HomeMy WebLinkAbout031-245-0127 _~
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FBill- Pearsall
8f,66 Thermalito Ave., lot 8, Oroville
f j
Ad M i 1 y
31-245-12
ITEW OWNER
366 Ther to Ave, Oroville
Permit #3303-78P,'E,M(inst. AC) SF
031-2147.5-01 '937-121-8,'E
031-245-012 06-1833
66
`STURNACLE, MICHAEL
'_�-___--,,`_,-__.'L�_�
Cont:�
n
'._
LO
`BUTTE COUNTY
o �V T Two DEPARTMENT.OF DEVELOPMENT SERVICES
BUILDING PERMIT
G - . � c 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
G - — - - o OFFICE #: (530) 538-7541
CSU N'�y
PERMIT NO.
WIV. *N
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 07/31/2006 APN: 031-245-012-000
the Business and Professions Code, and my license is in full force and
effect. /► -1
License ass :C Licenslje Number: 17� Site Address: 866 THERMALITO AVE ORO
Date: �1 �ontractor:66(lacAh'i'•� Map Index:
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):):
❑ 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 (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.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
O 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: S—�1�"o,+e/� 1 Jr1u 1�17C
Policy #:_ 1► 3- (20 3 J •J
❑ 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 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:
WARNIN 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.
Description: CHANGE OUT HVAC UNIT- SPLIT SYSTEM
Owner: STURNACLE MICHAEL & MARY M
866 THERMALITO AVE
OROVILLE, CA
95965-4425
Applicant: GALLAGHER'S HEATING & AIR
PO BOX 35
LOS MOLINAS, CA 96055
530-384-2444
Contractor: GALLAGHER'S HEATING & AIR
PO BOX 35
LOS MOLINAS, CA 96055
800-892-3556
License #: 777334
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 County Code and/or
I hereby affirm that there is a construction lending agency for the Resolution t do work indicated bove or which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ) 17-3
Name: By:.Date: 1 O
Address: PERMIT EX IRES ON:
0 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
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 Buite County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection urposes.
Print Name: �ri. I ( C� r'(A
Signature:
Date: � I �' 0�D
❑ Owner
❑ Contractor
❑ Agent for Owner
Q�Agent for Contractor
o. t. ouuomg vermrt 01-16-04 oa 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE 4: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
APPLICANT SIGNATURE
r office use only:
OWNER INFORMATION
Last Name I "U _ , , X _�
'T
P,it
am .. M.
Address
.
Y
'
Ing s
City
i
State
Zip
Phone.
O2
Fax
E-mail
Class
an
APPLICANT SIGNATURE
r office use only:
CONTRACTOR
Name
f_ „ 'S HVAC
Addres
Type Const.
City
'
Ing s
Statr a
Zip Cr(D��
�
PhonZR r
`I �
?40 r I
`-t
Fax
E-mail)
Lic. #-�.1, 3
Class
an
APPLICANT SIGNATURE
r office use only:
ARCHITECT/ENGINEER
Name
f_ „ 'S HVAC
Address
Type Const.
City
'
Ing s
State
Zip
Phone
al
Fax
E-mail
State License Number
APPLICANT SIGNATURE
r office use only:
APPLICANT INFORMATION
Name CLI
f_ „ 'S HVAC
Address
Type Const.
CityLon
'
Ing s
State_,
Zi
Phone39
al
Fax
E-mail
APPLICANT SIGNATURE
r office use only:
Zoning Flood Zone
SRA I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
BP C
BIN #
PROJECT LOCATION
AP# 0 l -2 0i
Pro erty Address
Ci
Cross Street
WORKER'S COMPENSATION
Policy Number _ W I SS
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
OVER FOR SUBMITTAL REQUIREMENTS Ll
K:\FORMS\BUILDIN6FORMS\BldgApplSubRgmts.doc Page 1 oft
Descri tion or Scope of Work:
iVj
n fe�and o
Sq FT- Living Garage C06n Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written'request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
dD
Received by: Amount: . iy�� b.. Bldg
SRA
Receipt #: �j�i`i Sheriff
C� 127 Co
Date:01 - O GO
SMIP
Other
,OCI Total
REV 8-12-05
,F ,
i
v
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541
APPLICATIONQAND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
031-245-012
ZONipNG
' AR
BUILDING PERMIT
OWNER
JOSEPH SKOWRONSKI
TELEPHONE
533-1680
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
880 THERMLITO AVE OROVILLE 95965
CONTRACTOR'S NAME
0>;.�tJER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
8U1866 TIM MALITO AVE OROVILLE
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
�y
SF rY Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I W
@ 15.00
TYPE OF WORK
New Additions Remodel❑; Utilities yJainstaliation[ Other ❑
Describe work: REPAIRS TO MAIN SERVICE _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200ATO1000AI
_
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
U i, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.&\
OR ACDNS. 1 ACC. BLDGS. II
3.6$sq.ft.
