HomeMy WebLinkAbout039-170-010317=10 -
Byron Tobey
W/S DayDn Rd., app.4 mi.S.of Rogers B 039-17—
Ave., Chico RYON G AND SARA 0'010
Permit #2231-77B,E�1(service change & 2334 DAYTON A TOBEY
2334 DAYTON RD., CHICO
OPEN DECK . I
BUILDING CODE. VIOLATION -
LETTER 30 DAY'S 039-170-010 03-1762
1 BARTLETT, BARRY
3p V Vq 2334 DAYTON, CHICO
COVER EX DECK - BP02-1537
B08-0893 039-170-010
S /O S MISCELLANEOUS Electric Panel
REPLACE DAMAGED PANEL O t D
2334 DAYTON RD v t
BARTLETT, BARRY M REVOCABLE Tl
f= i a Cn' -0
$oc442 Cswintd) 039-1-70-010
bar}ttA, Garry m.
2* Dayan Q& Okcb �i�etri ca I
Pam POWE2- POLL
e0TR: Utdri-Cal
� `�
� I � �'' �
,�
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION(IVR)#: (530) 538-4365
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 2334 DAYTON RD
Owner:
Permit No: B08-0893
APN: 039-170-010
BARTLETT, BARRY M REVOC
Issued Date: 05/15/2008 By KEJ
Permit type: MISCELLANEOUS
PO BOX 1827
Subtype: Electric Panel
CHICO, CA 95927
Expiration Date: 05/15/2009
Description: REPLACE DAMAGED PANEL
(530) 521-1003
Occupancy: Zoning: A10
Contractor
Applicant:
Square Footage:
ALLEN ELECTRIC
ALLEN ELECTRIC
Building Garage Remdl/Addn
129 DELANEY DR
129 DELANEY DR
CHICO, CA 95928
CHICO, CA 95928
Other Porch/Patio Total
(530)321-7375
(530)321-7375
FEE INFORMATION
DBE Single Phase Service-Resid $59.00
Total Charged: $59.00 Fees Paid: $59.00
Balance Due: $0.00 Receipt No: B7355
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
ALLEN ELECTRIC 896942 / C10 / 05/31/2009
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in fu Fl9 effet .
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
IX 055/155/2008
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractor's Signature Date
El1, 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
❑❑
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractors License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier: Policy Number: Exp. Date:
section need not be completed if the permit is oris or on�llars ($100)-6r less.)
�This
❑IAM EXEMPT 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
05/15/2008
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owner's Signature Date
provisions.
05/15/2008
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
injury, including death, and property damage roused arising out of, in any way connected with
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the
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
prope ed to act on the property owners behalf.
CONSTRUCTION LENDING AGENCY
05/15!2008
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name of Perrrfittedd[S GN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
❑ Owner ❑ Contractor OR; I gent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
r BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION"
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.nettdds
o,A1,111V PLEASE PRINT CLEARLY
"When filed this application and all supporting material becomes subject to the California Public Records Act. All I
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
CONTRACTOR
OWNER INFORMATION
Last Name
City
First Name
Zip Z
City
�t
Mailing Address
j , S—
Phone32 �-
Fax
<
City
Class
State
Tip y
-4,
Phone
jo
Fax
E-mail
CONTRACTOR
Name t t
Address ,L f
City
State
Zip Z
City
State
j , S—
Phone32 �-
Fax
E-mai 7
Lic. #
Class
10 t b
APPLICANT INFORMATION
ARCHITECTIENGINEER
Name
City Sta
Address
Phone^� 7 Fax
City
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
v
Address
t
City Sta
s,� .•.�
Phone^� 7 Fax
Email
APPLICANT SIGNATURE
X
PROJECT LOCATION
AN
Property Address ! )y ,/g
City
01,
PERMIT
NO.
BIN #
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.
G : ftp r1541rto
K /m ! �f //OJ/44/
Sq. FT- Living Garage-/ Open ov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
I
For office use only:
Zoning FloodZone SRA Yes No
Occ.
Type Const.
4C /we
DROP BOX COVER SHEET
All of the following information. must be completed: Writing must
be legible.
4
Date:
7 C� 03q_j -7 O— O / 0
Assessor's Parcel Number:
Owner and/or Applicant: 8q_,vw
Permit/Application Number:
E -Mail Address:
Contact Phone Number:
Directed to (Staff Person): ai�__
EFEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
YL NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200,1
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1.7.
SECTION A - PROPERTY OWNER INFORMATION Fa Insurance Cornpany use:
BUILDING OWNER'S NAME roucy Numoer
BARRY BARTLETT
BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
2334 DAYTON RD.
CITY STATE ZIP CODE
CHICO CA 95928
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
APN 006-690.001
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
New Residential Structure
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( W - #9 - ##.##" or ##.#####') ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NAP COMMUNITY NAME 8 COMMUNITY NUMBER B2. COUNTY NAME 63. STATE
BUTTE CO., CA. BINCORP. AREAS 060017 BUTTE COUNTY I CA
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX DATE
B7. FIRM PANEL
B8. FLOOD ZONE(S)
B9. BASE FLOOD ELEVATION(S)
NUMBER
y
o c) Bottom of lowest horizontal structural member (V zones only)
EFFECTIVEIREASED DATE
.0 m
(Lone A0, use depth of flooding)
060017 330
D
SEPT. 29,1989
APRIL 2D,=
X
SEE COMMENTS
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ AS Profile ❑ FIRM ❑ Community Determined ® Other (Describe): SEE COMMENTS
B11. Indicate the elevation datum used for the BFE in 139: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Oti>er (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ®No Designation Date WA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ® Construction Drawings' ❑ Building Under Construction' ❑ Finished Construction
'A new Elevation Certificate will be required when oonshcfion of the building is complete.
C2. Building Diagram Number 8 (Select the building diagram most similar to the building for which this oertificate is being completed - see pages 6 and 7. If no diagram
accurately represents the building, provide a sketch or photograph.)
C3. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AWA, ARAE, AWA1-A30, AR/AH, ARIAO
Complete Items C3. -a4 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from to datum used for the BFE in
Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comrnents area of
Section D or Section G, as appropriate, to document the datum conversion
Datum NGVD 1929 Conversion/Comments
Elevation reference mark used RM 4 Does this elevation refem noe mark used appear on the FIRM? ® Yes ❑ No
o a) Top of bottom floor (including basement or enclosure)
162.0 ft(m)
a
o b) Top of next higher floor
163.0 t m)00
y
o c) Bottom of lowest horizontal structural member (V zones only)
WA. �k(m)
.0 m
o d) Attached garage (top of slab)
WA ft (m)
o e) lowest elevation of machinery and/or equipment
o servicing the building (Describe in a Comments area)
WA ft.(m)
z' .
o f) Lowest adjacent (finished) grade (LAG)
162.0 fL(m)
o g) Highest adjacent (finished) grade (HAG)
162.0 k(m)
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
o i) Total area of all permanent openings (flood vents) in C3.h . in. (sq. cm)
QRDFESSrp,�
G A �F�!
