HomeMy WebLinkAbout031-281-024'. �.v..t
P' ,•t'j� 1.
,i
�.:'h'a+.:rlgi"3.. ..q'.f'T'.?6.�. :'.� '�.Si a�Ab::•'��: :.��.f: `.L�.', /;keur-.%ii���•��; .:'•;.
,
�. . � ... � f 1. ' 4 � .: a r:. .• "'� .... ..'• - t,•'� ,'R"t+:
L
:
4
i
5
3.TI��i°,u....:i'.u+'..c.e: SViA':e �:.. J w..: -• a........,_._.... ., wv.r ... ... ,.:._. .. a ..... .... ..-
031-28 1-024 - ,'
'J.
TOWNSEND 92-3918.B 4
CIR NTS,
W.
!�q81B
, David & Jane *_ 70
t;• .
3860P -
1510'lOtN St' OroviTle '•
partial
ieroof%sf
(0'-9 Z .
1510 10th St.,
Oroville
(addition)
031-281.024
(#change w ndows
&doors)
Gadd
front
VANG,
9-6
NENG/'P--/
04-2576
1510 10TH STRE
7
Cont: OWNER , ETI OROVILLE
SIDING/DECK
REPAIR
'. �.v..t
P' ,•t'j� 1.
,i
�.:'h'a+.:rlgi"3.. ..q'.f'T'.?6.�. :'.� '�.Si a�Ab::•'��: :.��.f: `.L�.', /;keur-.%ii���•��; .:'•;.
,
�. . � ... � f 1. ' 4 � .: a r:. .• "'� .... ..'• - t,•'� ,'R"t+:
L
:
4
i
5
3.TI��i°,u....:i'.u+'..c.e: SViA':e �:.. J w..: -• a........,_._.... ., wv.r ... ... ,.:._. .. a ..... .... ..-
.a
S' I
t;• .
-
�
,-
_} 77
� 4 - x `r f � � � n4�Sv+r &r �'. r t " �ti �• ,t ; �'�
K: t 3 ;.+ s r�&�,'-„4..� '�t� p -.'Sl t iatf' ✓'r i� j `) / ..
e' � } -:y r
� �x'�'iwiM �` '� � � �' '�` a ,� s t•�. S� �!:` b �, -L Y S � i .. '?�,�,. 9` �'. > {
%"`" �„ t U � v�. E`d 4-:3§ d � �•A'a •3' r �' ?sit �,k.., �' � err tyj� �e .�i+4 'r r �" ;.9t`}, � w,� �'-
'd�'�
trt is -
': r
Ix, 't°t+F*„'!�''t°�il'
gel`,'
s1 Z ll
.,�}. t4, t<n ,X�-
Li "1 F<
�"'�
+ i
I �� 3�:. a Y t�1� '" t ♦s� � .. a K � a, X. t i r, t_ r
7 t 4 �yyi�� � '�'& *t �h .Y-� , ' s i' >•�{ , d �- '`�-T �u "} `t' <�}(� j�t� ` -` _: s � k� t��.
G6N iPli a 'CRY w t� fx-SA,Ju15
-f
' k'�` 1�,s �' "A�a •� � S � 't�:-""'� � "� i i e` ";"� + ti r / i i t � .': :; t ✓ 4 � � �x
�y..�yyu.F�+. y'�r^"�'wdbh^''"YuS'.� iJr-v+t> � ^�!'!y�'y1�R+ �"'""^y�-1 3` ,�.'.• `...++'.�"+'y.• ..4.A^-.+1..1{.• -NSM-•7'-.+..4i
j'
��,, 0
z r
'a " �+ 2 ! r.y t`Yo- jt^" "' r h rad` '� .J• -.Y,
�� t � I ��� � h ti � � t< a � ✓ � "� F��Y' ? "^� v?k{� � ) >� {� � 41 4#� � � �^ . Yr � N �i. +lt. •'
.y^"; �"y��^o z�3 3 3 �. d,, �"Es ��tl�J trr I' �t s ,,y �" h ,•�`� y�,�K `� �c�e s�' 3 t"� �N �s4-j t � / ." ,, � 't.
