Loading...
HomeMy WebLinkAbout039-270-109IN 39-j7-' y�r,'� v �g Larry Lambert 3959 Front St. , blot 03, Dayton Permit #5495-80B,P,E,M(2ew single fam.) ' 4 1 I � NEW OWNER 39-27-1091j ' � vl GEORGE STENLUND ' Contr: Chris Lambert a'� ` rermft#501'-88a,'E,Nl'('iiddition & remodel/SF 039-270-109: 04-1370 . 1 HARSTON;"JEFFREY _ t 3965 FRONT ST, DAYTON - Cont: "RELIANCE PROPANE Y PROPANE TANK/LINES 3 -27 -. - fL.. STON, JEFFERY 1 3965FRONT ST, :DAYTON INALE® Cou.c: SI-T.SRATON SE:RVI.CE s 2i b4 REPLACE EX GRT HVAC i e t p 1 p V 1 9 BUTTE COUNTY . DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP041435 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/19/2004 APN: 039-270-109-000 the Business and Professions Code, and my license is in full force and effect. License Class: 0 License Number: l J�ICJ^` Site Address: 3965 FRONT ST DAY c Date: I O Contractor: P(C��(j(� . eryl Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: replace ex ground mount hvac Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: HARSTON JEFFERY M. & DEADRA E to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 3965 FRONT ST 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 95928 applicant to a civil penalty of not more than five hundred dollars ($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 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: HARSTON JEFFERY M & DEADRA E such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have* the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: SHERATON SERVICES O 1 am Exempt under Article 3 of the Business and Professions Code 1170 E LASSEN AVENUE Date: owner: CHICO, CHICO, CA 95973 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 License #: 733676 Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation n Engineer: insurance carrier and policynumber are: g C 5� Vk3` Carrier: `A_ J Total Square Ft: 0 S. F. Policy #: LO 2� D, (_p BOO O 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 Valuation: $0.00 become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall (/ forthwith comply with those provisions. Date: g I Cl it) r Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor 4.05% 14- -511,910'— code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the This permitishereby issued under the applicable provisions of the Bufte County Coda anrvor - Resolufio�sl to d ork indicated above for fees have been performance of the work for which this permit is issued Sec 3097 Civ. p ( ) which paid. 5�l Name: BY:Daje: PERMIT EXPIRES N: J Date Address: ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or doc ment of Butte County. I hereby authorize representatives of Butte enter upon the above mentioned property for inspection purposes. 'County �to Print Name: %),I/y4 (�f ��.0 (J�-) /4fl % Signature: L Date: ❑ Owner O Contractor ❑ Agent for Owner )kAgent for Contractor .a BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP041435 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/19/2004 APN: 039-270-109-000 the Business and Professions Code, and my license is in full force and effect. j _^1 License Class: cao License Number: /0 Site Address: 3965 FRONT ST DAY Date: I 0 Contractor: 1f�� 1(� 7F'li1�l Map Index: Description: replace ex ground mount hvac OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: HARSTON JEFFERY M & DEADRA E to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 3965 FRONT ST 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA she is exempt therefrom and the basis for the alleged exemption. Any 95928 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: HARSTON JEFFERY M & DEADRA E such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: SHERATON SERVICES ❑ I am Exempt under Article 3 of the Business and Professions Code 1170 E LASSEN AVENUE Date: Owner: CHICO, CA 95973 - 530-342-2562 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 License #: 733676 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: g insurance and number are: eccaardeerr ppolic`y` C✓ Carrier: "'�� V 1 `C Total Square Ft: 0 S. F. Policy#: t- 0� a co-xm ❑ I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor _ 405"7 14- 5/1-9/,04- t5 S code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Birtte County Codeanrvor I hereby affirm that there is a construction lending agency for the Resolutio to d ork indi ted above for which fees have been paid. �' ^ 1 performance of the work for which this permit is issued (Sec 3097 Civ.) , (/// Name: By. .� 5 PERMIT EXPIRES N: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or doc ment of Butte County. I hereby authorize representatives of Butte enter upon the above mentioned property for inspection purposes. �to ,County ��Y.� (�f !