No. (27647 70
EXP. 3/31/06
9TF OF CA0F��
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information.
1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
CERTIFIERS NAME LICENSE NUMBER
ROBERT G. AGEE, JR RCE 27647
TITLE COMPANY NAME
Civil Engineer SIERRA WEST SURVEYING.
ADDRESS CITY STATE ZJP CODE
5437 BLACK OLIVE DR. PARADISE CA 95969
SIGNATURE , 11_, / DATE TELEPHONE
FEMA Form 81-31, January 2003
/ May 26, 2005 877-6253
side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the comesponding information from Section A- For Insurarice Company Use:
`SUILD ET ADDRESS (IndudkV Apt, Unk Suite, ardor Bldg. No.) OR P.O. ROUTE AND BOX NO. Poky Number
2334 DAYTON RD.
CITY STATE ZJP CODE Company NAIC Number
CHICO CA 95928
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUoompany, and (3) building owner.
COMMENTS
THIS LOT IS IN T ZONE AND IS PROTECTED BY LEVEE ALONG MUD CREEK.
❑ Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
E1. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6.8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ t(m) _in.(crn) above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4. The top of the platform of machinery ardor equipment servicing the building is _ ft.(m) _in.(crm) ❑ above or ❑ below (deck one) the highest adjacent grade. (Use
natural grade, if available).
E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the communiVs floodplain management ordinance?
❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (witl out a FEMAissued or community -
issued BFE) or Zone AO must sign here. The daterr r in Sedm A, B C, and E are coned to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
CITY STATE ZJPCODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑ Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B. C (or E), and G of this Elevation
Certificate. Complete the applicable item(s) and sign below.
G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify, elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMAmissued or communityissued BFE) or Zone A0.
G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes.
G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-buill lowest floor (including basement) of the building is: f4m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: ft(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
TURE DATE
COMMENTS
❑ Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions
EFEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Read the instructions on pages 1- 7.
O.M.B. No. 3067-0077
Expires December 31, 200,r-
SECTION
00,
SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
BARRY BARTLETT
BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
2334 DAYTON RD.
CITY STATE ZIP CODE
CHICO CA 95928
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
APN 006-690-001
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, N necessary.)
New Residential Structure
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( #tP - ##' - ##.##' or ##.###1/#) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME 83. STATE
BUTTE CO, CA & INCORP. AREAS 060017 BUTTE COUMY I CA
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX DATE
B7. FIRM PANEL
B8. FLOOD ZONE(S)
B9. BASE FLOOD ELEVATION(S)
NUMBER
o a) Top of bottom floor (including basement or enclosure)
EFFECTIVEIREVISED DATE
(Zone A0, use depth dflooding)
060017 330
D
SEPT. 29,1989
APRIL 20,2M
X
SEE COMMENTS
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile []FIRM ❑ Community Determined ® Other (Describe): SEE COMMENTS
B11. Indicate the elevation datum used forte BFE in 139: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12, Is the building lasted in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date NIA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ® Construction Drawings' ❑ Building Under Construction' ❑ Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 8 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. ff no diagram
accurately represents the building, provide a sketch or photograph.)
C3. Bevations—Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, ARIA1-A30, ARIAH, ARIAO
Complete Items C3. -a4 below according to the building diagram specified in Item C2 State the datum used. ff the datum is different from the datum used for the BFE in
Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Cornments area of
Section D or Section G, as appropriate, to document the datum conversion.
Datum _NGVD 1929 ConversionlComments
Elevation neference mark used RM 4 Does this elevation reference marls used appear on the FIRM? 0 Yes ❑ No
o a) Top of bottom floor (including basement or enclosure)
162.0 ft.(m)
o b) Top of next higher floor
163.0 t(m)
o c) Bottom of lowest horizontal structural member (V zones only)
WA. _ft.(m)
M.,
w a
•Lu d) Attached garage (top of slab)
WA k(m)
o e) Lowest elevation of machinery and/or equipment
o servicing the building (Describe in a Comments area)
NLA
z N
o f) Lowest adjacent (finished) grade (LAG)
1620 ft.(m)
o g) Highest adjacent (finished) grade (HAG)
1620 ft(m)
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
o i) Total area of all permanent openings (flood vents) in C3.h . in. (sq. an)
Q PROFESS I
G ACFc^
Lau!
No. 27647 A
1 EXP. 3/31/06
9TF OF CAS-IF�Q
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIERS NAME LICENSE NUMBER
ROBERT G. AGEE, JR RCE 27647
TITLE COMPANY NAME
Civil Engineer SIERRA WEST SURVEYING.
ADDRESS CITY STATE ZJP CODE
5437 BLACK OLIVE DR. PARADISE CA 95969
SIGNATURE DATE TELEPHONE
I ... May 26, 2005 877-6253
FEMA Form 81-31, January 2009 rl SeeWverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A For Insuranoe Carpany use:
BUILDIN9 STREET ADDRESS (Indudag Apt, Unit Sure, ardor Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number
2334 DAYTON RD.
CITY STATE ZIP CODE Carpany NAIC Number
CHICO CA 95928
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate fa (1) communityofficial, (2) insurance agentloompany, and (3) building owner.
COMMENTS
THIS LOT IS IN °X° ZONE AND IS PROTECTED BY LEVEE ALONG MUD CREEK.
❑ Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting iri mration for a LOMA or LOMR-F,
Section C must be completed.
E1. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being corrnpleted — see pages 6 and 7. ff no diagram aocurdtaly
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(am) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6.8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ fL(m) _in.(an) above the highest adjacent
grade. Complete items C3.h and C3.i on front of hTn.
E4. The top of the platform of machinery ardor equipment sere dng the building is _ ft.(m) _in,(an) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, If available).
E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in aocorda oe with the community's floodplain management ordinance?
❑ Yes ❑ No ❑ Unknown. The local official must 6erti6r this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owrne or owners au prized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community -
issued 8FE) or Zone AO must sign here. The statements inn Sections A, a C, aid E ore correct to the bestof my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP
SIGNATURE DATE TELEPHONE
COMMENTS
❑ Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation
Certificate. Complete the applicable ftem(s) and sign below.
G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMAAssued or communitymissued BFE) or Zone A0.
G3. ❑ The following information (herbs Goa) is provided for community floodplain management purposes.
PERMIT NUMBER I G5. DATE PERMIT ISSUED I G6. DATE CERTIFICATE OF
G7. This permit has been issued for. ❑ New Cahstruction ❑ Substantial Improvement
G8. Elevation of a&buitt lowest flax (induding basement) of the building is: t(m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
TURE DATE
COMMENTS
❑ Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 /PEWIT No.
(Rev.12/96) APPLICATION AND PERMIT C_
ISESQ PARD NUMBER
(5,
ZONING
A-10
BUILDING PERMIT
OWNER
B, :Y,T= BARRY
TELEPHONE
343-6340
SO. FT. OCC. BUILDING VALUATION
520 0 3640.00
OWNER'S MAIUNG ADDRESS
2334 DAYTON P.D. CHICO CA 95928
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Ellin Fee
$ 20.00
Permit Fee
ARCHITECT OR ENGINEER'S MAULING ADDRESS
Plan Checking Fee
$ 40.90
ADDRESS
BUIL14134 DAYT'O�T P.D. CHICO
Energy Plan Checking Fee
$
PERMIT FEE
$ 19-1-95
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF 1X Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: 0PEN DEC:..