fi . r, ��., P � �� �`' j t � � } i � r - r � N > { '4 ,- -x--0'4 t 'F. ✓ � l c t't� � � � � t
', �p i � .� '� 0. � ti. F}I �t'�# i�r � S �>SF '-� F 4 ,NOG,. i f S-. �. K ; � p � ' i � ��'j x• ' � f-� a. ,a
a rx'r
'�` a;fit v.t'1jr`4� �l'✓r �t ��-:_ t+r:'7/3 ,�`?� %`� "� .,x...,�, �. �,�: s `�. �,ps: < y( {., kt.�1�x y. i m�"-� �r4" "` .tiq 1C
✓f, ."t t`�'� `'t v r� 3' fisf� - ��5 f w -� t r �' r F's5 ' `,t -y� *y
<�^�«4' ���;�`�v .r'�;#`(-5 � $.v. '�.a °"e �^���', v`,��"`�' Y f'yrjk��r`a g�C`rl• ;"1' n� yr s.�'n ( .tiy.<, y, is
i � d+"�� kt ::��` `��'.:��`� x e1.i.. t �"t� ����'h'r�c�/ �'t5 r � � ✓.tirA,Tr � •s r �: �� � �� .r t ,i.atixx � �'a:`. �"t"� '� 1 � 4'ra� � 1 n f Yz
�" e i. .TS7'.l�"k �ix'yy �'�;,. `d�4 �� � d t_ � � �" '. x � ! t4+�'`r ..I � ..J -t d <'�' !:, s r � J axi • §' � 4y
' '� r �.} L-` r �+ T�"�"' ` Y f ,F d � i� F �t v, sC. , a- ,fi � � 'k}.; ,• '7
��P � � 3i d's ' � � ,�._ 5 �, � \ y � i '� =.^, i. Jr -s •;�, r 4� •; rt '�.: L t � t a '` �' `u ,� x � S} � fi
t e �� I +r. 7 A d 7v. r Sr'.y / r+ y �' ✓ z - ` ,+, � � ,IC >
k y
i S
w.,
7
4T,•
V4 4 N
-1'
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ' PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541,
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
AR
BUILDING PERMIT
OWNER
�11 11 A TAnp Thmmaend
TELEPHONE,.;'.
511-8834
SO. FT. OCC - . BUILDING VALUATION
O WNERS AILING ADDRESS
1A %inr1niid Circlo, Oroville 95965
130 390.m
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation 1$390.00
LENDER'S MAILING ADbFiffss
ARCHITECT OR ENGINEER NO.
Filing Fee
$- 15.00
Permit Fee
Plan Checking Fee
$ 15.00
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
`Penalty
$
BUILDING ADDRESS
Permit fee
$ 30.00
15in 1()tb St.,, (Jrnyillp r
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.s
iUBDIVISION NAME
PARCEqMAP
Water piping
7.00
Each q.as water heater or vent
7.001
USE OF STRUCTURE
SF Duplex❑ Mobi I ehome 0 Other
SPECT FY fS
Gas piping system 1 - 5 outlets
5.001
Building sewer
1 15.001
Mobile Home GI W I
@ 15.00
TYPE OF WORK
NewF] AdditionE Remodelo UtilitiesO InstallationE] Other
Describe work: Partial Reroof (WILT UP) I
300 So. Ft.
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
600V OR LESS
Main service 200A OR LESS
18.50
CONTRACTORS LICENSE LAW
I declare underpenalty of perjury (check one):
F-1 I am licensed under provisions of Chapt. 9, Div. 3 of the,BOsiness
and Professions Code and my license is in full force and. effect.
License No. Classification
Fj 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended orioffered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting' with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec.-, Busines's and Professions Code
for this reason
Main Service 200A TO 1 OOOA).
31.501
NEW CONST. I DWELLING OCCURM
OR ADONS. % ACC. BLDGS.
3.64 sq.ft.
NEW CONSTR_ 7_U�TI_OUTLET
NON R.S,., BRANCH CIRC ', LI TO
@ 5.00
(POWER APPARATUS
SINGLE OUTLET CI.&)
Ex. Occup(OUTLE TS OR FIXTURES
1 20 @ 791
RAI 6 AF;J
FIXED APLN
Ex. Occup. OUTLETS P(RESSI.DO.)REA.)
3.00
--Temporary service
15.00,
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
'of Consent to Self -Insure.
