HomeMy WebLinkAbout039-230-023COMPLAINT TO INSPECTOR<
i
' PERMIT DESIGNATION: B -BUILDING
DEPARTMENT OF P -PLUMBING
T -TRAILER
BUILDING AND SAFETY
A.P. 39-23-23
IRA ISRAM
+ e/s Fimple Rd. app. 325' no. of .Dayton--
Durham Rd . j DurhamCi�t; /%-3
Permit 712-73P,F
(utilitie for .mobile�home) _
039-230-023 05-2012 f1
ISHAM FAMILY LIVING TRU „P
ETAL I
WINAE9626 FIMPLE RD, DURHA
EDCont: OWNER ISSUED REMARKS
I ELEC SERV RECONNECT�
E - ELECTRICAL
TV -RADIO -TV ANTENNA
S/W-SIDEWALK NOTICE
U -USE PERMIT
V - VARIANCE
S - SIGN PERMIT
a
HM- HOUSE MOVING
EP -ENCROACHMENT
D - DEMOLITION 600.1
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INSPECTION RECORD
BUILDING APPROVALS
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PLUMBING APPROVALS
PERMIT NUMBERI
SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE
ROUGH -IN
GAS PRESSURE TEST
WATER PIPING
SEWER LINE
APPLIANCES & VENTS
FINAL
ELECTRICAL APPROVALS
PERMIT NUMBERt
DESIGNATION SIG.
DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE
SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE
ROUGH -IN
FIXTURES & APPLIANCES
METERS
FINAL
MISCELLANEOUS APPROVALS
PERMIT NUMBER:
DESIGNATION SIG.
DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE
NOTES
RESIDENTIAL
PERMIT NO.
039-230-023 05-2012
t ISHAM FAMILY LIVING TRUST, B
ETAL
9626 FIMPLE RD, DURHAM I
Cont: OWNER
ELEC SERV RECONNECT
F•
SPECIAL CONDITIONS
CHECKE
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
OFFICE COPY
Address
GAS
Meter By Date
ELECTRIC
Meter By Date
JOB FINALED (Date
�s--�
Signature
J=OK
0= Not OK
- = Not ApfiReady
. =Not Ready
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s'
Date
1. Zoning Requirements-Setbacks-Easements
2. Soils; Special MH Support Sketch
3. Sewer, Location-Test-Fall-C/0-Concrete
4. Water, Location-Test-Easement Needed (Sketch)
5. Electricity, Location-Clearances-Gmd-/ /Amp-Concrete
6. Gas; Location-Test-Wrap;-1 /" L'ft.
/ P Nat. or/ /" L "ftJ P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
8. •Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Easements
Date
2. Footings; Size-Spacing-Marriage Line
Date
3. Gas; MH Test-Demand-Valve-Connector
4. Electricity; MH Test-Crossovers-Breakers-Clearances
5. Drain; MH Test-Fall-Flex Connector
6. Water, MH Test-Regulator-Connectoe
7. Water and Sewer Connected-C/O to Grade-HD Approval
8. Gas and Electricity Tagged
9. Tie Downs-Type-Installation Cert.
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
Date
Cana B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1. Zoning Requirements-Setbacks-Easements
2. Footings; Size-Spacing-Marriage Line
3. Blocking
4. Gas; MH Test-Demand-Valve
5. Electricity; MH Test
6. Water, MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
10. License Decals
11. Verify #'s with Office
Date
_ Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. •Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
= OK
= Not OK
= Not Appriable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ /" Fig. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth
4. Fig., Porches & Decks; Soils -Steel-/ /' Fig. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler, Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) .OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI
Insulated Neutral O Yes O No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Cana B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking -clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door, Swing -Landing -Closure
76. A.C. Dud in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.1.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor O Yes
83. Following InstldJDrive 0 Yes 0 No/Walks O Yes O No/Planters O Yes O No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fre Sprinkler
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
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COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Ortiville, CA • (530) 538-7541
CORRECTION NOTICE
OWNER
PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
s'
Date Inspector Li M& d/x���
02
REV 4/05 Phone # �, h l (,1
FOR RE -INSPECTION CALL: 538-.7.636 OR 891-2834
j
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 )FAX#: (530)538-2140
WEBSITE: www.buttecounty.neAdds
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that 'I am Aicensed under
provisions of Chapter 9 (commencing with Section 7000)•6f Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any.city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance;- also requires the applicant for such permit to file - a
signed statement IQ he or she is licensed'pursuant to the provisions.of
the Contractor's State`License Law (Chapter 9 commencing with Section .
