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HomeMy WebLinkAbout035-222-026i t 035-222-026 -PERMIT#95.3023 JONES, Larry C . 913-68B LESUik,- .Rodger t..- 4853 Lincoln Blvd., OrovilleCont' Keith Orman �, 2 Reroof/SF/v:7co/� -222-26 9~. 4853 P" Rd., Oroville 035-222-026 CONTR: Farm & Home Const., F.O. Box 214382 OS -2882 LEASURE, ROGER (vinyl si ' ng) Sacramento 4853 LINCOLN BLVD, OROVILLE Cont: RYAN GULLETTE _ ELECSERV ; f YIN- I �o(� ' i 035-222-026 OS -3246 - LEASURE, ROGER - 4853 LINCOLN BLVD, OROVILLE ,. G Cont: KEN PAUL WINDOWS, SIDING 035-222-026 `'`OST3247 LEASURE,ROGER 4853 LINCOLN BLVD, OROVILLE Cont: PAUL KEN HVAC 'sti BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (630) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7641 PERMIT NO. BP053247 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 12/12/2005 APN: 035-222-026-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 4853 LINCOLN BLVD ORO Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): TZi I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3e 3 of the and Prpk-ode Date: WL Owner: `��/ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as -to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dale: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Address: Map Index: Description: NEW HVAC UNIT Owner: LEASURE ROGER W III 4861 LINCOLN BLVD OROVILLE, CA . 95966 (916) 825-1498 Applicant: PAUL, KEN 7832 WINDING WAY FAIR OAKS, CA 95628 (916)459-6901 Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: (2- i2- 05 This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated a ove Ir which fees have been paid. By: 2LA Ly { Date: PERMIT EXPIRES ON: 12-12- 1 (` O CD ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑'Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. C3Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: }. //>`/,( /,//I — Pe Gt1 5 % Signature - Date: ❑ Owner ❑ Contractor ErAgent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (630) 638-7636 (OROVILLE) (630) 891-2834 (CHICO) OFFICE #: (630) 638-7641 PERMIT NO. BP053246 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 12/12/2005 APN: 035-222-026-000 the Business and Professions Code, and my license is in full force and effect. License Class: License.Number: Site Address: 4853 LINCOLN BLVD ORO Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: REPLACE 7 WINDOWS, SIDING(680 SQ) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: LEASU RE ROGER W III to its issuance, also requires the applicant for such permit to file a 4861 LINCOLN BLVD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95966 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the (916) 825-1498 applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: PAUL, KEN owner of property who builds or improves thereon, and who does 7832 WINDING WAY such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for FAIR OAKS_, CA sale. If however, the building or improvements are sold within one 95628 year of completion, the owner -builder will have the burden of 459-6901 proving that he or she did not build or improve for the purpose of (916 ) sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Pro esl't7fi5 6 de Date:Z� _Owner. WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ 1 have and will maintain Workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S.F. Policy #: Valuation: $0.00 ❑ 1 certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. J Date: J f 12-i2-05 Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolu io s to do work indicate above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)Ir� Name: t n - By: Date: !' I ( ll ON: Address: PERMIT EXPIRES (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑. Notification in accordance with Section 19827.5 of California Health & Safely Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and slate laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butt/County to enter upon the mentioned property for inspection purposes. /above Print Name: ��_ S%— Signature: 616G1 (IJ Dale: // 7i/© ❑ Owner O Contractor Elf Agent for Owner O Agent for Contractor B. C. Building Permit 01-16-04 pg 1 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 OFAPPLICATION "PLEASE PRINT CLEARLY*.* APPLICANT SIGNATURE X For office use only: OWNER La am t.v First Nam Address v city 7 Stat Zip p0roL) M v/ E -mail Z �� APPLICANT SIGNATURE X For office use only: CONTRACTOR Name t.v Address r1` City State Zip Phone v/ Fax E-mail Planner Lic. # Class APPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name t.v Address r1` City State Zip Phone v/ Fax E-mail Planner State License Number APPLICANT SIGNATURE X For office use only: APPLICANT NAME Name t.v Addres Q3 r1` City �I 4 State Zip Pho E v/ Fax E-mail Planner APPLICANT SIGNATURE X For office use only: Zoning Property Address 0coin Flood Zone I SRA t Yes No Doc. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. :-9 BIN # LOCATION AP# b35 22 9, 0 Property Address 0coin Ci &Ov1I� Cross Street Sheriff 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: q—�OL� il� KeplUCecl I I Sq. Footage _ a ,., !W ❑ 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: Fj Amount: <6 5� . 5 -a --Bldg SRA Receipt # 10S I .. Sheriff SMIP Date: ' �y J ��_ 0 5 Other L Total SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to. the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS- WILL NOT BEA CCEPTED. 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'plaris (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). 0 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 by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs 6-r 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 preparers NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed cal culations,• . 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). z ❑ 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 KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 12/12/2005 09:52 FAX 916853926 CAPITOL CITY TILE Dee 12 05 10:00a Sidirig OWNER -BUILDER VERIFICATION Attention Property Owner: It 10003 p.3 Perris I 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. lO. I personally pian to provide theajor labor and material for construction of this proposed property imp ovement: YES[ q] NO[ ). Z� I HAVE [ HAVE NOT ( J signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S 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: NAME: _ ADDRESS: PHONE: 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: PROPERTY OWNER: DATE: I NOTE: This Owner -Builder verification is required by Section 1.9831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd IIW2004 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 591-2534 OFFICE 4: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER as Name First Name Q Address Q �l (J� Cityocl (% State /I Zi Ph VzS-/ J Fat?/,) 77 E-mail AP (CANT NAME CONTRACTOR Name City « 0 S Address SRA City Fax State Zip Phone Map Book Fax E-mail Planner Lie. # Class AP (CANT NAME ARCHITECT/ENGINEER Name City « 0 S Address SRA City Fax State Zip Phone Map Book Fax E-mail Planner State License Number AP (CANT NAME Name Addres Lt' City « 0 S S SRA Ph G 7U/ Fax E-mail APPLICANT SIGN X For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # LOCATION AP# O 13 5 ` 2- q_ Property Address Cily Lincoln Bl o aV�ll Cross Street 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: Sq. 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. C Received by:K G. Amount: 05. Bldg \, SRA Receipt #:I 1 Sheriff SMIP Date: 12' �� other 00 Total SUBMITTAL &PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED.. ALL PLANS MUST BE LEG/BLEAND IN INK' ❑ 1.`= Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. El 8. Manufactured homes: ()'installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) MetaiBldg.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. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site,plan and business license approval from the City of Biggs. ❑ .10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ ' 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ - 3. California Department of Forestry'plan approval (if required). ❑ 4. NPDES Form. 5. Encroachment Permit for. driveway from the Public Works Dept. (construction approval prior to occupancy). 6.- Contractor's license information. (Number, Name Style, Classification). 7. Worker's Compensation Carrier and Policy Number. 8. Owner -Builder Verification (if required). 9. Letter of Signature authorization (if required). 10. Recorded copy of Agricultural Acknowledgment Statement. 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action )n an application after expiration, anew 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 tears from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits ssued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan ,heck fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION ,AFORMSMILDING F0RMS\13IdgApp1SubRgmts.doc ' Page 2 of 2 REV 2-24-05 12/12/2005 09:51 FAX 916853926 CAPITOL CITY TILE 01002 Dec 12 05 10:00a P.2 OWNER -BUILDER VERIFICATION Attention Property Owner: HVAC F�rmJ 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. Ol I personally plan to provide the, major labor and material for construction of this proposed Prop" i rovement: YES j J� j NO [ ). 0J I HAVE [ ) HAVE NOT [ ) signed an application for a building permit for the proposed work. ' 3. I have contracted with the following person (firm) to provide the'proposed construction: NAME: ADDRESS: _ PHONE: CONTRACTOR'S LICENSE NO: 4. T plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDKESS: PHONE: 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 Si;GNED: . PROPERTY OWNER: aL-- DATE: k NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Pwv'd 11/4/2004 13/12/2005 08:52 FAX 818853925 CAPITOL CITY TILE Wjuu4 k.NT7 LLC December 12, 2005 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 530-538-7541 530-538-2140 fax RE: 4861 Lincoln Blvd, Orville, CA 95966 To Whom It May Concern., Please allow Ken Paul to pull any permit on our behalf necessary to complete the remodel taking place on. Lincoln Blvd. Feel free to call me should you have any questions. i Sincerely, eah Thomas Controller Leasure Developments BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO52882 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 10/19/2005 APN: 035-222-026-000 the Business and Professions Code, and my license is in full force and effect. License Class: o Lic se Number: 00 G Site Address: 4853 LINCOLN BLVD ORO Date: t'q Contractor: 1,04 Map Index: Description: ELECTRICAL SERVICE UPGRADE (NEW OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 PANEL 220 ) Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: LEASURE ROGER W III signed statement that he or she is licensed pursuant to the provisions of PO BOX 623 the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or ORANGEVALE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95662_0623 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon,; and who does Applicant: RYAN GULLETTE such work himself or herself or through his or her own employees, P.O. BOX 2984 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one ORANGEVALE CA year of completion, the owner -builder will have the burden of 95662 proving that he or she did not build or improve for the purpose of (916) 990-9282 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: RYAN GULLETTE pursuant to the Contractors' State License Law.). P.O. BOX 2984 ❑ I am Exempt under Article 3 of the Business and Professions Code ORANGEVALE CA 95662 Date: owner: (916) 990-9282 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 832461 l� I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy#: Total Square Ft: 0 S. F. ❑ I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith corttplyw''ith those provisions. Date: rr (/ vl Applicant: WARNING: Fai ure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. G a _ CONSTRUCTION LENDING AGENCY This permit is hereby issued under th app able provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Re oI tions t do work indicted a ve fo hich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: Z �(� BY zwwz Date: J PERMIT Address: EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize repre lives of Butte County to enter upon the above mentioned property for inspection pur s. Print Name: Signature: Date: I)r+ / iC1 /� I if ❑ Owner contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE 9: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION .Website: www.buttecounty.net/dds 'PLEASE PRINT CLEARLY'"'- OWNER LEARLY'* OWNER Last Name. LAA 5 Firs me 'Address Ckv CC State (f Zip P4LOac5 1 9 -6-S 'D& E-mail APPLICANT NAME CONTRACTOR Name Address f� Z City, Fax State( �Zis- Phon I cl Z�Z Fax I (-) q So- Z �7 E-mail Planner Lic. # .z Clash IO APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip' Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address L, �o /�� Flood Zone ___FSRA7 WORKER'S COMPENSATION Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS n,w+ 014-11 A__ PERMIT NO. r�5 ,Z$ BIN # LOCA TION AP#033`- ©ZCp Property Address L, �o /�� Cit Cross Street 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: e Sq. 