Z11 I shall not employ any person in any manner so as to become subject
tote W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
the W. C. provisions of the Labor Code,you must forthwith comply with such
provisions or this permit shal I be deemed evoked.
revoked.
Contractor
MECHANICAL PERMIT
Fi I i rig Fee 15.00
Heating
Cooling
Hood
1 6.501
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 dounty Ordinances and State Laws relating
to building construction, and hereby authorize represeritatives of the CountyOt
Butte to enter upon the -above-mentioned property for inspection purposes:
I also agree to save, iddemnify and keep -harmless thelCounty of Butte against
all liabilities;}judgments, costs,.. -and expenses �,whi ch'may in any way accrue
against said County in consequence of the granting of this permit.
Xk Date 97-
Sig _u e of'kpplicaint Owner Contractor El Agent E]
k
An OSHA p a
permit is required f . or excavations -over r '0 . . . . . . demolition or construct-
son structures ovpr�,3- tories
Receipt N6.
Mobile Home Installation Fee
Energy Inspection Fee
occ
CONST TYPE
TOTAL -FEE,,$ 10-00
I
HAZ
I -D FEES -J
'IMP
I FLOOD
I CDF
I PARCEL
PD.
HD
ISsu
This permit is hereby issued under the applicable provi
sions of the Butte County Code and/or resolutions to do
. _,�_ I / - I
work indicated above
,orf o,
--,e for which fe ave been paid_
CIrrN n, A
DIRECTOR OF PUBLIC?
7 14f D
By Date)/
Da� - ' . 7
PERM IT"0Z0NE§
WHITE -D.P.W., TELLOW-ASSC2530R, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville. California'*965 - Telephone: 916/538-7541, p
iAPPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
031-281-024A.-
OWNER-- -,' --
ZONING,
BUILDING PERMIT
-LLEPHONE
533-H834300
SQ. FT. OCC. BUILDING VALUATION
OWN 'S MAILING ADDRESS _
95965
130 390.00
,
'SEornVille
CONT AC NAM
TELEPHONE
CONT R•S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation 1$390.00
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER LICENSE NO.
Filing Fee
$ 15.00
Permit Fee
Plan Checking Fee
$ 15.00.
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$$
BUILDING ADDRESS
Permit fee
$ 30.00
1530 161;h St nrnyi I I In
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME -
PARCEL MAP
dater piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SFEk Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets5.00
Building sewer
15.00
Mobile Home S G W
@ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ®
Describe work: Partial Rarnnf (BUILT UP)
3D0_S4 Ft
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200AORLESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of
p y perjury fur y (Check One):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work, and the structure is not intended or offered
for sale. (Sec. 7044)
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
Main service 200A TO i000A)
37.50
NEW CONST. DWELLING OCCUP,EI\
OR ADDNS. ACC. BLDGS. /
3.64sq.ft.
NEW CONSTR.I.OUTLET
NON-RESID BRANCH IRC S
@ 5.00
POWER APPARATUS &)
SINGLE OUTLET CIR. /
Ex. Occup(OUTLETS OR FIXTURES
20 76
Ex. Occup. OUTLETS (RESID )REAJ
3.00
Temporary service
.15.00
Mobile Home Facilities
15.00
�Misc. Wiring
-15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
I Consent to Self -Insure.
LJ ' shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject-
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions'or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
(Heating
Cooling
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.
Date
Sig Dw a of Applicant — Owner CDntrocrDr ❑ Agent ❑
An 0 HA permit is required for excavations over5'0'' deep and demolition or construct-
ion of structures over 3 stories in height.DIR
129646
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $30.00
I
I
HA2
I DFEES I
IMP
I FLOOD
I CDF
PARCEL
PD
I HD
Issu rr
This permit is hereby issued under the applicable provi-
Bions of Butte County Code and/or resolutions to do
wor di ted *aboWohich fe ve been paid.
ted BLI RKS
B Date
PE 44 94 44
X I. S Date
d
3
j
..
k;
8
COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 965 - Telephone: 916!538-7541
APPLICATION AND PERMIT
'.ASSESSOR PARCEL NUMBER
28 (= �Z
ZONING
r�1
,
BUILDING PERMIT
owNER
TELEPHONE
3 cs3
SQ. FT. OCC. BUILDING VALUATION
OWNf,*S MAILING' ADDRE - -L—qcpo'
CONTRACTOR'5 NAME --,
UIJ
.T.ELEPHONE
CONTRACTOR'S MAILING ADDRESS -
-
Firepiace
CONSTRUCTION LENDER -
UNKNOWN
Total Valuation $-
LENDER'S MAILING ADDRESS -
Filing Fee -
$ 15.00
Permit Fee.