NE
NEW TLET
NON.RESID. BRANCH CIRCU ITS@
5.00
/POWER APPARATUS &)
(POWER
OUTLET CIR.
Occup(OUTLETS OR FIXTURES
Ex. OCCU
20X760
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.)
3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00 O•u
Permit Fee
$ .UV
Contractor
-
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you becomesubject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiiingFee 15.00
Heating
Cooling
Hood
6.50
Ventilation
permit Fee
;
L Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save indemnify and keep harmless the County of Butte against
all liabilities, judg ents, ckqts, and expenses which may in any way accrue
against said Count y in cons uence of the granting of this permit.
X JN Date
Signature Appli Ont — Owner Contractor ❑ Agent ❑
An OSHA permit Is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Ener Inspection Fee $
9Y P
occ
CONST TYPE
TOTAL FEES 30.00
HAz
11 FEES
IMP
FLOOD
CDF
PARCEL
PO
HO
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated ave for which fees
Ir
IREcToR 00'0UBLIC
By ��../ �^�
PERMIT`EXPIRES * Date
applicable provi-
resolutions to do
have been paid.
WORKS
Da g
Receipt No. 140598
WHITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916,`538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESS R PARCEL NUMBER
0 1-245-012
ZONING
'" AR
BUILDING PERMIT
OWNER
JOSEPH SKOWRONSKI
TELEPHONE
533-1680
SQ. FT. OCC. BUILDING VALUATIO
OWNER'S MAILING ADDRESS
880 THERMALITO AVE OROVILLE 95965
CONTRACTOR'SNAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
866 THERMALITO AVE OROVILLE
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each pas water heater or vent
7.00
USE OF STRUCTURE
rrYyYy
SF P Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G JW I
@ 15.00
TYPE OF WORK
New ; Addition Remodel UtilitiesFUXlnstailation❑ Other ❑
Describe work: REPAIRS TO MAIN SERVICE _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 20GATO 1oo0A)
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessPOWER
and Professions Code and my license Is In full force and effect.
License Ao. Classification
(_f(CO
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST, DWELLING OCCUP.&
OR ADDNS. ( ACC. BLDG S'
_37.50
3.64 sq.ft.
NEW CONSTRULTI.OUTLET
NON-RESID BRANCH CIRC ITS
@ 5 00
APPARATUS &
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURESA20
761
45
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESID.) EA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. byirin g
'15.00 -OT
Permit Fee
$
-
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Coolin g
Hood
6.50
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save indemnify and keep harmless the County of Butte against
all liabilities, judg ents, c sts, andexpenses which may in any way accrue
against said Coun y In cops uence of the granting of this permit.
Date
o Appli ant — Owner Contractor ❑ Agent ❑
An OSHA permit s required for excavations over 5'0" deep and demolition or construct-
ion of structures ver 3 stories in height.
Receipt No. 140598
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEES 30.00
!
HAz
I DFEES I
IMP
I FLOOD
CDF
PARCEL
PD
HO
ISSUE
This permit is hereby issued under the
of the Butte County C and/or
sionsSignature
work indicated ve f (ch fees
TO UBLIC
ByDa
PERMITIRES Date
applicable provi-
resolutions to do
have been aid.
