HomeMy WebLinkAbout039-470-004o =47-0 004 4 93=1607 B
ERRIDGE,
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ERRIDGE, FRANK
3732 COSBY, CHICO
REROOF/SF
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville. Qalifornia 95965 - Telephone: 916.'538-7541
APPLICATIONAND PERMIT
ASSESSOR PARCEL NUMBER
b�fl 0 - 6� -cs-U
ZONING
A-5
BUILDING PERMIT
0 WNER�/
%l�AlIC
TELEPHONE
343-4782
VALUATION
S0. FT. OCC. BUILDINGQ(1
((
����
080.0+
OWNER'S MAILING ADDRESS
3732 Cosby Ave. Chico 95926
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
p /�(0�
Total Valuation $ 1,080.00
Filing Fee $ 15.00
LENDER'S MAILING ADDRESS
Permit Fee $ 24.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Permit fee $ 39.00
PLUMBING PERMIT Filing Fee 15.00
'1711 (`n�hp AVE?.. Cficn
Each Trap 1 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF E] Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G I W
TYPE OF WORK
New'AdditionRemodelE Utilities❑ InstallationC Other®
Describe work: Reroof w/Comp. _
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 600V OR LESS 18.50
200A OR LESS
Main service 200A TO IOOOA> 37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 1 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
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 CONST./ DWELLING OCCUP.&) 3.64 sq.ft.
OR ADDNS. ( ACC. BLDGS. r
NEW CONSTR ULTI-OUT LET 5 00
NON•R ESID BRANCH CIRC ITS @
POWER APPARATUS
(SINGLE OUTLET CIR.6 )
Ex. Occup(ouTLETS OR FIXTURES 20 760
A
FIXED
Ex. Occup. OUTLETS P(RESID IRE A.) I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
—
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.
teI 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 FiIirig Fee 15.00
Heating
Cooling
Hood 6.50
I 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 Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in nsequence 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-
on of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
DCC CONST TYPE
TOTAL FEE $ 39.00
HAz
I DFEES
IMP
FLOOD
CDF
PARCEL
PO
HD
ISSUE
This permit is,hereby issued under the applicable provi-
sions of the'Butte Coiolty Code and/or resolutions to do
work indicated aboGGve for,which fees have been paid.
%/(RECTOR OF PUBLIC WORKS
/!
By v / ""C__� Date
PERMI EXPIRES Date / �V
Receipt No. 143164
WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
/ COUNTY OF BUTTE -DEPARTMENT OF PUBLI RKS
OM
: 1 S PERMIT 0.
7 County Center Drive - Oroville, California 95965 - Teleph38-7541 / F�
�t 4 " APPLICATION AND PERMIT f�C�
ASSESSOR PARCEL NUMBER
3 q .- 4,,r-77,0 — 00 a
ZONING
A-5
BUILDING PERMIT
OWNER
FY&? kl ��
TELEPHONE
343-4782
SQ. FT. OCC. BUILDING VALUATION
Q
1,080.00
OWNER'S MAILING ADDRESS
3732 Cosby Ave. Chico 95926
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
p
Total Valuation $ 1,080.00
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 24.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ 39.00
PLUMBING PERMIT
Filing Fee 15.00
'1719 roqhV Avp-, Chico
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF X❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G JW I
@ 15.00
TYPE OF WORK
New r Addition t� Remodel ❑I Utilities ❑ Installation❑ Other ®
Describe work: lRe—of w/Cam¢ _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600v OR LESS
200A OR LESS
18.50
Main service 200A TO 1000A)
37.50
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 Code and my license is in full force and effect.
License ;Jo. ClassificationEx.
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)
LlI, 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 OCCUPM
OR ACDNS, l ACC. B II
3.66sq.ft.
OUT LET
NEW CONST"ES'.. RANCH CIRCUITS)
NO O.."ESID BRANCH CIRC ITS
@ 5.00
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Occup(OUTLETS OR FIXTURES
761
20 @0 46
FIXED \
Ex. QCCUp. P
OUTLETS (RESID )REAJ
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
Contractor
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
F -1I 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.
2g 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 15.00
Heating
Cooling
Hood
6.50
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 Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in ns equence of the granting of this permit.
X Date 6 — 1 .. � o
Signature of Applic��aant — 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 S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 39.00
I
HAz
OFEES IMP
I FLOOD
I CDF
I PARCEL
I PD
I HD
IssuE
This permit i er y iss ed under the
sions of th ut Co ty de and/or
work ind' ate ab e r hich fees
I T O P
By
PER EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORK$
D to 9�
Receipt No. 143164
WNITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
� ..J'.i'r•i.,,.r_ .a .,j. �,.i� �v.�,��t'f,.,I'��+s°�`rit'a'y,' It%s�'>.��•d:.�1it,��'.r�,.,.s^•-"�'{.i�r+{blt�.•^iyi.r,.:.,t�{r+i "'^`.,.�rN�..
COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENTS C S -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - LEPHONE NE(9116)538-75411
PERMIT APPLICATION DATA SHEET
OWNER
Proposed Building Use Pan Building Inspector Date
At time of permit ¢lication, I was advised the following data must be submitted prior to permit processing and/or issuance:
s DATE RECEIVED BY
1. All items have been submitted . .......... ..............................
2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... .
3, Complete plans, 3/4 sets, signed by preparer of plans . ......................
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5.. Hazardous Material Form . ..............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ..........................................
11. Impact fees as shown on attached schedule . ..............................
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . ............
15. City of Chico plumbing permit . ........................................ .
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . .........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. .. .. .
20. Pre -inspection for Pre4nspectiion requeis
required. . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner _). ...........
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .....
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ...................................
29. Documentation of legal access. :.................... :................. .
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. . Other Date By
The following data must be submitted, prior to permit issuance: (Circle new item not -checked above).
1. Index permiffor above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder t .
Copy - Department of Public Works
COUNTY OF BUTTE - Department of Public Works
7.County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property �imp"rovement (yes or no)
2. I (have/have not) r�'1�4V signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4: I plan to provide' portions of this work, butI have hired -the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors Lioense No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide .the work indicated:
Name Address . Phone Type of Work
Signed:
Property Owner
Social Sec rity Number
Date / " z�U I.
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.