$ r,.
ARCHITECT OR ENGINEER
LICENSE NO.
Plan-Checkl'ng.Fee
$ ,
ARCHITECT OR ENGINEER'S MAILING ADDRESS -
Energy Plan Checking Fee
$ .
Penalty
$
BUILDING ADDRESS
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 aas water. heater or vent
7.00
USE OF STRUCTURE
SF Duplex❑ Mob ilehome❑ =Other
SPECI FY,
Gas piping system 1 - 5.outlets
5.00
Building sewer
15.00
Mobile Nome S G W
@ 15.00
TYPE OF WORK
New ❑ Addition Remodelit' Installation❑ Other
Describe work: aYf(Cld re❑ U "l1❑.1 — -SW FT,
errnit Fee
$
Contractor
ELECTRICAL,PERMIT
Filing Fee 15.00
.
Main service 600V OR LESS
-. 200A OR LESS
- 18.50
CONTRACTORS LICENSE LAW
I declare under penalty of
P y perjury Iur y (check one):
❑, I am .licensed under provisions of Chapt. 9, Div. 3. of the Business
and Professions .Code and my. license Is In full 'force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages -as their sole compen-
sation, will do the work,and the structure is not "intended or offered
for sale. (Sec. 7044)
❑ 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
Main service 200ATO1000A)
37.50
NEW CONST./ DWELLING OCCUP.&)
OR ADDNS. ( ACC. SLOGS. //
3.6d-sq.ft.
NEW CONSTRNON.RESID BRANU I.OUTLET
CH CPC"
RC ITS
@ 5.00
(POWER APPARATUS 6)
SINGLE OUTLET CIR.
-
Ex. Occup(OUTLETS 0R.FIXTURES
202-7
FIXED APPLNS. OR
Ex. Occup. OUTLETS IRESID)EA.)
j 3.00 '
Temporary service
15.00 ;
Mobile Home Facilities
15.00
Misc. Wiring
•15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The.permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance'or a Certificate
of Consent to Self -Insure.
❑ I shall hot employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
Provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIirig Fee "15.00
Heating
Cooling
Hood
6.50
Ventilation
Permit Fee -
$
Contractor
I certify that.l 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
But"te 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.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE $3�
HAZ
DFEES
IMP
FLooD
cDF
PARCEL _[Po]
D
HD
ISSUE
A Date
Signature of Applicant — Owner Contractor ❑ Agent"❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories .in height.
Receipt No.
TELLOW-ASSC SOR, PINK -INSPECTOR•, GOLD ENRa D-APPLI CA NT
.I nis permit is nereoy Issued under, the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY Date.
PERMIT EXPIRES Date
SPECIAL COMMONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
J
J=OK
0 = Not OK
NotReai;Yah1e
1.
. MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
3.
1.
Zoning Requirements -Setbacks -Easements
Gas; MH Test -Demand -Valve
2.
Soils; Special MH Support Sketch'
i 6.
3.
Sewer; Location -Test -Fall -C/O -Concrete
Water and Sewer. Connected
4.
Water; Location -Test -Easement Needed (Sketch)
9.
5.
Electricity; Location -Clearances-Grnd-/ /Amp -Concrete
License Decals,
6.
Gas; Location=Test-Wrap;-/ /" L'ft. "
/ P Nat. or / /" L "ft./ /'LPG
Card B-1 Date Card B-1
7.
Well Clearance & Disconnect
Card B-1 Date . Card B-1
8.
Utility Clearance
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
Date
Elec.; Enclosures; Conduit Entries -Terminals -Listed
Card B-1 Date Card B -1 -
Date
8.
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements-Setbacks=Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector .
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.=Sketch
11.
Cert. of Occupancy
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
- Date PERMANENT END SYSTEM (ONLY) ,
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size_Spacing-Marriage Line
3.