p
WORKS C
C7
WHITE-D.P. W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORK,--
7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541
APPLICATION_ AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBERZONING
03 /- Zys. �/ Z
BUILDING PERMIT
OWNERTk
MOO e ll LS 0W r onl-sKf,
EPHONE
33 _/60e
SO. FT. OCC. BUILDING VALUATION
i OWNER'S MAI LI GADD SS
uA t/ -^q A,71-0 'Abli xov, 1"e -
CONTRACTOR' ME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$
i ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
p
G / (/
Permit fee
$
PLUMBING PERMIT Filing Fee 15.00
Each Trap
1 5.00
Solar or heat pump water heater 20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF6Z Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G JW 1 1
515.001
TYPE OF WORK
New _. Addition Remodel 7 UtilitieAq Installation❑ Other ❑
Describe work:�P/l��i�i��rUiCF __
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
_
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200A TO 1000AI
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.SINGLE
License No. Classification
_LNS
J I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING oCCUP.h)
OR ADDNS. ACC. BLDGS.
3.6d sq.ft.
NEW CONSTR. MULTI -OUTLET
NON.RESID BRANCH CIRC ITS
5 00
POWER APPARATUS 6
OUTLET CIR. I
EX. OCcup(OUTLETS OR FIXTURES
20 764
A
FIXED
P1EA.)
Ex. Occup. OUTLETS IRESID
j 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00 %S.00
Permit Fee
$ 'To. c
Contractor
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
F-1 The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ 1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiIirig Fee 15.00
Heating
Cooling
Hood
6.50
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Si nature of Applicant - OWner ❑ Agent ❑
g pp ❑ Cs over
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee
$
occ CONST TY"
TOTAL FEE
$ ��=' —
HAZ
DFEES
I IMP
I FLOOD
I CDF
I PARCEL
PD
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No. L���
WNITE-D.P.W., TEL LOW -ASSESSOR, RINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE-..Depar'tment of Public Works
.7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An -"owner -builder" building permit has been'applied for in your name and bearing
your signature.
Please complete and return this .information at your earliest opportunity to avoid
unnecessary delay in processing•and issuing your building permit.' No building permit
will be issued until this verification is received.
1 I personally plan to provide the major labor and materials -for construction of
the proposed property improvement (yes or no)
2. I (have/have not) signed�an'application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
.construction:
Name
Address City
Phone Contractors License No:
.4. •I plan to provide portions of this work-, but -I have hired the following person
to coordinate, supervise, and provide the major work:
-Name
AddressCity
Phone Contractors License No.
5:_ I will -provide some of.the work but.I.hay.e contracted (hired) the following
persons to provide the work indicated:..
Name Address Phone Type of Work
• Signed:
Property Owner
Social_Security Numter
Date Mau :?1Q 9
✓+ROH'" :. - _
I. i
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832-, of the -_California Heal-th,-and Safety Code: - - -
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
;r PERMIT NO: ' 4029-77B,P,E,M
r 9bPERMIT EXPIRES
`!' I#- Bill Pearsall
OWNER
CONTR. owner,
P LOCATION (A.P. 31-245-9 .port.
866'Thermalito Ave., lot 8, Thermalito
y.
-
t
I
Temp. Power Pole
Called PG&E
'Temp. Elec. Serv.��l oo�
Called PG&E
Temp. Gas Serv.
•
Called PG&E
JOB
L/. FINALED
(Date)
r
(Signa ure)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
Water Piping Sewer Gas Piping
MOB16EUOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS_
(NOTE: An entry must be made on this form each time you visit the job site.)
77
THIS IS TO CERTIFY _THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE" CURRENT REGULA-
TIONS, CALIFORNIA ADMINISTRATIVE CODE, W'TITLE .25,. STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
Street Lot Number Tract No.
EXTERIOR WALLS
Thickness/Type Manufacturer / yre R Valu
CEILINGS
Batts: Manufacturer Thickness R Value
,Blown: Manufacturer %! Thickness No. Bags_ Wt./Bag
Sq. Ft. Covered 2_4 R Values %
FLOORS
Manufacturer Thickness/Type R Value
SLAB ON GRADE
Manufacturer Thickness/Type R Value
<' Width of Insuliti—inches
FOUNDATION WALLS
Manufacturer Thickness/Type R Valu,-
GENERAL
alueGENERAL CONTRACTOR LICENSE No.
BY TITLE - DATE
INSULAAT19N CONTRACTOR: HAWKINS INSULATION CO. LICENSE No. 21 -925
BY,s/- TITLE G'`- DATE—
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS
7 County Center Drive = Urovikle„California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
¢OaS�x1'
ol
X ---a Date
Signature of PerqVee or Agent
Receipt No. I to 7 e.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the butte county Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF P ELIC WORKS .
