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035-180-012
35-18-12 F. B. HOLLAND o 22W2 Ithica, Oroville Permit #6381-77P (replace broken gas line) SF 35-18-12 Permit#1212-80B,P,E(repair as per `tr`' ` housing inspection) SF HOLLAND, JEFF 2261 ITHACA, OROVILLE Cont: OWNER REPLACE 2 ELE SER B08-0926 ' _ 035-180-012 MISCELLANEOUS Remodel REMODEL. 2261 ITHACA ST HOLLAND, JEFFREY D ' J P--1 le�-6 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7601 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.nettdds PLEASE PRINT CLEARLY PERMIT NO. BIN # "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 C t.l ( 1 e v - G� Flrst Name Tip. oil VA J I J e Mailing Address Phone 107 12 City t' State 01 ht - Zip Sp� Phone I o I Fax E -mail APPLICANT INFORMATION CONTRACTOR Name Q % C t.l ( 1 e v - G� Address Tip. City Fax State Zip Phone Fax E-mail lic. 9 Class APPLICANT INFORMATION ARCHITECTIENGINEER Name City Address Tip. City Fax State Zip Phone Fax Email State License Number APPLICANT INFORMATION Name Address City State Tip. Phone Fax Email APPUCANT SIGNATOR ix 4ie4a J PROJECT LOCATION AN Property Add �s 2 Zb 1 2 ^ ah' O►�o WORKER'S COMPENSATION Policy Number Carrier ff hidng anyone otrier than Ikensed contractors, a cerdflcate of worker's compensation must be shown of the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. o 1C 2 c Sq FT- Living 5Ot7 Garage o Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA Yes No Ooc. Type Const. J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT ig BUILDING Owner SQ. FT. OCC. BUILDING VALUATIO Mailing Address` 1 el phhoone o. Contractor Mailing Address Fireplace Total Valuation e Tlephone No. Permit Fee Building Address Plan Checking Fee &/orPenalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 (� Each Trap 1.50 Repair drainage or vent piping A. P. N — '� I Zonin $Planning Water piping 1.50 Each gas water heater or vent 4—% F s W.C. Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel aration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. PI Rec'd Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ ELECTRICAL No. @ FEE v PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5•�� Single Family Duplex ❑ Mobil Home ❑ Others Main service EA. ADD'L 100 AMP 2.50 ER 600V Main service 10 0 AMP OR LESS 25.00 Main servlce EA. ADD'L 100 AMP 1.00 NEW CONST OR ADDNS. ACCLBLDGS.LING CCUP. 4) 2�Sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: TLET NEW CONSTR BRANCH CIRCUITS NON.CRESID.ONST BRANCH CIRCUITS) 2.50ea NEW CONSTR /POWER APPARATUS fi NON-RESID. ,SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTURES) 50@ @1t BAL Ex. OCCU FIXED APP LNS. OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of Califomia. Permit Fee WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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 County of Butte to enter upon the above-mentioned property forinspectionpurposes. ,<- X Date 3 4 3 ignature of Perrmiit�te'e or Agent Receipt No. -3 LL-a� White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant MECHANICAL PERMIT FILING FEE Heating a,m.. is V,, Cooling @ $3.00 Ventilation Hood 1 2.00 Permit Fee $ 71 o $ Land Development Fee $ TOTAL PERMIT FEE $ ley 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. OF PUBLIC WORKS BY 0 Date Building permit expires Date— f.. yy t§r t' February 26, 1980_ ~fi • - . "�K'. �. tri �.Yawc' �- ..i Francis B. holland 815 Montgomery Street z Orovillei, CA 95965 t .,. ry' r•,•f Re 2261 and 2261 Ithaca St.# Oro. AP# 35-ld—D-12 h - Debr M.r.. Holland: This department has received two complaints concerning conditions at two rentals located at the above address". A search of the Butte County Assessor'.s_,_ Records indicates you are owner of the rentals. _ On rebrt ary 4, 19 0, anddinspection- of the premises at 2261 and 2261 Ithaca' f ' utrest, Crarille revealed the following conditions which are in violation of the Butte County Code and the State Housiog Law. 2261 Ithaca 1. Wastewater from the house sewerage system is "being discharged upon the ground next to 2261 Ithaca. 