��C �%�-) /��% Signature: Print Name: Date: 0 Owner 13 Contractor ❑ Agent for Owner Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION r�r Fo office use only: OWNER Name e*v Dr Address 39 toS F\\)(-2– City h I I Yes I No State Cia Zip qs q278 Phone 5 $ b_ 2-Z5 2 Fax E-mail 1 r�r Fo office use only: CONTRACTOR Name �He n M u_s L Address ,_den F\\)(-2– City �.h 1 C O I Yes I No Stat" Zip p�'5113 Phone �53p 2-Z5 2 Fax( -5-330 3y2-72%(0 E-mail 1 Lic. # Clast2o r�r Fo office use only: ARCHITECT/ENGINEER Name Address City I Yes I No State Zip Phone Subdivision Name Fax E-mail Page State License Number r�r Fo office use only: APPLICANT NAME Name Address City I Yes I No State Zip Phone Subdivision Name Fax E-mail Page r�r Fo office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. B T� BPS BIN # LOCATION AP# O `► 0,4q • 270 • I D Property Address 3q os- Frzvn-+ S -I aa:+ Cross Street l a Apy\ WORKER'S COMPENSATION Policyumber (0q �-a b Carrier AW— 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 K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: t ! C.v►id (*on rr>ac o _ v r\ -N) 121 Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: &I e— Amount: R t#: Date: 5119 % 64—• 55. Bldg SRA Sheriff SMIP Other 55:—"- Total REV 4-30-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to`'apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!' ❑ 3. 3 Engineered plans (if required) with wet: signature on plans AND 2 sets of stamped and signed calculations.. : ' ; ❑ 4. 2 Engineered truss' details -and layouts (if required) (NO FAXES!). ❑ . 5. Letter from Engineer or Architect for truss design review. !. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to mobile or modular homes.) ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner (if required), , ❑ 9. Sanitation and site plan approval from the Environmental Health Department, ❑- 10. Metal Buildings: (A) Metal Bldg Plans; (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet-si its the engineer. Mobile, Manufactured, or Modular homes: - - ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ' ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans'. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. -' ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet; -signed by the -engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT'APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds PERMIT NO. BP041370 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/13/2004 APN: 039-270-109-000 the Business and Professions Code, and my license is in full force and effect. ~� License Class: License Number:73--/21 31 U Site Address: 3965 FRONT ST DAY Date: Contractor. Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: tank set gas piping Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: HARSTON JEFFERY M & DEADRA E to its issuance, also requires the applicant for such permit to file a signed statement that he.or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 3965 FRONT ST 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 95928 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: HARSTON JEFFERY M & DEADRA E such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: RELIANCE PROPANE ❑ I am Exempt under Article 3 of the Business and Professions Code 6426 SKYWAY Date: Owner: PARADISE, CA 95969 530-872-9200 X206 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 License #: 734318 Labor Code, for the performance of the work for which this permit is issued. have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect' the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: �� ' F✓/) Carrier. e G 2 2 - OZ Policy #: Z(,/ 77 Total Square Ft: 0 S. F. ❑ I certify that in the performance of the work for which this permit is Valuation: issued, I shall not employ any person in any manner so as to $0.00 become subject to the workers' compensation laws of California, C@nSUS Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage ist unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. J'Y�O/ l•l( qe-) CONSTRUCTION LENDING AGENCY This permit is r b ued under the applicable provisions of the Butte Cnu ty Coda and/or I hereby affirm that there is a construction lending agency for the Resolutio ork i icated a o f wh' fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) ) -U Name: By: �Date. Address: PERMIT EXPIRES ON / Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. _ " ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document f Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos ey/,t 06 Print Name: Signature:, Date: s1" V Cie/ ❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor r BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. DATE: / 2 O ` APN: ZONING: NEAREST CROSS STREET: TRACT/LOT#7. SITE ADDRESS: 31 L 5 CITY, ZIP: � ol• � Q OWNER NAME: � PHONE ��— //315' /3 Ad�7 STREET ADDRESS: FAX any, ZIP: e .L - E-MAIL' APPLICANT NAME: `�V PHONE STREET ADDRESS: FAX CITY, ZIP: E-MAIL' CONTRACTOR NAME: RELIANCE PROPANE - DBA WOOD HEAT & S ONE I 872-9200 ext. STREEfADDRESS: 6426 SKYWAY FAX CITY, ZIP: E-MAIL LICENSE NUMBER LICENSE