Blocking
,. 4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
i 6.
Water; MH Test
7.
Water and Sewer. Connected
I7 8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals,
11.
Verify #'s with Office
Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
Date
Card B-1 Date . Card B-1
Date
Card B-1 Date Card B-1
ij
' MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
-1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext,; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5'-Circulating.Equip.7Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main Conduit
9. Health Department Approval
l 10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing -Alarms
r
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
o = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
Date
1.
Zoning -Setbacks -Easements -Flood -Slope
36.
2.
Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth
Vent Fan, Exhaust above insulation j
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /"'Ftg. Depth
39.
4.
Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth
Attic Access & Platform if Furnace in Attic
5.
Stemwalls, Main; Steel- Blockouts-Wrapped 1
Shear Walls; Nailing -Bolts
6.
Stemwalls, Garage; Steel- Blockouts-Wrapped
Brace Interior/Exterior Wall Panels
6a.
Hold Downs and Special Anchors
Insulation -Walls -Ceilings
7.
Slab, Steel -Wrapped
Infiltration -Walls -Windows
8.
Piers -Fireplace Ftg.-Steel
Card B-1 Date Card B-1
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
Card B-1 Date Card B-1
10.
UF, Gas Pipe; Size Anchors -Yard Gas Piping'; Size Test
11.
Water Pipe; Test-Anchors-Regulator-Seryice; Test
12.
Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15.
Access & Ventilation
16.
Insulation
70.
Stairs & Rails
Date
71.
Card B-1 Date Card B-1
Date
72.
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
17.
Water Htr.; Vent -Access -Combustion Air Baffle
Elec. Outlets & Receptacles at Kit. Counter
18.
Water Pipe; Test & Anchor -Nail Protection 1
Garage Fire Door; Swing -Landing -Closure
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
A.C. Duct in Garage -Damper
20.
Shower Pan; Test, First Floor -Tub Access
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
21.
Test Tub & Shower, Second Floor -Tub Access
Plb.; Elec. & Mech. Equip. Listed for Location
22.
Gas Pipe; Sixe & Anchors
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
23.
Fire Sprinkler; Test
Insulation -Foam -Looked in Attic
81.
Date
Card B-1 Date j Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
83.
24.
Fixture & Transformer Clearance -Ins. Protection
84.
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
85.
26.
Size Boxes & No. of Conductors Stapled I
86.
27.
Romex Installed Close to Edge of Studs & C.J.
87.
28.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
88.
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
89.
30.
Subfeed Wire Size/ /ga. Cu or Al-A.C. Wire Size/ /ga Cu or Al
90.
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral ❑ Yes ❑ No
91.
32.
Service -Riser Conductors & Ground Main Disconnect
92.
33.
Equip. Clearances Panels-Motors-Mech. Equip.
93.
34.
Clothes Closet Light -Shower Light -Spa Light
94.
35.
Smoke Detector '
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
36.
A.C. Ducts Insulation & Support
37.
Vent Fan, Exhaust above insulation j
38.
Condensate Drain & Overflow, Size & Grade
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40.
Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date FRAMING (Permit) OK except #'s
41.
Sills Proper Materials & Anchors j
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
43.
Bearing Walls over Girders & Floor Nailing
44.
Draft Stop in Walls (rat proof)
45.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46.
Headers & Beams -Size & Bearing
Shear Walls; Nailing -Bolts
Date FRAMING (Continued)
47.
Hangers -Post Caps -Anchors -Connectors
48.
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garaoe 3rd Storv. 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57.
Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59.
Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64.
Ext. Steps -Door & Sidelight Protection -Landings
65.
Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68.
G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70.
Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72.
Elec. Outlets at Wood Panel, Int. & Ext.
73.
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74.
Elec. Outlets & Receptacles at Kit. Counter
75.
Garage Fire Door; Swing -Landing -Closure
76.
A.C. Duct in Garage -Damper
77.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83.
Following Instld./Drive ❑ Yes ❑ No/Walks ❑ Yes ❑ No/Planters ❑ Yes ❑ No
84.
Stucco Brown -Finish
85.
A.C. Unit Disconnect, Electrical -Plumbing
86.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87.
Water Well, Disconnect, Electrical, Plumbing
88.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
89.