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: . C, a Bldg SRA Receipt Sheriff ICfish SMIP Other Dae: _/j �� 61 C .1 Total RGv �_�d_ns SUBMITTAL & PERMIT REQUIREMENTS The,following drawings and specifications. must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED.. ALL PLANS MUST BE LEGIBLE AND /N INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans,, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. 'Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, -ail in duplicate ❑ 7.: 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 -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet'stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11 Detached Accessory Building Form filled out by the owner (if required). _ El12. Hazardous Material Form (for Commercial Buildings only). t± Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway.from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Workers Compensation Carrier.and Policy Number. ❑ 8.. Owner -Builder Verification (if required). 01 9. i Letter of Sig nature -authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11.. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan'approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541: EXPIRATION OF APPLICATION Applications for which'a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can 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 not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing -fees, plan check fees for work plan checked and other. department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 H 035-222-026 PERMIT##95-3023 LESUIR, Rodger ►,. 4853 Lincoln Blvd., Oroville Cont:,Keith Orman :+ Reroof/SF T,4`v`xt'T "��`�; fJP'•Yrs..,.�,�;,�•�a�;�..��,-g`.�v-�:=v� yea ;:yey1�(•»:.ly'a:�I �r�.irF.•R+rytr' COUNTY OF BUTTE- DEPARTMENT OF aSrrAIELOPMENTSERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 347-- ZONING BUILDIN PERMIT OWNER A - TELEPHONE SO. FT. -' OCC. BUILDING VALUATION OWNERS MAILINGREMj,V)SS _D A CONTRACTOR'S yNAME //�qs/L 'A ✓/ TELEPHONE CONTRACTOR'S�jjIUNG Fireplace CONSTRUCTION LENDER ' UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS' Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ —'Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS, / I /'1 l OG! 7 UC d0j l e r PERMITFEE $ [�3IX PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 f USE OF STRUCTURE j SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY I Water piping % 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑Utilities ❑ Installation ❑ Other ❑ Describe Work: Ae -e012,0 COA",4 � Mobile Home ISI GI W1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.00 Main Service OOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 i LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of p€rjury 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. t�- License Class LFA 9 Lic. No. 4 9p - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages'as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR SO. OR ADDNS. ( d ACC. BLDS. ) 3.50 FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES 20 Q 1.00 BAL so Ex. Occup. ( OUTLEETS ((RREslo.j OR5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 forwhich this permit is issued. My workef,s' compensation -insurance carrief and,poliay number are: Carrier .j fe'fo (.�j{�y)j>� y:!,d e,'Dy J "Set ✓G�/�'P 411 MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 .f Ventilation I• ' -PERMITFEE $ Contractor Policy.Number //Q_:' f �n w (rhe above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ "I certify that in the performance of the work for which this permit is issued, I shall I 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 Fl�E—�°:�'.� �'j'L F-�' Date %/ Signature of Applicant - ❑ Owner ❑ Contractor WAgent TTT An OSHA permit is required for excavations over 60" deep and demolition or construction" of structures over 3 stories iinn.height. Mobile Home Installation Fee $ Energy Inspection Fee : $ occ r CONST. TYPE � TOTAL FEE $ Ej/3, e 0 r; HAZ. D. FEES - IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. L r� BY Date PERMITEXPIRESON T Receipt No. A 6 WHITE-D.D.S.-B.D. I CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF 1016ELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER �y! by ZONING BUILD PERMIT OWNER e TELEPHONE q4 V SQ. FT. OCC. BUILDING VALUATION $ /nom OWNERS ,3 V RE$ ,D D V �- e . ` CONTRACTOR'S9, E TELEPHONE NE��� //j_ CONTRACTORS (LING RESS QQ y> !i1 0.4- �/9 / — `J Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ a ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESSe� Ca / ae2gbJ� /_ f� PERMITFEE $ �3eW PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISIONS NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Cdr /I P SOD T 7� Mobile Home I S I G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20.00 Main Service / OOOV OR LESS 