TYPE ARCHITECT/ENGINEER NAME: PHONE STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER E-MAIL: DESCRIPTION OR SCOPE OF WORK:. _ / /n haves ❑ 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 fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: V� Application Received by: Date. Receipt number: ! ��l Amount Received: ?06 December 22, 2003 First Priority Financial 30 Landing Circle, Suite 101 Chico, CA 95973 ATTN: Jodie Holland 'eutte count, LAND OF NATURAL WEALTH AND BEAUTY PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530)538-7785 Re: 100% Rebuild -Bum -down letter for 3965 Front Street, Dayton, CA, (APN 039-270-109). Dear Mrs. Holland; The above referenced parcel is currently zoned SR- 1(Suburban Residential, l acre minimum). This zone allows for a single-family dwelling. This parcel is a .25 acre parcel which was created before the SR -1 zone, and is considered a legal pre-existing 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 SR -1 zoning are 50 feet from the center of the road and 5 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 PERMIT NO. — PERMIT EXPIRES OWNER Ungcm,. 4TRNT TTNn CONTR. Chri c T.amhort ASSESSOR PARCEL 39-27-109 i LOCATION _�.�FrG1gt St L1��tr1 0RA Fg,,2-nN — Myra-! weesc VI -a 9 -/ro - (rpm ntca �jp�e 's f A } i± k Temp. Power Pole Celled PG&E Temp. Elec. Service Called PG&E Temp. One Service Called PG&E 4 JOB FINALED (Date) Signature = OK 0 = Not OK = Not Read�yable MOBILE HOMES MISCELLANEOUS - Date ' MOBILE HOME UTILITIES (Plans) OK except #'s Date _ DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Soils-Size-Depth-Spacing-Conn6ctors-Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs-Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- , Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -81 Date Card -131 Date 10. Roof; Shthg-Roofing Card -81 Date Card -B1 Date 11. Ext.; Steps -Doors -Landings Date MOSILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -B1 Date Card -131 Date 2. Footings; Size -Spacing -Marriage Line Card -B1 Date Card -B1 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater Card -B1 Date Card -B1 Date 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes -Enc losures- Panel boards- Ins. to Main in Conduit Card -131 Date Card -81 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -81 Date Card -81 Date Card -81 Date Card -B1 Date = OK 0 = NotOK RESIDENTIAL (SFngle and Duplex) - =Not Applicable 4 ='Not Fleady Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements . Hangers -Post Caps -Anchors -Connectors Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth <4&-ang. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. -3=fTg., Garage; Soils -Steel-/ /" Ftg. Depth A46 -Fireplace Ties or Type A Flue -Fireplace Throat ;!;Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth x -47 -Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles temwalls, Main; Steel-Blockouts-Wrapped -48--Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6.-Stemwalls, Garage; Steel- Blockouts-Wrapped --4"arage Fire Protection Framing _S4ei-!Steol-tAMapped -SU-Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel A4txt. Doors -One T -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test --62-Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test iding-Nailing Veneer 12. Electric; Underground --%r Wcco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums &Ducts; Clearance-Material-Supprt-Ins. la . Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples ear Walls• ailing -Bolts 15. Insulation Ins on-Walls-Clg. filtration-Walls-Wndws Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -B1 Da 8 and -B1 Date Card -81 Date Card Date Date PLUMBING (Per it) OK except #'s -131 16. Water Ht. V t -Access -Combustion Air Date FILL (Plans) OK except #'s 17. Water Pipe/Test & Anchors -Nail Protection . Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; T t-Fttngs & Anchors -Nail Protection smoke Detector 19. Shower P n; Test, First Floor -Tub Access .62,F;ttrnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20.. Test TuV& Shower, 2nd Floor -Tub Access 21. Gas Pi ; Size & Anchors -68. Bedroom Exiting moi. .. & Bath Fixtures & Tub Access -Spa . Elec. Trim & Subpanel; Breaker Sizes -Labels Card -B1 Date Card -B1 Date 66_$ftts & Rails Card -131 Date Card -131 Date 67..-F"ptace or Stove; Clearances -Hearth Date ELECTRICAL (Permit) OK except #'s 68-Etec. Outlets at Wood Panel; Int. & Ext. 22. F ure & Transformer Clearance -Ins. Protection 69-. Kit�-Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance .Elec. Receptacles Spacing -Lights & Switches at Doors 70-Elec. Outlets & Receptacles at Kit. Counter ize Boxes & No. of Conductors -Stapled _Zl -Garage Fire Door; Swing -Landing -Closer iF4omex Installed Close to Edge of Studs & C.J. 72.-A$C. Duct in Garage -Damper ,26-E' uip. Ground made up w/Mech. Fasteners -Bond Gas &Water -73`Wtr-Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection ..-2izAppliance Circuits in Kitchen &Conductor Size _74_Plb„ Elec. & Mech. Equip. Listed for Location ,-22_Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al -75-ffec. Receptacles in Garage; (G.F.I.)-Rop G Protec. -29rRgnge Circ. / / ga. Cu or Al -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 76. Insulation -Foam -Looked in Attic Yes --pard Rails & Deck Construction -Post Caps -'30-Service-Riser Conductors & Ground -Main Disconnect -._-78-Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor O -Yes I*L-A'o 3l -quip. Clearances Panels-Motors-Mech. Equip. Clothey����r I inht-Shower Light -Spa Light -7T oollowing instld.; Drive &Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No / 4*-STucco; Brown -Finish Card -B1 Date Card -B1 Date Unit; Disconnect, Electrical, Plumbing Card -131 Date Card -131 Date '-82. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (P mit OK except #'s `83 -Water Well; Disconnect, Electrical, Plumbing, 33. A.C. Ducts In lation & Support -8' . terior Elec. Trim; G.F.I. Receptacle -Underground X34. Vent Fan; Ex aust above insulation ntilation throughout House 35. Condensate rain & Overflow; Size & Grade 96. CWss Protection 36. Furnace -V nt; Access -Comb. Air -Return Air Vent -115 outlet . Corrections from Previous Inpections 37. Attic Acc ss & Platform if Furnace in Attic --88.-Gas Test -Meters Tagged; Gas -Electric '' $§q% - I r & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Card-BlIq-y %DatS� Card -B1 Date Date FRAMING (Plans) OK except #'s Card -Ell Date CTS Card -B1 Date 5414s, Proper Material & Anchors . Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Card -131 Date Card -81 Date Comments at Final: aring W -Dover Girders & Floor Nailing -4t-'Draft Stop in Walls (rat proof) Fire to s; Furred Ceilings -Stairs -Chases -Tub 43. (NOTE: An entry must be made each time you visit job site) 'fes -�.,, , -... j{� .�; .. .�... - ..nom^ .--.., Y. _ _ � - .y •� -in;" COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS -' 196 Memorial Way, Chico— Phone: 891-2751 f 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 1 CORRECTION NOTICE S7"EN 4- pe OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. N , ?� • Gt/-t- ave- � v Date Inspector. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 - 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. I/ �I�� �\ PCD�a�/S ,� �fC�iGG7< �A, a1 Yrs �C�i o r► �-�° Date "qp 1 Inspector AA/IV —C I � COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2761 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 'f CORRECTION NOTICE OWNER A routine Inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. C 0 Inspector Date ENERGY INSTALLATION CERTIFICATE Building Owner Cc� f �4-� S��L��ll� , Building Permit # Sy \ - Building Location !29 b S �cS.,J 1 5 DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material Thickness(inches) 3'LL CEILING Batt or Blanket Type Thickness(inches) Loose Fill Type CSLL.VtU';,C Minimum Thickness (Inches) 1: - Area covered(ft.2) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width (inches) FOUNDATION WALL Material Thickness(inches) Brand Name Thermal Resistance (R Value) Brand Name C) W �') Cjc�Q lJ ( I Thermal Resistance(R Value) 11 Brand Name Thermal Re.sistance(R Value) Brand Name , Number of Bags Wt. per bag lb. Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building, is.consistent with approved building department plans and attachments and con= formas with requirements f Chapter 2-53 of State of California Energy Requiremen k 15 1aI�3D_ F-3 IRM NQME/OAR STATE CONTRACTOR'S LICENSE NO. SIGNATURE ep4lNSTALLATION APPLICATOR DATE I hereby certify the required features, devices, and equipment, at� shown on the approved Building Department plans and attachments have been installed and conform to the appli- ance standards and Chapter 2-53 of the State of California Energy Lequirements. BUILDING CONTRACTOR/OWNER (P ease Print) FIRM�NAME) SIGNATURE BUILDING CONTRACTOR/OWNER HVAC FIRM NAME/OWNER (Please Print) SIGNATURE' OF HVAC CONTRACTOR/OWNER 5a\ �3a 5 STATE CONTRACTOR'S LICENSE NO. a- 1C�-C-\, DATE STATE CONTRACTOR'S LICENSE NO. DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. SEPTEMBER 1988 �JCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0.1_ f 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 J(% APPLICATIONAND PERMIT ASSESSOR PARC L NUMBE:,7 � v—.1/ ZONING BUILDING PERMIT 0"'g-tP �� TEtedrwgLEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAIL NG ADDRESS '1 S� CONTRAC TO 'N A_ LE :OJ.I l (Q CONTRACTOR'S MA,LING ADDR SS s�%'•Q( Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDR S Filing Fee $ 10,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty BUILDING ADDRESS Permit fee !