HomeMy WebLinkAbout033-110-0540WER,�Chester �_ _ _ -, ---3415B_ .: 9
033-110-054 02-2879 INALE —
BRYSON, KATHY 33 6E
#5 MANILA WAY, OROVILLE ' 33 /A
CONVERT CARPORT TO GARAG 3-1111
'5 Manila Way; Oroville �`.. ..,.
(Moseley.&Hill, contractor)
(new, single;family)
033-110-054
BRYSON, KATHy w �s
03-2588 _.
5 MANILA WAY' OROVILLE�'
MISC ELECTRIC FOR GARq �NALED
B08-2207
033-11.1M0..-.0+54 �
MISCELLANEOUS Window/Glass Door
REPLACEMENT OF I1 WINDOWS 3 1: ,
5 MANILA WAY
BRYSON, KATHY A
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT -
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 5 MANILA WAY
Owner:
Permit NO: B08-2207
APN: 033-110-054
BRYSON, KATHY A
Issued Date: 10/29/2008 By TMP
Permit type: MISCELLANEOUS
5 MANILA WAY
Subtype: Window/Glass Door
OROVILLE, CA 95966
Expiration Date: 10/29/2009
Description: REPLACEMENT OF 11 WINDOWS
(530) 532-4610
Occupancy: Zoning: ARl
Contractor
Applicant:
Square Footage:
BRYSON, KATHY A
Building Garage Remdl/Addn
5 MANILA WAY
OROVILLE, CA 95966
Other Porch/Patio Total
(530)532-4610
FEE INFORMATION
DBMSC Window/Sldng GIs Dr-Repl $357.00
Total Charged: $357.00 Fees Paid: $357.00
Balance Due: $0.00 Receipt No: B8981
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
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
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Cade] 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
X 10/29/2008
the applicant to a civil penalty of not more than five hundred dollars [$500];
lease check' one of the following:
Contractors Signature Date
,ASOWNER 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 License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
WORKERS'COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
HAVE
the work himself or herself or through his or her own employees, provided that such improvements
AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
E]I
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractors License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Cartier: Policy Number. Exp. Date:
(This section need not be completed if the peril is or once hundred dollars ($100) or less.
❑ I AM EXEMPT under, -Section B. & P.C. for this reason:
❑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'
X 10/29/2008
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owners Si nature Date
provisions.
X 10/29/2008
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION,
( )
the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to ant r the above mentioned property for inspection purposes. I hereby certify that I am the
property roram ihorize act on the property owners behalf.
CONSTRUCTION LENDING AGENCY
` /1fd7� 10/29/2008
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name o ermittee SIGN] rint Date
the performance of the work for which this permit is issued. (3097 civ. code)
EKwner Contractor OR Agent for Owner Agent for Contractor
FILE COPY
Lenders Address City State Zip
BUTTE COUNTY
0�vTrF0 DEPARTMENT OF DEVELOPMENT SERVICES
0 o BUILDING PERMIT APPLICATION"
0 _ 0 OFFICE k (530) 538-7541 FAX #: (530) 538-2140
c - �!�►= v �- f o A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
c y Website: www.buttecounty.net/dds
O(JN� PLEASE PRINT CLEARLY
PERMIT
NO.
>1511-2 6r7
BIN N
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
APPLICANT INFORMATION
OWNER INFORMATION
Last Name
City
First Name
Mailing Address
City
City
_1 e_
State �
Zip
Phone 1_
6 D
Fax
E-mail
Lic. #
APPLICANT INFORMATION
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
PROJECT LOCATION
AP# Bio os
Property Address
City � � t
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than licensed contractors, a certificate of
worker's compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address.
DESCRIPTION OR SCOPE OF WORK:
d S'
Scl FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
FloodZone
SRA
Yes
No
Occ.
Type Const.