Gas piping systern 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
1@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service zoOA oR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
L w 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.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed R the permit is for work of a valuation
of one hundred dollars ($100) or less.)
certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
X*11compensation laws of California, and agree that if I should become subject to the
wo kers' compensation provisions of section 3700 of the Labor Code, I shall
with comply WithAos p ovi io S.
—' _ Q z_
X Date b i
Sig tur o plic t ':,%r%rvne# ':, n 13 Contractor ❑Agent
An OSHA per it is requir d for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service To
46.00so
CCU000A
WEE200A
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( a ACC. BIDS. 3.5¢FT.
NON-REESID. ANCHMULTI-OUTL.ET 97.50
POWER APPARATUS
a SINGLE OUTLET CIR.
Ex. Occu a20 p 1.000
OUTLET OR FIXTURES
Ex. Occup. oFtrrLEEDTSA RESID.OEA. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
VN
TOTAL FEE $ 12 3,95
HAZ.
-W
D. FEES
IM
CDF
PAY
PO
H
ISSU
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 ate zY
PERMIT EXPIRES ON - / O
Date
Receipt No. 353538 $123.95
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
-COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, �AI.IFORNIA 95965 - TELEPHONE (530) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: � � ' ASSESSOR PARCEL NUMBER: 0317-11 -W0
Proposed Building Use: �i,�£1r �� ! �M Building Inspector: U [Z&Aw2 Date: (0- I a -62-
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received
By
❑ 1. All items have been submitted.............................................................................................................
❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans............................................................................
❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans...................................................................
❑ 4. Engineered plans and calculations, 3/4 sets, with wet signature on plans.
All engineering must be shown on plans.............................................................................................
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ...............
❑ 6. Energy Design Compliance and supporting documentation................................................................
❑ 7. Statement of Intent for Non -Heated and A/C Buildings......................................................................
❑ 8. Hazardous Material Form....................................................................................................................
❑ 9. Manufactured Home Data and Installation Instructions including Tie Down Specifications ..............
❑ 10. Fees of $..........................................................................................................
❑ 11. Impact Fees as shown on the attached schedule..................................................................................
❑ 12. California Department of Forestry Plan Approval/Fees......................................................................
Q 1�, Flood Elevation Certificate .............. ............................................................................................
i „ 4. Sanitation and Plot Plan Approval Environmental Health Department.......... G -17 i
-
❑ 15. City of Chico Plumbing Permit............................................................................................................
❑ 16. Plot Plan and Business License Approval from the City of Biggs ......................................................
❑ 17. Planning Approval for (A) Use: e K (B) Parking: ........... % 73 - e7`Z
❑ 18. Contact Land Development about ❑ Improvements, Q Drainage, Q Legal Parcel ...........................
❑ 19. Encroachment Permit for Driveway (construction approval prior to occupancy) ...............................
❑ 20. Pre -Inspection for required. Request to Building Inspector
(Date)
❑ 21. Contractor's License Information (Number, Name Style, Classification) ...........................................
❑ 22. Workers' Compensation carrier and policy number..............................................................................
❑ 23. Owner -Builder Verification (❑ Given to Owner, Q Mailed to Owner) .............................................
❑ 24. Letter of Signature Authorization........................................................................................................
❑ 25. Recorded Copy of Agricultural Acknowledgment Statement..............................................................
Q 26. Letter of Intent on Building Use/Detached Accessory Building Form ................................................
❑ 27. Manufactured Home Utility Clearance................................................................................................
❑ 28. Existing violations and/or expired permits..........................................................................................
❑ 29. ❑ 433 A, ❑ Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D. $ -Z ....................
❑ 30. Other ....................
When ott issue the permit, process as follows: Q Mail to Owner ❑,Mail to Contractor.
-yalelephone
3U 3 -and hold for pickup at office. ❑ Del' er Inspector.
Applicant: Date:
`U Z
Copy of Haz-Mat form sent Q Health Department, Q Fire Department, ❑ Air Pollution ate: By:
Copy of Plans sent ❑ Health Department, ❑ Fire Department, ❑ Other Date: By:
1. Index permit Application for the above items numbered: ❑ Plan Check L j`
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by: ❑ phone, Q mail, ❑ Building Division counter, By: Date:
Contractor, designer, owner, was advised of the above required data by: ❑ phone, ❑ mail, ❑ Building Division counter, By: Date:
Contractor, designer, owner, was advised of the above required data by: Q phone, ❑ mail, Q Building Division counter, By: Date:
Contractor, designer, owner, was advised of the above required data by: ❑ phone, ❑ mail, ❑ Building Division counter, By: Date:
C-
Plans reviewed by: Date: Plans reviewed by:yw Date: 72-4-07-
Sets of plans on hold in ❑ Plan Cabinet, Q A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services - Building Division
e.H.USF-Guiv \'!
Piot Plan Attached
rioex Fi n Ates he
'^-Sant to G.D. /
TO: Building Department -4,
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal
Clearance for dwelling. Other _
Hold final for:
Final clearance O.K. for:
NOTE:
8/96
mental Health Specialist
Water Supply:
Public Private Well
6a�_
Date
Feb 01 02 08:13a
P.
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Orovil:), California 95965 • Telephone (530) 538-754 PERMIT NO.
^
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSORPARCELNUMDIA O� O� O ZOO BUILDING PERMIT
°w"eR ( -- -3q3TE'®"°"Ej_O �o SO. FT. OCC. BUILDING VALUATION
" FEAAUT FEE PAID
SRA
SHERIFF
01'H�R
AAIIOVW RECEMb
C -I 7 3 vi _-)
35363 9
" TO to IVT INTO COMMJTlR
Ex. Occup. ovneT OR FKmEs TO W ,.00
SAL .50
EX. Occup. W11D APPLNs. OR
on.E�O wESIO. eA 5.00
Temporary Service 23.00 _
Mobile Home Facilities 20.00 -.—
_Mk-.
Miso. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 1 20.00
I Hood I I 6.50 i I
PERMIT FEE S
Mobile Home Installation Fee $
Energy Inspection Fee $
occ * PE TO AL FEE $ ,
• 1 D. FEES I RI I 1100D I "OF I AN(CEL 1IND SUE
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*pald.
By
ReceiptNo, PERMIT EXPIRES ON
WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Date
(Dere)
Ow NG DRESS1j
--._. ----
O_..CONTRACTORS
CONTRACTOR'S NAME
MAIUNo ADDRESS •
CONSTRUCTIONLEN00%
LENDER'S MMLNJG ADDRESS
-
TELEPHONE
Flfe IQCO
Total Valuation $ UO
—_---'
--
,
-
•
ARCHIrECT OR ENGINEER
LICENSE NO.
