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HomeMy WebLinkAbout035-420-032- 35-42-32 Sunbeam Const.Co. 5315 Becky Lane, lot 111, Crestwood ° Sub#2, Oroville Permit �k3981-80B,P„E,M(// �� le�� family)- .7 a 1 035-420-032 _ 06-2192 QUEEN, JOANN 5315 BECKY LN, QROVILLE Cont: OWNER ° RE ROOF i a 1 r i wl ���Cl �::Yrr v .t..•k.•. s.�.i. K-!'Y',.`a.R •.�'i�' 11i�..� .`t Y• ...'t,�, 035-420-032 06-2192 QUEEN, JOANN r� •� --rt c�' NOTES 53 15 BECKY. LN, ORQVILLE, ContWNER"RO (RE ROOF rT�T7.t!_ ".a'w f t �R"s °•<`. RESIDENTIAL ` APN: Permit No. Owner Site Address: Contractor. Type of Permit: SPECIAL CONDITIONS CHECKED BY Q SRA Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED Q SPECIAL INSPECTION ITEMS HVERffIf _ USE PERMIT CONDITIONS Q SUBSTANDARD HOUSING LEITER Q ENCROACHMENT PERMIT Q REINSPECTION FEE PAID Q ENV HLTN CLEARANCE F Ley e;r b�p DATE JOB FINALED: _ n® SIGNATURE: R { i SPECIAL CONDITIONS CHECKED BY Q SRA Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED Q SPECIAL INSPECTION ITEMS HVERffIf _ USE PERMIT CONDITIONS Q SUBSTANDARD HOUSING LEITER Q ENCROACHMENT PERMIT Q REINSPECTION FEE PAID Q ENV HLTN CLEARANCE F Ley e;r b�p DATE JOB FINALED: _ n® SIGNATURE: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds 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 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: 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 subject.q 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 riot apply to an owner pf property who builds',or improves thereon, and v0ho 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.). ❑ 1 am Exempt under Article 3 of the Business a Professions Code Date )3- 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: PERMIT NO. BP062192 Issued Date: 09/13/2006 APN: 035-420-032-000 Site Address: 5315 BECKY LN ORO Map Index: Description: RE -ROOF (20 SQ) Owner: QUEEN JOANN D SS 5315 BECKY LANE OROVILLE, CA 95966 Applicant: QUEEN JOANN D SS 5315 BECKY LANE OROVILLE, CA 95966- (530) 534-0963 Contractor:. . License # Architect: Engineer: Carrier: Total Square Ft: 0 S. F. Policy#: Valuation: $0.00 Code: ViceCensus I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, L, �V and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall h �^ �� r• forthwith comply with those provisions. Date:.9—� Applicant: WARNI 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.) Name: This permit is hereby issued under the applicable provisions of the Butte County Code ?nrUpr Res0 BY ut�ns to do work indicated bove or which fees have been paid. I crt Date: �( t l PERMITEXPIRES ON: Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use 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. p 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 cbOnty 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: O Yl Signature: £J Date: — O caner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor +=OK o"= Not OK MANUFACTURED HOMES MISCELLANEOUS - DATE PERMANENT FOUNDATION SOFT -SET ----DATE D E C K rC O V E R S'C A R P O R T S tG A R A G E S 1 ZoningSetbacks-Easements 1 Zoning -:Setbacks -Easements 2 Soils; Special MH Support Sketch 2 Figs; SoilsSz4:)pthSpacing-CnnctrsSteei 3 Sewer, Loctn-Test; Fall/C/O-Concrete 3 Decks, Girders/Joists-Dcking-Brcing 4 Wtr, Loctn Test -Easement Needed -Regulator Stairs-Guard/Handrails 5 Elec Loctn-CImcs-Gmd Ampconcrete 6 Yard Gas; Loctn Test -Wrap - Nat D or LPD 4 Wood Awn; Posts-Beams-Rftrs-C_nnctrsShthg• Frmg-Brcng Inch Sz Ft Lngth 5 Alum Awn; Columns-CnncinsSplice-Decal-Enclsrs 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test -Demand Valve-Cnnctr 6 Carports; Wndws-Doors 7 Electric 9 Elec MH Cntnty Test-Crossovers-Breakers-Cirncs 8 Frmg; Sills-AnchrsStuds4bcm Trtisses 10 Drain; MH Test -Fall -Flex Cnnctr 9 Siding; Nailing -Veneer -Stucco -Lath 11 Wtr & Sewer Connected -C/O to Grade10 Roof, 5hthg-Roofing . 