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. I PERSONALLY PL�� 0 PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMP OVEMENT. OI'ES �R NO)
2. I E/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HA 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 THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: REPLACEMENT OF 11 WINDOWS 3 DOORS
Reference Number: B08-2207
Applicant Name: BRYSON, KATHY A
Owner's Name: BRYSON, KATHY A AP # :033-110-054
Signature of Property Owner: Date: h�
I
NOTES RESIDENTIAL '
�. PERMIT NO. 033-110-054. � _,�;,:�,,4
BRYSON, KATHY
#5 MANILA WAY, OROVILLE
CONVERT CARPORT TO GARAGE
1. l
{
SPECIAL CONDITIONS
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
CHECKED
BY
t -S 1, L --T r
F -?,s
JOB FINALED (Date) /-64,110
r _
Signature
J=OK
0 = Not OK
s = Not Ready NotApplicable MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ P' L 'ft.
/ /'Nat. or/ P' L "ft./ P LPG
7. Well Clearance & Disconnect
8. Utilitv Clearance
Date
Card B-1 Date Card B-1
Date
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 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
6. Water; MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
10. License Decals. .
11. -Verifv #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Hing Requirements-Setbacks-Easemehts
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks irders and/or Joists-Deckttig BElf i -S irs-Rails
Z.4
ood Awn.; P ea - ftrs-Conn s
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; -Windows -Doors
7.
ric
8.
Fr ill - ' r Stu s- - russes
9.
Sid ai ing- en tucco Mesh
10.
R ing
44,
-Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date ,g/, 3 Card B-1oDate Card B-1
Dates 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. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures-Panelboards-Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date Card B-1 Date . Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
Hangers -Post Caps -Anchors -Connectors
1. Zoning -Setbacks -Easements -Flood -Slope
Cling. Joist-Rftr. Ties- Purlin-Roll Brad. -Truss-Shting.-Rtng.
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
4. Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
5. Stemwalls, Main; Steel-Blockouts-Wrapped
Garage Fire Protection Framing -RC Channel
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
Date
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
74. Elec. Outlets & Receptacles at Kit. Counter
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
_
23. Fire Sprinkler; Test
84. Stucco Brown -Finish
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral O Yes O No
32. Service -Riser Conductors & Ground Main Disconnect
Date
33. Equip. Clearances Panels-Motors-Mech. Equip.
Date
34. Clothes Closet Light -Shower Light -Spa Light
Date
35. Smoke Detector
Comments at Final:
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
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
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
Date FRAMING (Continued) '
47.
Hangers -Post Caps -Anchors -Connectors
48.
Cling. Joist-Rftr. Ties- Purlin-Roll Brad. -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 Garage 3rd Story, 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 O Yes
_
83. Following Instld./Drive O Yes O No/Walks 0 Yes 0 No/Planters O Yes O 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:
-' 4 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 O.
(Rev. 12/96) APPLICATION AND PERMIT__IT /
ASSESSOR PARCEL NUMBER
02
ZONING
BUILDING PERMIT
OWNERs
TELEPHONE
SQ. Fr. OCC. BUILDING VALUATION
440
'^�+ R 2,200.00
OWNERS MAKING ADDA*
#5 KAPMA F CA 95%6
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAIUNG ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $ 2200.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee s54.00
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee $ 35• iu
BUILDING ADDRESS
#5 WMA OROMIEPERMIT
Energy Plan Checking Fee $
FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: CARPM TO GARAGE
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G I W I@20.00
PERMIT FEE $
ELECTRICAL PERMIT Fling Fee 20.00
Main Service '.oA oR LESS 23.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
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
Main Service TO 46.00
CCU000A
W:L200A
NEW CONST. DWEWNG OCCUP. SO
OR ADDNS. DW:
ACC. S.3.50FT.
NON-RESID. MULTI.OUTLET @7.50
POWER APPARATUS
d SINGLE ourLET CIR.
Ex. Occup. OUTLET OR FIXTURES BAL p I:w
Ex. Occu . oFlxuTLE�°SA R D OR" 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
/of one hundred dollars ($100) or less.)
Pf I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that 0 1 should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith compll ith those provisions.