7000); oPbivision3 of the Business and Professions Code) or that he or r
she is ,exempt therefrom and the basis, for,.the: alleged •exemption: Any.
violation : of Sectjon•„ 703:1;5 by any applicant for a perm!t sWbjects the..
applicani,, td:a..civil'penalty'of not more than five hundred'dollans ($500).):'
1, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
igtegded�or, offered,(orsale..(Sec...7p.44:,,Busingss a.nd _Professions„ ,..,., _
Code: The Contractors': State License: Law:does.:not apply to an
...:.. owner•of. property who,builds or. improves. thereon, and. who.does
such_work..himself.or.herself or through.his ocher own.employees,
provided that such improvements are not. intended or.offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
'proving that he or -she did not b�iddor' improve -for -the purpose of
sale.).
Q::; A..as...owner of....the•.property,_am..exclusively., contracting..with.•
licensed contractors to.construct'the-project (Sec. 7044, Business
-and. Professions Code: -The Contractors' State License Law does
not apply!o an owner of. property who builds.or improves thereon,
and .who contracts dor such projects with a contractor(s) licensed
pursuant to the.Contractors' State License Law.):
❑ >> 1 am Exempt.'under Article 3 o he' iness nd: ofessions Code. '
DalOwner: '
WORKERS' COMPENSATION DECLARATION,;
I bereby.affirm:under penalty of perjury one of the following•declarationsI
❑ I. Piave acid will maintain a certificate of consent to self -insure for
worker's,';compensation,. as provided for by ,Section .3700 of the
Labor .Code, for the performance of the work for which this permit
is issued:
LI 'I have .and.,will:�•maintairi:.workers' compensation insurance, as
-reggire.d.by Section 3700 the LabonCode; for the, performance -.of
the work for which this permit is: issued: My workers' compensation
insurance carrier. and 'policynumber are: '
Carrier: ;
Policy #:
kiss'u`ed;�1--
I certify'that in%th'erperformance:of:the work•'for which •this permit is
' shall. nob -employ any person in any manner so as to
become•;subject to the�.workers' compensation. laws of California,
and .agree that: if I, should'::become subject':.to the workers'
compensation provisions -of Section. 37.00 -of the Labor Code, I shall
forthwith comply with those provisions.
Date .. .
Applicant:'-,.: .;
WARNING:'=`.Failure o secure workers' compensation coverage is
unlawful; and',ihall subject an employer to criminal penalties and one
hundred~ thousand" dollars ($100;000); in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
.code, interest, and.attomey's. fees'. ,
CONSTRUCTION LENDING'AGENCY<.:
I hereby affirm�that therwis a construction'lerfding agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Address:
PERMIT NO.
BPO52012 .
Issued Date: 07/28/2005 APN: 039-230-023-000
Site Address: 9626 FIMPLE RD DUR
Map Index:
Description: RECONNECT ELECTRIC SERVICE
Owner: ISHAM FAMILY LIVING TRUST B ETAL
(SHAM IRA N..TRUSTEE
2611 OAK WAY
....:.CHICO, CA.95973
Applicant: ISHAM FAMILY LIVING TRUST B ETAL
Contractor:
License #:
Architect:
Engineer:
Total Square Ft:
Valuation:
Census Code:
ISHAM IRA N TRUSTEE
2611 OAK WAY
CHICO, CA 95973
0 S. F.
$0.00
This permit is here4y issued under the applicable pro
Resolutions to)2lork indieated above for which fee
PERMIT EXPIRES
sions of the Butle County Code endlor
have been paid.
Date:
ir1. 1
O I he'rebycertifythat.the.use of.this facility shall Comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling.and use. of hazardous materials.
❑ Notification in accordance' with'Section,19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project.
O Attached`are copies of the required E:P.A, notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county..and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any offi ' form or ocum of Butte County. I hereby
authorize representatives of Butte County, to enter, upon the above mentioned property for inspection purpos
7. j��
Print Name:.f— j rn / Yr fit 11 ' .fig Z '� f Signature:
" Owner • -❑ Contractor ❑ Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 536-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netWds
PERMIT NO.