$ $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20:00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF Lj,/Duplex❑ Mobilehome❑ Other Building sewer 5.00 SPECIFY Mobile Home I S I G I W r 10.00 ea TYPE OF WORK New ❑ Addition Re/model ❑ Utilities ❑ Instal lation❑ Other ❑ Permit Fee $ Describe work: 1�' /�c�liyc4 `O /, /) Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.8 ,/ZCSgft a I declare under Wally of perjury (Check One): OR ADDNS. ACC. BLDGS. NEW CONSTR.TI-OUTLET 2,50 ea ! I am licensed under provisions of Chapt. 9, Div. 3 of the Business NON.RESID .BRA CH CIRC ITS POWER APPARATUS e (SINGLE and Professio ss Code and my license is in ful force and effect. OUTLET CIR. License No. �^' I Classification Ex. Occup(OUTLETS OR FIXTURES DAL@30 ❑ I, as the owner, or my employees with wages as their sole compen- FIXED Ex. OCCUp. OUTLETS P(RESID )LINIS REA.) 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) Mobile Home Facilities 15.00 ❑ I, as the owner, am exclusively contracting with licensed contract- Misc. Wiring 15.00 ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ , Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling a not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation Notice to Appll ant: If after making this statement,. should you become subject Pertnit Fee $ B to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ 6, 0e) to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT F $ I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgm nts, costs, and expenses which may in any way accrue rUP. CONST,TrPa 5 No I'V A (/ PARCEL P ND 1S9�,� agai st s id Co ty 'n consequ ce of the granting of this permit. '`/!� Date/ �/ — �45 This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do Signature of Aplicant – Owner ❑ Contractor ❑ Agent ❑ wor n icated tove for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct -R C -TOR OF PUBLIC WORKS ion of structures over 3 stories in height. B �aJ,01 ,,� ZM6 Receipt No. Date /yam WNITE-D.P.W.. YELLOW-ASSEOSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date �+ y"►^ri.r?yi'l. ��-^'•'�r'sf �r,rr`l.G'V�T^'.1'*�►.!/:X"+_,�C��i`Ir"i's.liF1 V'/`�:�iM1.✓+'A+'S3'1�'S.l�li"'^if��a N `.' j' �. 1' � .." (3 �� ; i � �. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - ORE)Wt:LE'.-CALIFORNIA 95965 - TELEPHONE: 916/538-7541 , r PERMIT APPLICXTION DATA SHEET Permit No. OWNER // rt A. P. No. Proposed Building Use ! aZae4 �°c. Building Inspector Z12 Date !g 417" -CP At time of permit application, I was advised the following data must be submitted prior to permit processing and/or Issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . — 2. Plot plans in duplicate/triplicate, signed by preparer of plans. _ 3. Complete plans in duplicate/triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. / 5. Plans with Energy Design Compliance Statement. \6. .b (tS t) School District ''Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorizatiofi - . . . . . . . 0. Sanitation approval from a� & Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) _14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . . r Pre-Inspec.request to 17. Pre -Inspection for __. _ Required. Building Inspector (Date) 18. Recorded copy of Agricultural Acknowledgment Statement. ' 19. Driveway Permit. 20. Plot plan approval from city of 21. Fnvi nPPred trneSP4 in dtil 1i r -ate (-regtii red prior to plan check)_ 22. When you issue the permit, process as -follows: Mail to owner, tii to contractor. Telephone and hold for pickup at—off ice, Deliver w/inspector. t, Other A p p l i c a.n` . t��= _ Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior toe it i nce: (Circle new item not checked above). 1. Index permit for above items No. _. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---rnail_counter by date _ Contractor, designer, owner, was advised c? above required data by—phone —ma il—counter by , date Ce� Plans checked by Date Plans approved by 6/Date Sets of plans on hold in File cabinet AP folder Copy—DPW TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Z3 Vic_ " �n_______.--D- Owner Location AP# Plan Approved for: Hold final for: Sewage Disposal Water Supply Water Supply Final clearance O.R. for: Water Supply Clearance for bedroom mobile home. Other ��Y1�rPr��lOY� (art- c�c,D l NOTE * * * S Lit —' Date •. •��c-s••• • r>. • 1•d+v 4. 99." •••e• •cf• .+•.•r vr.u•.v . ..n • iueorj v Iog"Im•44• •w•il I(I1 ta' 1011 •r1 lal0 11 •a 0.1101Mg ) w :1 ,al• to arcODtaart situ Trt•!a M9 MWI-V? JOI.1 � hv11 .t'1 •• 9 •• •I t •• .r11 as ef•arlt 7• O.O.C.0.22c"tt• Iro.• Ir / 1savo•1 ao. It•1 • arJ 1 • � 1» a • of 1 s., . I&we MR 18.0 •:7 J ? 7 I/J 1 • r1 J 1,01• D 1/21" 9 !.• ttfO.r1M lata LY117► lvral.ti• •.• rr_v ♦ ) 7 117 I • rl 7 ••tt• 7 11710t•O11NMIt ior'I: •1N • Ll•10.• ►LItA11"• tarle.9ID • 1.1.i.• ►tr J • • UIK • • A • Ir0111 • �l1 O/"fr► n•ao UVt • •.aJtn7.J • a 017 1 1 r1 t t/•to N $late 0 r , •o►• 91.41" • t.►44112. r..1 Cot • •.D• tu••• I • 1 r • r9 • ram IIaOtM "Mc c -c" finet !