X _l_,'/ �,i LDate % ,(�/ [
Signature of Applicant 10 Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 1()9. 10.
HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD SU
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, "s
%� i �;r r ;' j r
By '/" ? �,` %�"`�' '`�''' Date
PERMIT EXPIRES ON
J "(Date)
Receipt No. �n ,nn .n
WHITE-D.D.S.-B. "CANANASSeS§O°R PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
i
CORRECTION NOTICE
OWNER f PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work Is
completed. If you have any questions pertaining to this matter, or need additional explanation,
nr_v Wive
I r
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive Oroville, California 95965 • Telephone (530) 538-7541
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
033-110-054
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
440
. OWNERS MAILING ADD ESS — -
,4,-'9 MANTTA WAY, 01RQVTTJE CA 95966
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $ 2200.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
s54.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
Energy Plan Checking Fee
$
$
PERMIT FEE
$ "
LOT NO.
SUBDNISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: CARPORT TO GARAGE
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I WF__
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service ZOO. OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.PSING
License Class Lic. NO.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law foythe following reason:
C3/I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service ZOO. TO
46.00
CCU000A
NEW CONST. DWFLJNG OCCUP.
OR ADDNS. ( 8 ACC. BLDS.
SO
3.5¢T.
I,D.R6IDT ==ET,
97,50
OWELEPPARATUS
8 R A
OUTLET C IR.
EX. Occup. OUTLET OR FIXTURES
20
@ I,00
Ex. Occup. ouT>tis AFM.DEn
5.00
Temporary Service
23.00 .
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$
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
E9' one hundred dollars ($100) or less.)
2/I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensatioj'laws,lof California, and agree that if I should become subject to the
wor ers' c (npe s tion provisions of section 3700 of the Labor Code, I shall
wit m h those provisions.
X Date �® '� ���L�
Signa0e, of icant - Owner ❑ Contractor ❑ Agent
An OSHA perm ' requir, d for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 109. 10
HAZ. D FEES IMP I FLOOD CDF PARCEL PD HD bSU
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
BY
PERMIT EXPIRES ON 1
applicable provisions
Resolutions to do work
been paid.
Vato1
a
pgre
receipt No.
HITE-D.D.S.- . NA @ R PINK -INSPECTOR GOLDENROD -APPLICANT
OWNER -BUILDER VERIFICATION �
Attention Property Owner:
An "owner-buildef building permit has been applied for in your name and bearing ya
Please complete and return this information at your earliest opportunity to avoid uoaeeessary dd�gr
in processing and issuing your building permit. No building permit will be $is
verification is received.
1. I personally pian to provide the m for labor and materials for construction of the proposed
property impro dml ent : YES NO O
2. 1, HAVE 0/ HAVE NOT 0 signed an application for a building permit for tie proposed wn&
3. I have contracted with the following person (firm) to provide the proposed c'onstruetkm- . _
NAivIZ:
�9
PHONE:
4. I plan to provide po
supervise, and provide
NALN E:
ADDRESS:
PHOr7E:
CONYMkCTOR'S LICENSE NO.
of this work, but I have hired the following person to coordinate,
maior work:
CM:
CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME
SIGNED:
PROPERTYO
ADDRESS PHONE TYPE OF WORK
S OCIAL. SECURITY NUMBER:
DATE: 7 i'
NO TF: This Owner -Builder Verification is required by Section 19831,' and 194314WAa
California Health and Safety Code. This verification must be eompk*d and
returned to our office before we are permitted to issue the permit
OVER
OWNER BUILDER INFORiti1ATION
An application for a building permit has been submitted in your name listing yourself as the builder ofproperty
improvements specified.
For your protection. you should be aware that as "owner -builder" you are the responsible patty ofrecotd on such
a permit. Building permits are not required to be signed by property, owners unless they are personally per6ortttip 15eir
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract', you ihould
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family. and the worst (including materials
and other toss) is $300 or more for the entire project, and such persons are not licensed as contractors or
subcorractors. hen you may be an employer.
