HomeMy WebLinkAbout035-420-03935-42-39
Sunbeam Const.Co.
5334 Diane Ct., lot 104, Crestwood
Sub#2, Oroville
Permit #3976-80B,P,E,M(new single
fa mily)�� �lw*oo
B06-2517 035-420-039
MISCELLANEOUS Wall Furnace
GAS FURNACE HEATER
5334 DIANE CT
TUNISON,,RICHARD WAYNE
'Z/6 'C - Z'
LAS Ptap%S
T- P-1 6G'6 b IZ -
"U I I Ed %_Xjull I I
DEPARTMENT OF DEVELOPMENT SERVICES
INSPECTION CA"
24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico)
Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds
Permit No:
B06-2517 Issued: 10/25/2006
Address:
5334 DIANE CT OROVILLE
APN:
035-429-039 Permit Subtype: Wall Furnace
Owner:
TUNISON, RICHARD WAYNE
Applicant:
BROWN JOHN HEATING AND AIR
Description: GAS FURNACE HEATER
MUST BE ON JOB SITE
JOB SHALL BE READY PRIOR TO CALLING FOR
INSPECTION. THE INSPECTION CARD AND
APPROVED PLANS MUST BE AVAILABLE FOR EACH
INSPECTION OR THE INSPECTION WILL NOT BE
MADE AND A RE -INSPECTION FEE MAY BE
ASSESSED.
ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING
Inspection Type
1VR INSP DATE
Setbacks
132
Foundations / Footings
III
Pier/Column Footings
122
Grade Beams
114
Eufer Ground
216
Forms/Steel/Holdowns
122
Do Not Pour Concrete Until Above are Signed
Pre -Slab
124
Gas Test
404
Masonry Grout
120
Masonry Bond Beam
119
Underfloor Framing
149
Underfloor Ducts
319
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Gas Piping
403 L
Do Not Install Floor Sheathing or Slab Until Above Signed
Rough Framing
128
Rough Plumbing
406
Rough Mechanical
316
Rough Electrical
208
Gas Piping
403
Roof Nail
T29
Shower Pan/Tub Test
408
Fire Sprinkler
702
Do Not Insulate Until Above Signed
Wall Insulation
117
Ceiling Insulation
118
Do Not ver Until Above Signed
T -Bar Ceiling / RC
145
Gas Test
404
Stucco Lath
142
Stucco Scratch
143
Stucco Brown
144
Building Final
802
Electrical Final
803
Mechanical Final
809
Plumbing Final
813
Project Final
801 btbC_
ff FIR -11
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS
COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION
Inspector Copy
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.net\dds
PROJECT INFORMATION
Site Address: 5334 DIANE CT
Owner:
Pennit No: B06-2517
APN: 035-420-039
TUNISON, RICHARD WAYNE
Issued Date: 10/25/2006 By KCG
Permit type: MISCELLANEOUS
5334 DIANE COURT
Subtype: Wall Furnace
OROVILLE, CA 95966
Expiration Date: 10/25/2007
Description: GAS FURNACE HEATER
(530) 533-4951
Occupancy: Zoning: R1
Contractor
Applicant:
Square Footage:
BROWN JOHN HEATING AND AIR
BROWN JOHN HEATING AN)
Building Garage Remdl/Addn
1024 REGENCY DRIVE
1024 REGENCY DRIVE
CHICO, CA 95926
CHICO, CA 95926
(530) 345-4654
(530) 345-4654
Other Porch/Patio Total
FEE INFORMATION
Heater (Wall) $55.00
Total Charged: $55.00 Fees Paid: $55.00
Balance Due: $0.00 Receipt No: B642
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
BROWN JOHN HEATING AND i CSLB-825622 / C20 / 10/31/2007
Law for the following reason (See. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions 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
X 10/25/2006
the applicant to a civil penalty of not more than five hundred dollars [$5001;
Please check one of the following:
Contractors Signature Date
1. 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 Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
WORKERS" COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
1, As OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier: Policy Number: Exp. Date:
'is
(This section need not be completed if the permit To—r one hundred dollars ($1 00)—o—r Fe—ss.)
I AM EX EMPT under Section B. & P.C. for this reason:
CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
SSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
X 10/25/2006
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owners Signature Date
provisions.
X 10/25/2006
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property owner or am authorized to act on the property owner's behalf.
10/25/2006
CONSTRUCTION LENDING AGENCY
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name of Perimittee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
1:1 Owner 1:1 Contractor OR: 1:1 Agent for Owner DAgent for Contractor
INSPECTOR COPY
Lenders Address city State
CaICERTS - Certificate
https://www.calcerts.com/cf4r_printLcertificate.cftn?lots=44455&cert—...