12 Gas and Electricity Tagged 13 Tie Downs D Foundation 11 Ext Steps -Doors -Landings 12 Braced Wall pnts 14 Exits 15 Cert of Occupancy 16 HUD Labellinsignia Numbers Serial Numbers °$ 41'' ° DATE JPOOLS 1 Setbacks -Easements 2 Soils; -CompactionStructure Stability ' 3 Pool Structure; Steel-Cnnchu-Thickness Dead Men-LJning 4 Elec Rcptcis/LUng; Distance -GH 5 Elec Pool L,ting;15 volts-GFI ` 6 Elec.Ench;rs; Conduit Entries -Terminals -listed °,a °ter a • °� 7•Elec Bonding; Metal w15-Crdtng Eqp-Itr 8 Elec Grndng; Eqp w/5' Crdtng Eqp-Pool Ightg Boxes-En&-.r;-pnlboards . nsultn to Main Conduit 9 health Dept AppM ' :10 Pimb; Cir Test-Wtr Supply Test = 11 Lt Niche 12 Endsr, Fencing -Alarms ' 13 Bonding, Diving board or Slide , =Nat RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Gmd Ftp Dpth 3 Ftg Garage; SoilsSteel-Elec Gmd Ftg Dpth 4 Ftg Parches/Decks; Soils -Steel Ftg Dpth 5 Stemwalis 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 CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test Anchrs-RgitrService Test 12. Efec Undrgmd 13 Plenums & Ducts; CImc-MaterialSupportansultn 14 GirdersSills-Anchr BoitsJoists Vnts-Cripples 15 Acc & VnUtn 16 Insulation DATE FRAMING 17 Silts Proper Materials & An 18 iiAls Studs -Nailing Spacing & Braces-PlatesSound 19 Bearing Walls over Girder :A fir Nailing 20 Draft Stop in Walls (iat Proof) 21 Fire Stops; Furred CeiGngsStairs-Chasers Tubs 22 Headers 8, BearesSi &•Bearing' 23 Hangers-P•ost'Caps-Anchrs-Cnnctns 24 Ceii'ing Joist-Rftr Ties-Pttrf't -Roof Brac TrussShthg 25 Frplc Ties or `type A Flue:f • Ic Throat Clrnc 26 Attic A&z Sz &Tim�i F.itctjiStop4ns Baffles 27 Bdrm Wndws or EXiting 1)oorsSlfl lit & Dimensions 28 Garage Ftre Prtchi Fnimfng-RC Charinei 29 Prprty Line Firewall -& Opngs' . 30 Ext Doors -One 3' -Check Garage 3r4 Story, 2 Exits 31 Stairs; Width-Hiirm-Rise-Rim-Land`ing-Fire Prtctn 32 Plywd on koof Ovrhng-Attic Vnts-Rftr Outrgm 33 Sidmg-Nairing Veneer - 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Area -Class PrtctnSkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insults Walls -Ceilings 39 Infiltration -Walls -W ndws DATE JELECTRICAL 40 Fxtr & Tmsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcts Spacing-Dts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Gmd made up w/Mech Fstnm 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires In Ktchn & Cndctr Sz GFl 47 Subfeed Wire Sz rA ElcU orAL AC Wire Sz Qa [] Cu or AL 48 Range Ckc pa Q CU or AL Oven Circ Qa Q CU or CIAL Insulated Neutral 0Yes ❑ No 49 Service -Riser Cndctrs & Gmd Main Dscnnd 50 Eqp Cimcs pnls-Motors-Meeh Eqp 51 Clothes Closet UShwr Lt -Spa Lt 52 Smoke Detector DATE PLUMBING 53 Wtr Htr, Vent-Acc-Cmbstn Air Baffle 54 Wtr.Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr.Nail Pr(ctn 56 Shwr Pan; Test, First fir Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub Ace 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler, Test 60 Yard Gas Piping a o' gs o,P ops` DATE MECHAN'1CAL 61 AC Ducts Insulin & Support 62 Vent Fan, Exhaust abv Insulin 63 Condensate Drain & Ovrtlw, Sz & Grade 64 Furnace -Vent Acc-Comb Air RtnuVent 115 Outlet 65 Attic Acc & Pltfrin if Furnace In attic o'{ 41 DATE dr DATE FINAL 66 Ext Steps -Door & S1deU Pdctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts- Mlech Prtctn 69 Bedroom Exiting 70 GFl 8. Bath Fxtrs & Tub Acc-Spa 71 GFl Arc Faun 72 Elec Trim & Subpni, Breaker Szs & Labels 73 Stairs, Guard/Handrafls 74 Frplc or Stove, Clmc-Hearth 75 Elec Outlets at Woo4 Pnl, int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-AirGap-Cooking Cimc 77 Elec Outlets & Rcptcs at Ktchn Counter 78 Garage Fie Dobr, Swing -Landing -Closure 79 AC Dud In Garage -Damper. 