♦ [, you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including'state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation Contributions.
♦ There may be F.nancial risks for you if you do not carry out these obligations, and these risks are especially, serious
with respect to worker's compensation insurance.
♦ For more sccculc information about your obligarions under Federal Law, contract the Internal Revenue Service (and,
i r You wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact he Department of Benefit Payments and the Division of Industrial Accidence.
I: the mc ure is intended for sale. property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
to secure an "owner builder" building
A frequent practice of unlicensed persons professing to be contractors is
pcmli% erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 101-0 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these marters. The building permit will not be issued until the verification is returned.
MLA6A_1
Nfie el C. Vi ira, C.B.O.
bi ger, Building Inspection
NOTE: Tits Owner -Builder Information is required by Secdlon 19810 ofrhe California Health and SaJery Codes
OVER
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: 61�e_l 2�1ckqrjrl ASSESSOR PARCEL NUM—BER
Proposed Building Use: �/1 r r / �Q A (Fl P_Counter Technician: t U ' Date: 67-
Itteems required in order to apply for a permit. All boxes UST be checked OR marked NA in order to apply.
/a Plot plans, 3 or 4 sets, signedty the preparer of the plans.
Complete plans, 3 or 4 sets, signed by the preparer;of the plans.
3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Energy compliance design and supporting documentation in duplicate.
❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or
foundation plans, all in duplicate.
❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate.
(D) Floor plans in triplicate. All of these must be stamped and wet -signed b the he en ineer. '
Items required for initial plan review. If checked items have not been received, plan review cannot proceed.T,he.permit will be
indexed and returned to the plan review line-up when required items are received.
Date Received By
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ 1
❑ 9. Plot plan and business license approval from the City of Biggs ....................................
.0--10. Letter of intent for non-residential buildings.........................................................
�1.,, Detached Accessory Building Form filled out by the owner .....................................
11;/ 12. 'Hazardous Material Form..........................................................:....................
❑ 13. Other, _
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 14. Fees as.shown on the attached Schedule of Fees Due Sheet .......................................
❑ 15. Statement of Intent for Non -heated and A/C Buildings .............................................
❑ 16. Sanitation and plot plan approval from the Environmental Health Department in
❑ 17. City of Chico Plumbing permit.........................................................................
❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ......................
❑ 19. Planning approval for (A) Use: DK, (B)Parking: (C) Parcel Check: I o-18— O2
❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ...............................
❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).--
0
ccupancy).—"❑ 22. Pre -Inspection for required ................
❑ 23. Contractor's license information. (Number, Name Style, Classification) ......................
Cle24. Worker's Compensation Carrier and Policy Number ..............:..............................
,5R_25—Owner-Builder Verification (❑ Given to owner, ❑ Mailed to owner)...........:.........�1
❑ 26. Letter of Signature authorization.............................................................. .
❑ 27. Recorded copy of Agricultural Acknowledgment Statement :::::::::::::.::::::::.:::::::::::::
❑ 28. Manufactured home utility clearance::........../
❑ 29. Existing vinlatinns incl/naexnirerl nermitc
&95Gn
1Other:
When issued'
I have been informed of the above items and req
Applicant:
1. Index permit application for the above items numbered
2. Additional items required
Contractor, designer, owner, was advised cf the above data'by
Contractor, designer, owner, was advised of the above data by
Plans reviewed by: Date:
Structural reviewed by: Date:
Note transfer by: Date:
Yellow: Buildin[
...................
r from Legal O,
, ❑ Check to H.C.D. $
and hold for pickup.
ing a b ' ermit.QV
n
iG VV
Plan Check Le 1'
❑ phone, ❑ mail, ❑ counter, by Date:
❑ phone, ❑ mail, ❑ co u r by Date:
_ Plans approved by: Date: 4440
_Structural approved by: Date:
Division
a
d �
_ _ 3
N
LA,
1i ��2 BUTTS COUNTY - -
�i�c-rv.�c..