CERTIFICATE OF FIELD VERIFICATION SL DIAGNOSTIC TESTING (Page I of 8) CF -4R
5334 diane ct. - oroville, CA 9S966 john brown htg @ air / 825622
Project Address Contractor Name / License No.
b06-2517
Contractor Contact Telephone
John Revok/I 530-518-1109
HERS Ror'�,l Telephone
/Y,_:X��bctober 25, 2006
CZ__-V Date
ing Signature
Fi . Revilak's HERS Rater
Street Address: PO Box 1609
Permit Number
44455
Sample Group Number
CC14-1798385037
Certificate Number
HERS Provider: CalCERTS
City/State/Zip:Magalia / CA / 95954
Copies to: Homeowner, HERS Provider and Building Department
This CF -4R has been registered with the CalCERTS@ registry in accordance with the Title 24 & Title 20 of the CCR.
CalCERTS@ is an approved HERS provider by the California Energy Commission.
WEIRS RATER COMPLIANCE STATEMENT
The house was R Tested El Approved as part of sample testing, but was not tested.
As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the
diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution
system is fully ducted and corrict tape Is used before a CF -411 may be released on every tested building. The HERS rater must not release
the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings.
The installer has provided a copy of the CF -611 (Installation Certificate).
New Distribution system is fully ducted (i.e., does not use building 6vitles as plenums or platform returns In lieu of ducts).
New systems where cloth backed, rubber adhesive duct tape Is Insi,alled, mastic and drawbands are used In combination with cloth
backed, rubber adhesive duct tape to seal leaks at duct connections.
MMINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT:
NEW CONSTRUCTION
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Values
1
Enter Tested 6ealoge.Fiew In GFM�
N/A
2
,Enter
Fan Flow: Calculated (liomInal 0 Cooling 0 Heating) or 0 Measured
Total Fan Flow in CFM:
998
3
1 Pass If 6eakage Pereentage * 6%, E 100 x ( 6ine 1 / 6ine 2
N/A�'
N/A
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out
4
Enter Tested Leakage Flow In CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct
System Alteration and/or Equipment Change -Out. %
314
5
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Du
System Alteration and/or Equipment Change -Out.
94
6
Enter Reduction in Leakage for Altered Duct System
[Une 4 - Une 5] - (Only if Applicable)
220
7
Enter Tested Leakage Flow In CFM to Outside (Only If Applicable)
8
Entire New Duct System - Pass If Leakage Percentage < 6% 100 x ( Line 5 / Line 2
Pass Fail
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC
Equipment Change -Out, use one of the following four Test or Verification
Standards for compliance:
9
Pass if Leakage Percentage <= 15% C 100 x ( Line 5 / Line 2
9.42%
R Pass El Fall
10
Pass if Leakage to Outside Percentage <= 10% C 100 x Line 7 Line 2
EI Pass El Fall
11
Pass-ifLeakage Reductio6. Percentage >= 60% [ 100 x Line 6 Line 4
and Verification by Smoke Test and Visual Inspection
E]Pass El Fail
12
Pass if Se.a.11 . n.6 of 011 Accessible Leaks and Verification by Smoke Test and Visual Inspection
10- Pass El Fall
- . . . : Pass If One of Lines *9 through #12 pass
I R -Pass 0 Fail
I of 1 10/25/2006 1:23 PM
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (Ibe
inibrmation provided on this form is required) After completion of ftal inspection, a copy must be provided to the building
department (upon request) and the building owner at occupancy� per Section 10-103(a).
HVAC SYSTEMS:
HeadnZEqA*mgW
Equip Type
(pk& heapump)
CEC Certified Mft.
Name and Model
Number
# Of
Identical
Sys=
Efficiency
(AFJI�, etc.)
(2�MlRvalue)—
Dud
location
(atticetc.)
Dud or
Piping
R-Valuc
Heating
Load
mtuft)
Heating
cap=4
(BW
4- C-1,
L11--g.s 06,9A
An
C
CWftE4*MVd
Equip Type
(Vk9, heg pump)
CEC Certified ME.
'Nam and Model
Number
Rof
Identical
Systems,
Efficiency
(SEEP. or EM)
(a-MIRvalue)
Dud
location
(attic,
Duct
R -value
coolins
load
Mtuft)
Cooling
capacity
(Btuft).