Fling Fee
$
_
20.00
ARCHTECT OR ENGWEERS MAKING ADDRESS
-BUROWOA00RESs
Permit Fee $
Plan Checkin Fee $
Q3314 —
hl
Energy Plan Checking Fee
$
PERMIT FEE $ 3•
toTNo. SLRONEilONSNAME
PARCEL MAP
PLUMBING PERMIT Fling Fee
20.00
USEOFSTRUCTURE t) /S '`
SF,' Duplex ❑ Mobilehome ❑ Other
OPEC"Each
Each Tr 7.001_
Solar or heat um water heater 23.00
Water piping 15.00
as water heater or vent 15.00
TYPE OF WORK
New O Addition Remodel ❑ U61ities ❑ h/stallation ❑ Other 13
Describe Work: oin G� �OxjG
Gas pipina system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home 3 -- W Co?20.00
PERMIT FEE S
ELECTRICAL PERMIT Filing Fee
20.00
E00V OR HESS
Main Service tow oR LESS 23.00
----'
J O a O
Main Service 200A TO IowA
46.00
NLW COM.. .cc
OR ADDNS. OWAArn �"Own UP. ) I 3.52S—O
" FEAAUT FEE PAID
SRA
SHERIFF
01'H�R
AAIIOVW RECEMb
C -I 7 3 vi _-)
35363 9
" TO to IVT INTO COMMJTlR
Ex. Occup. ovneT OR FKmEs TO W ,.00
SAL .50
EX. Occup. W11D APPLNs. OR
on.E�O wESIO. eA 5.00
Temporary Service 23.00 _
Mobile Home Facilities 20.00 -.—
_Mk-.
Miso. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 1 20.00
I Hood I I 6.50 i I
PERMIT FEE S
Mobile Home Installation Fee $
Energy Inspection Fee $
occ * PE TO AL FEE $ ,
• 1 D. FEES I RI I 1100D I "OF I AN(CEL 1IND SUE
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*pald.
By
ReceiptNo, PERMIT EXPIRES ON
WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Date
(Dere)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING 000N
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT XM
ASSESSOR PARCEL NUMBER
039-170-010
ZONING
1 All()
BUILDING PERMIT
OWNER 342-6340
TELEP
SQ. FT. OCC. BUILDING VALUATION
480 6240.00
. OWNER'S MAILING ADDRES
9334 Dayton Rd, Chke
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $ 6240.
0
ARCHITECT OR ENGINEER
LICENSE NO.
Rlina Fee
$ 20.00
Permit Fee
$ 90.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESt334 Dsyton Rd Chico
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 168.50
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: refer to 02-1537
cover existing deck
Gas piping system 1 - 5 outlets
15.00
Building sewer15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Feel 20.00
600VOR LESS
Main Service 200A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
LaVv 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
Main Service To
46.00so
CCU000A
NEW CONST. DWELLJNG OCCUP.
DWE200ALLING
S.
OR A oNST. (
3,5QSO.
FT.
MUL�rCo�i
NON-RESID.
97.50
POWER APPARATUS
6 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
20 x''00
BAL .50
Ex. Occup. oFlxuT>Frs a D
A
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
$
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
f one hundred dollars ($100) or less.)
certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that H I should become subject to the
ions of section 3700 of the Labor Code, I shall
f wi h comply witvis' n
wor rs' compensazow
X Date
_ _ r
Si tura of Ap icant -❑ Co tractor ❑ Agent
An OSHA permit is required for excavations ov r 5'0" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 168.50
HAz.
o FEES IMP FLOOD CDF PARCEL Po HD ISSUE
This permit is hereby issued under the
of the Butte County Code and/or Resolutions
indicated abov for which fees have
�%
By /
I PERMIT EXPIRES ON b /
applicable provisions
to do work
been paid.
Date
Dale
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASS SOR PINK -INSPECTOR GOLDENROD -APPLICANT
It
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION63 -/- <-6 Z
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NC
APPLICATION AND PERMIT
.l G/7vJ
D3ef ^ 1 Q. o
"/# _/
BUILDING PERMIT
n+ER /a/�R- �✓- /Jh d
TELEP'""E;. %z,
—����
So. FT. OCC. BUILDING
VALUATION
qV D t c,(r�
Jan�
MERS VAWDOMSS C� cAD cr
OWN
114Tm
TELEPHONE
,WRICTOMS NAMNM ADORESS
iNSTRULnON LVOER
Fireplace
NDERS MOIUNO AD RE=
Total Valuation S
ip4RECT OR ENStNEFA_
LI00CE NO.
F6rT Fee S
2D.00
Permit Fee S cll�
iCNRE= OR ENOWEERS WAM ADORESS .
Plan Checkina Fee
A.DWS ADORM` ,n ��
�J
Energy Plan Checking Fee S
S
p
G L V"
PERMIT FEE S
�'
3T NO.
S0007V6CN5 1
P ieL MAP
PLUMBING PERMIT Feng Fee
20.Do
Each Trap -- --
7.00
USEOFSTRUCTURE
.F D�-pllD: Mobilehome ❑- Other
Solar or heat pump water heater
23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
•law ❑ Addilion ❑ Remodel ❑ L06es ❑ Instakrmn ❑ Other ❑
Describe � Work: ��
Gas piping systerri 1 - 5 outlets
15.00
Bulfmg sewer 15.00
Mobile Home I S G W @20.00
PERMIT FEE t
ELECTRICAL PERMIT
Fling Fee
20.DD
Main Service xo= o0. 0:
23.OD
��/
Emma
S'k X > -
•
S1tier I a
co 4-ht.,olr-
J
� a
Maur Service 2M4 TO SOOOA
46.00
NEW cosi: OWELL o Occup. 3.5¢
DR ADDNS. a IGC. ELDS.
may MR41 MML KULTtoNttET @7.50 _
FowER APPAaaTus
a oun.ET a0.
OvnEr OR FKTUAEs 20 6?
6L Occu Bn� o
FOCED APPUS. OR S.oD
Ex. Occup. o�mE�s m. Ei
Temporary Service 23.00
Moble Home Faclities 20.00
Wmc. Wiring 23.00
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood ( s.so
Ventilation
PERMIT FEE= S
Moble Home Installation Fee S
Energy Inspection Fee S
Oce
CONST. TYP£
_
TOTAL FEE $ f
N:Z.
D. FEES
[up
FLOOD
I MF I
PRAM!
PD
KMI 6SJE
144 �1ro bc.��..� •�r��o
cav%fw'�L'r
This permit is hereby issued under the applicable provisions
of the Butte County Code end/or Resolutions to do work
indicated above for which fees have been paid.
.By Date ----
PERMIT EXPIRES ON
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: /�/i-///t-j Ae-Ak J L' P^f"'_ ASSESSOR PARCEL NUMBER v 5�
C.�J�./� ��'�Si _oC�C O♦ -/fes z
Proposed Building Use: 0 k Counter Technician: Date: C� L
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in orde to apply.
1.. Plot plans, 3 or 4 sets, signed�y the preparer of the plans.
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
(� ❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Energy compliance design and supporting documentation in duplicate.
❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or
foundation plans, all in duplicate.
❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate.