80 Wtr Mr. Vnts-Cimc-Com Air Cnnctr-PRY; abv fir Mech Prteln; LPG Appince Undr House 3' drain 81 Pimb; Elec & Mech Egp Listed for Loctn 82 Elec Rcptcls in Garage (GF) Romex Prtctn 83 Insults -Foam -Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vats & Crawl Hole Door Dmge & Wood -Earth 86 Cimc Drnge Planters Q Yes Q No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb�lppinc-Frplc-CImc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GF Reptcl-Undrgmd 92 Vntitn thru House 93 Glass Prtctn 94 Corrections from previous hispetns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE)' (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.bulltecounty.netWds - PERMIT NO. BP062192 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/13/2006 APN: 035-420-032-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 5315 BECKY LN ORO Date: Contractor. Map Index: Description: RE -ROOF (20 SQ) 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 Owner: QUEEN JOANN D SS to its issuance, also requires the applicant for such permit to file a 5315 BECKY LANE signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA 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 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 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 Applicant: QUEEN JOANN D SS Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 5315 BECKY LANE such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95966 sale. If however, the building or improvements are sold within one year .of completion, the owner -builder will have the burden of (530) 534-0963 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 Contractor:. 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.). O 1 am Exempt under Article 3 of the Business qW Professions Code Date t7 3- b Owner: C W__aA_ License #: WORKERS'COKiPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 Architect: is issued. Engineer: ❑ 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: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Y I IO V and agree that if I should become subject to the workers' 1 compensation provisions of Section 3700 of the Labor Code, I shall Z� /^ ((j I forthwith comply with those provisions. 1 Date: Z-/,3--(, r5 `-') h - I �- 06 1 Applicant: WARNIlif 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 Cods and/or I hereby affirm that there is a construction lending agency for the Resoluti As to do work indicated bove or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) (� � r By. Date: -I - it -)�ZI Name: PERMIT EXPIRES ON: Address: Date ❑ 1 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 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all coOnty 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: O Y7 Signature: el '- `— .6 Date: / 01:5wner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name wee first Mme n M ' ' dd es Ci ct. City o Y • zz�I States � Zip9�'� S3 I/ D vl 3 Faro h� E-mail- 0 State APPLICANT INFORMATION CONTRACTOR Name/b�141 City Address Address City ram cr City Zip State Subdivision Name Zip Phone Page Fax Planner E-mail Date Approved: Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Subdivision Name Fax E-mail Page State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Al 035_2 ' 2 Zoning � Flood Zone WORKER'S COMPENSATION SRA I Yes I No Occ. LENDING AGENCY Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP BIN # PROJECT LOCATION Al 035_2 ' 2 Property Add r��--c-�1 � Cross Street LLQ �� WORKER'S COMPENSATION Policy Number C rri r If hiring anyone other than license contractors, a dertificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Aid r-6 0 F-� - Rbof 20 Sq FT- Living Garage L Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. I I Received by:.V Amount: (Io•� Bldg I I Receipt #:4(c 13Z wkDI�i SRA Sheriff SMIP 1Date: -i -OCA Other I I 1 Total K:\Building\WEBSITE FORMS\BldgApplSubRgmts82506.doc Page 1 of 2 REV 8-25-06 a 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 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 faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, (E) Manufactured Home Support Data (form available on our website) all in duplicate ❑ 7. Metal bidgs: (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 (if building in the City of Biggs). ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 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). If your project is located in State Responsibility Area (SRA), you are required to meet the SRA Fire Safe Requirements sheet. ❑ 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. ❑ 13. Planning Division approval for parcel check, use and parking (if required). If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. A FEE WILL BE REQUIRED AT TIME OF APPLICATION. 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 KABuilding\WEBSITE F0RMS\B1dgApp1SubRgmts82506.doc Page 2 of 2 REV 8-25-06 a. 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. 1. I personally plan to provide the major labor and material for construction of this proposed property -improvement: YES f[ ] NO [ ]. 2. I HAVE [.J HANE 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: _ A.DDRES S : 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: ork 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: z 3 b �f NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. 'rl,;r cn-r-;9t-at;nn miict hP rmmnlPtF-A and rPtiimpji to n'ur office before we are Dermitted to issue the Butte County .department of Development Services 0 ADMINISTRATION `BUILDING `GIS PLANNING o� �0 p 6 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile C�UN�y OWNER -(BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do'your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specibc information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or. through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, Califomm 95814. . Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector F PE,QMIT NO. 3.981-80B,P,E,M - PERMIT EXPIRES `Sunbeam Const.Co. �y OWNER owner �CONTR. 35-42-32 LOCATION. (A.P. ) 5315 BeckyLane,. lot 111, Crestwood Sub#2,Orc i e I. :u lC' F� A Temp. Power Pole ( Called G&E Temp. El c'. Serv. l Cal ed PG&E D -Tem p Gas Serv. alled PG&E L� �OB FINALEDZko (Date) (Signat IV7 J North. Burbank Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95965 Telephone 533-2000 DISTRICT APPROVAL AND 167-80 VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. C3 Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North Burbank Public Utility District, must be submitted to Butte County. ci Applicant: SUNBEAM CONSTRUCTION CO. �v Applicant Address: .11190 HOOPER LANE, LOS ALTOS HILLS, CA 94022 Applicant Phone No.: 415-948-6482 Property Location (s): 5315 BECKY LANE. OROVILLE CRESTWOOD UNIT NO. 2, LOT 111 035-42-0-032-0 A. P. No. (s): Fees Paid: $300.00 SCOR FACILITY CHARGE PAID 6/29/79 NBPUD CONNECTION FEE UNPAID Application for service approved: North Burbank AUGUST 6, 1980 Public Utility District Inspection(s) made and successful test(s) observed: Location: LOT—& Date: By: North Burbank Public Utility District release to close permit: Date: By: RES I AKNT I Al. FNFk(;Y CO.!",IAVAT]OIJ' 1,17ANDARDS CONSTRUCTION CiNPLIANCE CERMICAT1.7, THIS 1S 5) CERTIFY THAT ENERGY CONSERVATI*ON REQUIRE-MENTS IL -%V]--, BEEN WLTII C1JRkEN'l.` ENERGY CONSERVAMON REGULATToNS 6_� (location) I'll) I 1 1) 1 N(; PF kill rT No. A. P.- NO. THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or. write. N/A if not applicable) INSULATION: S L-th Fkl),.c NA .Special (Insulated) NA Floors & SLIDING DRS. W J, WEATUHRSTRIPPEn DRS. NA BACK FANS NA Circulating Plpcs-, NA Allili-:i)VFJ) HFATI.J., NA IWO)= M.M. NA GLAZING: Sinije. GlazedA A .Special (Insulated) —AN-- 00— CrRT. & LABELED WDS. & SLIDING DRS. NA WEATUHRSTRIPPEn DRS. NA BACK FANS NA A;NITEON DEVICES NA NA I DECLARE THAT ALL RE'HIRED ITrMS AS NnTFD ABOVE HAVE BEEN TNSTALLEI) 1:1 A000iJ)AN`CI-: 1J 1.'M THE ENERGY CONSERVATION REQUIPMEWS AND AGREE TO THi-: (':()tHI'1J:TFNFSS OF THIS CERTIFICATE AS TIBMITTED. Jiv:uIaLit)n Appl ic;tLor Name._ Hawkins Insulation QojDc. Signature ol: (pll ase