 - Telephone (916) 538-75419/7-'� R (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBBER 31-201-008 - ZONING AR BUILDING PERMIT OWNERSCOTT OLRY .. 5De ,909 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 171 N. KAREN AVE CLOVIS, 93612 CONTRACTOR'S NAME �/f'f�1ER TELEPHONE CONTRACTOR'S MAILING ADDRESS 'CONSTRUCTION LENDER +1L LT.��, Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. FilingFee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS -;� Plan Checking Fee $ BUILDING ADDRESS 1963 10V ST Energy Plan Checking Fee $ $ OROVILLE PERMIT FEE $ LOT NO. SUBONISaN'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑; Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: UPGRADE TO 100 AMP MIL E1:ECTRIC ;ERV AND REWIRE DWELLING Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G I W 920.00 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.PGWER License Class LIC. No. 10WNER-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, 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. ( a ACC. s.o . SO 3.50 • NEW CONST. MULTI.OUTLET NON-RESID. Rq H 1 C @7.50 APPARATUS a SINGLE OUTLET CIS. Ex. Occup. OUTLET OR FIXTURES p' AL @ I50 B. FIXED APPLNS. OR Ex. Occup. ourLErs RESID. EA 5,00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PIRE, 300 PERMIT FEE $ 00 • WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I 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 FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation 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' X of compensation laws of California, and agree that if I should become subject to the wprke'rs' comp'eqsation provisions of section 3700 of the Labor Code, I shall forthwith complywi 'hose provisions. Q �n X _ _ Date _3"' 0 - % _ Signature^of Applicant - ❑Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONSTTYPE . TOTAL FEE $ 86.00 HAZ. D. FEES IMP I FLOOD CDF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By 1 Date PERMIT EXPIRES ON Is'Ici'�'1� Defe Receipt No. *210294 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT V • COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDINGDIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERM No. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 31-201-008 ZONING AR BUILDING PERMIT .. OWNER SCOTT OLRY 3r--Gi�09 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 171 N. KAREN AVE CLOVIS , 93612 . CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S 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 1963 10TH ST Energy Plan Checking Fee $ OROVILLE $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF C:K Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um 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: UPGRADE TO 100 AMP MAIL ELECTRIC SERV AND REWIRE DWELLING Gas piping system 1- 5 outlets• 15.00 Building sewer 15.00 Mobile Home IS I GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zo.AOR mss 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POINGL 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. �Q I, as owner of the property, am exclusively contracting with licensed contractors ` to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 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' COMPsation laws of California, and agree that if I should become subject to the W114. rs' Com sation provisions of section 3700 of the Labor Code, I shall f with comp a provisions. Date l 3— i •�— Sr Applicant - Own ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service To 46.00so WEE200A CCUOOOA NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( d ACC. BUDS. 3.50FT. NEW NON -RES DT MUICTI.O%.0 @7,50 8 SOUTLET WER APPARATUCIR.s E j 20 @' o Ex. Occup. OUTLET OR FIXTURES ens Ex. Occup. ouTLEEDTs RESIOOEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PIRE INSPECTION0 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 86.00 HAZ. D. FEES IMP FLOOD I COF PARCEL I PO HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Q 6LOinn,Date}} `3 —� Q `—� •� PERMIT EXPIRES O (Da te ReceiptNo. 210294 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ��__ ..�,�-w..-i ✓.-1.w�..r c t -. a .., .:r - st..,.�;„^,�;,rti•:,1•+ , a a.....i - lr`+ryt%a.,: 11''tY�.t�...Vs SQPINTY OF BUTTE DEPARTMENT OF DEWLOP,MENT SERVICES - BUILDING DIVISION 7COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: JC - n �-� ASSESSOR PARCEL NUMBER: 3/ - a D I - U Proposed Building Use: Building Inspector: Date: At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By 111. All items have been submitted. --------------- =--------- ="=--------------------------- I --------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered , , plans, 3/4 setswith wet signature gln � p on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan'review) No faxes! ------------------ El 6. Energy Design Compliance and supporting documentation. ---------------------------------------------------- 117. --------------------------------------------------- ❑7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- I] 10. Fees of $ ------------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule.----------------------------------------------------------------. ❑ 12. California Department of Forestry plan approval/fees. -------------------- ❑ 13. Flood elevation ce"rtif cate. ------------------ ------------ ❑ 14. Sanitation and plot plan3approval 1 Health Departm' t. ------ ❑ 15. City of Chico plumbing perant. --==------- :r Y: ------ =----------:------- ❑ 16. Plot plan and business license approval from the City of Biggs. =----- ❑ 17. Planning approval for (N),Use: (B) Parking: ❑ 18. Contact Land Development abod-0 Improvements,. 11 Drainage, IR Legal Parcel. ❑ I 9,Jnricroachment Permit for driveway (construction approval prior to o'ccupancy)------------------------ ---- C}/� 0: Pre -inspection for � ��/� � ly / C -Q_ requiied. Request to Building Inspector o��7 (Date) ❑21. Contractor's license information. (Number, Name Style, Classification). ❑22. Workers' -Compensation carrier and policy number. ----------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). - wa.: p • 024. Letter of signature authorization. -------------------------------------------- ❑ 25. Recorded copy of Agricultural Acknowledgment Statement. ------------- r j 026. Letter of intent on building use. ---------------------------------. ❑27. Manufactured Home utility clearance. -------------------------- 028. Existing violations and/or expired permits. --------------------. ❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ ❑30. Other: When you issue the permit, process as follows ❑ Mail to owner,, ❑Mail to contractor. []Telephone --- 2-ff - and hold for pickup at ^' ` ffice.,DIS eliv with inspector. Apphc Date. b Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ ution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Otli�r: Date: By: 1. Index permit application for the above items numbered: 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mai}, Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mails Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, Plans reviewed by: Date: Plans approved Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by Yellow Copy - Department of Development Services, Building Division. ❑ Plan Check List by ❑ Building Division counter,by -t., Date: ❑ Building Division counter, by Date: ` o Building Division counter, by Date: ❑1iBuilding Division counter, by Date: Date: Date: 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 : YESIA NO[ ]. ' .2.: I HAVE - HAVE NOT[ J signed an application for a building permit for the proposed work- 3. ork3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CTTY: 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: NAINlE ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: SOCIAL SECURITY NUMBER: - (). DATE: 7?j-- �1 1:2 . 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 Dear Property Owner. Aa 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 retard 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 passible 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: _ 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed. as contractors or subcontractors, then you may be an employer. 0 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. 0 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. 0 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 employe -.s, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material red to be sinned by properry owners unless they are performing their own personally. Building Permits are not requi work personally. be obtained by contracting the Contractors State License Information about licensed contractors may Board in your community or at 1020 N Street, Sacramento, CA. 95314. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are awue of these matters. The building permit will not be issued until the verification is returned. Sincerely, ' Michael C. Vieiia, C.B.O. Manager, Building Inspection NOTE: This owner -Builder Information is required by Section 19830 of the California Health and Safety Code. m OVER ` COUNTY OF BUTTE- DEPARTMENT OFOEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 3--20 � � �- Do ZONING 412- BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS J. /71 42 J_ G N 5 93 CONTRACTOR'S NAME TELEPHONE ' CONTRACTOR'S 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 ADDRESSf4 �-J 5,74 -Energy Plan Checking Fee $ $ IV,vl,�( -e PERMIT FEE S LOT NO. SUBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap Solar or heat um water heater 7.00 23.00 USEOFSTRUCTURE SF b Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation S Other ❑ Describe Work: � � Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800R LESS Main Service 20OAOR LESS 23.00 aj-" 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. ❑ 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. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA -permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service zooA To I000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACc. BLOs. C 3.5¢x: �" H gE°S,o MULTI.OUTLE @7.50 APPARATUS a SINGLE AP= CIR. Ex. Occup. OUTLETSAP FIXTURES BAS p I: o Ex. Occup. our .S gE�.I , 2% 5.00 'Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 Pre PERMIT FEE 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 $ 514, , o -v HAZ. D. FEES IMP I FLOOD I CDF PARCEL PO I HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have - By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. ai L WHITE-D.D.S.-B.D. CANARY - ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 1) 9OWNER: �G e f �' �, DATE: LOCATION: / J /Q yti AP.#: ZONING: CONTRACTOR: CO ti -e PRE -INSPECTION FOR DATE TO INSPECTOR PERMIT HISTORY:.[ ]NONE [ ]AS FOLLOWS: TYPE OF OCCUPANCY: BUILDING INSPECTOR'S REPORT ng Description: [ ] Commercial/Usage: [ ] Residential/4 of Units: Mobile Home: Yes[ ] No[ ) [ ] Currently Occupied. [ ] Abandoned/Vacant. [ ] Yes [ - ] No Electric is currently : [ ) On [ ] Off Condition of electrical? • Natural [ ] Propane[ ] None[ ] Currently On[ J Off[ ) f .. Obvious problems: itation: Plumbing working Yes[ ] No[ OFFICE COPY Well: Yes[ ] No[ ] Potable water: Yes[ ) No[ ] j- Address -&3 �a , Obvious Sewage Problems: j Meter By Date Hold for: �' ELECTRIC 2� ion Recommended: (]Issue [ J Meter By Date' �c ector: Date: _ I' (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7.541. APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCELNUMSER ZONING 412- BUILDING PERMIT OWNER TELEPHONE C/ SO. FT. OCC. BUILDING VALUATION OWNERS MALLJNG ADDRESS OWNER'S A, ;_ 1— o L �-5 CONTRACTOR'S NAME TELEPHONE ' CONTACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS tion $ ARCHITECT OR ENGINEER LICENSE NO. F $ 20.00 $ ARCHITECT OR ENGWEERS MANNG ADDRESS in Fee $ SUILDINGADDRESS_ l/I t� �� Energy Plan Checking Fee $ $ PERMIT FEE S EDT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK / New [3 Addition ❑ Remodel ❑ Utilities ❑ Installation E7 Other ❑ Describe Work: — �'; •C -g- 4— Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2000AOReoov LESSLEss 23.00 23--.r LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law 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 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.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ person in manner so as to become subject to workers' P Y an Y P any � compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service To I 46.00 NEW CONST. DWEWNG OCUP. / �7 SO WEE SCU OR ADONS. ( d ACC. 1' 3.5¢x, c OUTLET NEW CONS MULTI.OUTLET @7.50 NON-REBID.CIRCUITS POW �P^ US a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAL Q+. 0 Ex. Occup. GflxrrLE�°rs AE�s Ge. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 I - G PERMIT FEE $ C� tom. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee 1 $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ c o c l HAZ. D. FEES IMP I FLOOD I CDF PARCEL PO HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date Palo) ReceiptNo. -) / (- = (/ e / - WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Butte County Department of Development Services: OurrE� r I N ®TES 7 County Center Drive, Oroville, CA 95965 .00 (530)538-7601 www.butt@countynetidds �Oty• I RESIDENTIAL �l APN: ly�'� ✓ Permit No. 'r Owner. Site Address: Contractor. CALType of Permit: v V V V r SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS. ' VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE +=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATIONSOFT-SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test -Crossovers -Breakers -Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID EC K S'C O V E R S'C A R P O RTS -G A R A G ES 1 Zoning -Setbacks -Easements 2 Ftgs; Soils Sz-DpthSpacing-Cnnctr-Steel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnztrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries-Termirals-Listed 7 Elec Bonding; Metal w/5'-Crcltng EqF•-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bones-Enclsrs-pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide c' �4 ,s s 0 ° Q1• `1� 0 Pool Drawing .=OK n= mm RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE IPLUMBING 1 Zoning-Setbacks-Easements-FloodSlope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils -Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First fir -Tub Acc 5 Stemwalls Main; Steel -Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped• 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV;' Fall -Fitting -Test -2 -way C/O -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1�1 \, s 0\ °' °\ 1.1 Wtr Pipe; Test-Anchrs-RgltrService Test DATE IMECHANICAL 12 Elec Undrgrnd 61 AC Ducts Insultn & Support 13 Plenums & Ducts; Clrnc-MaterialSupport4psultn 14 GirdersSills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic DATE IFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrflr Acc 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnis 38 Insultn-Walls-Ceilings 39 Infiltration-Walls-Wndws 0 0� 0\S Oq as DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or ❑AL AC Wire Sz ga ❑ CU or ❑ AL 48 Range Circ ga ❑ CU or ❑ AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o c 090 0 Oa O\ FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters [:]Yes ❑No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler \� S