(D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be
indexed and returned to the plan review line-up when required items are received.
Date Received By
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................
❑ 9. Plot 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 .....................................
❑ 12. Hazardous Material Form...............................................................................
❑ 13. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 14.
Fees as shown on the attached Schedule of Fees Due Sheet .......................................
❑ 15.
Statement of Intent for Non -heated and A/C Buildings .............................................
❑ 16.
Sanitation and plot plan approval from the Environmental Health Department in
❑ 17.
City of Chico Plumbing permit.........................................................................
❑ 18.
California Department of Forestry plan approval ❑ paid. Sent by: ......................
❑ 19.
Planning approval for (A) Use: (B)Parking: . (C) Parcel Check:
❑ 20.
Contact Land Development about ❑ Improvements, ❑ Drainage ...............................
❑ 21.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 22.
❑ 23.
❑ 24.
❑ 25.
❑ 26.
❑ 27.
❑ 28.
❑ 29.
❑ 30.
Pre -Inspection for required ................
Contractor's license information. (Number, Name Style, Classification) ......................
Worker's Compensation Carrier and Policy Number ..............:..............................
Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
Letter of Signature authorization....................................................................
Recorded copy of Agricultural Acknowledgment Statement ....................................
Manufactured home utility clearance...............................................................
Existing violations and/or expired permits.........................................................
❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
❑ 31. Other:
When issued Telephone
and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant:
Date:
1. Index permit application for the above items numbered: Plan Check Letter
2. Additional items required
Contractor, designer, owner, was advised cf the above data by ❑ phone, ❑ mail, ❑ counter, by Date: _
Contractor, designer, owner was advised of the above ata by ❑ phone, ❑ mail, ❑ counter, by Date:
4 -✓
Plans reviewed by: bhi Date: Plans approved by: � Date: / �
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: Date:
Yellow Ruildino nivicinn
o.R- I
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,t-ke ajor labor and materials for construction of the proposed
property improvement: YES NO ❑
2. 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: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (lured) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTYOWNER:
SOCIAL SECURITY NUMBER:
DATE:4
NOTE. This Owner -Builder Verifkation 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.
OVER
OWNER BUILDER INFORMATION
Dear Property Owner.
O.B.- I
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified .
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors; then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are .
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation inciirarnce, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,
ifyou 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 contractors 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 contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned
J
ly,
elC:Vi ira, C.B.O.
er, Building Inspection
NOTE. itis Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
-DECK Poor
; 4p
oor-
hamcps
16 i`
0,C
F -RD OT V t L IN
-_� OPEN
j,y'i �x to
�Mo �x6 BUTT. COUNTY
BUILDING DIVISION
APPROVED
'S'(D-5 V 'r W
scat's 4% 11 = 1'
;4p
V.
Building Permit Number: &2—/S37
Owner Name: GLr+e
Residential Construction Requirements
IMPORTANT
This set of plans and specifications MUST be kept on the job site at all times and it is
unlawful to make any changes or alterations on same without written permission from the
Building Division, County of Butte.
All materials and workmanship shall be in accordance with recognized good practices
and of a quality prescribed for the specific use in the 1998 California Building Code
(1997 U.B.C), 1998 California Plumbing Code ( 1997 U.P.C.), 1998 California
Mechanical Code (1997 U.M.C.) and the 1998 California Electrical Code (1996 N.E.C.)
COMPLY WITH ITEMS CHECKED BELOW
aYour parcel lies within a designated 100 -year flood plain. Finish floor, electrical,
H.V.A.C. equipment and services shall be a minimum of one foot above the elevation
shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate
will also be required
Note: We will normally accept the following as compliance with the flood elevation
requirements:
1. Building is anchored to concrete stemwall system with conventional anchor bolts.
2. Building plate on top of stemwall to be one foot or more above the 100 -year flood
elevation. (Plate height less than 24" above grade, or engineered design required).
3. Electrical, heating, ventilation, plumbing and air conditioning equipment and
facilities located above the plate.
4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total
net area of not less than 1 square inch for every square foot of enclosed area.
5. The bottom of the openings shall be no higher than 1 foot above grade.
6. The openings may be screened or covered with other devices that will permit
automatic entry and exit of floodwater.
En
Paget of 2
Building Permit Number:
Owner Name:
Parcel lies within the State Responsibility. Area (SRA). Comply with attached
requirements.
❑ Fire sprinklers are required in this structure.
❑ The following parcel map requirements shall be met:
r
All structures and equipment including overhangs shall be clear of all easements.
A setback of feet from the
side and _ID_ feet from the rear property lines and 20
feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of
structures and equipment except for a 2 foot overhang.
4 Expansive soil may be encountered on this site. This condition may require the
foundation to be designed by a California registered engineer or licensed architect.
Page 2 of 2
�CV q4
X
(9)
5h,L-O
0 Iq- Q-- I ^ b'EQ
1 �
;661 UH
N
T - �.•9 A Q
a PC ;
V t
4• '
co ►- Q. a
d Y O`c •9 Z IL
ti1A l M = o
p,pUj
xvw �-
1 1 N •1.1191311 'litlb�ll'roM ' i7 •: 7 `dIC
oc
It
LU
LF0
p ter. Q ac u
�I 6 • • •
O
•xvw W W
L4
CMI
OL
s • LAJ t�ir
.>o
z .
a
J
Ny ��tc•
J OC w
Q� D
y
v
DL
w1w. . 7r
EJ
November 6, 2002
Butte Community Bank
2041 Forest Avenue
Chico, CA 95928
ATTN: Jeri Cerrato
- 1;'Utte
160unt
L A N D O F N A T U R A L W E A L T H A N D B E A U T Y
PLANNING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (530) 538-7601
FAX: (530)538-7785
Re: Burn -down letter for 2334 Dayton Rd.,Chico, CA, (APN 039-170-010).
Dear Mrs. Cerrato;
The above referenced parcel is currently zoned A-10 (Agricultural, 10 acre minimum). This zone
allows for a single-family dwelling. This parcel is a pre-existing legal non -conforming parcel.
Should the dwelling be catastrophically destroyed it may be reconstructed, provided it will not be
placed within the required building setback areas and meets sanitation codes in effect at the time of
reconstruction.
The setback requirements for the A-10 zoning are 50 feet from the center of the road and 10 feet side
and rear yard property lines.
Should you have any further questions, please contact this office between the hours of 8:00 a.m. and
4:00 p.m., Monday through Friday, at 530-538-7977.
Sincerely,
arry Painter
Planning Technician H
CC: Development Services, .Building Division
Butte County Department of Development Services Planning Division
?.
Jill
r }
1
J
.- tel. -- 1 ♦
i• y
I`
July 16, 2002
Barry Bartlett
5969 Cana Hwy
Chico, CA. 95973
RE: Formal Warning Notice
Butte County Code Violation
2334 Dayton Rd., Durham, CA.
SAP# 039-170-010
Dear Barry Bartlett:
,gutte Co
L A N D O F N A T U R A L W E A L T H A N D B E A U T Y
PLANNING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (530) 538-7601
FAX: (530) 538-7785
Through our courtesy notice on June 19, 2002, you were notified pursuant to Section 41-2 of the Butte
County Code of the presence of code violations on your above -referenced property. According to our
records, the courtesy notice has not resulted in abatement or correction of the operation of a port -a -potty
business and/or storage of port -a -potties from your property. Your failure to eliminate the stated violations are
cause for the issuance of this formal warning notice.