BP052012
LICENSED CONTRACTORS DECLARATION '
I hereby affirm under penalty of perjury that 'I am licensed under
provisions of Chapter 9 (commencing with Section 7000)rof Division 3 of
Issued Date: 07/28/2005 APN: 039-230-023-000
the Business and Professions Code, and my license is in full force and •
effect.
License Class: License Number:
Site Address: 9626 FIMPLE RD DUR
Date: Contractor:
Map Index:
Description: RECONNECT ELECTRIC SERVICE
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contactors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: (SHAM FAMILY LIVING TRUST 6 ETAL • • ••• - ••••
permit to construct, alter, improve, demolish, or repair any structure, prior
--•-r -
t;•. t,.:•
to its issuance; -also requires the applicant for such permit to file -a
: -r: s :,.. ,
signed statement that he or she is licensed -pursuant to the provisions of;;`ISHAM
I.RA`NdTRUSTEE `
the Contractor,'s Siate'License Law (Chapter 9 commencing with Section
i
7000);o1`,Dmsion 3 of tfie$usiness and Professions Code) or that he qr+
_!_: '; ;` 2611 OAK WAY
she, is;exempt therefrom and the basis for,the alleged exemption: Any:
i,•.,� • CHICO,,CA.95973. ; ; l
wolationof Se -666'7631.5 by any applicant for a permit subjects the,
-ii
applicarii td:a 6 penalty of not more than five hundred dollars
I, as owner df the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
...�,,,int�ndedor,offered,tor•sale•.,(Sec.,70.44.,,Busimess,artd,f'rofessions,
„-,•,,•,,,,,•,,,,,�„�� _
Code The Contactors State License, Law'Aoes.not apply to an
Applicant: ISHAM FAMILY LIVING TRUST B ETAL
..owner of. property who1builds or.imp,roves thereon(,and who.does
,,, such work-,himself.or.herself or through his or her own employees,
provided,that such improvements are intended or.offered for
(SHAM IRA N TRUSTEE
_'sale. If however, the building or improvements are sold within one
�(
year of completion, the owner -builder will have the burden of
2611 OAK WAY
`proving that he or she did not build`or improve for,the-purpose of
CHICO, CA 95973
sale.).
,0,.,.,,1, „as._owner•,.:of,,,the:...property,,..am—exclusivel.y.,,contracting,.with.
licensed contractors to constFuct.the.project (Sec. 7044, Business
-and Professions Code.,,The Contractors' State License Law does
t;,not applyto an owner of, property who builds. or, improves thereon,
;,,:• and who contract' for such projects, with a contractor(s) licensed
-•. pursuant. to the Contractors' State License Law.): • ”Contractor:
• " 1._ � ^
❑ .,,I am Exempt- 'under Article 3 o he iness rid. ofessions Code' -
Date: Owners "
..
_
COMPENSATION DECLARATION,'—.,
I .hereby.affirm.under penalty of perjury one of the followingg• declarations'•
❑ 1. ve"`and will maintain a certificate of consent to self -insure for
License #: , • • - • - • --
workers-_compensation,,,as provided for by,Section,3700 of,the
Labor _Code, for, the performance of the work for which this permit
is issued
O I"- have •maintam•;.workers' 'compe as
.• J
and will sation-iinsu ance,
Architect:
,.,,--required, by Section 13700 the Labor Code; for,the performance of
.the work forwhichthis permit is issued:; My workers` compensation
Engineer:
insurance carrier, and policy number are., :. . .
v.
Carrier:'; : +
Total Square Ft: 0 S. F.