print) insulAtion ApplicatQr General Cont ractor/("icr Wune Signature of Gell,•r.11. COn t rac tor/Ovnicr State Contractors License No, 3784o7 - (please print) Date State Contractors License No. TM CENTFIWATE NAST 'BE ON FILE WTTH THF. l',111-LDING DEP.AR'lTII-',NT PRIOR TO F1,;;A1. AND SHALL LF IN A CONSPI'CIIOII': LOCATION ;TI I I THI.: 1 RESIDENTIAL ENERGY CONSERVATION STANDARDS _ CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY.,THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION. REGULATIONS AT Lot /// CRESTWOOM SUBDIVISION TINIT NO P -• (location) BUILDING PERMIT N0. f'l — S'ro _ A:P N0.�— THE FOLL014TNG HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not.applicable) INSULATION: Slab Edge._ Fdn. Walls Floors NA Walls. x Ceiling/ X Ducts x Circulating Pipes NA APPROVED HEATER X APPROVED WTR.HTR. X GLAZING: Single Glazed;,, NA Special (Insul'ated). X' CERT, & LABELED WDS.- & SLIDING DRS.' X WEATHERSTRIPPED DRS. NA. BACK DAMPERED FANS X. INTERMITTENT IGNITION DEVICES_, CERT. APPLIANCES X I DECLARE THAT ALL REQUIRED ITEMS AS NOTED.ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH; THE ENERGY,CONSERVATION REQUIREMENTS AND AGREE TO.. ^' THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. ; Insulation Applicator Name SEE ATTACHED (please print). Signature of .Insulation Applicator State.Contractors License No. General Contractor%Owner NameSUNBEAM CONSTRT�'mTnrT COMPANY (please print) Signature of General Contractor/Owner DateAUG V1St1C82S State Contractors Gregory T. License Na: 1 2 0 THIS CERT IF ICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) Signature = OK = Not OK = Not Applicable RESIDENTIAL.(Sing,le and Duplex)' = Not Ready Date UND FLOOR Plans OK except #'s Date FRAMING (Continued) I-"Zgning requirements-Setbacks-Easements.r7ti►•Property Line Firewall & Openings tg.,Vt4ain; SoSis-St -Ele rnd.- / Ftg. Depth xt. Doors -One 3' -Check Garage -3rd story, 2 exits 8/Ft , GgaCfe; S ' s -Steel- / Ftg. Depth -Jfl-'Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection t ,Porches &Decks; Soils -Steel- / /" D th ,ywood on Roof Overhang -Attic Vents -Rafter Outriggers temw , M ; w -Bloc uts- r SI 3&. -Siding -Nailing -Veneer 6. Ste Is, ge; Sta9ILBIQ4 uts-WrWppe -66-•Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access r9 -Piers -Fireplace Ftg.-Steel O/ .111//S 17-6 lazing Area -Glass Protection -Skylights -Plastic W.V.: Fall -Fittings -Test way - ewerr Test 35-�-Shear Walls; Nailing -Bolts •-9-Gas Pipe; Size -Anchors r" 10. Water Pipe; Test-Anchors-Regulator-Servi est dd- Electric; Underground -'W- Plenums & Ducts; Clearance -Material -Support -Ins. 43- Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date BI Date Card -BI Date Card -BI Date n ® Card -BI Date Card -BI Date Card -BI Date Z� Card -BI ate C� -� �O Date FINA (Plans) OK except #'s tel -Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLU ING (Permit) OK except #'s 27v,�tfoke Detector W_4ter Ht.; Vent -Access -Combustion Air W. Furnace; Vents -Clearance -Comb. Air -Connector - Ducts-Mech. Protection W er Pipe; Test & Anchors -Nail Protection D�W.V.; Test-Fttngs & Anchors -Nail Protection Bedroom Exiting Shower Pan; Test, First Floor -Tub Access F.I. &Bath Fixtures &Tub Access --1A Iagt Tub & Shower, 2nd Floor -Tub Access Elec. Trim & Subpanel; Breaker Sizes -Labels Gas Pipe; Size & Anchors 69, Stairs Stairs & Rails •69--F'replace or Stove; Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date t. Fixt. & Appliance; Grnd.-Cookin Clearance Card -BI Da Card -BI Date Pec. Outlets & Receptacles at Kit. Counter Date ELEC RICAL Permit OK except #'s Garage Fire Door; Swing -Landing -Closer V60 -C. Duct in Garage -Damper V. Fixture &Transformer Clearance -Ins. Protection Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- -Mach. Protection Elec. Receptacles Spacing -Lights & Switches at Doors Elec. & Mech. Equip. Listed for Location Siz .Boxes & No. of Conductors -Stapled ec. Receptacles in Garage; (G.F.I.)