As of this date, our records indicate that the following violations to the Butte County, Code still exist:
Butte County Code, Chapter 24, Section 24-65 - Applicability of zoning regulations. All uses of land
within a zoned district not specifically authorized or permitted by regulations are prohibited.
Butte County Code, Chapter 24, Section 24-270 - Home Occupations.
The business activities occurring at the above -referenced location have not met the requirements of a
Home Occupation as defined in Butte County Code, Chapter 24, Section 24-305.195.
The determination that this violation exists on the property is based on the following definition in the Butte
County Code:
Butte County Code, Chapter 24, Section 24-305.451 - Violator. An adult owner, tenant, occupant,
resident or other person having possession, control or any other ownership interest in or the right of
access to the premises, who is suspected or alleged to have violated or to be in violation of any Butte
County Code provisions of the Chapters specified in Butte County Code Section 24-305.451
In order to bring the property into compliance with the Butte County Code and avoid further enforcement
actions, you are hereby requested to take the following abatement or correction actions:
Barry Bartlett
July 16, 2002
Page 2
Cease and desist in the operation of a port -a -potty business and/or storage of port -a -potties from your
property.
2. Obtain an Administrative Permit from the Department of Development Services, Planning Division,
located at 7 County Center Drive, Oroville, California, for a Home Occupation permit, as per Section
24-270 pursuant to Section 24-40 of the Butte County Code.
This is your final warning. Unless you contact this office and make the proper arrangements to correct or
abate the violation(s) voluntarily, within ten 10 days from the date of this letter, enforcement shall be
pursued through the issuance of a citation (ordering you to appear in court) for said violation(s) and for failing
to comply with this warning letter.
Upon conviction of said violation(s) or of failing to comply with this letter, the court shall impose penalties
(fines) and allotice of Violation shall be recorded in accordance with Butte County Code Section 41-7. The
Notice of Violation will include a description of the premises the violation concerns, a description of the
violation, the date of your convictions and the action necessary to correct or abate the violation(s).
Should you have any questions concerning this matter, please contact me at the address or telephone number
listed above.
qin
E. Frank Cook
Code Enforcement Officer
EFC: kj
cc: Department of Development Services, Code Enforcement,
Rachel Marie Bartlett, 219 Tonea Way, Chico, CA. 95973
r,4
PROOF OF SERVICE BY MAIL
1
I am a citizen of the United States and employed in the County of Butte; I am,
2
and was at the time of the service hereinafter mentioned, over the age of eighteen years
3 and not a party to the within action. My business address is Department of
4 Development Services, Building Division, 7 County Center Drive, Oroville, California
5 95965. 1 am readily familiar with the County's practice for collection and processing of
6
correspondence/documents for mailing with the United States Postal Service and that
7 said correspondence/documents are deposited with the United States Postal Service in
8
the ordinary course of business on the same day.
9 On July 16, 2002, 1 served the foregoing 10 Day Letter on the person(s) named
10
below by placing a true copy thereof in a sealed envelope, with first class postage
11
thereon fully paid, addressed as indicated below, and by placing said envelope
12
X In the appropriate place within the Department of Development
13
Services where mail is collected for mailing with the United States Postal
14
Services on the same day.
15
In the United States Postal Service Mail in Oroville, California.
16
17 Barry Bartlett
5969 Cana Hwy.
18 Chico, CA. 95973
19
20 1 declare under penalty of perjury under the laws of the State of California that
21 the foregoing is true and correct and that this declaration was executed on July 16,
22 2002, at Oroville, California.
23
24
25
Kare . Jo es
26
27
28
.,:_�; .
"-
1Y,
00,
W7`
<
i
I
(0
5��
Cnvironmental Health
JUR 1 2* 2002
Chico, CA
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 o provide 1healaborjor and materials for construction of the proposed
property imp,jefement : YES NO
2. 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: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: CITY:
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
SOCIAL SECURITY NUMBER:
2�1DATE: G� —fNOTE. This Owner -Builder Ver (cation 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.
OVER
OWNER BUILDER INFORMATION I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors. then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your obligations under Federal Law, contract 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 contractors 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 contracting the Contractors State License Board in your
community or at 1030 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
IIMicPelC.
Vi ira, C.B.O.
uilding Inspection
NOTE: This Owner -Builder Information is required by Sectlon 19830 of the Californla Health and Safety Code -
OVER
039-170-010 u c 99-1458
BARTLETT, Barry f
,.2334 Dayton„Road, Chico
Contr: Owner- I
Demo portionL pe Ietter dated 6/24/98
SJ-
Arun- 6' i`�o ��
0
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 ��"' PMI .
(Rev. 12/96) APPLICATION AND PERMIT 0
ASSESSOR PARCEL NUMBER
039-170-010
ZONING
BUILDING PERMIT
OWNER
R PRY TTARTT T'NT'
TELEPHONE
4'A rmn
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
996Q CAVA 151Y IN rO rA Q5Q71
CONTRACTORSNAME
ii*P 1 f ,li
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
•
Filing Fee $
20.00
Permit Fee $
15.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
134 T Y' N RD., ('.t ICO
Energy Plan Checking Fee $
$
PERMIT FEE
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 0X Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other FO
Describe Work: DFMO PORTION - PER LT?TI'FR DATED 6/24/98
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W 1
920.00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
V OR LE
Main Service . ' OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
Id 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
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
1 3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
1 (The 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
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' compensationj provisions of section 3700 of the Labor Code, I shall
forthwit comply with,those pf s' ns.
� — Z
X ', � Date
it�iature of A plicanf - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service TO
46.00
NEW CONST. DWEWNO OCCUCUP.SO
EL
OR ADDNS. ( & ACC. BLDS. 3.5¢x.
Np RO., 1p T. MULTI -OUTLET
. BRANCH CIRCUITS
@7,50
POWER APPARATUS
& SINGLE OUTLET CIR.
20
EX. Occup. OUTLET OR FIXTURES BAL ®I
Ex. Occup. OFIXUTIEEOfSA RESS16.OEl 5.00
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ o nn
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
PD
HO
ISSUE
i
This permit is hereby issued under the applicable provisions
in the Butte County Code and/or Resolutions to do work
indicated a ova for which fees have been paid.