Policy #-
_
.{I • t, 1%�s. ..+ wr<1an , viiY �'vs:w-15,...vh•..'rwuwu%Yi. •.i:r.ctstlM.«...., .M\.,
certify that in therperformance"ofaie workforwhich•this permit is
Valuation: $0.00
issued;^'1: shall;: not.•empioy any person -in' -any -manner -so -as to
Census Code:
become -subject to they.workers' compensation: laws of California.
and agree that..4, I should•>become , subject to the workers' .
compensation provisions -of Section 3700 -of the Labor Code, 1 shall
. .
forthwith comply with -those provisions
Date:
Applicant,'+,
i•+; z , ,
WARNING:'Failurewto secure workers' coniperisation coverageis
unlawful, and;•shali'subject an employer to`criminal penalties and one
•• -
hundred4thousand dollars ($100;000), 'i6, addition to the cost of
compensation damages as provided for in Section , 3706 of the Labor
code, interest and attorney's fees. , .,. ' ., , ,•
r . CONSTRUCTION LENDINGAGENCY-r
This permit is here4y issued under the applicable provisions of the Butte Cnunty Code ?nd/or
,!I hereby affirm1hat there -is a constriiction'lending agency for the
Resolutions to ork indie led above for which fees have been paid.
performance'of the work for which this permit is issued (Sec 3097 Civ.)'
Name:
B Q�
y Date:
PERMIT EXPIRES 1 Q �p
Address.
(Lbte)
❑ - fl herebycertify that the use of this facility shall +comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling, and use. of,hazardous matterials.
❑r Notification in accordance'wfth Section -19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
Cl Attached are copies of ttie'requiied E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner., I agree to comply with
,
all county and, state laws relating to building construction. 1 acknowledge it is unlawful to alter the substance of any offi ' form or ocum of Butte County. I hereby
authorize representatives of BButte County to upon the above mentioned property for inspection purpos
enter
Print Nam_ a ri- m / '' vt 71 ' /•✓J� �, .� ��> Signature:
Date,
` "'Owner-- ;' ❑ Contractor 13 Agent for Owner 0 Agent for Contactor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
APPLICANT NAME
OWNER
Lasf ameT
State
First Name
Address
City
City
State
Sta�
Zi 5—
Phone-
yZ
_/��
Fax
E-mail
Lic. #
APPLICANT NAME
CONTRACTOR
Name oW
State
Address
Phone
City
E-mail `
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
State
Address
Phone
City
E-mail `
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
Address
1
City
State
Zip
Phone
Fax
E-mail `
APPLICANT SIGNATURE
X
For office use only:
Zoning
Property A�esp
66
Flood Zone
Cross Street
c, 0
SRA
I es
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
TLot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
6r- 'a61�
BP
BIN #
LOCATION
AP#
3 - 0-02 3-OaO
Property A�esp
66
City
U
Cross Street
c, 0
WORKER' COMPENSA ION
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.
SMIP
LENDING AGENCY
Name
Address
Description or Sf Work:
co a o
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Page 1 of 2
REV 2-24-05
Receive by: Amount:
Bldg
SRA
Receipt #:
Sheriff
q9 ss L'
SMIP
Other
Date. I`—
Tn4al
Page 1 of 2
REV 2-24-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ A. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538.7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
�,::F�,Y `i•a.i:i. %!�i:lf�a:i�L.k.: •. !ti.. �•t +;'.�..+ +. ri i::i:`. - _ __
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return'this information at your earliest opportunity to avoid unnecessary
delay in processing and issuing your building permit. No building permit will be issued until this
verification is.received.
1. I personally plan to provide the major labor and material for construction of this proposed
property improvement: YES t4] NO [ ].
2. I HAVE [p'] HAVE NOT [ ] signed an application for a building permit for the proposed
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:'
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise, and provide themajor work:
NAME: _
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTY OWNER:
DATE: - O
'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.
Rev'd 11/42004
Butte County Department of Development Services
ADMINISTRATION ° BUILDING t GIS' PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile
ti
-a::.� ii<.F.x+, r.,< S._ F.s.C3Lij!•.4�"'N2 :ii'c" \Y�'i.''%..Y"4u`Y°`.,�Y�""':;c..�....J;;o'�:'i�:s;;a;
WN�TILD L_{ �.TO�kN
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their own
work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the city or county. They are also required by law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal govemment as an employer and you are subject
to several obligations including state and federal income tax withholding, federal social security taxes, workers'
compensation insurance, disability insurance costs, and unemployment compensation contributions.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be 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 contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
ON -1
C. Vieil C.B4O.
, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
.
Butte County Department of Development Services
ADMINISTRATION * BUILDING * GIS * PLANNING
7 County Center Drive
Oroville, CA 95965 t' ti xy
RETURN SERVICE REQUESTED
Occupant
9626 Fimple Rd..
Durham, CA 95938
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COUNTY OF BUTTE = DEPARTMENT OF PUBLIC WORKS
r 7 County Center Drivq,� OroviIIe, California 95965
Telephone: 533'1230,,,1Ext:1259 534-4541
APPLICATION AND PERMIT
auuwllcc ICpICJelIIdUVeJ ul Ule Uuunry of dune to enter upon [ne
above-mentioned property for inspection purposes.
A v %; . ,.�- Date
Signature of Permitee or Agent`
Receipt No.
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building Permit Expires Date '7
BUILDING
Owner a
SQ. FT. OCC. BUILDING VALUATION
Mailing Address.
Fireplace
Contractor (�!l�l.!''0
Total Valuation
Mailing AddressPermit
'
Fee
Plan Checking Fee &/or Penalty
Permit Fee $
$
Building Address
PLUMBING No.1 @ FEE
'PERMIT FILING FEE $2.00 a,(, d' v
A.N"A1, i- /
,Eacp Trap 1.50
/'
lfie—_"-....
Repair drainage or vent piping 1.50
Water piping 1,50 a "
'
Each gas water heater or vent 1.50
fr«
A. P. No. !� „- "" �, �,.«�
- /-n
Zoning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet 1 .50
Fire Zone
Fire Dept. (�
Sanitation -/A'71<
,Planning
Building sewer )71A,& /," 5.00
0—
Plans �r�
Fees 00-1,1W.
C.
•----
R/W
Encroachment
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ OTHER Q
Permit Fee
" 'n Al f.V J
' "
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
V r„�. - , -
Main service incl. 1 meter _RV W
,
Additional meters, each 1,00
Sub -panel (12 or less) (more than 12)
USE OF STRUCTURE Single Family'[91 Duplex ❑ Others -1:1
Range, dryer or water heater 1.00
`
Oven, Cook -top or space heater 1.00
Light fixtures20 R 25
Receps., switches & fix outlets b
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F. A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump /
Misc. wiring ---IW o,�r /'•�,( fl• , w� , v n
License No. - ,Classification
0 i am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
a 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
Permit 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
Insfrumentaoiontrpf groo^ion $0.07/$1000 Evaluation
$
TOTALY PERMIT FEE
$--� V
auuwllcc ICpICJelIIdUVeJ ul Ule Uuunry of dune to enter upon [ne
above-mentioned property for inspection purposes.
A v %; . ,.�- Date
Signature of Permitee or Agent`
Receipt No.
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building Permit Expires Date '7
14
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives or the County of Butte to enter upon the
above-mentioned propert for ins ection purposes.
X Date
Signature of Permitee or AA nntt
Receipt No. / O `�C SCJ
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date .5— z—O -i
Building Permit Expires Date —7
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
ciFireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Permit Fee $
$
Building Address S
PLUMBING No. @ FEE
FILING FEE $2.00 r
/nfUMIT
JWP Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50 0
`
Each gas water heater or vent 1.50
A. P. No. ing -3
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .50
Fire Zone
Fire Dept.
Planning
Building sewer 5.00
Plans
Fees
W. C. R/W
Encroachment
Lawn sprinkler system 2.00
NEW ❑ DI N ❑ OTHER �
Permit Fee $
$
ELECTRICAL No.1 @ •FEE
PERMIT FILING FEE $3.00
Main service incl 1 meter
Additional meters, each 1.00
USE OF STRUCTURE Single Family
Duplex ❑ Others ❑
Sub -panel (12 or less) (more than 12)
Range, dryer or water heater 1.00
Oven, Cook -top or space heater 1.00
Light fixtures
Receps., switches & fix outlets 20025b
CONTRACTORS LICENSE LAW
I am licensed under - the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F. A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Misc. wiring
License No. Classification
i am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
-
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Permit 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
tate Fee for Str ng Motion
n;trumentation fyrogrom $0.07/$1000 Evaluation
$
TOT AL PERMIT FEE
$
authorize representatives or the County of Butte to enter upon the
above-mentioned propert for ins ection purposes.
X Date
Signature of Permitee or AA nntt
Receipt No. / O `�C SCJ
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date .5— z—O -i
Building Permit Expires Date —7