226Vi Ithaca ' 1. Waste water from the kitchen sink is being discharged.onto the ground at the rear of 2261 Ithaca r. . 2. Thelarge window next to -the front entry door is broken. 3. The flue pipe on the space heater is too close to a combustible wall and is a fire hazard. L;. The .,,ater heater is insLalled outside, ana lacks weather protaetioa and a tea<pera ture -pressure relief value and line. `Whose conditions render both rentals s:abstandard and unfit for human habitation. The conditions shall be repaired or corrected within 30 days._ jr (2) Pard.4fts will ba required for most of the repaiis, they may be obtained from the Butte County Department of Public Works,, -7 County Center Drive,, Groville. The conditions shall be corrected as follows: 2261 Ithaca 1. Repair or replace defective house sewerage so all wastewater is confined to the public -sewer and no waste water is allowed to flow onto the ground. 2261�4 Ithaca 1. Rarair or replace the kitchen sink plumbing so all waste water is confined to the public sewer. .2. Replace the broken.window by the front entry door, Replace 3- 1 - ce the flue pipe with a proper fl -de and provide pMper clearances from all combustible surfaces. .4. Frovide.a proverlyinstalled -water heater and enclosure. Provide a - tempera- ture -pressure relief valve ard line for the water heater. Please complete all repairs as indicated. If you have.any questions contact the tmdersigned at the above address or telephone number. Very truly yours,, [toward J. Snyder, kyr., R.S. Division of Environmental Health ljn cc: J. Glanders Public'Works Do � (+ V U�ECOUNTY a b QI�L-DING-DERARTM�� � - �P W _ �w m 0 VMAL r i-,- i r,, -, 1 1 'fes \ i i � �• � -%S ' � + � � Ci �'r C 1 L '1 ,� rl ; L;. � �� I ' r � � r ' J ' �-r. � / �v 3`3 77 z 7 COUNTY OF BUTTE — �PARTMENT OF PUBLIC WORKS y 7 Count Center Drive oville, California 95965 Telephone: 54541 APPLICATION AND PERMIT ?7 i a.I+�a.ucnaa v.. vi U— VVUIIIy UI OU LLV LU V1 ICI UPUII II IC above-mentioned property for inspection purposes. X cs. ,a' r t,l Harp % + .ate• �! s a Signature of Per/miiee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS f By .A tri;: Date -Building permit expires Date BUILDING Owner Z� 44 -�:w SQ. FT. OCC. BUILDING VALUATION Mailing Address } C1 Telephone No. rev t `�I� "��T' %"fly.-i� Fireplace Contractor I Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address —;� �� �� PLUMBING No. @ FEE PERMIT FILING FEE J$3.00,�� Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.1 '" lC'> ^1 11 f\ F...- ZoningBPlanning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W:C' Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Improvements p ovements Lawn sprinkler system 2.00 -Bldg:-'Plans-Rec'"8" Parcel Approval Plans Approval Permit Fee $ / ,_ $ s'/ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHERELECTRICAL ❑ No. @ FEE PERMIT FILING FEE $3.00 j[j� �Iri -�,� �1 1►t`� Main service V OR LE 10000 AMP ORSLESS 5.00 Main service EA. ADD•L 100 AMP 2.50 Main service VER 600V 10 0 AMP OR LESS 25.00 Single Family 0 Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS. OCCUP. &) 20 sq ft NEW CONSTR. MULTI.OUTLET NON.RESID, BRANCH CIRCUITS) 12.50ea NEW CONSTR. (POWER APPARATUS & NON•RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: - Ex. Occup(OUTLETS OR FIXTURES)@� BAL@1 FIXED APPLNS. OR EX. Occup. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this ~ •permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation J2.00 Hood Permit Fee $ $ 1 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 TOTAL PERMIT FEE `' ^� $ 1 -i t, i a.I+�a.ucnaa v.. vi U— VVUIIIy UI OU LLV LU V1 ICI UPUII II IC above-mentioned property for inspection purposes. X cs. ,a' r t,l Harp % + .ate• �! s a Signature of Per/miiee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS f By .A tri;: Date -Building permit expires Date - le COUNTY OF BUTTE — DEPA TMENT OF PUBLIC WORKS 7 County Center privp, " C: ville, California 95965 Tel epho 534- 541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned propert for inspection purposes. X Date — Signature of Per/mi ee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. CTO OF PUBLIC WORKS By 0 Date 2 permit expires Date T��7 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address �U 'lL,ele hhonneeNo.� V ��ttJJ Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty — e Tlephone No. Building Address V Permit Fee PLUMBING No.1 @ I FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. r Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 F& Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Plans Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER - ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 � Rw at ca [31�Ie r, �j ►� no Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADO'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 00 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONSDWELING O OR ADDNST ( ACCLBLDGSCCUP. &) 2¢sgft . NEW CONSTR. MULTI -OUT NON-RESID. ( L T BRANCH CIRCUITS) 2.50ea NEW CONSTPOWER APPARATUS & NON- R. RESID. If OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)@ BAL@1 FIXED APP LNS. OR Ex. Occu P'(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 .License No.Classification Misc. Wiring 6.25 �I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. 1 -have placed on file with the County of Butte a certificate of ❑ Workmen's Compensation Insurance. KI certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 2.00 Permit Fee $ $ 1 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 TOTAL PERMIT FEE authorize representatives of the County of Butte to enter upon the above-mentioned propert for inspection purposes. X Date — Signature of Per/mi ee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. CTO OF PUBLIC WORKS By 0 Date 2 permit expires Date T��7 ``PERMIT NO. 1212- 80B,P,M P PERMIT EXPIRES 3/13/81 6WNER F.B. HOLLAND CONTR. owner LOCATION (A.p. 35-18-12 22612 Ithica St,'Oroville 94 is -A Temp. Power Pole_ CalledPG&E — Temp. Elec. Serv.— Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED— (Date) (Signature) -.� -� -.- ..-+�.`rr�^.....,:+.a.,,r,,,t�.t.; ..` ..�,.ryt-r,;+vCY+1.+...r=:4�y...•' .-.. .�•.r--�• t" COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT til Owner r Mailing Address (?),(' Contractor p4A 4,) V, Mai I i ng Address Building Address BUILDING SQ. FT. OCC. BUILDING VALUATION 0A_L4 4 S -r 1 r%i13 VTelephone No. Telephone No. A. P. No. ) R, ^�,,,.. Zoning & Planning Fees /W.C. -Sanitation, [FireDept. Fire Zone Use Permit E6A Parking I Parcel Parcel Ma 60' R/W Improvements Plans Declaration P provements Bldg. Plans Recd Parcel Approval Plans Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER L❑, Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system RIo�7� 1 r �iS ',_,CW % SINN R 1 �p Permit Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Single Family Q Duplex ❑ Mobil Home ❑ - Others ®" Main service EA. ADD'L 100 AMP • Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST. ! DWELLING OCCUP. 5 OR ADDNS. 1 ACC. BLDGS. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name st le of: y NEW RESID,BRANCH CIRCUITS T NON -RESIT BRANCH CIRCUITS NEW CONST(POWER APPARATUS 8 NON -RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTURE: Ex. OCCU FIXED APPLNS. OR p• OUTLETS (RESID.) EA Temporary service Mobile Home Facilities License No. Classification Misc. Wiring OI am exempt from the Contractors License Laws of the State of Cal ifomia. Permit Fee WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. y 0 I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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 County of Butte to enter upon the above-mentioned property four inspection purposes. X jQ6 . �`' �1L>I---d� Date ..Signature of Pe mitee or Agent Receipt No. - -s White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant i MECHANICAL PERMIT FILING FEE, J Heating -Tu,. -a0 R Vv Cooling @ FEE $3.00 1.50 1.50 .1-.50 t?. n 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 2.00 10.00 15.00 6.25 @ FEE $3.00 : M Ventilation Hood 1 2.00 Permit Fee $ 7,60 $ -7 " Land Development Fee $ TOTAL PERMIT FEE is This permit is hereby issued under the applicable provision's of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. �DIRECTO'R OF PUBLIC WORKS R10- /� By (2` � Date 1 Aj) I- V `� _ 1 Building permit expires Date T COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING I BUILDING-(Cont'd) I PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicapped Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES - - - - - - - - - - - - - - - - - - Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping BILE HOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE d REMARKS OR CORRECTIONS T1.40, 12Z ` ( I t Y (NOTE: An entry must be made on this form each time 'you ,visit the job site.). U X, February 26, 1980-_ i. Francis B. Holland ; 815 Montgomery :street Oroville, CA 95965 Re: 2261 and 2261't Ithaca St., Oro AP# 35a1d-0-012 Dear 'Mr. Holland: This department has received two complarots concerning conditions.at two rentals located at the above address. A search of the Butte County Assessor's._ Records indicates you are owner of tits- rentals. _ On February 4, 1960, andinspection of the przmises at 2261 and 226V2 Ithaca Street, Croville revealed the .following conditions which are ir: violation of the Butte County Code anti the State Housing Law. 2261 Ithaca 1. Waste water from the house sewerage system is being discharged upon the ground next to 2261 Ithaca. 2261'-�* Ithaca 1. -Waste grater from the kitchen sink is being discharged onto the ground at the . rear of 2261' Ithaca. 2. The large window next to tAhe front entry door is broken. 3- The flue pipe on the spaco heater is too close to a cbmbustibla mall and is a fire hazard. L. The :rater heater is installed outside, and lacks weather proteetioc and a tecaraure-pressure r®lief valve and dine. a� hese conditionsrender both rentals s; bst-andard and un it for human habitation. i'ha conditicas shall be repaired or corrected within 30 clays..' T .; (2; Oe. - r Permits will be required for most of the repaigs, they „may oe obtained from the Butte County Department of Public Works,, .? Cow;ty Canter Drive., Groville. The conditions shall be corrected as follows: 2261 Ithaca 1. Repair or replace defective house sewerage so all waste avatar is confined to the public suer and no waste water is allowed to flow onto the grouid. 226111 Ithaca 1. Rarair or replace the kitchen aink plumbing so all waste water is confined to the public sewer. 2. Replace the broken window by the.front entry door. . i 3. Replace the flub pipe with a proper flka and _provide proper clearances from all combustible surfaces.. 4. !Provide a properly installed crater ^eater and enclosure. Provide a tempera- ture -pressure relief valve and line for tire.. water heater. Please complete all repairs as indicated. If you have.any questions contact the tndsrsigned at the above address or telephone nLwiber. Very truly yours, - - - - froward J. Snyder, Or., R.S. Diiiision of Environmental Health ljn ccs J.uIander, Public darks e, 4--7" 0-0- K) r o 7� Q-�3-S- 1 So-b_,LZ ca REC oy-70 A JAN 2 6 2005 —• wie-eex� DEt'ELOI'\IE\T tiERNCES ' o- - �� .,• tf �:. .>, �11_.. 3� `' '`moi.. ' - ��:�r.tF�c%. r�:�;w•:;� . z M _ 1. V.r 34 F.'r�%��c`�. .�. r f �i3��'S!r! _ ! :Y+- _ � .`N''..1� .:�. •S._� .�iT +T rrr>r• . �'.3 't .:3 i�::F: L`V4�Iri_�ye C .. :1i - ., . 431, r . u+rri f:7 17 - • — .-I . . . __ -_. . — . 1 ..6� 1 l.F'� '' `{; � ,.. $Ei�' ... .. _.. .. ', J: _�Sti,.. ter•: ; .. ..��h. y: n 1 .....�.. PT IA t .. I 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: A__ ASSESSOR PARCEL NUMBER V� ✓' 16l� �. U Proposed Building Use: ffJ , Counter Technician: bate: - ' 6Z Items required in order to pl r a permit. All boxes MUST be checked OR marked NA in order to ly. Q 1. Site plans, 3 or 4 set , igned by the preparer of the plans. ❑ 2, Complete plans, 3 or 4 sets, signed by the preparer of the plans. 1 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! 0 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of intent for Non -heated and ,AIC for Non -Residential Buildings. 173 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in 6plicate. 0 9. Metal bidgs; (A) Metal Bldg Plans, (B) Fnd plans and caics in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate: Cl 11. Site plan and business license approval from the City of.Biggs. 12. Letter of intent for non-residential buildings, ❑ 13. Detached Accessory Building Form filled out by the owner. ❑ 14. Hazardous Material Form. 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. Fj 16. Other Remaining items needed to Issue the permit. (May require additional plan review upon receipt of the following Items.) ❑ 17. Fire Sprinklers ❑ 18. Agr icultbral Buffer clearance and site plan approval from the Ag Commissioner's office 19. Soils Report and/or Engineered Foundation required. 0 20. Erosion Control Plan Required. C 21. Fees as shown on the attached Schedule of Fees. Due Sheet. G 22. City of Chico Plumbing permit. ❑ 23. California Department of Forestry plan approval ❑ paid'. 0 24. Planning approval for (A) Use: e _(B)Parking: (C) Parcel Check: ❑ 25, Contact Land Development about __ Improvements, -Drainage. ❑ 26. NPDES Form t7 27. Encroachment Perrpit. for driveway frppm the P blic Wolfs Dept. (construction approval prior to occupancy). 28. Pre -Inspection for U required. ❑ 29. Contractor's license in rti n. (Number, Name Style, Classification). ❑ 30. Worker's Compensation Maier and Policy Number. ❑ 31. Owner -Builder Verification, (_ Given to owner, -'Mailed to owner). ❑ 32. Letter of Signature authorization. n 33. Recorded copy of Agricultural Acknowledgment Statement. ❑ 34. Manufactured home utility clearance. 0 35. Existing violations and/or expired permits. ❑ 36. Deed Restriction. E3 37. ❑ Grant Deed, 1_1 M.H. TitleiStatement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other:`--- ----------- When issued Taieohone _ and hold for pickup. I have been infarmieY t e aoovg items and require ents for obtaining a building permit. Applicant: _ / Dater EXPIRATION OF APPLICATION Application for h' a permit has not been issued will expire one year. after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits ret issued, and two years frorr the date of permit issuance for permits issued; however, on issued permils refunds can only be marie if no construction woes has been :Ione. F;iinr; fees, plan check fees for work plan checked and other department costs are not refundable. Original•Applicarl w. BUTTE / u 1� COUNTY MAY 2 0 2005 t. DEVELOPMENT SERVICES County of Butte Oroville, California GENERAL CLAIM CLAIMANT ADDRESS: CITY & STATE: nATF OF (LAIM- , Jeffrey Holland P.O. Box 6377 Oroville, CA 95966 05/10/05 ': ,. SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Refund i Claim - See attached calculation sheet APN: 035-180-012 Permit No.: 04-2055 PAID RETAINED REFUND Develo ment Services $ 165.00 $ 82.49 $ 82.51 THERM DRNG $ - $ - $ - SMIP . $ $ - $ SHR $ $ - $ - SRA $ $ - TOTAL $ 165.00 $ 82.49 $ 82.51 ....... ............ ............. ............ )6;r: >::< .. . .. .. .. ... . ............................................................ .............................. ............................................................ ::::BREARDOVI!N :::::::::: .... .. .. . .............. BUDGET':::ACCOUNT ............. ............. .... .. ............. .............. ............. ::AIvTO[JI T: 101001 DVLPMNT SVC 440-001 4210500 $ 82.51 1011822 THERM DRNG 1800 280 $ - 1011430 SMTP 1001 280 $ 1011811 SHR 1800 280 $ - 101001 SRA 0100 4617240 $ TOTALI $ 82.51 $ 82.51 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is We and correct as stated. �� Dated this . day of /��a/ , 2005, at (2f'c)?o , Calif. oil?G Sig rture2K Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles pecified above hav een p rmed or delivered and that fere is a Budget Appropriation or Specific Board Approval (Check c ) forlthe same. �f Dated this day of jAl-L—' 2005, at Oroville CaIH. I Depart ne ead or A th rued Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. I .