-Ro ex Protec. ex Installed Close to Edge of Studs & C.J. . Insulation -Foam -Looked in Attic es qu' . Ground made up w/Mech. Fasteners -Bond Gas & Water �5uard Rails & Deck Construct ion -Posts l�pIiance Circuits in Kitchen & Conductor Size 'PeF-Draita�ge &Woo rth Clearance s �Su ed Wire Size / / ga. C or AI-A.C. Wire Size / / ga. Cu or Al _ XW-Range Circ. / / ga. Cu o � OO en Circ. / / ga. Cu or AI, sula Neu rat CYes �o Following instld.: Drive es No; Walks Yes [3No; Planters 11 Yes o +�6.. Stucco; Brown -Finish S ice-R.iccr.fendeeWFs & nd-Main Disconnect -P9-• p. Clearances; Panels-Motors-Mech. Equip. A C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet . Clothes Closet Light -Shower Light . Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. Card B -I Card B -I -Date and -Bi Date Date Card -BI Date -Q. Water Well; Disconnect, Electrical, Plumbing 901"Exterior Elec. Trim; G.F.I. Receptacle -Underground entilation throughout House 8Q,/Glass Protection Date ME HANICAL (Perrr,it) OK except #'s _ %Corrections from Previous Inspections as Test -Meters Tagged; Gas -Electric A. C.Ducts: Insulation & Support _ VVent FhInsulation C�^ _an: Exhaust abovensuon 9&- Condensate_ Drain _& Overflow; Size & Grade . W r & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates aao"Furnace-Vent;Access-Comb. Air -Return Air Vent -115V outlet ..21 Attic Access & Platform if Furnace in Attic /// Card -BI Date /� /L�Aard-BI _ _Date Card -BI Date / ! Card -BI Date Card -BI Date / Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMI (Plans) OK except #'s Comments at Final: jo�ills; Proper Material & Anchors lls: Stu -ds -Nailing, Spacing 8 Bracing-_Plate_s_-Sound Z*aring Walls over Girders & Floor Nailing _ raft Stop in Walls (rat proof) ire Stops; Furred Ceilings -Stairs -Chases -Tub t _ Header & Beam -Size & Bearing _ ,.4agers-Post Caps -Anchors -Connectors -::;,H Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq,-Rfnp. .64... Fi place Ties or Type A Flue -Fireplace Throat 4�A Access; Size & Romex Protection -Draft Stop -Ins. Baffles . Windows or Exiting Doors -Sill Hpt. & Dimensions Garage Fire Protection Framing _ (NOTE: Anentrymust be made each time you visit jobsite) J =OK O = Not OK - = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans).OK except H's - 1. Zoning Requirements-Setbacks',=Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1, Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -6/b -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) - 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete _ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L" ft:/' /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date i Card -BI Date Card -BI Date Card -BI Date Card -BI Date r Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME 1 STALLATION (Plans) OK except N's Date POOLS (Plans) OK except k's 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connec ed -C/O to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment Neater 8. Gas and Electricity Tagged' 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes-Enclbsures- Pane Iboards- Ins. to Main in Conduit ; 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test �..% Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date EI 9 - J l l F� tr rootins Footing ELEtTR AL Masonry Walls Throat Rough 2 U C) Reinf. Steel Final t,Fixtures a Bond Beam FIRE SPRINKLERS Motors Framing /6 Z Test Water Htr. - Stucco Final Subpanels Mesh MECHANI Al_ Grd. Fault Prot. l< / Scratch -Heating Service Brown Cooling Temp. Pole j Finish Ducts O y C7 Underground I Interior Lath P 4 VentRationRgmane Al Door Closer Final final l / U MOBILEHOMEUTILITIES --------------c- Service ec. Pedestal Water Piping Sewer Gas Piping BI E OME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDIN Cont'd) P MBINf. Setback Firewall Soil Piping1 Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwaII'Siding 