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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. / Q'/ p- License Class L`—`'j �} Lic. No. (p 9x_? � OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR SO. OR ADDNS. ( 8 ACC. BLDS. ) 3.5¢ FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) BA0 @ I.w Ex. Occup. oFIXEEDrs PLNS. OR ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. XI 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 worker�ss' compens tion insurance carrie1 and poli number are: Carrier JY -CG fe D� (_6"IGI S'Q i d !q JASz4,- <qe P F� Policy Number /lj/Q g� — ,s (The above sections need not be completed R the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, 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 _ _ ` Date Signature of Applicant - ❑ Owner ❑ Contractor XAgerit An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee Is occ coNsr. TYPE TOTAL FEE $ 1/3, 0 HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for,which fees have been paid. By Date 2 �J PERMITEXPIRESON �/7 1-71— (pate) Receipt No. 1 TLy 4C3 I WHITE-D.D.S.-B.D. 9- CANARY -A SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �qc .t .s: t.�M.r_, ni.,«t. r ;y�};.�ry�f.«:a!�C: W'.�,rY+"•W yeT.pl�...'S ems.- �Y it"; •+•'7•r9. r:7,�a;�7yt¢..:r6S� C.r t1,��...r-�•�: �q.�a, a yV r S IS L DEC -18-199,22 61:41RI FROM / q�z ► TO 1-,3o2140 P. 02 m a 0 G TOTAL P.02 1 t - Butte County Department of Development Services. eurrf° ARE^ 1 N ® T E S 7 County Center Drive, Oroville, CA 95965 • l� (530) 538-7601 www.butteco.LtntyneUdds °Ouw<y RESIDENTIAL APN: Permit No. 3 — F035-222-026 05-2882 ---�_ — ll owner. .-L-EASURE,ROGER-_.. %V 2'je 1 -48-"LINCOLN BLVD, OROVILLE Si a ddress: d,wl non q CQ�N ' � Rai Lt �rin� uMG� Cont: RYAN GULLETTE - - ---`— :Contractor. ELEC SERV tvv p ,P gado stn. —S.ej . — — _-.� U - & Z/' n Type of Permit: ®; - 31q 7 H VAL IZ- /q -0r nn��+� G�A.G Jars- A,94 to ► � V o Ac o?S.1 ego 4,.O s e Lj r r OFFICE COPY Address q R(q 1 C i n C "`I GAS Meter By Date ELECTRIC N%---ZiJr' Meter By L, Date �� F ti CHECKED BY F ❑ SRA ❑ FLOOD CERTIFICATE EQUIRED ❑ FIRE SPRINKLERS REQUIRED ❑ SPECIAL INSPECTION ITEMS ] VERIFY Q USE PERMIT CONDITIONS } ❑ SUB -STANDARD HOUSING LETTER ❑ ENCROACHMENT PERMIT . ❑ REINSPECTION FEE PAID ❑ ENV HLTH CLEARANCE DATE JOB FINALED: / Z Z 7— SIGNATURE: = OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE 1UNDERFLOOR F DATE IPLUMBING 1 ZoningSetbacks-Easements-Flood-Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg.Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test Tt Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgrnd 13 Plenums & Ducts; Cirnc-MaterialSupport-Insultn _ 14 Girders-Sills-Anchr BoltsJoists-Vnts-Cripples 15 Acc & Vntltn 16 Insulation s � s DATE IFRAMING _ 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & flr Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrfir Acc 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration-Walls-Wndws DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or [:1 AL AC Wire Sz ga ❑ CU or ❑AL 48 Range Circ ga ❑ CU or ❑AL Oven Circ ga ❑ CU or ❑AL Insulated Neutral ❑Yes ❑No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector oma• It o 4 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Prtctn 56 Shwr Pan; Test, First fir -Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub, Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping DATE IMECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes ❑No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Cirnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C10 to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler S` S +=OK . 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE' PERMANENT FOUNDATION SOFT -SET ' 1 Zoning -Setbacks -Easements. 2 Soils; Special MH Support Sketch' .. 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd 'y Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap ' � Nat ❑] or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D E C K S'C O V E R S'C A R P O R T S `GARAGE S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-Dpth-Spacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts -Beams-Rftrs -C nn ctrs -S hthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath Y 10`Roof, Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls DATE TFOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr. 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bones-Enclsrs-pniboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms y 13 Bonding, Diving board or Slide 1 °9m Pool Drawing