-r%_ 0- 91 ? G,)J S <8-- 1101 Chief Building Inspector REFUND CALCULATION SHEET CLAIMANT: Jeffrey Holland ADDRESS: P.O. BOX 6377 CITY a STATE: Oroville, CA 95966 DATE OF CLAIM: 03/07/05 APN: 035-180-012 RECEIPT INFORMATION NUMBER: 406823 DATE: 07/13/2004 ISSUED TO: Jeffrey Holland CHECK #: 1689 AMOUNT: $165.00 PERMIT #: 04-20'5555 Yes No Yes No Yes No PRIOR REFUNDS: X FEES VERIFIED X REFUND BREAKDOWN Title BLDG THRM DRNG AUD SUSP SHER DEV FEE FIRE Fund 0010 1800 1001 1800 0100 Dept 440-001 rHRM DRN (SMTP) (SHR) (SRA) Accnt 4210500 280 280 280 4617240 Cash 101001 1011822 1011430 1011811 101001 DETAIL PAID RETAIN REFUND BLDG Time 109.98 165.00 ::::::::::::::: :: ::::::::::::::::::::::.::.:::.:.:.:.:. ::::::::::::::::::::::::::::::::::::::: .......... :::::::::: .................... :::::::::: :::::::: :.:.:.:.::.:.::: ::::::::::::::::: Filingfrom Plan Check 0.00 0.00 0.00 Plan Check/Filing0.25 27.50 66.00 27.50 38.50 38.50 Inspection 0.00 99.00 99.00 99.00 BLDG FEES OTHER BLDG 0.00 0.00 0.00 0.00 ::::::::::.:::::::::::::::::::: .......... .......... REFUND PROCESS FEE 54.99 54•99 54.99 yq.gg •;•;•;•;•;....;.; :•:::•:•:::::::: ::: ::::::::::::::::::::::::::::: .......... ::::::::::: :::: .......... :::::::::: .......... :::::::::::::: ::::::::: ......... ::::: >: >: ......... BUILDING TOTAL 165.00 82.49 82.51 82.51 THERM DRNG 0.00 0.00 SMTP 0.00 0.00 SHR 0.00 0.00:::::: »: SRA 0.00 0.0( $ 165.00 $ 82.49 $ 82.51 $ 82.51 $ - $ - $ - $ - APPROVAL CHECK: $82.51 Date Reviewed 05/05/2005 DIFFERENCE: $0.00 Scott Rutherford �� ,fid (Should be blank) Chief Building Inspector Butte County Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY -Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on t he receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Development Services for payment processing. CL*AIMAIVT'SNA \j (f fl A - , 4 71 S MAILING -ADDRESS-) (S30 )�Fi�-Z�� 7 PHOIVE:� ASSESSOR'S PARCEL'NO_. -1 1- - Lg - Q -i .� [Please use one claim form per permit.] BLDG PERMIT NO.: i Lj _ - Receipt No. 1 - Receipt No. 2 Receipt No. 3 IP RECEIPT NO': / _' o Z 3✓ ------ — — — — —— _ C . RECEIPTDATE: ----�-- Oo + RECEIPT AMOUNT: REASON" FOR REFUND REQUEST: O(E�_ d eV,teVw1���� =!-h- eC+l,1e-q( l�i���4�� Work wqS Y10+ Check thoseJees which you wish to have considered for refund,, Building Permit Fees =Sheriff Fees =SRA Fees (CDF Fire Planning) =Other (specify): Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may ick them up prior to that time. 7/g t r/e - - Date' _ BUTTE o s/Refund - tion 082203 COUNTY FEB 0 7 2005 DEVELOPMENT SERVICES r4 ,C PRE -INSPECTION REPORT � OWNER: �.kAo)Ql� DATE: I LOCATION: � �- �A. P. #' CONTRACTOR: ZONING: REASON FOR PRE -INSPECTION CQ e DATE TO INSPECTOR: PERMIT HIi�o_STORY ( ) NONE SEE ATT Building Description: BUILDING INSPECTOR'S REPORT Commercial/Usage: Residential # of Units: Mobile home # of Units: Currently Occupied ( )yes (") No Abando scant: __ Electric: Electric CurrentlyOn , j,� ()Off r Condition of Electric ,J Gas: Currently ( On i" - Condition Sanitation: � Plumbing Working Yes o Obvious Sewage Problems ( e ( N( (ACTION -RECO M1 [ENDED• - -ISSUE O_Yes Hold for permits or verify- �2 (� �2 °�- - q'V kA/\e- Inspector• _ N / Date: / (0 0 0 0 L T BUTTE COUNTY 0 DEPARTMENT OF DEVELOPMENT SERVICES 0 BUILDING PERMIT APPLICATION j 0 AND SUBMITTAL REQUIREMENTS V 0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 0 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" APPLICANT NAME OWNER Last Name• City O - 1 irst Naammee Address 10-7 \ v e ✓, Aj I P_ Lt) City 'or •r State State C i Zp ,_q�6 Phones S — Z —7 Fax 2 `� E-mail Map Book APPLICANT NAME CONTRACTOR Name City O - 1 Addres --- Zip city Fax n, gIr - 2A, 7 State Zip Phone Type Const Fax E-mail Map Book Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City O - 1 Address Zip City Fax n, gIr - 2A, 7 State Zip Phone Type Const Fax ` E-mail Map Book State License Number APPLICANT NAME �` i o , Name l e 'fit 'h- Address 6 \ Ye Lo City O - 1 State C Zip Phones &-ci —2A -7 Fax n, gIr - 2A, 7 E-mail APPLIC44NT SIGNATURE l01NA', i J�1 Fo tce use only: AP# 2— Zoning City ' 10r01yM11C_ Flood Zone SRA I Yes I No Occ• Type Const Subdivision Name Address Map Book Page Lot # Planner Date Approved: UVr-K ruts SUt3MllI IAL REQUIREMENTS PERMIT BP BIN # LOCATION AP# 2— Property Address ZZlc� .� ha c City ' 10r01yM11C_ Cross Street ,P_ V' WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: �-.. So. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount �— Bldg 4Z�� SRA Receipt # Sheriff Lk, SMIP Date: —7 Other (� 2o Total 44 N 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 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" APPLICANT NAME OWNER Last Name• Address 0 R\V(?1PV1 • irst Name Address 07 \vV_r II P_ty City Oro State State CA Phone Phone S_ Z -I Fax S92— 2q`7`7 E-mail Lic• # APPLICANT NAME CONTRACTOR Name Address 0 R\V(?1PV1 • Addres e 04 City +Fax Phones _ Z C1 7 7 State Zip Phone Type Const. Fax E-mail Map Book Lic• # Class APPLICANT NAME ARCHITECT/ENGINEER Name Address 0 R\V(?1PV1 • Address e 04 City +Fax Phones _ Z C1 7 7 State Zip Phone Type Const. Fax E-mail Map Book State License Number APPLICANT NAME Name T e_ � r o '"f� y- Zoning Address 0 R\V(?1PV1 • City t7 e 04 Zip ca +Fax Phones _ Z C1 7 7 '' g _ Zc 7 E-mail sAPPLICj4NT SIGNATURE /W l ,tel Fo ice use only: Zoning City ©�0 111 Flood Zone SRA I Yes No 0cc• Type Const. Subdivision Name Address Map Book Page Lot # Planner Date Approved: PERMIT NO. �v 55 BP BIN # LOCATION Property Address = tiac City ©�0 111 Cross Street Ir WORKER'S COMPENSATION Policy Number Carrier ffhiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time ofpermit issuance. LENDING AGENCY Name Address OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: , K. I ❑ Proposed Change of Occupancy v (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: Bldg SRA Receipt #: Sheriff "K�5 SMIP Date: (51 Other Total REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed b the engineer. Mobile, Manufactured, or Modular homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). - ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS1BIdgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 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: v�. �" \ ASSESSOR PARCEL NUMBER `�10' v /� Proposed Building Use: Counter Technician: Date: - 1-5-6y Items required in order, to ppl r a permit. All boxes MUST be checked OR marked NA in order to ly. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. 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. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data.sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet-signedby the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) -� ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ............................... *................... ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. �, �„ •� ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ X26. NPDES Form............................................................................................. V`-28. 27. Encroachment Permit for driveway from the Pi bliic Wolks Dept ........................... Pre -Inspection for U�P�cxcu �C��; � required....... ❑ 29. Contractor's license in rrriallon. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation CarrieInd Policy Number ....................................... a. 31. Owner -Builder Verification (_✓Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone and hold for pickup. I have been i rmed ft e abov items and require ents for obtaining a building permit. -7)Applicant: Date: % Co Ll 1. Index per ' a I t'o for the above items numbered: Plan Check Letter 2. Additi nitem �requ red Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, - ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division O.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this -verification is received. Y personally plan to provide the j or labor and materials for construction of the proposed roperty improvement :YES NO ❑ HAVE ❑ HAVE NOT signed an application for a building permit for the proposed work. I have contracted with the following person (fun) to provide the proposed construction: nM:E: ADDRESS: CITY.. PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, butl have hired the following person to coordinate,- supervise., oordinate,supervise, and provide the major work: NAME: ADDRESS: PHONE: CITY: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS' PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: DATE: Q NOT'M This Owner -Builder Verification is required by Seaton 19831 and 19532 of the California Health and Safety Code, This verification must be coWleted and returned to our office before we are permitted to issue the permit. •iDI OWNER BUILDER INFORMATION Dear Property Owner; OB. -1 An application for a building permit has been submitted in Your name listing yourself as the builder of property improvements specified. For yourprot=&A you should be aware that as "owner -builder" you are the responsible party ofrecord on such a Permit Building Pemifts are not required to lie signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yoursel, 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 iammediate family, and the work (mrluding materials and other costs) is $300 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 const register wA the State and Federal Govemmenis as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation imsur-ance, disabilAy mso7rance costs, and unemployment compensa#ioa conkftWns. Tbere may be financial risks for You if you do not carry out these obligations, and these risks are especially serious with respect to worm's compensation bsu ance. ♦ For more specific III&Mx3tion about your obligations under Federal Law, coact the Intemal Revelme Service (and, ate if you wish, the U.S. Small Business Adminfstration). For more specific information about your obligations under StLaw, contact the Department of Benefit Payments and the Division of industrial Aaidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work Gond ionpeps. nallY or (rough their own employees, without a licensed contractor or subcontractor, only under limited A frequent Practice of unlicensed persons pnvfessing to be oonlract m is to secure an "owner builder" building Pew =On=* aaplyimg that the pmperty owner is providing his or her awn labor permits are not required to be signed by property Own= unless and material personally. Building inf nation about licensed factors may be obtained are Pig their own work personally, community or at 102014 St eA S ecto, CA. 95814. �e State Board in your Please ly � �mP � a�Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these mattam The building pmmit will not be issued >mil tha verification is retumed. NOTA Y715 Owner-Butlderrnfo"Mrwn Is rep tred by Section 13830 ofthe Cagornia Health and Safety Code 07/13/2004 13:48 5305387991 BUTTE COUNTY ASSESSR PAGE 01 BUTTE COUNTY ASSESSOR 25-.County. CeftteF Drive, ' Orovillc, CA 95965 Fax Cover Sheet DATE: Tac - el•a&- FROM' _- Hoy,. n pKONE:_: FAX_.. (5W63,8-7111- .. RE Numher.o'Lpages_indudinp_.cover- sheet:._ Message: 2ymxzo SrrympAr—Q RG=04WJ,a4PD lw+ rrm 50 5 Rev. 12f9 i (c:word/msofficclwirEwordlfor�s/faxcavcroro l03)- A/O 103 / rT&:)la..L:V 1 JAL d.L MUllffte fftGUU U- ;i i � ,� AOaRESS f Cds ns I S�E£T Gos1 Un I Cost �. � � • L ra/C 'i Co.,cost cv t DECR/pT0Of8UlL DIN , t tl.ASS,d SM&E C owsMuCTIdN STRUCtURAL, E TERI R OOF L16 TING, At GO DITION I ROOM A D 'f NlSH DETA/t '_• (iynl , _.___ l'ieme Siucm oa fioi �i Pi1cA f-Wirlli { 9 rk�o/i "9' i I� ROOMS • L00 S FLOOR FfNISN INTERIOR FINISH QSre-sion�ord_ ✓ �'J•':�` Nt '%; yd , ' KT 1, Ca!�uir Forced, '40?� TRJIi Q ( 2; Md1erle/ Lro?E 16ovsI IC(�i/in s CL RCH/ ECT RE s✓—old.o >nofhia Sibin &la !e B K. oble 'ro✓i/y';ti'u..iid /lI �- IMve -s �an�aorb' 4Lexre.e B/oc.(� Sh[b / fiX ores Nb/r Ghf , Sfanes SpEcn;l �6 d. ) b G , ` Cuf. Up ' few f Chop fnl. me// USE .TYPE DoimErs Oro. e�ba+ '%a v t / 3+'nyie umvi rto tJ 1!e'obe Snakes Mfony dp►!&O/ ZoneW.if Dmnq •• (soublp tf . 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