I. > symbol reads greakr-than or equal to what is irnficated on the CF -m vahte—
Lclude both SEER and EEK if compliance credit for high EER air conditioner is claimedL
,/ 011, the xmdersigned, va* that equipment fisted above is: 1) is the actual equipment installed, 2) equivalent to or
more efficient than that specified in the cerdficate of compliance (Form CF -IR) submitted for compliance with the
FAvV Fffxwxy Snvukrds for residential buildinA and 3) equipment that meets or exceeds the appropriate
requirements for mamifitctured devices (fiom theAppliance EfflamV ReguLations or Part 6), where applicable.
bstalling Subcontractor (Co. Name) OR General
Contractor (Co. Name) 05pwjnr
/6;� 0 4.4b, L�,
S
Date: .
Copies to: BUILDING DEPAXTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Aesidemlal ConWfiance Forna April 2005 -
INSTALLATION CERTMCATE (Page 4 of 12) CF -
Site Address Permit Number
!� -; -3 1 CIL 1A a(a -2 5/7 71
INSTALLER COMEPLUNCE STATEMENT FOR DUCT. LEAKAGE
INSTALLER COWLLANCE STATEWNT
Ile building was: -' 12Tested at Final v 0 Tested at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE:
E�P]Iemove at least one supply and one return regista, and verify that the spaces between the register boot and the interior
finishing wall are properly sealedL
P Ifthe house rough -in duct leakage test was conducted without an air handier installed, insped the connection points
between the air handier and the supply and return plenums to v%* that the connection points are properly sealed.
IffInspect all joints to ensure that no cloth backed rubber adhesive duct tape is used
E9 New Distribution system is fidly ducted (Le., does not use building cavities as plenums or platforms.returns in lieu of
duq�.
,/ EJ -DUCT LEAKAGE REDUCTION
Procedures for fieM verbleadon and dfwnos1tc tesdhL- of air dhtOudon smstwn are ava&ble in iMCM. Aavendft RC4.3
NEWCONSTRUCTION:
5CA fk 4 -aa (,x L&
Signature: -9 Ot
Duct Pressurization Test Results (CFM 25 Pa)
Measured
values
I
Enter Tested Leakage Flow in CFM:
Fan Flow- Calculated (Nominal:,/ 0 CoolingV'121 Heating) or 13 Measured
2
If Fan Flow is Calculated as 400 cfin/ton x number oftons or as 21.7 cfin/(kBtu/hr) x Heating
Capacity in Thousands of Btulfir, enter total. calculated or measured fan flow in CFM here:
3
Pass if Leakage Percentaga5 6% for Final or:5 4% at Rough -in:
0 Pass 0 Fail
[100 x L ______(Line # 1) # 2)11
ALTERATIONS:
Duct Systern and/or HVAC Equipment Change -Out
4
tem
Enter Tested Leakage Flow in CFM from Pre-Testof Existing Dud Sys PriortoDuct
31X
4
System Alteration and/or Equipment Change-OuL
Emu Tested Leakage Flow in CFM from Nnal Test ofNew Duct System or Altered Duct
5
System for Duct System Afteratio'n and/or Equipment Change-OuL
9
Enter Reduction in Leakage for Altered Duct System
Z- I Z
6
f —(Line # 4) Mmus —(Line # 5)] — (Ouly if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
Entire New Duct System - Pass if Leakage Perc=tage:5 60% for Final
E3 Pass. 0 Fail
8
100 x L _(Line # 5) # 2)11
M91 OR VERMCATION STANDARDS: For Aftered Duct System and/or EIVAC Equipment Change -
Out Use one of the following four Test or Verification Standards for compliance:
9
Pon if Leakage Percentage --. 15% [100 x [ _Y_X_(Lme # 5) / _21ff _ (Line # 2)]]
r/
Aff Pass 13 Fail
10
Pass if Leakage to Outside Percentage:5 10% [100 x L --(Line # 7) /_(Line# 2)]]
13 Pass 13 Fail
Pass if Leakage Reduction Percentage;-> 609% [100 x L --(Line # 6) (Line # 4)]]
'and
0 Pass 0
11
Verification by Smoke Test and Visual Inspection
12
Pass if Sealing ofall Accessible Lvaks and Verification by Smoke Test and Visual on
Vfii �p:mw
0 Pass E3 Fail
Pass if One of ILAnes # 9 th
45Pass E3
the undersigned� verify that the above diagnostic test results were performed in conformance with the requrements for
compliance crediL I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and
Fans comply'with Mandatory requirement spwffied in Section 150 (m)-ofthe 2005 Building Energy Efficiency standards.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
5CA fk 4 -aa (,x L&
Signature: -9 Ot
Date: W
Copies to: BUILDING DEPARrMElff, EUERS RATER (IF APPLICABW BUELDING OWNER AT OCCUPANCY
ResidewW Complimwe Forna SWIember 200S
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.net\dds
PROJECT INFORMATION
Site Address: 5334 DIANE CT
Owner:
Permit No: B06-2517
APN: 035-420-039
TUNISON, RICHARD WAYNE
Issued Date: 10/25/2006 By KCG
Permit type: MISCELLANEOUS
5334 DIANE COURT
Subtype: Wall Furnace
OROVILLE, CA 95966
Expiration Date: 10/25/2007
Description: GAS FURNACE HEATER
(530) 533-4951
Occupancy: Zoning: RI
Contractor
Applicant:
Square Footage:
BROWN JOHN HEATING AND AIR
BROWN JOHN HEATING ANI
Building Garage RemdUAddn
1024 REGENCY DRIVE
1024 REGENCY DRIVE
CHICO, CA 95926
CHICO, CA 95926
Other Porch/Patio Total
(530) 345-4654
(530) 345-4654
1
FEE INFORMATION
Heater (Wall) $55.00
Total Charged: $55.00 Fees Paid: $55.00
Balance Due: $0.00 Receipt No: B642
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractors License
BROWN JOHN HEATING AND i CSLB-825622 / C20 if 10/31/2607
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish. or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(comm li with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000)
is in ful r and effect.
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
10/25/2006
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractor's Sig�atu're' Date
1, 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 Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
WORKERS* COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
I HAVE
the work himself or herself or through his or her own employees, provided that such improvements
AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
11
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
0 I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
1. AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
EICONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compansation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier: Policy Number: Exp' Date:
(This section need not be completed if the permit is for one hundred dollars ($100)—or-Te—ss.)
F-1 I AM EXEMPT under Section B. & P.C. for this reason:
NI CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
SSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
X 10/25/2006
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owners Signature Date
provisions
X 10/25/2006
- -
1 hereby certify that I have read this applicatio n and st ate that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,
const uction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte"County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEYS FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
o r to act on the property owner's behalf
CONSTRUCTION LENDING AGEN CY
ga;rty gauthorized
10/25/2006
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
NamQ0-0t Permittee [SIGN] /print Date
the performance of the work for which this permit is issued. (3097 civ. code)
1:1 Owner 1:1 Contractor OR: 1:1 Agent for Owner EQAgent for Contractor
FILE COPY
Lenders Address city Sta��
BUTTE COUNTY PEFWIT
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION NO.
AND SUBMITTAL REQUIREMENTS
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED A T TIME OFAPPLICA TION
Website: www.buftecounty.netldds BIN H
"PLEASE PRINT CLEARLY" 1.
OWNER INFORMATION
Last Name A_W_ft� k 17 i � b h
r irst Name A
Mailing Address g-7
Lo
city
State
zip
Phone,5,3p�
lax
E-mail
CONTRACTOR
'Name Y-1
Address /() 2L4 6-n
city
' State
C14
zip 015-�
Phone
Fax
E-mail
Lic. # 81-S-6 P
C It, s-
-APPLICANT INFORMATION
ARCHITECTIENGINEER
Name
City
Address
zip
city
Fax
State
Zip
Phone
I Page
Fax
E-mail
State License Number
-APPLICANT INFORMATION
Name
.je
Address 9,,,q X
City
State CA
zip
Phone 609) 8 V -3 L/
Fax
E-mail
N T SIGNA TURE
X A
For office use only:
AP# 035 _q2D-()3�
Zoning
City
Flood Zone SRA I Yes No
Occ.
WORKER'S COMPENSATION
I Type Const.
Subdivision Name
lf hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
Map Book
I Page
Lot#
IDate Approved:
PROJECT LOCATION
AP# 035 _q2D-()3�
Property Address -
City
Cross Street
—Sheriff
WORKER'S COMPENSATION
Policy Number
Carder
lf 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
Descriiption or Scope of Work:
�as
S*42�T- Living Garage Open Cov
0 Structure Built without Permits
0 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�o
Amount: C5 5. 00 Bldg
SRA
Receipt#:NqE
—Sheriff
SMIP
Date:
0-3 Other
I Total
PE�MIT NO. 3p76i,-804.,P.,E,M
PERMIT EXPIRES.
OWNER Sunbeam �on st.Co.
owner
CONTR.
35 -42 -39 --
LOCATION (A.P.