Ventilation Throughout House
90.
Glass Protection
91.
Corrections from Previous Inspections
92.
Gas Test -Meters Tagged, Gas -Electric
93.
Water & Sewer Connected -C/O to Grade -HD Approval
94.
Energy Compliance Certificate -Other Certificates
95.
Address Posted
96.
Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
o �V $ o f''. DEPARTMENT OF ,DEVELOPMENT' SERVICES
o BUILDING PERMIT
o' _ 24 HOUR INSPECTION M (530) 538-7636(OROVILLE) (530) 891-2634 (CHICO)
o o X#
OFFICE fit (530) 538-7541 FA:(530)538-2140
WEBSITE: www.buttecounty.net\dds
UN r
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: 09/02/2004' APN: 031-281-024-000
' the Business and Professlons Code, and mylicense is in fu lt force and
effect
License Class : License Number:;
Site Address: 1510 10TH ST ORO
Date: Contractor.
Map Index:
De8criptlon SIDING(72) I& REPAIR DECK
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.
-or
Owner: VANG NENG CHU & MAO THAO '
permit to construct, alter, improve, demolish, 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
1510 10TH ST'
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
OROVILLE, CA-,
she is exempt therefrom and the basis for the alleged exemption. Any.
95965
. violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil. penalty of not more than five hundred dollars ($500).):
�( I, as owner of the property, or my employees with wages as their
!
sole compensation, will do the work, .and the structure is not
,.intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: VANG NENG CHU &MAO THAO
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
1510 10TH. ST
sale.. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of,
_ OROVILLE, CA
proving that, he or she did not build or improve for the purpose of
95965
• 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.).
Contractor:
❑ 1 am Exe'mpt.under Article 3 of the Business andProfessions Code
Date: roZ--O Owner: -MAO
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penally of perjuryone of the following declarations:
Q I have and will maintain'a certificate of consent to self -insure for
{
License #:
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
Architect'
required; by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
i
Carrier:
Policy,#:
Total. Square Ft: 0 S.F
' . I, certify that.in the performance of the work for which this permit is
Valuation: $0.00
. i1ssued,. l shall not employ any person in any manner so as to
I
become subject to the workers' compensation laws of California,
and agree. that : if - I should become subject to the workers'
Census Code:
% %
compensation provisions of Section 3700 of the Labor Code, 1 shall
? lTn
forthwith comply with those, provisions.
Date)
1 ALS,
°21
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.
P t
f .
CONSTRUCTION'LENDING AGENCY ' 4 "'''�'
Thisop� is s hdereby issu d` r theappiicable pro isions'of the'Bu a Count God : anrvor'-- — -
--
I hereby affirm that there is a construction lending,agency for the
ed
Res l i o wo i a or ic, f have been paid.
performance of the,work for which'this permit is issued (Sec 3097 Civ:),
/ t
By Date:
Name:
PERMIT EXPIRES ON:
Address
to
O 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'ofhazardousmaterials:
A , Notification in -accordance with Section 19827,5 of California`Health & Safely Code is not,applicabla to the scheduled construction of this. project.
❑ Attached are copies of the required E:P:A notification forms.
t 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 end'state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or documentof Butte County. I hereby
1
authorize representatives of Butte, to enter upon the above mentioned property for inspection purposes.-
I
/County
/IV L/``I r).
Print Name (' / / LL Signature: 1 I r 1 v
•`�vy
Date: !
�[ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
o - DEPARTMENT OF DEVELOPMENT SERVICES-
BUILDING'PERMIT
6 24 HOUR INSPECTION #: (530)538-7636 (OROVILLE) (530) 891-2834 (CHICO)
' O OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.net\dds
LICENSED:CONTRACTORS DECLARATION
-
I hereby affirm under penalty of perjury that. I am .:licensedunder
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 09/02/2004: APN• 031-281-024-000
the Business and Professions Code, and my license is in full force and
effect:
License Class: License Number'::''.
Site Address: 15101'OTH ST,ORO
;.
Date: Contractor . '.