'' 6/29/1)9
'�- A44/Date
U6-
By (.G
l (16/2/00
PERMIT EXPIRES ON
Date
Receipt No. L��tat
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
A .I
-,COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 �/PERRMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT . -
ASSESSOR PARCEL NUMBER
039-170-010
ZONING
BU I LDI NG P ERM IT
OWNER
BARRY BARTLETT
TELEPHONE
343--6340
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
5969 CANA HWY. CHICO,
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation Is
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
15.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
2334 DAYTON
Energy Plan Checking Fee $
$
PERMIT FEE $
35.00
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF OX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Others —Building
Describe Work: DEMO PORTION - PER LETTER DATED 6/24/98
Gas piping system 1 - 5 outlets
15.00
sewer
15.00
Mobile Home IS I G W
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service ZOO, OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.POWER
License Class Llc. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
LiLwjor the following reason:
PQ I, as owner of the property, or my employees with wages astheir sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
- of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
com ensation laws of California, and agree that f I should become subject to the
v� ers' compensatio provisions of section 3700 of the Labor Code, I shall
�( h ' comply wi ose s' s.
��
X Date /
ature of plic - Owner ❑ Contractor ❑ Agent
An OSHA per it is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWEWNG OCCUP. SO
OR ( a acc. BIDS. 3.50'7.
CONS
NO pEOSD. MULTI.OUTLEr @7,50
APPARATUS
a SINGLE OUTLET CIR.
00
OR
EX. Occup. OUTLET OR FURES BAL @ 1 0
Ex. Occup. ouriErs RESID.OEA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $
NAZ.
D FEES IMP
I FLOOD
CDF
I PARCEL
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated a ove for which fees have ben paid.
^
6/29/99
By auzg Ak Date
PERMIT EXPIRES ON /29/00
Date
Receipt No. 273261
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
%
COUNTY OF BUTTE %- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive a Oroville, California 95965 • Telephone (530) 538-7541
;Rev.12/96) APPLICATION AND PERMIT
=�
N� IAFICeL
BUILDING PERMIT
SO. FT. OCC. BUILDING VALUATION
oowrRUCrwFF x1"01
ItForFrs WAXING AMOWN
A1110"" T OR 1140111
AR MRCT OR 011*'U Is WILING AD
rorwa suaavranwut
USEOFSTRUCTURE
SF 10 Duplex O Mobllshome O Other
TYPE OF WORK
New O Addition O Remodel O Utlllies %installat
Describe Work: d,lk- 1n . .)4L -i
20.00 I
11111 Fee 20.00
7.00
23.00
15.00
15.00
15.00
-,T-500
020.00
Fireplace
t
Total Valuation Is
ucuse NO.
Firina Fee =
al Olt
"" OR LM
Permit Fee =
Main Service
Plan Checking Fee i
40.00
Energy Plan Checking Fee i
c �
i
woraRoio. ' (
PERMIT FEE _
rARca "AP
PLUMBING PERMIT
Each Trap
Solar a heat pump water heater
Water piping
eF6cnr
Each as water heater or vent
Gas piping tem 1 -5 outlets
O Other
0 f I 0A
Building sewer
Mobile Home S G W
20.00 I
11111 Fee 20.00
7.00
23.00
15.00
15.00
15.00
-,T-500
020.00
I Ex. Occup. ( ourw OR mmolles ) 1 1 - S'-:° I I
5.00
I Mobile Home Facilities 1 1 20.001 l
23.00
PERMIT FEE 18 IF
MECHANICAL PERMIT I Flinn Feer 20.00
ve
PERMIT FEE S
Mobile Home Installation Fee $
Energy Inspection Fee i
OC` C016T. TVPE TOTAL FEE $
NAL 10. Firs INr ncoo I Cor I rArca Fo1O ss1.c
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
ReceiptNo._^i���/ PERMIT EXPIRES ON
WNIIE•0.0.3. 9.0. g R p�y�.��QpEC70N nn� ne..oAO•APPLIC�NT
PERMIT FEE
t
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service
al Olt
"" OR LM
23.00
Main Service
20" To IMA
40.00
Hew CONST.
OR bow•
o�aui�oc.
3.5tFFT.
woraRoio. ' (
MuiTFountT )
BRAWN C/Idl}f
Q7.50
I Ex. Occup. ( ourw OR mmolles ) 1 1 - S'-:° I I
5.00
I Mobile Home Facilities 1 1 20.001 l
23.00
PERMIT FEE 18 IF
MECHANICAL PERMIT I Flinn Feer 20.00
ve
PERMIT FEE S
Mobile Home Installation Fee $
Energy Inspection Fee i
OC` C016T. TVPE TOTAL FEE $
NAL 10. Firs INr ncoo I Cor I rArca Fo1O ss1.c
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
ReceiptNo._^i���/ PERMIT EXPIRES ON
WNIIE•0.0.3. 9.0. g R p�y�.��QpEC70N nn� ne..oAO•APPLIC�NT
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.
I personally plan to provide the major labor and materials for construction of the
proposed property improvement: YES NO[ ].
I HAVE[�j HAVE NOT[ j sigrfed 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: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to
coordinate, supervise, and provide the major work:
NAME:
ADDRESS: —CITY:
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:
SOCIAL SECURITY NUMBER:
DATE:
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.
May 1995 2.26
J , ,
Dear Property Owner:
O.B.-1
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are personally
performing their own work. If your work is being performed by someone other than yourself, you may protect
yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all permits
for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and other costs) is $300 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract 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 contractors is to secure an "ownerbuilder"
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 contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned.
Sincerely,
Michael C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
May 1995 2.27
Demolition Permits
Asbestos Notification Statement
Date
AP#
Pursuant to section 19827.5 of the California Health and Safety Code, all
demolition permit applicants are required to fill out this form.
"19827.5. A demolition permit shall not be issued by any city, county,
city and county, or state and local agency which is authorized to issue
demolition permits as to any building or structure except upon the receipt
from the permit applicant of a copy of each written asbestos notification
regarding the building that has been required to be submitted to the United
States Environmental Protection Agency or to a designated state agency, or
both, pursuant to Part'61 of Title 40 of the Code of Federal Regulations,
or the successor to that part. The.permit may be issued without the applicant
submitting a copy of the written notification if the applicant declares that
the notification is not applicable to the scheduled demolition project. The
permitting agency may require the applicant to make the declaration in writing,
or it may incorporate the applicant's response on the demolition permit appli-
cation."
Attached is a copy of my written asbestos notification to the United States
Environmental Protection Agency for the demolition project located at
Signature of Applicant
6R
I hereby declare that a written asbestos notification to the United States
Environmental Protection Agency is not applicabl to this demo on project.
gnatu a of Applicant
2/19/91
PERMIT NO. 2231-77B,E,M
PERMIT EXPIRES
OWNER Byron Tobey
CONTR. owner
LOCATION (A.P. 39-17-10
W/S Dayton Rd.,app.4 mi/S.of Rogers Ave., Chico
Temp. Power%Pole
Called PG&E
-ftvWlec. Serv.
C Ied PG&E
Te P.Gas Serv.
Called PG&E
JOB
'} Q
cZ —,71 O
(Date)
(Signature)
k
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS '
BUILDING INSPECTION RECORD
BUILDING. BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwall
Insulation
Heaters
Slab
Carport
Footings
Prov. for physically
handicaped
Conformance of ex.
structure
Appliances
Gas Piping& Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
FIRE SPRINK
H tr.
Mesh
MECHANICAL Grd. Fault Prot.