5334 Diane Ct.,
lot 104, Crestwood Sub#2,
Oroville
Power PotLT—
Tempz
diled PG&E
Te p. Elec. Serv.—
1,
Called PG&E
Im
T mp. Gas Se ry
Called PG
JOB
FINALED
(Date)
(Signaturo
North Burbank Public Utility District
1960 Elgin Street
ORO'VILLE, CALIFORNIA 9S96S
'DISTRICT APPROVAL AND
VERIFICATION OF INSPECTION
BUILDING SEWERS
Telephone
533-2000
162-80
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.
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.
Applicant: SUNBEAM CONSTRUCTION CO.
Applicant Address: 1119.0 HOOPER LANE, LOS ALTOS HILLS, CA 94022
Applicant Phone No.: 41-5-948-R4R2
P roperty Location (S). 5334 DIANE COURT, OROVILLE
CRESTWOOD UNIT NO. 2t LOT 104
A. P. No. (s): 035-42-0-039-0
Fees Paid: $300.00 SCOR FACTT,TTV rl-TARGE PATT) A19.0 1 /70
NBPUD CONNECTION FEE( �AID J///
wd,
V
z1o,
Application for service approved: C.-001 Cr -
North Burbank
AUGUST 6, 1980 Public Utility District
Inspection(s) made and successful test(s) observed:
Location: Date: 14-12— ?0
U
M
North Burbank Public Utility District release to close permit:
11 '7-,? %�
Date: -/1-12- -00 By: Of k 6,4�-
CONSTRUCTION CiNPLI NCE,CrRTrFICATF
THIS K D; CERTIFY THAT ENERGY CONSERVATION RFQUIRT-TIF.NTS IL,%VE BEI -IN
U'VI'll CURRENT ENERGY CONS I.: RVAT 1.011 RECULATIONS
(location)
A. P. NO.
THF. 1701,1.01,41'NG HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Chvik ench itum or write N/A if not,npplicable)
INSGLATION: CLA Z 114C : �
NA Sipgle
NA Special (TrIsulated) NA
Al CFRT. & LABELED WDS.
I & SLIDING DRS.
ca L I i up/Roo C, WEATHERSTRIPPED DRS.__. NA
I A ! C C : 1-- -- — BACK DAMIII-:1:1:1) FANS 'NA
Circulaying f1peA, IRA WrEwurrvur fCNITION OEVICES_ NA,, -
NA CER.T. APPLIAI;Ci�:S NA
NA
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
I"I 14I.Tif THE ENERGY COMSERVATION k0jUIREMENCS AND ACKEE TO
THF 0)t'-H'I.1:TI-:NESS OF THIS CERTIFICATE AS SUBMITTED.
hr:0;t[Ji,n Applicator NNm(!..— Hawking Insulation Co ic.
JL
(P Pan. print)
Apj)Lfcawr_��
State Contractors
Licenso No. 378407
Cencral Contraccor/Owner N.-AUNIBEAM 'CONSTRUCTION (,O_
(please print)
Sii"n.-ItIlre of
GenwrAi. Contractor/ovmc Imte OCT 27 1980_
State Contractors
JAcenso No. 0""r AISS206
TN1� CENT 1VICATE MUST 'BE ON FILE WITH THE BUTLD7NC DEPAwrmENP PRioR P)
IN.-'.PI::C'I.'f0N AND SHALI. BE P0:;TI-:D IN A CONSPIC11011", LOCATION
WiTIII:! THE
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPTIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION.REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH' CURRENT ENERGY CONSERVATION REGULATIONS
AT Lot �o!5�_CRESTWQQDX SUBDIVISUN UNIT NQ___2
klocation)
BUILDING PERMIT 140. ` 3 f 7/,-- .2 0 A;" P, NO. Sj S�2_
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(C�eck each item or write N/A if not applicable)..
.INSULATION:
Slab Edge
ii7 �,
Fdn.� Wall"
..Floors NA
Walls x __
Ceiling/MW__2�_
Ducts' x
Circulating Pipes NA
APPROVED HEATER X
APPROVED WT R. HTR. X
GLAZING:
Single Glazed
NA
Special (Insulated)
X'
CERT. & LABELED WDS.
& SLIDING DRS.-
x
WEATHERSTRIPPED DRS.
NA
BACK DAMPERED FANS
x
INTERMITTENT IGNITION
DEV ICE S___X_
CERT. APPLIANCES
x
�'I DECLA RE THAT'ALL RE QU IRED ITEMS AS.NOTED.ABOVE HAVE BEEN INSTALLED
GY CONSERVATION REQUIREMENTS AND AGREE TO
IN ACCORDANCE WITH THE ENER
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name-- SEE ATTACHED
(please print)
Signature of
-�'.Insulatioh-Applicato
State.Contractors
License No.
General Contractor/Owner NameSUNBEAM. 0 OMPA14Y
(please print) OCT 2 7 1980
Signature of
General.Contractor/Owner _____7 Date
State Contractors
Gregory -T. istica9Paes I
License No. 1512QO
LE WITH THE BUILDING DEPARTMENT PRIOR TO
THIS CERTIFICATE MUST BE ON Ff SPICUOUS LOCATION
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CON
WITHIN THE DWELLING.
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
Temp. Gas Service
CalledPG&E
JOB FINALED (Date)
Signature
= OK
= Not OK
= Not Applicable RESIDENTIAL (Single and Duplex)
= Not Ready
Date UNDERFLOOR (Plans) OK except #'s
Date FRAMING (Continued)
ning requirements -Setbacks -Easements
-49.—Property Line Firewall & Openings
F!.q.�Main; Soils-Steel-Elec. Grnd.- 11D /" Ftg. Depth
49 --Ext. Doors -One 3'-C heck -Garage-3rd story, 2 exits
ge'Ftg., Garage; Soils -Steel- //C>/" Ftg. Depth
56� Stairs: Width -Headroom -R ise-Run-Landi ng -F ire Protection
4. Ftg., Porches & Decks; Soils -Steel- Ftg. DfpW
i�iwood on Roof Overhang -Attic Vents -Rafter Outriggers
gXwalls, Main; Steel-BIockouts-WrappedAa9tt5r
9*r- Siding -Nailing -Veneer
4-"Stemwalls, Garage; Steel-Blockouts-Wrapped leg�m
ft. -Stucco Mesh -Drip Screed-Fdn. Vents-UnderfIr. Access
7. Piers -Fireplace Ftg.-Steel
46��Iazing Area -Glass Protect i on -Sky I ights-P last ic
dwol-W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test
96e $hear Walls; Nai I ing-Bolts
Bas Pipe; Size -Anchors
-.44-Water Pipe; Test-Anchors-Regu lator-Sery ice Test
-'(I- Electric; Underground
'r2,. -Plenums & Ducts; Clearance -Material -Support -ins.
44. -Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI Card -BI Date
Card -Bl- Date Card -BI Date
Card -BI Date Card -BI Date
Card -13 1 jj0t__-Date card -BI Date
Date FINA6, (Plans) OK except #'s
Steps -Door & Sidelight Protection -Landings
Card -BI Date Card -BI Date
Date_.,,� PLUMBING (Permit) OK except #'s
9.1--Irmoke Detector
14. Water Ht.; Vent- Access -Combust ion Air
W. Furnace; Vents -Clearance -Comb. Air -Connector -
F'oe Ducts-Mech. Protection
15. Viatw Pipgt; Test & A�2hors-Nail Protectio
18'.- D.W#V- Tege-Pttage & Arthdr's-Nai 14atty-ection W e,10
$91"',Pedroom Exiting
17. Shower Pan; Test, First Floor -Tub Access
& Bath Fixtures & Tub Access
18. Test Tub & Shower, 2nd Floor -Tub Access
A111" Elec. Trim & Subpanel; Breaker Sizes -Labels
_Ze & Anchors
'Off- Stairs & Rails
Fireplace or Stove; Clearances -Hearth
Z
Kzlec. Outlets at Wood Panel; Int. & Ext.
Card -BI Dat A Card -BI Date
Vj� Kit. Fixt. & Appliance; Grnd.-4ir�Cooking Clearance
L*' Card -B I Date
Card -BI D!K�
f-lec. Outlets & Receptacles at Kit. Counter
Date ELECIMCAL (Permit) OK except #'s
Garage Fire Door; Swing-Landi ng -C loser
C. Duct in Garage -Damper
:5�WA;r.
Fwture & Transformer Clearance -Ins. Protection
Htr.; Vents -C leara nce-Comb. Air-Connector-P.R.V.-
ech. Protection
2 . Ejec. Receptacles Spacing -Lights & Switches at Doors
Loo lb., Elec. & Mach. Equip. Listed for Location
2e-q�ize Boxes & No. of Conductors -Stapled
!! �-�_6c - Receptacles in Garage; (G.F.I.)-Ro!pex Protec.
t!:.::R2mex Installed Close to Edge of Studs & C.J.
API I nsu let ion -Foam- Looked in Attic N01'es
&�-Egpip. Ground made up w/Mech. Fasteners -Bond Gas & Water
4-3--D4rd Rails & Deck Construct ion -Post C-"<
Z4-1 Appliance Circuits in Kitchen & Conductor Size
Uo.' t&-&.QUmuLaak�.�Draillid6b & Wood-EhM Clearance
to" RIO- B T119
-Gr- Ubfeed Wire Size ga. C%or AI-A.C. Wire Size ga. Cu or Al
97,." Range Circ. / Yl ga. Cu or ALLOven Circ. ga. Cu or At,
Insulate5,Neutral Eyes ai<o 'I,/
L%�.O'Following instid.: priveoIC9,fies E] No; Walks F -Y -'as E) No;
Planters 0 Y e s a
MMUCT6r—s& GrbTnd-Main Disconnect
Brown -Finish
p.,Cle�rances; Pane I s-Motors-Mec h. Equip.
Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
I he CIO set Light -Shower Light
_C_
&Vents Above Roof; Plbg.-Appliance-Firepi.-Clearance to Opngs.
&�ard �B-1 .-Date W7
-- - ,/ /01�6ard-Bl Date
Card B -I Date / / Card -BI Date
Well; Disconnect, Electrical, Plumbing
V.,exterior Elec. Trim; G.F.I. Receptacle -Underground
throughout House
oVentilation
Protection
D a_!g MEC��NICAL (Permit) OK except #'s
_lass
§��orrections from Previous Inspections
T -t -Meters Tagged; Gas -Electric
Ducts: Insulation & Support
wn nt-Fan; Exhaust above Insulation
%Zml.-C ndensate Drain & Overflow: Size & Grade
Fur nace- Vent: Access -Comb. Air -Return Air Vent -115V outlet
Access & Platform if Furnace in Attic
Card -BOJ Date/ fd6ard-B, Date
Card -BI Da te C��d-13_1 Date
a -C/O to Grade -HD Approval
W_V ter & Sewer Connected
Qp.-" Energy Compliance Certificate -Other Certificates
4 4,
Card -BI )Le,2 Date 1441 NO Card -BI Date
7,L
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Comments at Final:
Date FRAEtNG(Plans) OK except #'s
_'Hls; Proper Material & Anchors
k.Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound
,98 --'Bearing Walls over Girders & Floor -Nailing -
a aft Stap in Walls (rat proof)
4:11�1'�Flre Stops; Furred Ceilings -Stairs -Chases -Tub
4-r' Header & Beam -size & Bearing
rs-Post Caps -Anchors
-47. e -Connectors
4e,�-Clng. Joist-Rftr. T ies- Purl in -Roof -Brac. -Truss-Shthng.-Rfnp. I
Ties or Type A Flue -Fireplace Throat
&—Ro—mex Protect i on-Dra It Stop -Ins. Baffles
9 __
�Wrrn_. Windutsor Exitin Doors -Sill Hat. & Dimensions
4-.�`Garage Fire Pnote-clion Framing
(NOTE: Anentrymust be made each time youvisit jobsite)
%/ = OK
0 = Not OK
- = Not Applicable MOBILEHOMES
* = Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except #'s
1. Zoning ge�q'uirigments-Setback�"�Eg�seiiients
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Speci - al MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
.t n.
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; L ocat i on- Test- Easernerit Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Braci'ng
5. Electricity; Location-Clearancbs-Grnd.-/ Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Locatioa-Test-Wrap: / /"L"ft./- /"Nat.or/ /"L"ft./ LPG
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
Card -BI
Date Card- B I Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Ease'ments
Card-Bll
Date
Date Card -BI Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
-
2. Footings; Size -Spacing -Marriage Line
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�-Crossover�-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- Regu lator-Connector
6. Elec.; Enclosures; C onduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/O to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes- Enc losures- Pane I boards- Ins. to Main in Conduit
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
.t n.
C. w,
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING I�YILDING PLUMBING'
Setback 23- Firewall (Cogt'd Soil Piping
Forms Parapets 1 st F I 'or
0
Main Bldg. Restroom Finish 2nd Floor
Footings Windows 3rd FWor
Stemwa I I Siding
Slab Roof Sheathing Water Piping
Piers Roofing Sewer dlrove
Garage Fdn. Vents - — Fixtures /4//,%/
Footings Garage Vents
Stemwa I I Insulation W�� �17 X L Heaters
Slab Prov. for physicially Alipliances
Carport handicaplied `1 --,) — -0
Conformance of ex. Gas Piping & Test
Footings jAnoMre Temp. Gas 100e—
Slab Inal 71 P'V SaDAaljon
Patio 0V rna I
-Z/
--Z
Footings Footina ar- -EL,0bTR1'CAV
Masonry Walls Throat Rough
ReInf. Steel Final Fixtures V,,,�r
Bond Beamn FIRE SPRINKLERS Motors
Framing (1-Z5 1191 Test Water Htr.
Stucco Final Subpanels
Mesh V --4A�CHANICAL Gird. Fault Prot.
Scratch Heating Service
Brown Cooling
Temp. Pole
Finish Ducts Underground
Interior Lath Ventilation --Rqrman@Ptq
Door Closer Final �'F-Ind 22 A111
MOBILEHOME OTILITIES ------------------- Elec. Service TF-'� Pre"cle,
%FVater Piping Sewer Gas Piping
DdgBI6EHOME INSTALLATION ------------- =upp,rt Elec. ContinuitV
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
le -o'/
Sk
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541/9
APPLICATION AND PERMIT
ASS ESSO -NUMBER-
��ARCEL
— 4 .2
ZO I G
BUILDING PERMIT
OW R
,C-" " /
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
CrWNER'5 ;MZING ADDRESS
oa Xgc Ae& AM
00
CONTRACTOJR*S NAME
CC- 40 -e- k—
T—ELEPHONE
CONTRACTOR'S MAILING ADDRESS
TION LENDER
;0X 42', &:�<
UNKNOWN
I
Fireplace
Total Valuation $
LENDER's MAILINQOO-ADDYSS
Permit Fee
$
ARCHITECT OR ENGINEER
le—
CENSE NO.
F
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEE`R'S MAILING ADDRESS
Permit fee
$
BUILDING
_qSS p
, M
Ct
PLUMBING PERMIT
Fi ling Fee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
Water piping
LOT N
6);V
,Z
UB DIVISION NA>�E
27
I S elr� I
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SFFk� Duplexn Mobilehomen Other
SPECIFY
Building sewer
Lawn sprinkler system
2.00
-
TYPE OF WORK
New [0 AdditionE] Remodel EJ utiiitiesO installation Other
Describe work: I
2�41
z4g!;�.e le"
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 3.00
600V OR LESS
Main service 100 AMP OR LESS
5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. I DWEL
OR_ACCNS. %Acc.y,:�,V42U-11) 20 sq ft 2 as"
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Busines S
and Professions Code and my license is in full force and effect.
License No. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NEW uUNbT F;L -OUTLET
. SI (MULTI
NON RE - D. BRANCH CIRCUITS) 2.50 ea
NEW CONSTR. /POWER APPARATUS .11)
NON,RESID, %SINGLE OUTLET CIR
50 @ 259�
Ex. OCCUP(OUTLETS OR FIXTURES BAL@10C
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESIC.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $ _:�Z, &,S -7 -
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
F-] The permit is for $100.00 (valuation) or less.
E] 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 shal I be deemed revoked.
MECHANICAL PERMIT
Fi I ing Fee 3.00
Heating
I
C
Cooling _450:1
Xoa
Hood
2.00 :ZC20
Ventilation
I
Permit Fee
$ CPO
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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
againstAaiid County in coi),sequence of the granting of this permit.
12-t
X Date 0
-7
Own
Signature of Applicant — e &ntroctor E] 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 $ 'All
��G Y
TYPE OF CONST. -F
V_ /V
I PA:�A
I t7l
ND
I ISSUE
4.-'
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DI CTOR 0 PUBLIC
By-
PERMIT EXPIRES Date--
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt NO. �4 / V3 9
WHITE-D.P.W., YELLOW -ASSESSOR. PINii-INSPFCTOR. GOLDFNROD-APPLI CANT
NOM
ol plans aA sPecli�lccficns MUST bo .—All' Materials & Workmanship Shall Be '16
mes and it is unlawful to Accordance with Recognized Good Pr
Aept on the job at all ti )n'same Without. octices amd,
m ake any changes or alt.e.rations t?f a � quality prescribed for the Specified use in the
written permission f rorn the Department of. Public - Uniform Building, Plumbing & Machanic.al Codes and*
Works, Count� Of' Butte. the National Electrical -Code.
E L 2 A setback of ft. from the
P4.0 -A Z 4F, V,-1 property lines and a setback
of 50ft. from the road
centerline shall be clear of
structures or equipment except
for a 2 ft. eave overhang.
7r- --
2 E -
Al
74:;
0-73"M F/,:,
z x
60�lPc 7
BUTTE COUNTY
BUILDING DEPARTMENT
See Master Plan on file 'for- 4uildins APPROVED
plans.,
77---7 7=��
7- -7
A ZrAl-P e.
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.7417,rS CO.. 44MIMMIA
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