Ma p Index:
Description: SIDING(72) &'REPAIR DECK
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of.pedury that I.am exempt, fromthe
Contractors'- State. License Law for the following reason (Sec: 7031.5
Business and Professions Code: "Any citybr county which requires a
. VANGNENG CHU'& MAO THAO`',
Owner:
permit to construct, after, improve, demolish, orrepaieany structure, prior
to its Issuance, also requires r the • applicant for such permit to file a
signed.statemenf that he or she is licensed pursuant to the provisions of
1510 10TH ST
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
OROVILLE, CA
she is exempt therefrom and the basis, for the alleged exemption:,. Any
95965-
violation of Section 7031.5. by any applicant for a permit subjects the,
applicant to a civil penalty. f.not more.than five hundred•dollars ($500).): .
$( I, as owner of the'property, or my employees with wages as their"
sole compensation, will do the work, and the structure is, not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply, to an
Applicant VANE NENG CMU: $� MAO THAO
owner of: property woo, 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
1510 10TH ST
sale. If however, the building or improvements,are sold within one
year of completion; the owner -builder will have the burden of
OROVILLE,' CA
proving that he or she did not build or improve for,the purpose of
95965
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.):
COntraCtOr: '
❑ 1 am Exempt under Article 33 of the Ru�siiness and Professions Code
Date: "OZ` Owner.
WORKERS' COMPENSATION DECLARATION
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
LIC@nS@ #' -
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: the Labor Code, for•.the performance of
Architect:
the work forwhich this, permit is issued.' My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier.
Total Square Ft: 0 S.F.
Policy #:
I certify that in. the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation'laws of California,
Census Code:
and agree that if i should become' subject to the workers'
/!
compensation provisions of Section -3700 of the Labor Code,' I shall
forthwithcomply 'those provisions.
�{ T
%with
Date:
Applicant:��l
.
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
a "
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 hereby issued under the applicable provisions of the Butte Count Cod pnrUc±r
rN at there is a construction lending agency for the
Resoluti s do work indi ed a for ich fees have been paid:'
e work for which this permit is issued (Sec 3097 Civ.)
%{
— -
to
By Date:
V 14 V
PERMIT EXPIRES ON:
to
Address
❑ I hereby certify that,the use of this facility shall comply with Sections 25505,-25533, and 25534. of the Califomia'Health and Safety Code, which regulate the, storage,
handling and use of hazardous materials.
❑ Notification in accordance wdhSection 19827.5 of'Califomia 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 owAer.orthe 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 atter the substance of any'official form or document of Butte County. 1 hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. ({\)
..
.1 "
Print Name:��i`t�' Signature. / v' -
��"�.
Date:
�Q Owner ❑ Contractor ❑ . Agent.focOwner n ❑ Agent -for Contractor.
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT, APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#:.OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538=7541
AFEE'WILL•BEREOUIRED,AT TIME OFAPPLICATION
**PLEASE PRINT CLEARLY
OWNER ..
Last Nameirst Nam
Address
O -e
City�
State
Oro ot 1,
Phone 7.�' Fax
E-mail
S (A
PERMIT.
NO. •
BPo4'25'1
.BIN#
LOCATION.
'ARCHITECT/ENGINEER
Name .
Property Address
Address '
Cross Street '
�( t"Cl.
City
WORKER'S COMPENSATION
State
Zip
Phone
LENDING AGENCY
Fax
E-mail,
Page
State License Number
PERMIT.
NO. •
BPo4'25'1
.BIN#
LOCATION.
AP#
Zoning
Property Address
City `
Cross Street '
�( t"Cl.
Yes
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.'S
LENDING AGENCY
Name
Address
Descri tion or cope f Work:
0__ _Vie
C_7�
Sq. Footage
-77
❑ 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 .
required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration'of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
APPLICANT SIGNATURE refundable.
X Received OK Amount: Bldg
II SRA II
For:office use only:'
Zoning
Flood Zone
SRA
Yes
No
Occ.
Type Const.
Subdivision Name
Map Book'
Page
Planner
Date Approved:.
OVER FOR SUBMITTAL RV_QU1KEMEN 15
:K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 o
2
Ktv /-Z/-U4
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in -order to 'apply for a y
'permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED: ALL PLANS MUST BE LEG/BL=AND'IN INIC
0 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. (Note: Not -required for additions to
mobile or modular -homes.);
❑ 5. Statement of'Intent for Nonheated' and A/C for Non -Residential Buildings.