BY Date C—/ ''7
` I
Building permit expires Date 0—/, ,��t
BUILDING
Owner �� A Y• L
SQ. FT. 'OCC. BUILDING VALUATION
Il So '.L- 2 �a• civ
-.
Mailing Address o Ifa30�'9
i S
Telephone No.
Fireplaceti
Contractor'
Total Valuation' •SIP 4d • o
, -
Mai I ing Address w �! Ir”
Permit Fee
Plan Checking Fee'&/or Penalty
•
Telephone No.
Permit Fee $ "!1•�
Z O
•
Building Address P a I�
- PLUMBING No. @ -FEE
PERMIT FILING FEE $3.00 .�
_
Each Trap, -, r - 1.50 Y.p
( + r -Al o %h1f�+4 aLoTv i+ve J��
Repair drainage or vent piping 1.50
- —
Water piping 1.50 ,
Zoning Verifica ion ®nlx
Each gas water heater or vent 1.50
A. P. o. Z
Za
Gas piping system 1 - 5 outlets 1.50
Each additional outlet 30
Fes
.C. i tion
FireDept.
Fire zone
Use Permit
Building sewer 5.00
EQA Parking
Plans
Parcel
Declaration
a
Parcel Map'
P
60' R/W
Improvements
provements
Lawn sprinkler system 2.00
C
B dg. Plans Recd
Parc pproval
Plc pproval
Permit Fee fl
NEW ADDITION ❑ UTILITIES-[] OTHER ❑
ELECTRICAL No. @1,FEE
PERMIT FILING FEE $3.00 ,8
Main service 100 AMP OR ORSL 'S 5.00
Main service EA. ADD'L too AMP 2.50
'
Sin
Single Family Duplex Mobil'Home
9 Y P ❑ ❑ . Others ❑,
Main service'• OVER 600V100
too AMP OR LESS 25.00
too AMP 1.00
Main serviceNEW
CONST. ( DWELINGEA..ADDIL
OR ADDNS. ACCLBLDGOC$/ &) 20syft .ia•s!�
NEW CONSTR. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS) 2.50ea
. - -
•
NEW CONSTR. POWER. APPARATUS &
NON-RESID. (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: - '
Y
oe '0
50
Ex. Occup(ou'TLETS-OR FIXTURES) @@1
BAL@1
FIXED APP LNS. OR -
Ex.,Occup.(ouTLETs (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
gg,�-,,
License No.�GE/(�f Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee$S. j (i
$ S d
WORKMEN'S -COMPENSATION INSURANCE.,
I am aware of the provisions of Section3700'of the California. Labor
Code which requires every employer to be, insured against liability
for Workmen's.Compensat ion.
have placed on file with the County of Butte a certificate of
� Workmen's Compensation Insurance.
❑Iermit is issued I shall not employ certify that in the performance of the work for which -this
P p y an y person in an manner
y
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL- No.1 @ FEE
PERMIT FILING FEE J$3.00 o
Heating ,/pp;ocp 8
Cooling
Ventilation
Hood 2.00 L O it
Permit Fee $
$
I certify that (,have read this application and state that the above
information -is correct. I agree to comply to all County Ordinances
and ,State Laws relating to- building construction, and hereby
authorize representatives of the -County of Butte to enter upon the
Ahnve-mantinnari nrnnorty fnr )r e,.t;, n
L4 V'ci Dava-Lu 'PAa t✓%
C
TOTAL PERMIT FEE
This ermit is hereby
P y issued under the applicable provisions
of
ol
X ---a Date
Signature of PerqVee or Agent
Receipt No. I to 7 e.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the butte county Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF P ELIC WORKS .
BY Date C—/ ''7
` I
Building permit expires Date 0—/, ,��t
., SI-...,,.
THERMALITO IRRIGATION DISTRICT
410 G,RANDrAVENUE
OROVILLE, CALIFORNIA 95965
TELEPHONE 533-0740
i
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: a-� . • / s='t�
Owner's Name: '�= t Date: ! `7
Address: ' -i f'. ...r a ;�` �.-+� r..'. ' ` Acct. No:
y �r
A.P. No.: --
Phone: No. Units: �� ►�
Applicant/Agent: Agents Proof:
Address:
Fees:
Phone: Application $
Arrearage
Preliminary Review By:Date: r `' `7 -i CSA 26
Remarks: SC -OR
1St mo. S.C.
Other
Total Fees
Collected By:
Date: 7 -7
Field Review By: (1 P4111-.. Date: /.*1 — 7 _%
Remarks:
77
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
❑ 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
;i•
to/
o n/
COUNTY OF BUTTE — DEP'ARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Tel epttone: 531-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X
Signature of Permitee or Agent
Date
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.
DIRECTOR OF PUBLIC WORKS
By
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor _
Mailing Address , -, : r `. f
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address `1 �l. ,, 1.� j
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
.r -
Repair drainage or vent piping 1.50
,� 7
A. P. No. }
Zoning & Planning
Water piping 1.50 f
Each gas water heater or vent 1.50
Fees
W. C.
Sanitation
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. Plans Recd
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
)
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 "
Main service 600V OR LESS
100 AMP LESS 5.00
SinSingle Famil ❑ Duplex ❑ Mobil Home ❑ Others
9 Y ❑
-L
Main service E4. ADD100 AMP 2.50
Main service OVER eooV 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1,00
NEW CONST.
OR ADDNS. ACC'"BLOGS.LING CCUP. '1'1 22sgft
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
st le of:
Y
z'.
NEW CONSTR. LTI.OUTLET 1r
NON-RESID ( BRANCH CIRCUITS/ 2.50ea
NEW CONSTR. POWER APPARATUS 8
NON-RESID. SINGLE OUTLET CIR.
Ex. OCCUp(OUTLETS OR FIXTIIPES a ,� oa
Ex. Occu FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
r
Mobile Home Facilities 15.00
r
License No. Classification
Misc. Wiring 6.25
❑ 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.
EJI 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.
MECHANICAL No @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling F I(r
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X
Signature of Permitee or Agent
Date
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.
DIRECTOR OF PUBLIC WORKS
By
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Tel ephone: ,534-4+541. v
APPLICATION AND PERMIT
aurnurize representatives of the County of butte to enter upon the
above-mentioned property for inspection purposes. c/
00, 01
X ZADate
Signa ure a! P�errmitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
IRE IZ PUBLIC WORKS
By Date E)Qb
-permit expires date / .3
BUILDING
Owner S 'C.
SQ. FT. OCC. BUILDING VALUATION
Mailing Address r h`1141 le
1
`
Telephone No.
Contractor 'Y\ k)
Mailing Address
Fireplace
Total Valuation
W_r ele ho o,
Permit Fee
Building Address
erynalj�6
AV 9—
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00 0
Each Trap 1.50
V ( 1
Repair drainage or vent piping. 1.50
r� S —�
A. P. No. J Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fees
W.C.
SBflTTatftm'
Fire Dept.
Fire Zone Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
I Parcel Map
1 60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Parcel A royalPlans
Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER .
Permit Fee $
$
V
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L too AMP 2.50
Main service OVER 25.00
100 AMPP OR LESS O
Main service EA. ADD'L 100'AMP 1.00
OR ADDNSEW T ACCLBLOGS.DWELING CCUP. Yl 22sgft
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:
%� 0,4
�,� 0(4/
NEW CONSTR BRANCH CIRCUITS)
NON.RESID BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS a
NON.RESIO. SINGLE OUTLET CIR.
EX. OCcuD(OUTLETS OR FIXTIIPES BAL@t0Q
P• � FIXED AS (RESID,) EA) 2•00
Ex. Occup. FIXED APPLNS. OR ,00
Temporary service 10.00
11
Mobile Home Facilities 15.00
License No. �7r9'o2 Classification (r— CD
Misc. Wiring 6.25
❑ 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.
13rfI have placed on file with the County of Butte a certificate of
orkmen'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.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling �/ 3-0-0
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby I
Land Development Fee
$
TOTAL PERMIT FEE
$ S
aurnurize representatives of the County of butte to enter upon the
above-mentioned property for inspection purposes. c/
00, 01
X ZADate
Signa ure a! P�errmitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
IRE IZ PUBLIC WORKS
By Date E)Qb
-permit expires date / .3