Scratch
Heating Service
Brown
Cooling Temp. Pole
Finish
Ducts Underaround
Interior Lath
I Ventilation
I Permanent
Door Closer
I Final
Final
MOBILEHOME UTILITIES
------------------ Elec_ Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
MOBILEHOME INSTALLATION
-------------- Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE
REMARKS OR CORRECTIONS
/j a�(NOTE: An entry must be m de on thi�eac time you visit the job siie.)
r
a i -A17
19 1: -��r
,5 ,
P , F
- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
Owner
Mailing Address
BUILDING W' ► `"
SQ. FT. OCC. BUILDING VALUATION
QW .tel e -w
.. < / _ V*6c"Z AJC J c �� �l��c_ rf•
CL L. � %-0 ! V --- / �lGlrl Tel ? ell?_ 40 � 9d
Cont
Mai I ing Address
Telephone No.
Building Address
A. P. N9v J y1— `/0 Zoning & Planning
Fees W.C. FireDept. Fire Zone Use Permit
EQA I ParkingI Declaration P P Parcel
Plans Parcel Ma I 60' R/W I Improvements
ec Parcel Approval I Plans Approval
NEW ❑ ADDITION ❑ UTILITIES ❑ OT�H-ER ,N
�OVUIC-� Ah® o -/0o AL...®.2ft
Single Family
1 Duplex ❑ Mobil Home ❑ Others ❑
Fireplace
Total Valuation
Permit Fee _
Plan Checking Fee &/or Penalty
Permit Fee
PLUMBING
PERMIT FILING FEE
Each Trap
Repair drainage or vent piping
Water piping
Each gas water heater or vent
Gas piping system 1 - 5 outlets
Each additional outlet
Building sewer
Lawn sprinkler system
Permit Fee
NON.RESID. 1 SINGLE OUTLET CIR.
ELECTRICAL
PERMIT FILING FEE
Main service
600V OR LESS
100 AMP OR LESS
Main service
EA. ADD•L 100 AMP
Main service
OVER 600V
i0o AMP OR LESS
Main service
EA. ADD•L 100 AMP
NEW CONST. (DWELLING
OR ADDNS.
OCCUP. B
ACC. BLDGS.
NEW CONSTFR.
NON.RESID_
(MULTI -OUTLET
BRANCH CIRCUITS
@ FEE
$3.00 3 "
5.00 j c}.)
2.50
25.00
1.00
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above- entl d property for inspection purposes.
I
X ��Date 1�-
ue of Permitee or AgenY
Receipt No. \/llye / / G``/S-
White-D.P.W. — Y/I ssor Pink -In pelo8c— Goldenrod -Applicant
TOTAL PERMIT FEE $ Sd
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 aid.
DIRECTOR 0 P BLIC WORKS
BYu
Date__'�'1���
ilding permit expires Date
NON.RESID. 1 SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
St le of:
y
Ex. Occup(OUTLETS OR FIXTURES)50
@25qr
109
Ex. Occu FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
License No. Classification
Misc. Wiring SC -4v2-
6.25
_
I am exempt from the Contractors License Laws of the State of California.
49
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑1 have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No.
@ FEE
PERMIT FILING FEE
$3.00 --
Heating
Cooling '
Ventilation
Hood
2.00
Permit Fee
$ � 0 �-
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above- entl d property for inspection purposes.
I
X ��Date 1�-
ue of Permitee or AgenY
Receipt No. \/llye / / G``/S-
White-D.P.W. — Y/I ssor Pink -In pelo8c— Goldenrod -Applicant
TOTAL PERMIT FEE $ Sd
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 aid.
DIRECTOR 0 P BLIC WORKS
BYu
Date__'�'1���
ilding permit expires Date
COUNTY OF BUTTE m- DEPARTMENT OF PUBLIC WORKS .
7 County Center Drive - Uroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the county of Butte to enter upon the
above enti d property for inspection purposes.
X Date
v e of/Permitee or Agent
Receipt No. //6 ( _
White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant
`s
This per it is hereby issued under the applicable provisions of
the ButtO County .Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By- Date
Building permit expires Date
BUILDING
Owner6 42-
S0. FT.
OCC.
BUILDING VALUATION
Mailing Address I S
�, - — Tel hone No.
ContractT� U 14
Fireplace
Total Valuation
Mai I i ng Address {- -Q
Permi t. Fee
PlanCheckY} ingFeeB/or Penalty
Telephone No.
Permit Fee
Building Address—Q
__ PLUMBING. No. @ FEE
PERMIT FILING FEC $3.00
/
�,14U
Each Trap 1150
iJ'F f
Repair drainage or vent piping 1.50
-
--
_ C
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No J y� iW -� Q
Zoning & Planning
Z
Gas piping system 1 - 5_outlets 1.5U
.
Each additional outlet
Building sewer
sl
W.C.
SaR+rr
Fire Dept.
Fire Zone
Use Permit
EQA
I Parking
Plans
I Parcel
Declaration
parcel Ma p
60' R/N/
Improvements
Lawn sprinkler system A 111
if &
c
Parcel Approvol
Plans Approval
Permit Fee Ir if
F1 LN AL _FEE
PERMIT
PERMIT Ff L G E _ 0 3. 0�-c'
servic °o AMP Sees! 5.00 .-5, -V
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
fi -v (S�;?
_Main
,C� ,.�.(,
�je c�—`��`•"�'t C
Main servi a A. •L loo dP 2.50 _�..u.
Matin servic OvElklftoV00 4VP OR LE S 25.00
Main ser v E J. At D•L 1.00
Single Family E� duplex ❑ Mobil Home ❑ Others Ir_�J
-
01
NEW CO (D ELLI.NG CCUP.
OR AD \ A . BLDG ) 20sgft
NEWST / LTI.OUTL
TRAC FtS LICENSE LAW 0
I am licensed under the provisions of Chapter 9, Div. 7, -e -
State of California Business & Professions Code under the name
of:
NON ID, l_ ANCA CI UITS) 2.50ea
NET WEFT P l'U&
N ESID. (SING OU T. CIRS .
@
x p I"E OR FIXTURES) 6AL@1
F IXstyle
E cu OUT TS P(R_ESID )REA) 2.00
TcAporvseoe 10.00
Mob Mome raciIities 15.00
License No. Classification
I am exempt from the Contractors License Laws of the State of Cal ifornia.er
ir g 25
""
A it
i ee _ $ Z
j� f
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I' have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHA AL
@ FEE
PERMIT FILING E
$3.00
Heating
ooling
,�lati /
2..00
e it Fee $ �
'-
$
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
TO A/- PERMIT FEE --
_- _
$ i2 Sl
authorize representatives of the county of Butte to enter upon the
above enti d property for inspection purposes.
X Date
v e of/Permitee or Agent
Receipt No. //6 ( _
White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant
`s
This per it is hereby issued under the applicable provisions of
the ButtO County .Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By- Date
Building permit expires Date
45--llq -7 7
gal A V ILIC— -T)
17 /Z 42 z;r-7 7orek:,94
pnoro"FF /Z
T
7-
914-14219-
�� Gs