1p To out ' oZ �4 Slab Roof Sheathin Water Piping _Ez Piers Roofing Sewer Q % Garage Fdn. Vents �— Fixtures VA Footings Stemwall Garage Vents Insulation /// d Water Htr. Heaters // Slab Car Port Footings Prov. for ph slcally handica ed Conformance of ex. r 9 Appliances Gas Piping &Test C4 Temp. Gas Slab /Find /11131Y0 S tion Patio FI EPLACE rootins Footing ELEtTR AL Masonry Walls Throat Rough 2 U C) Reinf. Steel Final t,Fixtures a Bond Beam FIRE SPRINKLERS Motors Framing /6 Z Test Water Htr. - Stucco Final Subpanels Mesh MECHANI Al_ Grd. Fault Prot. l< / Scratch -Heating Service Brown Cooling Temp. Pole j Finish Ducts O y C7 Underground I Interior Lath P 4 VentRationRgmane Al Door Closer Final final l / U MOBILEHOMEUTILITIES --------------c- Service ec. Pedestal Water Piping Sewer Gas Piping BI E OME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS P MIT. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-454 APPLICATION A.ND PERMIT ASS SOR PARCEL NUMBER ZONIN A BUILDING PERMIT O , TEL PHONE y SQ. FT. OCC. BUILDING VALUATION OWSDA I G ADDR SS I C;-.4,. CONTRACTOR'S NAME - TELEPHONE CONTRACTOR'S MAILING ADDRESS CON T UC ON LEN R UNKNOWN Fireplace Total Valuation $ L ENDERS MAI LI ADD SS _SU i ��+ / Permit Fee $ ARCHITECT OR EN INEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ Br G ADDRESS PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 , Q Repair drainage or vent piping 2.00 Water piping 1 LOT NO. / z1VISION NAMEPARCEL eSZt MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets A� USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 010 Lawn sprinkler system 2.00 TYPE OF WORK New [/Addition❑ Remodel0. Utilities❑ Installation❑ Other Describe work: �- - Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 600v OR LESS 100 AMP OR LESS 5•00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING O OR ADDNS. ACC. BLDGS ) 20 sq ft CONTRACTORS LICENSE LAWNEw I declare under penalty of perjury (check one): Business ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) �] I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec.—, Business and Professions Code for this reason CONSTR MULTI-OUTLET2.SOea NON•RESID, BRANCH CIRC ITS 61 NEW CONSTR. NON-RESID, ( POWER APPARATUS SINGLE OUTLET CIR. / 50 @ as Ex. Occup(o OR FIXTURES BAL@10¢ IXED A Ex. Occup.(OUTLETS P(RESID IKEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 3.00 WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the.County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling 3DO Hood 2.00 Ventilation permit Fee $ ,� ID Contractor 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 authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agains said County in 4o equen a of griti,ng of this permit. Gtirw/ (�� X����• ,— . Date v Signature of Applicant — Owner ❑ Controctor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ �© TOTAL PERMIT FEE $ , Occu P. GROUP G 3 TYPE OF CONST. � PARCEL PD NO v ISSUE v This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR TOWBLIC By + PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS op DateJ �� Receipt No.q19 q� WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT This set of plans and specifications MUST he kept on the job at all times and it is unlawful to make any changes -or alterations on some without written permission from the Department of Public Works, County of Butte. NOTE:—AII Materials & Workmanship Shall Be in Accordance with Recognized Good Practices and of a quality prescribed for the Specified use in the Uniform Building, Plumbing & Machanical Codes and .the National Electrical Code: f• 'l A setback of 5 ft. from the property lines and a setback of 50ft. from the road zo . centerline shall be clear of structures or equipment except s�• for a 2• ft. eave overhang. o•' F .44-76 See Master Plan on file for building plans. .b•ii0�\: f j�y"Q/®O �98 OC4C�� SAL®6'®AA1®A, . X :BUTTE COUNTY, i AFFROVED' r M _ 6