1-16. Manufactured homes: (A).Data sheets and installation inst, {B) Marriage line info, (C) Floor Plan, (D) Tie down
or fnd plans, all in duplicate.
❑ 7. Metal bld s: A Metal Bld Plans, B Fnd and calcs in triplicate,
g O . 9 (,) plans,(C) Elevations in triplicate. (D) Floor
plans in triplicate. All of.these must be stamped and wet =signed by the engineer..y
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicatel(if required).
❑ 9. Site plan and business license approval from the City of Biggs.
F-110. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out, bythe owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings.only).
❑ 13. Sanitation and site plan approval from the Environmental Health Department.
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 Iplan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3�. California Department of Forestry plan.approval (if requited):
❑ ,4. NPDES.Forrri:,
❑' S:.Enctoachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
O 6,. -•Contractors license information. (Number, Name Style, Classification).
E 7. Worker's Compensation Carrier and Policy Number.
El 8. Owner -Builder Verification (if required). "
❑ 9. Letter of Signature authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
0 11. ❑ Grant Deed, Or M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433Ns).
If you have questions or would like additional information regarding this process, contact`a Permit
Application 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�oniy bee 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
K:\ ORMSWILDING F0RMS\BIdgApp1SubRgmts.doc ', Page 2 of 2
REV 7-27-04
o,4VTtER Bb
ILDER INFORMATION
Dear Proper[y ate:
An application for a bml&g Permit has lbeen
imPravenumts specified. your m Your yourself as ffie bm7dw of property
poor yaurP yon should be aware that as aowner4m7dd' you � ge ��k Ply ofreoord on sn�h
aFP P ora not requned to 6e signed by ParoPertY owners ualess
own work If your wont is being Pied ' are PAY p�%m�g:tfr
iiab if that applies for the someone olh= tbaa yo.=et you may Proud yourself from pos ble
Peron prop= In his or her name.
COnkadOM are rUFdred by law to be Hr and bonded by the §W5 of Carnia and to have a business
ppbr from the city or They ora also by law to Put t� license number on aII
aPP1Y• I p=iis for which trey .
Ifyan plan to do your own wor1; WA the ex�ifoa ofvarfous:trades that
be aware of the fallowing moa for your benefit and pT0la;c An: 3' P� to sobcoIItra .you should
a Ifyoa employ ar oenpv.my p=ons offer than bmmTmtD . � � , and the work Cndng s
and other costs) is $300 or more for 5z' • Yom
thea You may be an emploYer. PFJ such persons are not licensed as contractors or `
if You are. as emploM you n -M
sabf ect to several ob ' wig tits State and Fedmral Gove is as an eaaploYer and are
s g state and iedeial
wozk= m on y insuramce m�e tear w�thholdmg; fedraal social secuuty taxes,
a Thome maybe financW � � YOU f fy-n do ; and ==Vjoynj�� cmmpensafm C°oas.
wi to worhes , �' Oil t .obligations, andtb�e risks are eq>e � serious
�d issma�e,
♦ Formote VwiSc kftmation about ob
ifyon wish. the U.S. Smail BusW s t Federal Law, caairad tB mal Revenue Service (M.
State Law. contu t the Departme ofB on)L For maga V=iffc moa about Yota obligations =dear
and the Division ofd Accides.
if the structure is intended fiat saLp, ProPmly owaeas who are nbt Rimed are allowed to
condhionL o; their own employees. a licensed contactor or sobm&ador, only under limited.
A frequent g me ce of iiii
P� �� &U the > s P g to be cant[=Wrs fs to secure an -owner bailda- b
ufldmg
P� are nat rem to be s� owner is his d hlabor and fal , B
mift
Pig own
moa about ' ° tom': am Pig &* own work pecsona� .
=Mmunl'y ca• at 1020 N Stream S� � be obbined by � Contras Sits Ucease Board is your
P1e= � � . GA. 95814.
P `Owner Bu ea Yerification I on reveasa side of this foam so that we can confirm tE2t
are aware of dzece matters, The bu ldmg Parrah wM not be issued Unt1 the ym
vetificaiion is returned. ..
i
02M.
TTcit t?rvrcer Brc&lerL ornrafior� is aqu?ed by Sectzoa IS830 of t?ie C, orn& HeaiBc mrd Safety Code
i