•M(al t7t• Taace NII. 0► coat 1.0a• I IM 1• Ila ►o• to -I.1,41 IN ►V J7 IN J 7 a 1/2 1 • ►1 1 1 1. 9-16• 0 •.N t 1• •DO Its r 1• .•7O • ♦ I. • J • a 1,7 • • ►T t N/Ofa 7 O/ilr 0 •-It• s •.N t •• I1• 7)•• r t. •170 • ♦ !• • • )• •-IO- • •.N t >a aa• ;tat • a• 1•• • J • o •• •-N- • •.M t •• •)• 9tH • 4. •N91 • ♦ •• • ♦ • • Ui • 1.0 h •MI IS • t 0-10• • •.N t M -41► I610 a S. -447 • J •• O r •• 0-10- 0 •.N t •• •!►7 I"a r •. -742 • I a • Jim I1 rt 9 0 N • 1a j o J •• r- • •.•• t s. !t7 t7•t • 7. NI • 7• • ••a •- 7- a •.N t t• 7Y 7!•1 IS • J P • J11 • 91 Y 1 A 11 '1 • N )- 0 7.N C •• •)N7 014 • J N 0 f1•• •- 7- 0 a.N aft• 12r ••• is*. ~ ' : •I entttl Tata• 04 to 10111 "Stood LIKINGS" LMMit 111• D• h • •.N 61 l• •t•D Ir• 6 a 1• a //7 t • ►7 ••••. 0s►ItN1tvc 61%c014199 Mugs owe Wes a70itrs to To" KSI" /N•• t 1 3 ? 111,72 ! i o� Ata 8941141.910 ata 9111114 lot ►I• H Wu 4 i•• 1•t retia• •am Nato cwT4c7 489.1 J ! /7Ciss�1 1.• 04811•+0 Oea0110 W to" t was an t0 Of 711• 11.04. OOT/Ma 191 Il8 J 0 1.29. t.• ampt6.tua Mau so OEM" NOWJa 1 t.• Lan•r Wee Use 0 at 1111 07a►tt"I M CIO • 101 r;Ir- tae 111 a a 1.1/••s no 011 - 0.1.11 \. on @-I* • - too IlVass ta120. 0.4•• , Slot :;r•- n% K a • 184/880 1111• rl• 0.14\4 T. ••• 9rI0•• Car) 4mc" MTS•• o.0•a BurTIE COUNTY �r` s�•4:i' _ � ---1111 _ • 1 :1� IGS '. � BUILDING ®E?ARTMENp".I.4f1-cm-71" � APPRjaVED SOUL, 700& tI 91Vt 0a/R1.RrCIK YKo! •.OPpOY1 Oo10NlI'fll► • .t4MLl1r� MaAa19T40.1. I'0 NVCM �..,--1111.-. 1111 � . �.-. 1111 1111 _1111 . 'y<''.A r....w11�w.-1111.« 1111. «1111•.... -, -may / 1 mawcusaat9MeIKtaenls•iaaatw : "<< twwl .; . ' . tC�yJr',1iL��►► OaRar►•tln•saaleUe.w•Maa1M1 ,'t.w •tgA►0Mfl1�YYR o�aa 1�fN OsasHOU R alas NS R d0Tto •l1. Ram as scum OILM @tlRarG 4•79P �•...��M. . ••181/"11 no 1.814.1010 iM11a11M . �aT9•Ctflr!•xe1 t11•ta A 1•C47e• 1,N •► tN O• ii•Miw/w�► •18111 fN my sN •t atA mmscas is mmo 00" •f'arlr/011 W =s *mm 1111 a Alsf. tat 6XIMM [r•"!f•MINIMUM V 1►OW>&* 111181000. tQ 1111 � � ". ' "•� .y t �f;. • - �' ' '•�?i`•. .i. •S' 1111 is .� 1111. 1111 i•�•y� �.�.: •:i�1.. •.�Sit.a,-'�^ 1111 ? 7,. i.. ,. - - �. 1111 r FORM 7 ADDITIONS TO RESIDENTIAL BUILDINGS ENERGY SHEET PACKAGE "A ,"Additions) Owner N5TFN to t> Climate Zone Permit # 50 E S D Floor Area The following data showing mandatory and required features of Package "A" shall be installed for additions to dwellings. Additions to dwellings include room additions, converting garages and patios to living areas, house moves that add footage and attic conversions, and any space that is existing non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. APPLIES TO NEW AREA Ot CEILING it WALL FLOOR SLAB GLAZING SHADING NE 11 R-30 R-11 R-11 R-7 U-.65 (Dual) SOUTH - OPTIMUM OVERHANG or .36 Shading Coefficient WEST - .36 Shading Coefficient LOOSE FILL INSULATION (Density) ONE 16 R 8 R 9 9 R-7 U-.65 (Dual) # INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) DUCTS PER UNIFORM MECHANICAL CODE - Ch. 10 LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT At MAXIMUM GLAZING 16% OF'AREA PLUS REMOVED GLAZING NEW HEATING, VENTILATING, AIR CONDITIONING AND HOT WATER SYSTEMS IN CONJUNCTION WITH AN ADDITION SHALL BE INSTALLED AS SHOWN ON BACK OF THIS SHEET. OTHER 12/85 *1 HEATING, VENTILATING, AIR CUNDITIO_NING SYSTEM (A) Heating ❑ Central Gas Furnace % (brand and model number) SE Btu/hr (heating capacity). ❑ Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) ❑ Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope ❑ Other (describe) *1 (B) Cooling ❑ Electric Air Conditioner . (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) ❑ Electric Heat Pump EER Btu/hr ` (cooling capacity at 95°F) ❑ Other (describe) DOMESTIC WATER SYSTEM ❑ • (A) Gas Only Gallons (brand and model number) (tank size) ❑ -Heat Pump w/Electric Backup (brand and model number) Gallons , 2 (tank size) ❑ * Active Solar (collector brand and model number) ,(rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) N *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form 464) or other approved methods, section 2-5352(g), and fill out the following: - Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load - maximum outlet capacity gas furnace BTU Cooling: Summer design temperature ', cooling load BTU *2 Submit T.I.P..S.E. chart or other approved system (form 465) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design m s the requirements of Title 24, Part 2, Chapter 2-53 of the California Admini rat on Code. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, Callfornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ERMI 7 No- A33ESSOR PARCEL NUMBER �Sq_Z _ ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC.1 BUILDING VALUATION O WNER•3 AI ING ADDRESS CONTRACTO NA�..R.S. EL PHONE CONT CTOR'S MA Ra Fireplace O • 3TRUCTION EN R N NOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee Plan Checking Fee $ a i $ ARCHITECT OR ENGINEER LICENSE NO. Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $� PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PA eEL M AIP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other,,642l4922-0— 8L&C SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service8001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 ONTRACTORS LICENSE LAW I declare under pen O perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.ai) , OR AODNS. ACC. SLOGS. /20sgft NEW CONSTR. TI.OUTLET NON.RESID BRANCH CIRC TS 2.50 ea POWER APPARATUS e _SINGLE OUTLET CIR. Ex. OCCUp\OUTLETS OR FIXTURES .200030 FIXED APP LNS. OR Ex. Occup. OUTLETS IRESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ L Contractor I ORKMEN'S COMPENSATION INSURANCE I declare under n Ity of perjury (check one): 17 The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County or Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against -said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TTPE SCHOOL FLOOD PARCEL PD ND 39UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date/7_ ^ Receipt No. WNITC-O.P.W., YELLOW-ASeC330R. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT NO. . 5495-80B,P,E,M r, PERMIT EXPIRES Larry Lambert OWNER owner k CONTR. 39-27-84 port. ASSESSOR PARCEL 3959 Front St., lot 103, Dayton LOCATION t. i1 i' i r ry .t� M f l 1 lli T� O a f Temp. Power Pole Called PG& emp Elec. Service Called PG&E Temp. Gas Service T " Cal led PG&'E 7�JOB FINAL D (Date) Signatgr J = OK 0 = Not OK - = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rig.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ P'Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'s 1, Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed. 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8, Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK 0 = Not OK' Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAW GI(Continued) Hing requirements -Setbacks -Easements Pr rty Line Firewall & Openings tg., Main; Soils -Steel -_lee. ^ / Zfi' Ftg. Depth 4"xt. Doors -One 3' -Check Garage -3rd story, 2 exits g„ arage; Soils -Steel- / �' Ftg. Depth t -Headroom-Rise-Run-Landing-Fire Protection g., P es & Decks; Soils -Steel- / Ftg epth 5 I ood on Roof Overhang -Attic Vents -Rafter Outriggers mwa Js, Main; Steel-Blockouts-Wrapped-S iding-Nailing-Veneer to I.ls, Garage; Steel -Blackouts -Wrapped -Slab -Drip Screed-Fdn. Vents-Underfir. Access kl"Riers- treplace Ftg.-Steel 5 lazing Area -Glass Protection -Skylights -Plastic ailing -Bolts V.: Fall -Fittings -Test -2 wa 0 -Sewer Test Size -Anchors -49ej Water -Ripe, Test -Anchors -Regulator -Service Test nderground ucts; Clearance -Material -Support -Ins. 1 -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI =��atq<2156W Card -BI Date Card -BI Date Card -BI Date Card -BI Date ] Card -BI Date Date FINAL ans) OK except N's Card -BIS DateI 1,1.E0 Card -BI Date Date PLUM_QAG (Permit) OK except q's 5 , teps-Door & Sidelight Protection -Landings qZ,4ruoke 'Detector _ 1 r Ht.; VaRI Access -Combustion Air 50—,e—Furnace; Vents -Clearance -Comb. Air -Connector - I9 -Gla -rage; Above Floor-Ducts-Mech. Protection 1 W�teF'Pipe; Test & Anchors -Nail Protection D.W.V.; Test-Fttngs & Anchors -Nail Protection Becoom Exiting ?iL.-Slaewet-Pan; Test, First Floor -Tub Access✓�F & Bath Fixtures & Tub Access 1n T"4—b-&-Shower, 2nd Floor -Tub Access lec. Trim & Subpanel; Breaker Sizes -Labels 19, tpe; ize & Anchors 6 i or Siwe- Clea rth Outlets at W anel; Int. & Ext. Card-BIDate Card -BI Date K' Ixt. & nc ; Grnd.-Air Gap -Cooking Cl ante Card -BI Date Card -BI DatePl4c. Outlets eceptacles at Kit. QaLWter Date ELE FOCAL Permit OK except q's Garage Fire Door; Swing -Landing I u t in Garage Damer F' re & Transformer Clearance -Ins. Protection r. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In rage; Above Floor-Mech. Protection ec. Receptacles Spacing -Lights & Switches at Doors z .Boxes & No. of Conductors -Stapled 7 Ib/, Elec. & Mech. Equip. Listed for Location 7 e eceptacles in Garage; (G.F.I.)-Rom Protec. ex Installed Close to Edge of Studs & C.J. 2EVO uip. Ground made up w/Mech. Fasteners -Bond Gas & Water 7 . solation -Foam -Looked in Attic es 7 u 'Rails & Deck Construct ion-Pos ps 2 ppliance Circuits in Kitchen & Conductor Size 2 u eed Wire Size /2/ ga. Cu - .C. Wire Size /" ga. Cu r AI 7 7 dn. nits & Crawl Hole D r r na & Wood -Earth Clearance L ed under Floor allowing instld.: Drive s ❑ No; Walks es E) No; Planters ❑Yes o own -Finish 2 ange Circ. / / ga. Cu o AI Oven Circ. / / ga. Cu or Al, In a d Neutral ❑Yes No 2 er ce-Riser Conductors & Ground -Main Disconnect 2t quip. Clearances; Panels-Motors-Mech. Equip. 7 C. U Disconnect-Clrnces Cond. Size -115V Outlet met Light -Shower Light ents bove Roof; Plbg.-Applian-Firepl.