BUILDING .DEPARTMENT
APPROVED
•
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
(77
116- i EY
_r 5 �vrN zl;ve Lo T iz PL EAS ANT
�''
Department of Development Services
Building Division
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 (530) 538-2140 FAX
DETACHED ACCESSORY BUILDING
OWNER'S STATEMENT OF USE
Plan review will not be started until this form is completed, signed by the property owner, and
returned to the Butte County Building Division. Attached Accessory Buildings and Additions
will be checked for residential use. Exception: Garages and Carports.
Owner:
Mailing Address
Site Address: . S
Phone: rO� S3o�lo /O
e/d vi /,
��( 4
/w *� c"— Gl �j—rJ
Assessor's Parcel Number: 0-33 1162 — Q S Zone:
Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of
this
form
GENERAL INFORRMATION:
1. Is dwelling
YesNo ❑
there a primary on the property?
2.
Is the structure already built, under construction, or under notice of code violation?
Yes 3 No
3.
Will items produced in this building be offered for sale?
Yes ❑
No
4.
Will the public have access to this building?
Yes [:1
No [�
5.
Will any advertising, on or off site, be associated with the use of this building?
Yes ❑
No [-
SITE CONDITIONS:
6.
Is the structure foundation within 5' of septic tank or 10' of leach lines?
Yes ❑
No [�
7.
Is any portion of the structure located closer than 20' to your front property line?
Yes ❑
No []�
8.
Do you plan to add a driveway or modify existing access to a county maintained road?
Yes ❑
No [ s
9.
Will the proposed structure encroach within any recorded easement?
Yes ❑
No
CONSTRUCTION
FEATURES:
10.
Will this building have insulated floor, walls, or ceiling?
Yes ❑
No
11.
Will this building be heated or cooled?
Yes ❑
No
12.
Will this building have a water closet/toilet?
Yes ❑
No ["
13.
Will this building have a sink?
Yes ❑
No
14.
Will this building have a water heater?
Yes C]No
[�
15. What type of floor covering will the building have? 67164-
16. What type of wall covering will the building have?
OVER
1 of 2
PROPOSED USE: (check only one boa)
1. ❑ Residential Storage Shed — I will be storing in this building and it will
not b used for any other purpose (no bathroom and no heating or cooling).
2. rivate Garage — "A building or a portion of a building not more that 1,000 square feet (3,000 by
exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are
stored or kept." A garage door is required.
3. ❑ Residential Carport — A covered structure intended for parking of vehicles. Two or more sides must be
entirely open.
4. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport.
If you checked #4, please check the uses below which best fit this building.
❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-law quarters
❑ Recreation Room ❑ Game Room ❑ Study ❑ Library
❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio
❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Sewing Room
❑ Canning Kitchen ❑ Music Room ❑ Family Room ❑ Sun Room
❑ Private Office ❑ Workshop 1 ❑ Home Occupancy Z ❑ Other — Use =
I. Descnbe type or Workshop
_ Must be approved by the Butte County Pluming Division.
Explanations: This area is for explanation of any "yes" answers on questions 2-14. Please indicate the question
number before the explanation.
Additional Information:
Plan review will not be started until this form is completed and received. A Plans Examiner will contact the
owner with specific requirements per the use indicated.
I hearby affirm under penalty of perjury that the above information is true and correct. I understand that any changes
to the use, or character of use, of this building will require permits from the permitting authority. I understand that
Real Estate Disclosure laws require
nndisclosure of this information if or when the property is offered for sale.
Owner's Name: Please Priru �/4 gryj"
Owner's Signature:Date: AQ —//-0 Z__
I IT - 10
2 of 2
'.`•E'a-'�;."'l/Yt7ksy�aw+„�j��,�y�'-T+F'r�M��i•K'"�taYlay�,..-..r�, r..-�+,aoo-° �. ��"•a*�: a�
' , 1
� s ♦ I 1
f..cnw+.syr•.a.-o�rvs-�.E^e••ry^cf'S�"ar-
033-110-054 03-2588
BRYSON,KATHY
5 MANILA WAY, OROVILLE
MISC ELECTRIC FOR GARAGE
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUI DING DIVISION
{ 7 County Center Drive • Oroville, California 95965 • Telephone (51 538-7541� P •No.—�
(Rev. 12/96) APPLICATION AND PERMIT t J-3-"iS
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation Is
ARCHITECT OR ENGINEER
LICENSE NO.
Filen Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS I.
r e{ht1T V nJ.'1�1T ^
Energy Plan Checking Fee $
$
PERMIT FEE $
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other 'W= CARArt:.
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: +DISC rUCHIC 1"OX Lf,` 2—? 7Q
Gas piping system 1 - 5 outlets
15.00
Building sewer
-FG
15.00
Mobile Home T§ W
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.POWEPPARATUS
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,
do the work, and the structure is not intended or offered for sale.
W/I, as owner of the property, am exclusively contracting with licensed contractors
W/1,
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 permitis issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP,
ORw ( ACC.MULTI-OUTLET BLDS.
3.50SO
corgi .
NON-RESID. BRANCH CIRCUITS
97.50
8 SINGLER AOUTLET C1 R.
Ex. OCCU OUTLET OR FDRURES
200 1'00
SAL_ @ .50
LNS
Ex. Occup. oUXTIEETS RES,6.OEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00 )-n nn
`
PERMIT FEE $
^r•,n
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
�-, /,
'✓' certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
)
X 7+, , i/� _Date �_
Signature of Applicant -�❑ Ow,76r ❑ Contractor ❑ Agent
An OSHA permit is required for excavati over 5'0" deep and demolition or construction
of structures ove tone ei 7
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $
AZ.
HS
D. FEE IMP FLOOD CDF PARCEL PD HD
ISSyE
V/
This permit is hereby issued under the applicable
of the Butte Qounty Code and/or Resolutions
ind' ated a v f whi h fees have been
B �D(at
PERMIT EXPIRES ON U
provisions
to do work
paid.
ete
ReceiptNo.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75410_ M!5Fg
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
(23-110-054
ZONING
BUILDING PERMIT
OWNER
BRYSON. KATHY
TELEPHONE
2-4610
SO. FT. OCC. BUILDING VALUATION
. OWNERS "UNG ADDRESS
5 MANILA WAY , QRQYTLLE, CA 99966
CONTRACTOR'S NAME
04JNa
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS "UNG ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
Energy Plan Checking Fee
$
PERMIT FEE
$
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other �S CARAGE
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other IN
Describe Work: MISC ELECTRIC FOR .6P;','02-247 3
Gas piping system 1 - 5 outlets
15.00
sewer
15.00
—Building
Mobile Home I S I G I W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
SS
Main Service( 800V OR p q OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.POWER
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, IS owner of the property, or my employees with wages as their sole compensation,
III 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
f one hundred dollars ($100) or less.)
I certity that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
wor rs' cc ensation provisions of section 3700 of the Labor Code, I shall
fo lth ly witth se provisions.
X Date ��
SigKiftur of ant Ow r ❑ Contractor ❑ Agent
An OSHA per it is r quired for a cavatio over 5'0" deep and demolition or construction
of structure over ei
Main Service 200A TO
46.00
NEW CONST. DWELLING OCCUR 3.5¢sO.
EL
( OR ADDNS. ACC.FT.
NEW CONST. MU
NONFRESID. 97.50
APPARATUS
8 SINGLE OUTLET CI R.
OUTLET OR FD(TURES
Ex. Occup.SAL
20 O I'00
o .so
Ex. Occup. oimEFrs EES16 °EA 5.00
A
Temporary Service 23.00
Mobile Home Facilities
20.00
Misc. Wirin 23.00
'
PERMIT FEE $
43.00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP FLOOD CDF PARCEL PO HD
5S
This permit is hereby issued under the
of the Butte unty C de and/or
in ated a v f whi h fees have
B
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
D Z�
efe
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PIN -INSPECTOR GOLDENROD -APPLICANT