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INTRA -DEPARTMENTAL MEMORANDUM
TO: Bill Barron, Building Department,
FROM: Ed Overhouse, Environmental Health Specialist
RE: 139 Gold St., Oroville, AP#! 033-026-003,
Housing Inspection
DATE: November 30, 1993
On October 15, 1993, you and I inspected the exterior of, and
surrounding area of, the above stated dwelling.
I discovered the following, but not limited to, items:
1. The exterior of the dwelling is covered with an
"asphalt -shingle type" siding. There are holes in the
siding showing rotten boards underneath. The house is
dilapidated - see photos.
2. There are about thirty (30) cubic yards of garbage and,
refuse ini the yard.
3. The "outhouse" has fallen in.
4. There is an open hand -dug well.
5. The electrical service to the dwelling has been
disconnected.
The following, but not limited to, items must be demonstrated
before the Health Department will clear the house for occupancy.
1. Show that the well water is safe and potable or abandon
the well (a well abandonment permit is required from
the Health Department) and tie into the Oroville
Wyandotte Irrigation Districts potable water system.
2. Demonstrate that there is sufficient soil depth and
soil quality to support a septic system. Soil depth
tests will be required, and percolation test may be
required. The lot is only fifty (50') by one hundred
and twenty-five (125') feet, and because of the septic
system space requirements, I am of the opinion that
this lot can sustain a maximum of a one bedroom house.
If adequate soil and space are not available. This lot
may not be "developable" until the community sewer
system is available.
0
v
Bill Barron, Bldg. Dept.
Page 2
November 30, 1993
3. Remove and properly dispose of all the garbage and
refuse.
4. Remove the remains of the outhouse and fill in with
soil.
5. Demonstrate thatIthe house is structurally sound.
6. Demonstrate that the wiring is safe..:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
93-3081
ASSESSOR PARCEL NUMBER
033-026-003
ZONING:
BUILDING PERMIT
OWNER
MARGARET ROEDELL
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
139 GOLD ST, OROVILLE 95965
CONTRACTOR'S NAME
UNKNO14N
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEER
L ENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESSPERMIT
139 GOLD ST OROVILLE
FEE $
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAME
PARCEt1AAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF CXDuplex ❑ Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets.
15.00
Building sewer
15.00
Mobile Home S G W
@20'00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ UtilitiesPERMIT
CKj{Installation ❑ Other ❑
Describe Work: RE—METER EXISTING CABIN FOR LOT CLEANUP
FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 200AORLESS )
23.00 23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. I & ACC. OLDS. )
SO,
3.5C FT.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
O 1 am a licensed underrovisions of Chapter 9, Division 3 of the Business and
P P
Professions Code and my license is in full force and effect.
License No. Classification
❑I s the owner, 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)
I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ lam exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
NON-flESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.0 0
BAL. .60
Ex. Occup.FIXED APPwS. OR
I O UTLETS (RESID.) EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
INSPECTION
20.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
ertificate of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
63.00
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
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 Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
1 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 consequencq of the granting of this permit.
X' r Date
esm Signature of plicant El Owner El Contractor ®Agent
An OSHA permit is required for excavations over -5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 63.00
HAZ•
1 D. FEES
IMP
I FLOOD
CDF
PARCEL PD
I HD
I 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.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES ON
IDe tel
Receipt No. 148585
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
--COUNTY OF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
OWNER 09
Proposed Building Use
PERMIT APPLICATION DATA SHEET
,po�DCl�
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
1. All items have been submitted . ....................................... .
2. Plot plans, 3/4 sets, signed by preparer of plans . ...........................
3, Complete plans, 3/4 sets, signed by preparer of plans . ......................
.4. Engineered plans and calcs, 3/4 sets, with wet signature on plans. ..........
5. Hazardous Material Form . .............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ...................... -
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ..........................................
11. Impact fees as shown on attached schedule . ............................. .
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking:
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
Driveway permit (constryctionaproval required prior to occupancy). . .
Pre -Inspection reque
20. Pre -inspection for �� J _ required. .. to Building lnspecto _Date)
21. Contractor's license information. (No., Name Style, Classification) . ............. .
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner _) ............
4. Recorded copy of Agricultural Acknowledgement Statement . ..................
Letter of signature authorization. ........ Cd?,PV...... .... .
26. Copy of recorded deed of parcel creation and 60 right of way to a /p ublic road. .... .
27. Letter of intent on building use . ..........................................
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33 .
.34.
When you issue the permit, process as follows: __Zt!:f`Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation r (} t
Acreage ApplicantDate �S /
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance:
1. Index permiffor above items No.
2. Additional items required:
ircle new item not,checked above).
Contractor, designer, owner, was advised of above required data by _ phone J mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone - mail Counter by _ Date
Plans checked by' Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 __J�ERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER �j
J
ZONING
BUILDING PERMIT
OWNER / % (/, _� %
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNEWS ADDN�p$�� 57
- `TELEPHONE
CONTRACTOR'S NAME
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee $
20.00
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 '• � � �
PERMIT FEE $
PLUMBING PERMIT Filing
Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO. SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SIX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G 1 W
@20.00
TYPE OF WORK
New ❑ Addition ❑ Remodel 0 U-trilitiiees❑ Installation El Other Ell
Describe Work: G 1 C ; ,/ b LOX'S /
PERMIT FEE $
Contractor
ELECTRICAL PERMIT Filing Fee 20.00
.� I„ l T / L A , /��
/jam /— I CN / L /, N
Main Service ( SOV OR LESS )
200A OR LESS
23.00 (J
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCC P.
OR ADDNS. ( & ACC. BLOS. )
SO.
3.54 FT.
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force and effect.
License No. Classification
❑ 1, as the owner, 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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
forthis reason
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
NEW CONST. MULTI -OUTLET
RESID. ( BRANCH CIRCUITS )
@7.50
--NON
POWER APPARATUS )
a SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES ) 200 1.00
BAL. .50
Ex. Occup. ( OUTLETFIXES R NS. OR ) 5.00
Temporary Service 23.00
Mobile Home Facilities
20.00
Misc. Wiring 23.00
PERMIT FEE $
Contractor
MECHANICAL PERMIT Filing Fee 20.00
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 Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of 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 acc ue aga' st said
County in consequence of the granting of this permit.
X Date,
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations ov 5"0" d p and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $
HAZ•
O. FEES
IMP
F100D
CDF
PARCEL 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.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES ON
!Date/
Receipt No. ?�
WHITE-D.D.S..B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
.y
PRE—INSPECTION
OWNER: IV Ill �� (�� T C�C�C� (DATE
A.P.
LOCATION: -35%Ste"/�—� # 33-62�-�G�
CONTRACTOR: V%�/�i%GU/� ZONING
PRE—INSPECTION FOR :
DATE TO INSPECTOR
PERMIT HISTORY: NONE Q AS FOLLOWS:,
TYPE OF OCCUPANCY
------------------------------
-----------------------------------------
s
FIELD — INFORMATION -
BUILDING USAGE: -
TENNANT:
[� OCCUPIED HAS ELECTRIC HAS GAS HAS SANITATION FACILITIES
[� HEATED—COOLED PERSON CONTACTED
OTHER COMMENTS:
ACTION RECOMMENDED: ,
ISSUE EN� HOLD FOR
OTHER:
BY %//� Z DATE
LA' rTORNEY OR PARTY WITHOUT ATTORNEY (Nam. and Address): CSB# 8 3 7 O 7
fIILLIAM TELEPHONE NO.: S. REUSTLE [707] 642-3031
►ttorriey 'at Law
51 Flemingtowne Center
A7allejo, CA 94589
A' rrORNEY FOR (Name): DORIS VORHIES
S UPERIOR COURT OF CALIFORNIA. COUNTY OF BUTTE
STREETADDRESS: 25 County Center Drive
MAILINGADDRESs: 25 County Center Drive
CITYANDZIPCODE: Oroville, CA 95965-3375
_ BRANCHNAME: BUTTE COUNTY SUPERIOR COURT C
E` !TATE OF (NAME):
LETTIE MARGARET ROEDELL, Hy'
ORDER FOR PROBATE
ORDER Q Executor
APPOINTING Q Administrator with Will Annexed
OX Administrator Q Special Administrator
0 Order Authorizing. Independent Administration of Estate
QX with full authority Q with limited authority
1 • Date of hearing: Time: Dept/Rm:
THE : COURT FINDS
2. a. All notices required by law have been given.
b. Decedent died on (date} December 26, 19 91
(1) QX a resident of the California county named above
(2) 0 a nonresident of California and lett an estate in the county named above
c. Decedent died
(1) QX intestate
(2) 0 testate and decedent's will dated:
and each codicil dated:
was admitted to probate by Minute Order on (date}
THE : COURT ORDERS
3 I !Name} DORIS VORHIES
i s appointed personal representative:
FOR COURr USE ONL Y
r,
�Yydk +i
J. GRUBBS, Butte Co. Cleric
!A- PATER Deputy
CASE NUMBER:
30234
Judge:
0 eoutor Of the decedent's will d. Q Special Administrator
It 1.. Q Administrator. with. will annexed
c :• QX Administrator (1) Q with general powers
(2) Q with special powers as specified in Attachment 3d
Ind letters shall issue on qualification. (3) Q without notice of hearing
4.
i. QX Full authority is granted to administer the estate under the Independent.Administration of Estates Act.
It t. Q Limited authority is granted to administer the estate under the Independent Administration of Estates Act (there is no
authority, without court supervision, to (1) sell or exchange real property or 2
or (3) borrow money with the loan secured by an encumbrance upon real property).rant an option to purchase real property
i• QX Bond is not required.
t 1. Q Bond is fixed at: $ to be furnished by an authorized surety company or as otherwise
provided by law.
C Q Deposits of: $
location}. are ordered to be placed in a blocked account at (specify institution and
•
and receipts shall be filed. No withdrawals shall be made without a court order.
Q (Name}
is appointed probate referee.
Date: /, ROGER GILBERT
Number Of pages attached: JUDGE OF THE SUPERIOR COURT
QSignature follows last attachment.
r Of' m Approved by the
�ue I Council of California
10 (Rev. July 1. 1989! ORDER FOR PROBATE Probate Code. 329
CEB
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`COMPLAINANT:
ADDRESS: F-7LO21 D!4
PHONE NUMBER: cl
OTHER COMMENTS:
d ` j
A�.�.�-a-c,�.r .L��i Flo .2Q .l-• ,Q�r, .� _ .�.-.-?.varv�-•��B? il.e-P' - �R u.�vnti' ..,T C?..Q�.cr�,-✓ 129
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ao
rTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address):
vILLIAM S. REUSTLE
attorney at Law
I Flemingtowne Center
lallejo, CA 94589
rrnRNEYFOR(Name>: DORIS VORHIES
83707 TELEPHONE NO.:
. [707] 642-3031
UPERIOR COURT OF CALIFORNIA.
COUNTY OF BUT
STREET ADDRESS: 25 County Center Drive
MAILINGADDRESs: 25 County Center Drive
CITYANDZIPCODE:Orovllle, CA 95965-3375 _ C
FRANC NAME BUTTE' COUNTY SUPERIOR COURT
STATE OF (NAME):
LETTIE MARGARET ROEDELL,
ORDER FOR PROBATE
ORDER Q Executor
APPOINTING Q Administrator with WIII Annexed
QX Administrator Q Special Administrator
OX Order Authorizing Independent Administration of Estate
OX with full authority 0 with limited authority
FOR COURT USE ONLY
T'�
klmw
sr a.r '.�e.
ti:
J. GRUBBS, Butte Co. Clerk
,W PEA-Wi Deputy
CASE NUMBER:-
30234
UMBER:
30234
Date of hearing: Time: Dept/Rm: Judge:
COLT FINDS
a. All notices required by law have been given. i
b. Decedent died on (date} December 26, 1991
(1) (�X a resident of the Calif omia county named above
(2) F__j a nonresident of California and left an estate in the county named above
c. Decedent died
(1) QX intestate
(2) 0 testate and decedent's will dated:
and each codicil dated:
was admitted to probate by Minute Order on (date}
COURT ORDERS
!Name}. DORIS VORHIES
s appointed personal representative:
3.. Q Executor of the decedent's will d. F. Special Administrator
1.. 0 Administrator.with.will annexed (1) [] with general powers
QX Administrator (2) 0 with special powers as specified in Attachment 3d
(3) 0 without notice of hearing
Ind letters shall issue. on qualification.
I. OX Full authority is granted to administer the estate under the Independent Administration of Estates Act.
1. 0 Limited authority is granted to administer the estate under the Independent Administration of Estates Act (there is no
authority, without court supervision, to (1) sell or exchange real property or (2) grant an option to purchase real property
or (3) borrow money with the loan secured by an encumbrance upon real property).
I. QX Bond is not required.
1. F__] Bond is fixed at::$ to be furnished by an authorized surety company or as otherwise
provided: by law.
placed in a blocked account at (specify institution and
Q Deposits of: $ are ordered to be
•• location}. "
and receipts shall be filed. No withdrawals shall be made without a court order.
Q (Name}
0 Number of pages attached:
is appointed probate referee.
ROGER GILBERT
JUDGE OF THE SUPERIOR COURT
Signal.,. lollovra last attachment
-- Probate Code. 329
m Approved by the ORDER FOR PROBATE
I Council of California C� '
tO (Rev. July 1, 19118(
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATIONAND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
CONTRACTORS NAME
TELEPHONE
CONTRACTORS MARINO ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Fling Fee
$ 20.00
LENDERS WALING ADDRESS
_
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
S
Energy Plan Checking Fee
$
ARCHITECT OR ENGWEEAS MAILING ADDRESS '
Penalty
$
BUILDING ADDRESS
PERMITFEE
$
PLUMBINGPERMIT
Fling Fee 20.00
Each- Trap
7.00
LGTNO. J SUBDNISIONSNAME PARCEL MAP
Solar or heat pump water heater
23.00
Water piping
15.00 U
USE FSTR TORE
SF ❑ fBnplex ❑ Mobilehome [3Oth\er�
SPEC"
Each gas water heater or vent
15.00 / • 0C
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TY ,\RK
New ElAddition 13Remodef•-0 e Iri Ration ❑ Other ❑
Describe Work:
1
Mobile Home S1 G W I
@20.00
PERMITFEE
Contractor
ELECTRICAL PERMIT
Filinq Fee 20.00
Main Service ( 000v OR LESS )
200A OR LESS
23.00 c� '
Main Service ( 200A TO I000A )
46.00
I
LIC £D CONTRACTOR'S DECLARATION
I hereby affirm under pen Ity of perjury that I am licensed under provisions of Chapter
9 (commencing with S on 7000) of Division 3 of the Business and Professions Code,
and my license is in -fall 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, 1 shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X 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.
NEW CONST. DWELLING OCCUP.
OR ADONS. ( a ACC. SLDs. )
SD
3.5c PT. 0..
NEW CONST. MULTI.OUTLET
NON•RESID. ( SRANCH CIRCUITS ) @7.50
POWER APPARATUS
(a SINGLE OUTLET 010. )
Ex. Occup. (OUTLET OR POCTUREs ) 20 ^ 1.50
�L
FIXED APPLNS. OR
• Occup. (OUTLETS (RESID.1 EA) 5.00
Temporary Service 23.00
Mobile Home Facilities
20.00
Misc. Wiring 23.00
PERMITFEE
$
Contractor
MECHANICAL PERMIT Filing Fee 20.00
g
Heating
Cooling
Hood 6.50 G,
Ventilation
PERMITFEE $ ``
Contractor
Mobile Home Installation Fee Is
Energy Inspection Fee Is
OCCco NSTTYPE
.
1
TOTAL FEE $
HAj
1 D. PEES I IMP I FLOOD I COP I PARCEL I POI HDI sSUE
This permit is hereby issued under me
of the Butte County Code and/or
indicated above for which fees have
BY
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
Date
0491
Receipt No.
WHITED 0 S •B 0 CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD•APPLICANT
LAND DEVELOPMENT
OROVIL /
BUILDI G / ENVIRONMENTAL HEALTH PERMIT CLEARANCE Building Permit No.
OWNERS
NAME_ �iLh/PS �o/Z1S
PRINT LAST NAME FIRST
ADDRESS / LOCATION: / 3 Z) � O L_ 1 D .4w----
A.P.
NUMBER
vT,
COUNTY ZONING
DESIGNATION: 2 FLOOD MAP: FLOOD ZONE: �C
APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL:
PARCEL CREATION BY Y DEEDS OR MAP V
DEED INFORMATION:
DATE OF CREATION: DEED REFERENCE:
LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: _ YES NO
COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO
MAP INFORMATION: r.�� A&rtc 14wDl nolo/
DATE OF RECORDING: LOT 2 BOOK PAGE 16
XCOMPLIANCE VJfTH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT
P7A.
YES NO. IIFF YES, MARK APPROPRIATE ITEM(S) BELOW: L SD;Y0 Qv/LTf7UT Construct road to PS 8 Lb)=-J/B.. Meet parcel size required by zone. _ `. Meet current E.H.D. requirements.
CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BUILDING DMSION UNLESS OTHERWISE NOTED.
X1. Maintain a 50 ft. building setback from centerline of road.
—2. Maintain a ft. building setback from right-of-way/centerline
—3. Comply with Zoning code for building setback from road.
—4. Maintain a 100 ft. leachfield setback from all existing wells.
—5. Maintain a ft. leachfield setback from
—6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department.
7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290.
8. Connect to a public water supply.
—9. Connect to a public sewer system.
10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire
Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA
Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the
parcel.