-Clearance to Opngs. at II; Disconnect, Electrical, Plumbing x or Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date en ' tion throughout House Card B -I Date Card -BI Date 424,—glairs-5fotection Date MEC NICAL (Permit) OK except N's 9,3e�Cgrr6ctions from Previous Inspections a st-Meters Tagged; Gas -Electric Ducts; Insulation &Support 8 & Sewer Connected -C/O to Grade -HD Approval 3 34e�t.y6ensate _V Fan; Exhaust above Insulation Drain & Overflow; Size & Grade Energy Compliance Certificate -Other Certificates urnace-Vent; Access -Comb. Air -Return Air Vent -115V outlet ittc ccess & Platform if Furnace in Attic Card -BI Dat and -BI Date Card -BI Date Card -BI Date Card -BI Dat and -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date omments at Final: Date FRA G(Plans) OK except q's 34 -"Si ; Proper Material & Anchors 3 Studs -Nailing, Spacing & Bracing -Plates -Sound _ 3 Walls over Girders & Floor Nailing 3§,.O-Dr_4KStop _ring in Walls (rat proof) _4 a Stops; Furred Ceilings -Stairs -Chases -Tub H d r & Beam -size & Bearing 4 H ers-Post Caps -Anchors -Connectors ng. Joist-Ritr. Ties-Purlin-Roof Brat.-Truss-Shthng.-Rfng. Fir lace Ties or Type A Flue -Fireplace Throat _ cess; Size & Romex Protection -Draft Stop -Ins. Baffles 4 . Windows or Exiting Doors -Sill Hgt. & Dimensions _ 4t,,It2rage Fire Protection Framing (NOTE: Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEaARTti+aNT OF PUBLI;G,WOFiYS 196 Memorial Way, Chico — Phone; 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 ECTION NOTIC BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations_,pf County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this "� .. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office Inspecto RESIDENTIAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY. CONSERVATION REQUIREMENTS HAVE BEEN INSTALL�ED" JN CONFORMA,,��t N�yO�VWITH CURRENT' ENERGY CONSERVATION REGULATIONS AT 7:1� L ��rrr, ,U BU ILD ING PERMIT NO A:Pe NO THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (6hec4 each item 'or write N/A -if not applicable) INSULATION: Slab Edge. �- Fdn. Walls Floors_ Walls Ceiling/R�of Ducts A� Circulating Pi es APPROVED HEATER APPROVED WTR.HTR. GLAZING: Single Glazed y Special (Insulated) CERT. & LABELED WDS/� & SLIDING DRS. WEATHERST$IPPED DRS., � " BACK DAMPERED FANS INTERMITTENT i:GNITiON DEVIC)ES CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERrI`F TE ASUB\1_ITTED. Insulation Applicator Naive Signature of Aease print Insulation Applicator State Contractors License No. General Contractor/Owner Name J 114AW AS T (grease print) Signature of l General Contractor/Chmer Date State Contracto s License No, .1.3 THIS CERT V ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING, `j� . i - COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PE IT NO. 7 County Center Drive - Oroville, Calif9rnia 95965 - Telephone 916/534-454 APPLICATION AND OERMIT ASSESSOR PARCEL NU E a�� ZON BUILDI G P RMI � OWNER 1,57 f4 TELEPHONE SQ. FT. OCC. BUILDIN/nG'� VALUATION V 40 0 OWNER'S M ILIN ADD ESS Rg C7 CONT CTOR•S NAME TELEPHONE O d CON ACTOR• MA LING ADDR 55 CON ORUCTI NE/S�E UNKNOWN } Fireplace O 0 Total Valuation 9V. OBJ LENDER'S MAILI G ADDRESS Q Permit Fee $ 57 ARCHITECT OR ENGINEER /ISO r LICENSE NO. Plan Checking Fee A $ /0'e7 U Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 00 BUII_Ci G ADD R S PLUMBING PERMIT Filing Fee /LJ.00 / Each Trap 2.00 16,00 Repair drainage or vent piping 2.00 Water piping ,d 0 LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New [�I�Addition Remodel ❑ Utilities ❑ Installation[-InstallationOther [:]Contractor Describe work: ��� /Tr � %�/� Permit Fee $ © p ELECTRICAL PERMIT Filing Fee l®.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 —,00 Main service EA. ADD'L 100 AMP ; O 2.50NEW CONST. LING OR ADDNS. (DACCLBLD 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions and my license is in full, force and effect. License No.7 y&y3 Classification 8"-1 ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR u Tl.ou LE NON-RESID BRANCH CIRC ITS 2.50 ea NEW CONSTR. (POWER APPARATUS &) NON-RESID. (POWER OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES a ICC FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID•) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc 1'v , 6.25 v ermlt Fee $ SJ Contractor G WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 00 HeatingN EK Q,4— SOU Cooling 1070 Hood 2.00 Ventilation Permit Fee $ C7O Contractor , JG I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabili ies, judgments, co s, and expenses which may in any way accrue against d County � con ence of the granting of this permit. 11-1340 X Datersions Signature of li nt — Owner ❑ Contractor Agent ❑ An OSHA pe it is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE S OCCO . G VP ? �J TYPE OF CONST. g' ,y PARCJ-PD Ho 5so� This permit is hereby issued under of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC By / PER EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date ����!// Receipt No. ,� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT r