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HomeMy WebLinkAbout039-470-019I �— . ice. sw :1 • .. x. � � 5�,�, 39 - 7-19 im MacMillan NE corner of Lone Pine Ave. & Rodgers Ave .\ Chico 'Perini ��2059-81B,P;E,M(new single"""-� r •. - �, family _ - 39-47-19 Permit # 19-82B(lst renewal 2059=81) a�� h 39-47-19 -Permit#3293-83B(2n renewal/2069-81) 39-47-19 39-47-19 _Permit#3n- 4-83B11(new •p tvate car ort) - - - . 9-�t7_19 p Permit�k1760-85B rd renewal/2059-81) Permit#1365 6B(lst & 2nd renewal/3294- r83)garage .i 1070© Lone -Pine -Aye; Ch-ico - -- - -�- Permit#1788-87B(-addition & remodel/SF) x 39-47-19 �J IM -MACMILLAN- 0700 Lone Pine, Chico l ermit #1827-87B,E (garage/workshop&deck) 1307=0656' "' MISCELLANEOUS Remodel CONVERT EX BDRM-TO LNDRY & D 10070 LONE PINE AVE - MACMILLAN; FAMILY TRUST •• - -' - - Y - ` ' ry�y I �— . ice. sw :1 • .. x. � � 5�,�, 39 - 7-19 im MacMillan NE corner of Lone Pine Ave. & Rodgers Ave .\ Chico 'Perini ��2059-81B,P;E,M(new single"""-� r •. - �, family _ - 39-47-19 Permit # 19-82B(lst renewal 2059=81) a�� h 39-47-19 -Permit#3293-83B(2n renewal/2069-81) 39-47-19 39-47-19 _Permit#3n- 4-83B11(new •p tvate car ort) - - - . 9-�t7_19 p Permit�k1760-85B rd renewal/2059-81) Permit#1365 6B(lst & 2nd renewal/3294- r83)garage .i 1070© Lone -Pine -Aye; Ch-ico - -- - -�- Permit#1788-87B(-addition & remodel/SF) x 39-47-19 �J IM -MACMILLAN- 0700 Lone Pine, Chico l ermit #1827-87B,E (garage/workshop&deck) 1307=0656' "' MISCELLANEOUS Remodel CONVERT EX BDRM-TO LNDRY & D 10070 LONE PINE AVE - MACMILLAN; FAMILY TRUST •• - -' - - Y - ` ' �`, =b���:� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 - WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 10070 LONE PINE AVE Owner: - Permit NO: B07-0656 APN: 039-470-019 MACMILLAN, FAMILY TRUST Issued Date: 04/02/2007 By GLB Permit type: MISCELLANEOUS 10700 LONE PINE AVENUE Subtype: Remodel CHICO, CA 95928 Expiration Date: 04/01/2008 Description: CONVERT EX BDRM TO LNDRY S (530) 872-2600 Occupancy: Zoning: A5 Contractor Applicant: Square Footage: ACCURATE PLUMBING MACMILLAN, FAMILY TRU'. Building Garage Remdl/Addn P O BOX 3056 10700 LONE PINE AVENUE CHICO, CA 95927 CHICO, CA 95928 Other Porch/Patio Total (650) 349-4902 (530) 872-2600 FEE INFORMATION DBMSC Fireplace Pre-fab/Metal $110.00 DBMSC Remodel -Residential $357.43 Total Charged: $467.43 Fees Paid: $467.43 Balance Due: $0.00 Receipt No: B2423 'LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / F- spires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License ACCURATE PLUMBING 871709 / C36 / 01/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that • requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 04/02/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's Signature Date 1, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by I� I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Dale: (This section nee not a completed if the permit is or one hundreddollars ($100) or less. ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: ®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 Workers' Compensation laws of California, and agree that if 1 should become subject to the workers'X� 04/02/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those O els Signature Date provisions. X04/02/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and Stale laws relating to building U!. �l� Signa W e Date WA NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter a above mentioned property for inspection purposes. I hereby certify that I am the Property own or am authorized to ct on the property owners behalf. �,,,� 04/02/2007 CONSTRUCTION LENDING AGENCY, 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for N f Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) ®OwnerContractor OR.Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name, ..LLQ First Name�r Mailing Addres�G 700 City d State Zip 1592 Phone 93_ Q� ¢ J9 Fax E-mail CONTRACTOR Name Address City State�� Zip Phonee•7e _ZG o0 Fax E-mail Zip Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail PPLICANT SIGNA URE X " PERMIT NO. r r _ m1q . . 66 BIN It PR JECT LOCATION AP# 0 / o - 6 1 Property Addres/s/67od LD,(���y� City r///CD WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Zoning- Flood Zone SRA I Yes I No Occ, Type Const. Sq FT- Living Garage Open 'C'jov ❑Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning- Flood Zone SRA I Yes I No Occ, Type Const. Butte County Department of Development Services TIM S 4ELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR • 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buftecounty.net/dds www.buttecieneralplan.net REQUIRED SWIMMING POOL SAFETY UPGRADES (EFFECTIVE JANUARY 1, 2007) TO: All Single Family Residential Remodel and Modification Permit Applicants FROM: Scott Rutherford Manager, Building Division RE: Correction of Pool & Spa Hazards, Assembly Bill 2977 (Mullin) Chapter 478, Statutes of 2006 California Health and Safety Code Section 115928 DATE: February 28, 2007 To eliminate safety hazards on existing pools and spas, Assembly Bill 2977 (Chapter 478, Statutes of 2006), effective January 1, 2007, requires the installation of pool anti -entrapment covers whenever a building permit is issued for the remodel or modification of a single family home. The permit shall require that the suction outlet of the existing swimming pool, toddler pool, or spa be upgraded so as to be equipped with an anti -entrapment cover meeting current standards of the American Society for Testing and Materials (ASTM) or the American Society of Mechanical Engineers (ASME), ASME/ANSI Standard A 112.19.8. DECLARATION The property located at le X00 ZOit/,--- /�/n�� /%d,F. �'/�iCd, e'W , has: (Check all that apply) ❑ a swimming pool ❑ a spa ❑ a wading /toddler pool 09 does not have a swimming pool, spa, or wading/toddler pool If there is an existing swimming pool, spa, or wading/toddler pool, I understand that a pool anti -entrapment device is required at the above address in conjunction with my permit. I also understand that if a pool anti -entrapment device is required, the completed Installation Certification below must be received by the building inspector at final inspection. Please note that permits cannot receive final inspection approval without this certification. I acknowled a that I have read and understand the requirements of AB 2977 and that the above is true and correct. I e«At 2 —o 7 S ipOafure Print Name Date Relationship to Project (please check one): A Owner ❑ Agent for Owner ❑ Licensed Contractor ❑ Agent for Licensed Contractor Company Name Contractor's State License Number INSTALLATION CERTIFICATION For the property located at I hereby certify that an anti -entrapment cover meeting the current standards of the American Society for Testing and Materials, or the American Society of Mechanical Engineers is installed in the ❑ swimming pool ❑ spa ❑ wading /toddler pool Signature Print Name Date Relationship to Project (please check one): ❑ Owner ❑ Agent for Owner ❑ Licensed Contractor ❑ Agent for Licensed Contractor ❑ Other: If "Licensed Contractor' or "Agent for Licensed Contractor" is checked, please complete the following: Company Name Contractors State License Number K:Forms/Building Forms/Swimming Pool Affidavit Anti -Entrapment Updated: 4/2/2007 Temp. Power Pole Called PG&E Temp. See. Service Called PG&E s Temp. Gas Service Called PG&E / JOB FINALED (Date) ���'•� Signature �� i/%����'0011 = OK 0 = Not OK ' = Not Read�yable MOBILE HOMES MISCELLANEOUS Date ' MOBILE HOME UTILITIES (Plans) OK except #'s. Dae DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s A. Zoning Requirements-Setbacks-Easements 1. Zoning Requirements-Setbacks-Easements 2. Soils; Special MH Support-Sketch 2. Footings; Soils-Size-Depth-Spacing-Connectors-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)__l 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5: Electricity; Location-Clearances-Grnd.-/ / Amp-Concrete 6. Gas; Location-Test-Wrap: / P 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-131 Date Card-131 Date 10. Roof; Shthg-Roofing Card-131 Date Card-131 Date 11. Ext.; Steps-Doors-landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements-Setbacks-Easements Card-81 Date Card-131 Date 2. Footings; Size-Spacing-Marriage Line Card-131 Date Card-131 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 8. Elec.; Grounding; Equip. w/5'-circulating Equip.-Pool Lghtg. Boxes-Enclosures-Panel boards-Ins. to Main in Conduit Card-61 Date: Card-81 Date Card=131 Date Card-131 Date 9. Health Department Approval 10. Plumb.; Cir. Test-Water Supply Test Card-131 Date Card-131 Date Card-131 Date Card-131 Date J = OK 0 = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable = Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. Zoning requirements -Setbacks -Easements 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Deptl 4. Ftg., Porches & Decks; Soils -Steel-/ /111 5. Stemwalls, Main; Steel-Blockouts-Wrappec 6. Stemwalls, Garage; Steel- Blockouts-Wrapr 7. Slab; Steel -Wrapped 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -131 Date Card -131 Date Card -131 Date Card -61 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -B1 Date Card -131 Date Card -B1 Date Card -131 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ina. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mach. Fasteners -Bond Gas & Water 27. 2 Appliance Circuits in Kitchen & Conductor Size 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels -Motors -Mach. Equip. 32. Clothes Closet Light -Shower Light -Spa Light Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Date MECHANICAL (Permit) OK except #'s 33. A.C. Ducts Insulation & Support 34. Vent Fan; Exhaust above insulation 35. Condensate Drain & Overflow; Size & Grade 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 37. Attic Access & Platform if Furnace in Attic Card -81 Date Card -B1 Date Card -61 Date Card -131 Date Date FRAMING (Plans) OK except #'s 38. Sills, Proper Material & Anchors 39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 40. Bearing Walls over Girders & Floor Nailing 41. Draft Stop in Walls (rat proof) 42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 43. Header & Beam -Size & Bearing `Date FRAMING (Continued) 44. Hangers -Post Caps -Anchors -Connectors 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 46. Fireplace Ties or Type A Flue -Fireplace Throat 47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 49. Garage Fire Protection Framing 50. Property Line Firewall & Openings 51. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 54. Siding -Nailing Veneer 55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 56. Glazing Area -Glass Protection -Skylights -Plastic 57. Shear Walls; Nailing -Bolts 58. Insulation -Wal Is-Clg. S 59. Infiltration-Walls-Wndws Card -131 Date Card -Bt Date Card -131 Date Card -Bt Date Date FINAL (Plans) OK except #'s 60. Ext. Steps -Door & Sidelight Protection -Landings 61. Smoke Detector 62. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 63. Bedroom Exiting 64. G.F.I. & Bath Fixtures & Tub Access -Spa 65. Elec. Trim & Subpanel; Breaker Sizes -Labels 66. Stairs & Rails 67. Fireplace or Stove; Clearances -Hearth 68. Elec. Outlets at Wood Panel; Int. & Ext. 69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 70. Elec. Outlets & Receptacles at Kit. Counter 71. Garage Fire Doof; wing -Landing -Closer 72. A.C. Duct in a e -Damper 73. Wtr. Htr.;a learance Comb. Air-Connector-P.R.V.- In Gara ; A Flo ech. Protection 74. Plb I c. & Mech. u . Listed for Location 75. EI c.Jffi ceptacl s ' Garage; (G.. .1.)-Romex Protec. 76. lnsulatio -Looked in Attic O Yes 77. Guard Raft & eck Construction -Post Caps 78. Fdn. Ven & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 79. Following instld.; Drive 0 Yes 0 No; Walks 0 Yes 0 No; Planters 0 Yes 0 No 80. Stucco; Brown -Finish 81. A.C. Unit; Disconnect, Electrical, Plumbing 82. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. 83. Water Well; Disconnect, Electrical, Plumbing 84. Exterior Elec. Trim; G.F.I. Receptacle -Underground 85. Ventilation throughout House 86. Glass Protection 87. Corrections from Previous Inpections 88. Gas Test -Meters Tagged; Gas -Electric 89. Water & Sewer Connected -C/O to Grade -HD Approval 90. Energy Compliance Certificate -Other Certificates Card -131 0 Dat - Card -B1 Date Card -81 Date Card -B1 Date Card -B1 Date Card -61 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS -7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. VIYI ASSESSOR PARCEL NUMBER d349_ L. _ ZONING BUILDING PERMI OWNER �i � k T PHON SQ. FT. OCC. BUILDING V TION o 'aa OWNER'S MAI//LING ADDRESS /f /'�I L 16 ad • /!/C' /�Cr A* CONTRACTOR'S NAME TELE ONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION V%LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ AR HITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ dr) Energy Plan Checking Fee 1-10 AR ZHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BU4LDING ADDRESS I 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 SFS Duplex❑ Mobilehome❑ Other A SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home is G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ fRemodei ❑ Utilities ❑ Installation❑ Ot er ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 �', ISOOV OR LESS Main service 100 AMP OR LESS 10.00 Main service EA. AOD'L 100 AMP 2.50 CONTRACTORS LIC NSE 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.(f` OR ADDNS. ACC. BLDGS. / , /20sgft NEW CONSTR. ULTI.OUTLET 2,50 ea NON.RESID BRANCH CIRCUITS POWER APPARATUS &) (SINGLE OUTLET CIR. / Ex. Occup\OUTLETS OR FIXTURES 20050Q SAI -030 FIXED PR Ex. Occup. OUTLETS (RESID 1EA.1 2.00 Temporary service 10.00 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. 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 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 againstO all liabilities, judgments, costs, and expenses which may in any way accrue against said unty in consequenqe of the granting of this permit. X C� Date 45—¢"-E7 Si nature 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 $ UP, CON 9T E FLOOD S .P ARC EL PD —PO D 199 e This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which DIRECTOR UBLIC 9 By PEQIW EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date -' Receipt No. WNITC-D.P.W.. YELLOW-ASSCSSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT I COUNTY OF BUTTE - Department of Public Works 7 County Center Drive,"Oroville, CA 95965 Phone: 916-534-4541 3 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 improvement (yes or no) 2. I (have/have not) signed an application—for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address ( City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed Property Owner Social Securit umber Date 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. 1.2. Certificate of Workmen's Compensation Insurance. . . . . . 13.- Contractor's License Information (no., name style, classif.) 14.- Owner -Builder Verification (Given to owner0, Mail to owner ❑•), 15. Improvements may be required. . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . Pre-Inspec. request to (Dote) 17. 'Pre -Inspection for Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19.- Driveway Permit. 20. Plot plan approval from city of 21. 22. When you issue the p, r. it, pr a as follows: Mail t wrier, Mail to contractor. C� _ (� V Telephone d'�3 T and hold for pickup at! 9fice, Deliver w/inspector.` Other Copy of plans sent Health Dept.,' Fire Dept., Other Date The following data must be submitted prior to permit issuance: (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--naiI—counter by date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by Date c Sets of plans on hold in File cabinet AP folder Copy—DPW — Flours: 10:00 a.m. - 3:00 p.m. COUNTY OF BUTTE - DEPARTMENT .OF. PUBLIC WORKS - BUILDING DIVISION OF 7 COUNTY CENTER DRIVE - OROVILLE, 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit No. OWNER 42�A. P. No. Proposed Building Use ��.�' GG�� Buil i Inspector Date i 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. . . . . . . . . . . . Plot plans in duplicate./triplicate, signed by preparer of plans. , —02. 3. Complete plans in duplicate./triplicate, signed by preparer of plans? 4.. Complete engineered plans and calcs; with wet signature on plans. 5. 6. Plans with Energy Design Compliance Statement. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . ... 9. Letter of signature authorizati 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 1.2. Certificate of Workmen's Compensation Insurance. . . . . . 13.- Contractor's License Information (no., name style, classif.) 14.- Owner -Builder Verification (Given to owner0, Mail to owner ❑•), 15. Improvements may be required. . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . Pre-Inspec. request to (Dote) 17. 'Pre -Inspection for Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19.- Driveway Permit. 20. Plot plan approval from city of 21. 22. When you issue the p, r. it, pr a as follows: Mail t wrier, Mail to contractor. C� _ (� V Telephone d'�3 T and hold for pickup at! 9fice, Deliver w/inspector.` Other Copy of plans sent Health Dept.,' Fire Dept., Other Date The following data must be submitted prior to permit issuance: (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--naiI—counter by date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by Date c Sets of plans on hold in File cabinet AP folder Copy—DPW — Flours: 10:00 a.m. - 3:00 p.m. � L'• a ;., - TO: Building Department FROM: Environmental Health, Chico SUBJECT: Sanitation Clearance �iw•G�►QRipc Owner �. Location nj_ AP Plann approved for; sewage disposal water supply Hold final for: water supply Final clearance O A . for: water supply r LL GAjjj Clearance for bedroom mobile home. Other �-f %t � G�Gt.� !.�/j�� � ®s. Note'!** <0 arian Date PERMIT NO. -1827-87B, E' PERMIT EXPIRES OWNER '".Ti m MarMi 1 1 an = OK 0 = Not OK - = Not Applicable = Not Ready 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 -Connectors -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: / P 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 -131 Date Card -131 Date- 10. Roof; Shthg-Roofing Card -131 Date Card -131 .. Date 11. Ext.; Steps -Doors -Landings tDate MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -61 Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line • Card -131 Date Card -81 Date 3. Gas; MH Test- Demand-Valve-Corinector 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 .Date 8. Elec.; Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit Card -61 Date Card -B1 Card -131 Date Card -131 Date 9. Health Department Approval _ - 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -131 Date Card -131 - Date Card -131 Date - = OK 0= Not'OK - ="Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UN FLOOR (Plans) OK except #'s 4paing requirements -Setbacks -Easements Main; Soils-Steel-Elec. Grnd.-/ t . Ftg., Garage; Soils -Steel-/ P' Ftg. Deptl _4-M., Porches & Decks; Soils -Steel-/ /111 „%,-Remwalls, Main; Steel-Blockouts-Wrappec /B!Stemwalls. Garage; Steel-Blockouts-Wrap[ 8. Pie s -Fireplace Ftg.-Steel 9. D. .V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. G s Pipe; Size -Anchors 11. Pipe; Test -Anchors -Regulator -Service Test ectric; Underground 13. Ilenums & Ducts; Clearance-Material-Supprt-Ins. 14. irders-Sills-Anchor Bolts -Joists -Vents -Cripples 15. fnsaiation ;K _DAA1.Ze1&,,JjriZ7b Card -131 6D DateB /Card- 1 Date sd Card -131 Date Card -B1 Date Date PLUMBING (Permit OK except #'s 16. Water Ht. Vent-Acc s -Combustion Air 17. Water Pipe; Test & nchors-Nail Protection 18. D.W.V.; Test-Fttn & Anchors -Nail Protection 19. Shower Pan; Tes First Floor -Tub Access 20. Test Tub & Showd\, 2nd Floor -Tub Access 21. Gas Pipe; Size & A chors Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date ELECTRICAL. (Permit) OK except #'s fixture & n a3eefec. Beceptacles Spacing -Lights & Switches at Doors e oxes & No. of Conductors -Stapled om nstalled Close to Edge of Studs & C.J. ZS-Eq-uip. Ground made up w/Mach. Fasteners-Bond•Ea Water rcui s in Kitchen & Conductor Size 28. Sub e='"— c• / ga. Cu or AI-A.C. Wire Size / /ga. Fir eFA1--� / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insi I Yes No onductors & Ground -Main Disconnect 31 --Equip. Glearaaces Panels-Motors-Mech. Equip. -32-61vthee-lMo-set Light -Shower Light -Spa Light Card -131 / Dat "� �,Y Card -B1 Date Card -B1 Date Card -81 Date Date MECHANICAL (Permit) OK except #'s ulation & Support 34. VunrftM, aust above insulation e rain & Overflow; Size & Grade _36-fvrnace=Went; Access -Comb. Air -Return Air Vent -115 outlet 3Z::AAt jG Ae� Platform if Furnace in Attic Card Date Card -B1 Date Card -B1\ Date Card -B1 Date Date FRAMI ans OK except #'s 98-'THls,,Pro_per Material & Anchors ,I ".ails Studs -Nailing, Spacing & Bracing -Plates -Sound 40-f*aring-Walls over Girders & Floor Nailing 4 . alls (rat proof) 42. FIFU ub er & Beam -Size & Bearing ill Hgt. & Dimensions ng Ings oors-On eck Gar$ o its -Rise-Run-Landing-Fire Protection Overhang -Attic Vents -Rafter Outriggers %ettcTing-Nailing Ve"eer-- 5 . Screed -Fd. Vents-Underflr. Access Protection -Skylights -Plastic r a s; ailing -Bolts Card -B1 VV Datta! // Card -131 Date Card -B1 Date Card -61 Date Date - FINAL (Plans) OK except #'s 90Qxt. Steps -Door & Sidelight Protection-Landi en s- learance-Comb. Air -Connector- I r -Ducts -Mach. Protection 63 ino ub Access -Spa ` lec. Trim & Subpanel; Breaker Sizes -Labels 6 - th t. -Air Gap -Cooking Clearance ounter R.V.- in ect►on 7 Meeh -Ek uip, Listed for Location 7&-V-ec. Receptacles in Garage; ( - om rotec. - - es 79-falFowing instld.; Drive ❑ Yes J..pinrWalks ❑ Yes m Nn• Planters ❑ Yes Uble-- J pl.-Clearance to bing . Exterior Elec. Trim; G.F-1-AeeeptaM-Und and e n revious Inpections rs Tagged; Gas -Electric ewer Connected -C/O to Grade -HD Approval nce Certificate -Other Certificates Card -B1 y_y W4,/4 Card -B1 Date Card -B1 Date Card -131 Date Card -B1 Date Card -131 Date Comments at Final: �I (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS j 196 Memorial Way, Chico — Phone: 891-2751 s 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road; Paradise — Phone: 872-6367 CORRECTION NOTICE r ki; OWNER ' PERMIT NO. a w 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 corre ion of work is completed. If you have any question pertaining to this 'matter r need additional explanation, please contact this office immediately. W Inspector Date 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 /�L9-G�t 6 LL.�l•�/ /� / "c OWNER PERMI 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. Inspector V A Date 7/83 2 Btu/hr (cooling capacity at 95°F) ❑ Electric Heat Pump i EER Btu/hr (cooling capacity at 95°F) ❑ Other (describe) ❑'. (C) g,-TWO-STAGE THERMOSTAT, which controls the supplementary heat on T its'second stage, shall be required for heat pumps. Q; (D) AN AUTOMATIC SETBACK shall be provided for all thermostats, except ,n those controlling heat pumps. ❑ (E) AN INTERMITTENT IGNITION DEVICE shall be provided for all gas-fired '2— fan type central furnaces, gas-fired fan type wall furnaces and gas cooking appliances. ❑ (F) BACKDRAFT DAMPERS shall be provided for all fan systems exhausting air to the outside. ❑ (G) DUCT CONSTRUCTION & INSULATION. All transverse duct, plenum, and fitting joints shall be sealed with pressure sensitive tape or mastic to prevent air loss and shall be insulated to conform to the provisions of Section 1005 of the UMC, 1976 Edition. 7/83 2 .._;,COUNTY OF BUTTE - DEPARTMENT 01 7 County Center Drive - Oroville, California 95965 - APPLICATION AND PERI PUBLIC WORKS PERMI NO Telephone: 916/538-7541 `� . , !IT ASSESSO PARCEL NUMBER ZONING BUILDING PERMIT OWNER s/ In3- TXLEPHON SO. FT. OCC. BUILDING ULUATION OWNER'S AILING ADDRESS C NTRACTO 'S NAME �' TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER S v/L UNKNOWN c Total Valuation $ Filing Fee $ 10.OQ LE .ER'S MAILING ADDRESS j E Permit Fee $ AR HITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESSZzemj� ' / A ) /v 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 STRUCTUR -eCA, SF❑• Duplex❑ Mobilehome❑ Other C!� P I FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W=# 10.00 ea TYPE OF WORK Newo Addition Remodel❑ Utilities ❑ Installation[]Other ❑ Describe work: r1;R5r6-_X- d Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS10.00 100 AMP OR LESS - Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check.one): El am licensed under provisions of Chapt. 9, Div. 3 of the BuslneSS 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 SOIe 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 oR ACONSDONST DWEACCLLIN GSCCU '/20sgft NEW CONSTR ULTI-OUTLET NON-RESIO BRANCH CIRC ITS 2.50 ea (/POWER APPARATUS e I SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 2AL SOS eALe3o FIXED APP * OR EX. Occup. OUTLETS (RESTESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. >Yirin 15.00 g 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. ivy 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 of 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 liabilities, judgments, costs, and expenses which may in any way accrue„�J against sai ounty in cqnsequince of the granting of this permit. X` Date S' ature of Appl cant - Owner ❑ Contractor ElAgent❑ 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.TYPEJ FLoo PARC PD ND ISSUE This permit is hereby issued under sions of the Butte County -Code and/or work indicated above for which DIRECTO 9F PUBLIC By PE EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date �f - 4 �— Receipt No. QV WNIT!-D.P.W., YELLOW-A98C330 R, PINK -INSPECTOR, GOLDENROD -APPLICANT TO: Building Department FROM: Environmental Health, Chico SUBJECT: Sanitation Clearance P"4 (IF, 3 '?-'�'7-(9 tmt Prg�le IL- P-0_jke - Owner Location /; , AP Plan approved for: sewage disposal water supply Hold final for: water supply Final clearance O -:K. for: water supply Clearance for bedroom mobile home. Other eG' Note*** Lir tarian Date COUNTY OF BUTTE - DEPARTMENTOF WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CAUFPPi NIA 95965 - TELEPHONE: 916/534-4541 � PERMIT APPLICATION, DATA SHEET I OWNER Proposed Building Use erml V. �y At time of permit application, I was advised the following data must be submitted prior to permit processing andJor issuance: DATE RECEIVED APPROVED A tems have been submitted. . . . . . . . . ` Plot plans in d ed by preparer. of plans.' 3. Complete plans in duplicate. /triplicate, signed by p ief-of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8.Fees of $ ,9. Letter of signature authorizati . ". ' A 0. Sanitation approval from 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 ❑ ). _15. Improvements may be"required. . . . . . . . . . . , 16. Mobilehome Installation Data. . . . . . . . . . 17. Pre -Inspection for Pre-Inspec. request to (Date) Required. Building In eCt�,.. 18. Recorded copy of Agricultural Acknowledgment Statement. SCI 19. Driveway Permit. J 20. Plot plan approval from city of 21. 22. When you issue the per it pr cess as follows: Mail to owner, Mail to contractor. _� Telephone �� and hold for pickup atzzzefbce, Deliver w/inspector. Other. Applicant Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to pe i issuance: (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---nall—counter by date Contractor, designer, owner, was advised of above required`data by—phone —mal l—counter by date/l Plans checked by Date Plans approved by �`�Date ( P Sets of plans on hold 'in`-- Fi:l.e.cabinet AP folder — Flours: 10:00 a.m. - 3:00 p.m. Copy—DPW 101 COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 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 improvement (yes or no) 2. I (have/have not) signed an application.for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors 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 ' 1 Signed: Property Owner Cc Social Securit tuber Date .5::'- XI!;;' -:9-7 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. Owner: James DA 'T ( 1?gj UCIM 111002 Permit No. I T -$? E N E R G Y C E R T I F I C A T I O N oo � /0" LOCATION A.P. No. DESCRIPTION OF INSULATION ROOF Material Brand Name Thickness(inches) Thermal Resistance (R Value) EXTERIOR WALL Material Q OL' 5 -F-; 6er5LssBrand Name - Corn n Thickness(inches) _ " Thermal Resistance(R Value) -I CEILING Batt or Blanket Type X0. 5 Brand Name Owens _ Co r n i n q Thickness(inches) U " Thermal Resistance(R Value)A7- 12 Loose Fill Type Brand Name Minimum Thickness(Inches) Number of Bags' Wt. per bag lb. Area covered(ft.2) Thermal Resistance(R Value) FLOOR, ELEVATED Material -, b er lct s ams Thickness(inches)- " FLOOR, SLAB Material Thickness(inches) Width(inches)- FOUNDATION idth(inches)_FOUNDATION WALL Material Thickness(inches) Brand Name pUJQhS - eor n t NG Thermal Resistance.(R Value) R 4L 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 in conformance with the State of Califoraa:Energy Requirements, FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. a °I . 19 98 SIGNATURE OF INSTALLATION APPLICATOR ATE I hereby certify.the above insulation -.and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. M_ 0A T -P -a.1 (Y\ac.mItIa- FIRM NAME/OWNER (Please print) G C-rn c l �n SIGNATURE OF GENERAL GONTRACTOR OWNER STATE CONTRACTOR'S•LICENSE NO. q -a9- —98 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. January 1984 • SIERRA GLASS-, O)v / -7,�,j 4-;� 2990 ESPLANADE CHICO, CALIFORNIA 95926 (9161 993-3630 r June 17, 1987 Conroy Construction Co. 3044-A Monticello Lane Chico, California 95926 Re: MacMillan Residence - Rogers & Lone Pine Ave. Chico, Ca. Insulated existing carved glass_ panels. Dear Pat: The glass we used as a facing material (out board lite) for your carved glass panels was 411 clear laminated with a .030 interlayer. This glass as manufactured by ,Buchmin Industries of Reedley, California) conforms to consumer products safety commission 16 CFR -1201, Category 'II and American National.Standards Institute 297.1, 1984. If you have further questions in regards to this material, please call. EC:gh Very truly your ve 'cru Ly your .� Z 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 OVR PERMIT NO. ion indicates that the following violations of County Ordinance e address and should be corrected. Please notify this office f work is completed. If you have any question pertaining to this dditional explanation, please contact this office immediately. r _ , Va velIV. I1 11"3L,'i .7 /// y Inspector_ Date ,« t t COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine insp ion Indicates that the following violations of County Ordinance exist at the bove address and should be corrected. Please notify this office when. For ction of work is completed. If you have any question pertaining to this matt or need additlonal *xxp�lanation, please contact this office immediately. t . • U i 11 tin , INVEIRMIR WINE- MG Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — 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. Inspector r .1 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 . need additional explanation, please contact this office immediately. Inspector Da COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE 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 nod additional explanation, please contact this office immediately. r Inspector�iAW::Z��Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC -WORKS 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradise — Phone'877-3435 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 when correction of work Is completed. If you have any question pertaining to this matte or need additional explanation, please contact this office immediately. t � Inspector TO: FROM: //���✓' 5!I�JECT: Inter -Departmental Memorandum ,pas/ �lGO i� �/, S COUNTY OF BUTTE k $ 41' � • DEPARTMENT OF:PUB1L9k 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 AD ESS 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 mater porn need additional explanation, please contact this office immediately. i/ 1 Inspect//'% ���✓� Date �%/ t COUNTY OF BUTTE DEPARTMENT OF PUBLIC, CORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDIN6 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 when correction of work is completed. If you have any question pertaining to this - matter, o eed additional explanation, please contact this office immediately. 1 (. d ' do 7' f ' � </ Luh 7/2 iii 775 Inspector Date PERMIT NO. PERMIT EXPIRES Ina 61OWNER e? Jim MacMillan CONTR. owner ASSESSOR PARCEL 39-47-19. LOCATION NE corner of Lone Pie Ave & J`CEJ ," Rodgers Ave., Chico na.: M. 3 Ed" Temp. Power Called P Temp. Elec. Called F Temp. Gas S, ta Cal led P Signatur (A� J = OK 0 Not OK f = Not Applicable MOBILEHOMES MISCELLANEOUS - Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except H's 1. Zoning Requirements -Setbacks -Easements 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.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"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 Card -BI Date Card -BI _ Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 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/O 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 ✓ -r. ` Jt i 0 VA P^% r` l' O- Not OK - = Not Applicable *\,= Not Ready V a, e r RESIDENTIAL (Single and Duplex) Date UNDE OOR Plans OK except #'s Date FRAMING Continued -Property 1 zon g requirements -Setbacks -Easements - Line Firewall & Openings g., Main; Soils -Steel -EI ,rd- / & /' Ftg. De th 4 xt. Doors -One 3'-Check,)Garage-3rd story, 2 exits ,S.-F+g ,,evrage; Soils -Steel- / /" Ftg. Depth (-5D Stairs; idth-Headroom=Rise-Run-Landing-Fire Protection t ., Porches & Decks; Soils -Steel- / /" Ftg. Depth 54. PI d on Roof Overhang -Attic Vents -Ra ter Outrigg s Main; Steel-Blockouts-Wrapped-Slab Siding -Nailing -Veneer _J,IASIemwalls, IIs, Garage; Steel-Blockouts- rapped- lab 53. Stucco Mesh -Drip Screed-Fdn. Vents- derfIr. Access irepla Ft,Steel KO 54. Glazing Area -Glass Protection -Skylights -Plastic FV -Fit ' s- sway C/O a er Te 55. Shear Walls; Nailing -Bolts -—Anchors 101 1 ater Pipe; Test-,6pchorsTRjgulator-Se ice Tes Un ound UW & Ducts; Clearance -Material -Support -Ins. - irders-Sills-Anchor Bolts -Joists -Vents -Cripples Card -BI -- Date Card -BI Date Card -BI l Date 8" Card -BI ! Date Card -BI Date Card -BI Date Card -BI Date7 I Card -BI Date Date .1 Tans) OK except k's Card -BI el Date Card -BI Date Date PLUMBING (Permit) OK except p's xt. Steps -Door & Sidelight Protection -Landings . S oke Detector 4. nt= Access -Combust ion Air Furnace; Vents -Clearance -Comb. Air -Connector- In Garage; Above Floor-Ducts-Mech. Protection 1 ter Pipe; T$_K& Anc r - I P n D V.; T g nc ail r edroom Exiting Shower Pan; Test, Fi loor-Tub-AZM§T— .I. & Bath Fixtures & Tub Access 18_4e�Shower, 2nd Floor -Tub Access — lec. Trim & Subpanel; Breaker Sizes -Labels i_ ipe; Size & Anchors ---Fireplace or Stove; Clearances -Hearth --el- Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date and -BI Date 6+- Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66!Elec. Outlets & Receptacles at Kit. Counter Date ELE TRICAL Permit OK except q's Garage Fire Door; Swing -Landing -Closer �GB�A.C. Duct in Garage -Damper Fixture & Transformer Clearance -Ins. Protection lec. Receptacles Spacing -Lights & Switches at Doors ✓ r. Htr.; Vents -Gleerame-Gmnb-Ai Co I lection pp�plb., Elec. &Mech. Equip. Listed for Location Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. •-?+, lT'lec. Receptacles in Garage; (G.F.I.)-Romex Protec. V�ulation- Foam -Looked in Attic es Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water _73 uard Rails & Deck Construction -Post Caps 2 Appliance Circuits,in Kitchen & Conductor Size J},il-dn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes Subfeed Wire Size / / ga Cu or AI-A.C. Wire Size / / ga. Cu :)r Al ange Circ. / / ga. Cu or AI -Oven Circ. 11W ga.Vdbr At, Insulated Neutral � El No k.;'Following instld.: Drivees ❑ No; Walks es E]No; Planters ❑Yes o 28. Service -Riser Conductors & Ground -Main Disconnect -Ye--"'[ucco; Brown -Finish Equip. Clearances; Panels-Motors-Mech. Equip. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light J$ ents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. Water Well; Disconnect, Electrical, Plumbing i� terior Elec. Trim; G.F.I. Receptacle -Underground Card B -I ' Date . Card -BI Date 6a!Ve 'lation throughout House Card B -I Date Gard -BI Date 8 1 Protection Date HANICAL (P K except q's _ orrections from Previous Inspections s Test -Meters Tagged; Gas -Electric C. Duc I Support Imlatere Sewer Connected -C/O to Grade -HD Approval n 8 ergy Compliance Certificate -Other Certificates _ ondensate Drain§.2Size& Grade - n en utlet Attic Access & Platform if Furnace in Attic Card -BI a e Card -BI Date Card -BI �/' Date ! 7 Card -BI to �a �Q Card -BI °^ Date Card -BI Date Card -BI Date) 2 O ftcard-BI Date Card -BI OQ Date Card -BI Date Date FRAMING Plans) OK except q's Comments�at Final: - Proper Material & Anchors �i �S-iIts; walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing 44 aft Stop in Walls (rat proof) Stops; Furred Ceilings -Stairs -Chases -Tub ti �,.,r32. aa1� _Qp'Fire r44,• Header & Beam -Size & Bearing �laagers-Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac. hng. Rinp. ®lace Ties o Ty u Fireplace Throa " 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions _ 4T' -Garage Fire Protection Framing (NOTE: An entry must be made each time you visit job site) / - , -COUNTY OF BUTTr - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 9/534 '41 O . 1-1 APPLICATION AND PERMIT ASSES PARCEL NUMBER V7- Zq ZO I N G _ — BUILDING PERMIT OWN R 7eaeLEPHONE i� C /� f /r/ J» SO. FT, OCC. BUILDING VALUATION OWNER'S MAILING AD RE _ f / o CON AC OR'S NAME -TELEPHONE CONTRACTOR' MAILING ADDRESS Fireplace mad CO TRUC TION LENDER , Xz60 / UNKNOWN c Total Val Ion $ Q Filing Fee $ 10.00 LENDER'S MAILING ADDRESS b Permit Fee $ ARCHITECT OR ENGINEER lff ,0� ICENSE NO. Plan Checking Fee $ "-� Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ Q BUILDIN RESS C9 £ PLUMBING PERMIT9 Filin Fee 10.00 Each Trap 2.00 1,6,00 Repair drainage or vent piping 5.00 Water piping 57 co OT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 501-A-9— • O TYPE OF WORK New Addition [:1Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ SZ, p O Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING O ' OR ADDNS. ACC. BLDG 2¢ 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 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) 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR I.DU LET 2.50 ea NON-RESID BRANCH CIRC ITS NEW CONSTFL J POWER APPARATUS &) 4 NON-RESID. V SINGLE OUTLET CIR, Ex. Occup OUTLETS OR FIXTURES BAL2i 00 FIXED APPLNS, OR EX. Occup.�OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 167,*11.1 Permit Fee $ r D Contractor le MECHANICAL PERMIT Filing Fee 10.00 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. Heating/ p G Cooling Hood 3.00 3 O Ventilation permit Fee S Contractor Ceo I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 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 sai ounty in c nsequenae of the granting of this permit. ^ � B� 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 $ TOTAL PERMIT FEE $ oce GROUP TYPE F CON 9T. PARC D D I99u This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DI RVOR OF PUBLIC By P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. 3 4%�AW. av WHITE-D.P.W., YELLOW -AR PINK-INSPEPPLI ANT S9E99OCTOR aLDENROa-A 1 :.t,% COUNTY OF BUTTE - DEPARTMENT•OF•PUBLIC WORKS - BUILDINGIDIVISION 7'COUNTY CENTER DRIVE - OROVILLE* CALIFORN+A 95965 - TELEPHONE: 916/534-4541 PERMIT APPL'ICA TIO N.DATA SHEET 1 , Permit No. OWNER Proposed Building Use Permit Fee Based Upon Building Inspector S A. P. No. -71--4,17— Complete Contract Price __/DPW Valuation Other (Explain) Date /,'- r_ - At time of permit application, I was advi's�he!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. . . . .� . . ... ' 3. Complete plans in duplicate. /triplicate. i 4. Complete engineered plans and calcs. . . . . . . . .# 5. Plans with Energy Design Compliance Statement. . . . 6. State Energy Forms No. . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . AZ9 Letter of signature authorizatio'n.. . 10. Sanitation approval from_ �iL.e� Health Dept.. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contracto'r's License Information (no., name style ,classif.) Q/l v14. Owner -Builder Verification (Given to owner 1�� ZiI to owner ❑•L� ) 15. Improvements may be required. . . . . . . . . . . . y 16. Mobilehome Installation Data. . . . . . . . . Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector (Date) A 18. Other r ti When -Tissue the permit, process as follows: Mail to owner. Mail to contractor. y Telephone_z�V7Z and hold for pickup at %lea office. Deliver w/inspector. Other Applican Date Copy of plans sent Health Dept., Fire Deptt.., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone .� !I By Plans P lans Other Mail Date Other Copy—DPW T0: Building lepartment From: Envs nonmex tal Health uubjeat o San.-. t,atior Clearance Plan approved for,,, Sewage disposal water supply Hold final for watr,r supply Fina, clearance 0,K. for: wat;;�r supply Clearance :for � � bedroom mobil, home � Other L �;�4�. , .�z42 -' clearance, for adds c. -ion of Note � � � 4"! COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 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 in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing 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 improvement (yes or no) S' ` 2. I (have/have not) �1,AV6-44:- 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 6/ X/ /r/"-ey N Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name 61 Al/eA,104 AI Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: ` Property Owner Social Security ;Ole r- Date .S� NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 find 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. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WO' KS 7 County Center Drive - Oroville, California 95965 - Telephone 916/ 34-4541 APPLICATION AND PERMIT PERMIT NO 1 C'3S--$Z. ASSESS R P�CEL NUMBER 7 ZONING - BUILDING PERMIT OWNER` TELEPHONE 7 V S0. FT. OCC. BUILDING VALUATION OWNER'S MAI L I N9 ADDRCESS 72-60- C/ / / CO A TOR'S NAME Ire LEPH ONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKN_ WIC C.� Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee 9.1Pc%-- $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING Ap RESS _ � � PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 C Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ 5pnodel ❑ Utilities ❑ Installation ❑ Other Describe work: �C �i/ rri/� A O Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR L 100 AMP OR OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. /DWELLING OCCUP.N) OR ADDNS. l ACC. BLDGS. 2�sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F-1NON-RESID. I am licensed under provisions of Chapt. 9, Div. 3 of the Businessso@2sa 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 CONSTR -OU LET 2.50 ea NON -R ESID BRANCH CIRC ITS NEW CONSTFL ( POWER APPARATUS SI SINGLE OUTLET CIR. Ex. OCCUp OUTLETS OR FIXTURES BAL0100 Ex. Occup.(OUT LETS IXED P(RESID )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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. 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 of 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 sai ounty in cons quepce of the granting of this permit. X Date — ��BZ Ignature 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 $ TOTAL PERMIT FEE $ occUP, GROUP I TYPE OF CONST. F I PARCEL 15D ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIVICTOR OF PUBLIC By PERMIT e the applicable provi- resolutions to do fees have been paid. WORKS Date -' / �V�Lz Receipt No.— WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT •.�::. fwx-'`a+.�.�L� �=�:,.��..�s-�'ri�...^�k.ri"�%�"'i"i' �+-"�!:'*F-.iJ.`." J9�:r�.'-a +,J !rte"-sw,�..,,•rf,,,TY.-t.L lr„ �.... �, COUNTY OF BUTTE - DEPARTMENT OF -PUBLIC WORKS - BUILDING DIVISION ii ..7GOUNTY CENTER DRIVE - OROVILLE, CALIF1RNlA.95965, - TELEPHONE: 916/534-441 PERMIT APPLICATION.PAT,A SHEET Permit No. OWNER /iL/ diff/, �� �/�%��Gt� A. P. No.9� Proposed Building Use { Permit Fee Based Upon: Complete Contract Price `-'DPW Valuation 3 Oth r E plain) Building Inspector V Date -7— At time of permit application, I was advised th 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. 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . s: 6. State Energy Forms No. Ar 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . J 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Gentractor's License Information (no., name style, cla s.if.) 0`G l�1�Owner-Builder Verification (Given to owner ail to owner ❑) r 15. Improvements may be required. . . . . . . . . . . . t 16. Mobilehome Installation Data. . . . . . . . . . . Pre-Inspec. request to (D'ate 17. Pre -Inspection for Required. Building Inspector 18. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. TJ,ephone a� hold for pickup atoffice. Deliver w/inspector. L/Other WI' /%r& lf'1.3 Applicant ��'� Date �'-`- a A" Copy of plans sent eHealth Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date Other: Copy -DPW R COUNTY OF BUTTE - Department*of Public Works 7 County Center Drive, Oroyille, CA. 95965 Phone: 916-534-4541 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 in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing 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 improvement (yes moo) 7/�S 2. f (have/.:.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, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work.but I have contracted'(hired) the following persons to provide the work indicated: Name Address Phone, Type of Work Signed: Property Owner Social Security nu ' r Date -,-- o-. /�22 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 permitted to issue the permit. N 'r Y COUNTY OF J3UTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. • -_ - 7 County Center Drive - Ooville, California 95965 - Telephone 916/534-4541 3 -' v7_ APPLICATION AND PERMIT ASSES PARCq,I71ABER �/'/ ZONING BUILDING PERMIT ow TELEPHONE SQ. FT. OCC. BUILDING VALUATION rCWNE S AILI GAD RON ACTOR'S NAME 1 TELEPHONE C ACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN ^'AI EDE 'S MAILING ADDRESS Total Valuation $ Filing Fee $ 10.00 Permit Fee $ j ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ r BUILDDDRESS d PLUMBING PERMIT Filing Fee 10.00 Each Trap 1 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 -- � USE OF STRUCTURE SF [9 Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00_ Mobile Home ISI G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe wor a4 _F_ermit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10Ov OR LESS 100 AMP OR LESS 10.00 1 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. I 2h2sgft CONTRACTORS LICENSE LAW I declare under pexh of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. y 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 CONSTR ULTI-OUTLET 2,50 ea NON.RESID BRANCH CIRCUITS) NEW CONSTR POWER APPARATUS &') NON-RESID. SINGLE OUTLET CIR. Ex. Occu 20®s0e P�o XTS OR FIXTURES SAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare and r enalty 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. CK I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I cfkrtify that I have read this application and state that the above information is`correct.=1 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 g,nst id o saunty in con equenceof the granting of this permit. Date —Z-1�-�This ture of Applic t — 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 $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. PARCEL PD ND I ISSUE permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DI E OR OF PUBLIC By I PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS y DathT 33, Receipt No. ® -7,'0 F� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department, of Public Works 7 County Center Dr' ve,. Oroville, CA. 95965 u OWNER -BUILDER VERIF ICAT ION Attention Property Owner: Phone: 916-534-4541 An "owner -builder" building permit has been applied for in your name.and bearing your signature. Please complete and return this information in the envelope -provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing 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 improvement (yes or no) . 2. I (have/have not)/ �% !/� signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address. City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors 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: �y Property Owner Social Security, er Date 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 permitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N % 1 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 39-4q-19 ZONING I BUILDING PERMIT OWNER Jim MAc-Millan TELEPHONE 345-2337 SO. FT. OCC. BUILDING VALUATION _ OWNER'S MAILING ADDRESS Rt. #3 Box 185 J, Chico CONTRACTOR'S NAME TELEPHONE 3rd renewal CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER U`Nk'l0WN 11[1 Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee 2 FEE $ 104.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 114.50 BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 NE Cor. Lone Pine & Rodgers Ave. Each Trap 2.00 Solar Water Heater 20.00 Chico Water piping 5.00 LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF FKI Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New X Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 3rd renewal Permit #2059-81 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 2nd renewal #3293-83) Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 2/20sgft CONTRACTORS LICENSE LAW I declare under pen ty of perjury (check One): ❑. I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. Y 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 thi reason NEW CONSTR. A U TI -OUTLET 2.SOea NON.RESID BRNCH CIRC ITS NEW CONSTR POWER APPARATUS & NON-RESID. SINGLE OUTLET CIR. 2oeSot Ex. Occup(o OR FIXTURES 9 XAL®ao ED A APP LNS. OR Ex. OCCUp. FIXED OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this applicat i'on•and state that the above information is correct. I agree to comply to.alllXG'ounty Ordinances and State Laws relating to building construction, and hereby authgr•izb`p'resentatives of the Countyot Butte to enter upon the above-mentionedVfor inspection purposes. I also agree to save, indemnify and keep' harmless the County of Butte against all liabilities, gments, cosfs,(and`expenses which may in any way accrue mss.-- J?inst said my in consequence of the granting of this permit. 02 ture 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 $ TOTAL PERMIT FEE $ 114.50 occuP. GROUP I TYPE OF CONST. PARCEL PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREOF UBLIC I,,-2 BY _ 4 h PE IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 1 Receipt No. WHITE-D.P.W.• YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 861 8 I 000 0 COUNTY OF BUTTE - Department of Public Works, 7 County Center Drive,.Oroville, CA. 95965 Phone: 916-534-4541 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 in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing 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 improvement (yes or no) 2. I (have/have not) /y-Qy-' permit for the proposed work. signed an application for a building t 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, but I have hired the following person to coordinate, supervise, and provide the.major work: Name Address City Phone Contractors 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 S igned : Property Owner Social Security er Date 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 permitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT P RMIT O. /14 � — L ASSESSOR PARCEL NUMBER ,— ZONING BUILDING PERMIT owN R c TMLEPHONE SO. FT. OCC. BUILDING VALUATION OW R'S MAILING ADDRESS 7 0 T CTOR'S NAME I 11-i %, TELEP ONE ONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee �' = J , $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ r in BUILDING ADDRESS r— PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF,K Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W I 1 110-00 Be TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 ' f ^fi Main service EA. ADD'L 100 AMP 2,50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2t/22sq ft CONTRACTORS LICENSE LAW I declare under pen Ity 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 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 NON-RESID R BRANCH CIRC TITS 2.50 ea NEW CONSTFL I POWER APPARATUS & NON-RESI D. SINGLE OUTLET CIR. Ex. OCCup(OU20e50e ALO 30t. A OR FIXTURES ePPLNS. FIXXEDED OR EX. DCCUp. OUTLETS (RESID.1 EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor "Ag -WORKMEN'S COMPENSATION INSURANCE I declare and nasty 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 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 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 accrueJ agains! 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 $ TOTAL PERMIT FEE OCCUP, GROUP TYPE OF CON 9T. PARCEL ND ISSUE 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 Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT Z-4211193= c4o ,PERMIT NO. PERMIT EXPIRES - OWNER JIM MadlILLAN CONTR. Owner ASSESSOR PARCEL 39-47-19. LOCATION NE cor*Lone Pine & Rodgers, Chico ra 0 c-> ^'eeL px�/t pw Temp. Power Pole Called PG&E Tern Tern JOE J = OK 0 = Not OK - = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except k's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'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.-Rfg'-Bracing_ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete _ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"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 2. Footings; Size -Spacing -Marriage Line Card -Bl, Date _ Date Card -BI Date _ POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability J 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 4, Elec.; Receptacles and Lighting; Distances-GFI 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/O 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 12 11 J = OK i 1 J f O = Not OK � = Not Applicable Not.�teady RESIDENTIAL Single and Duplex) = Date UNDERFLOOR PjaV`s')_OK except N's Date FRAMING (Continued) L.-ioning requirements -Setbacks -Easements 48. Property.- Line Firewall &:Openings 2. f Ftg., Main; Soils-Steel-Elec. Grnd.- / /:'9Ftg. Depth 49. Ext. Doors -One 3'-Checl±Garage-3rd story, 2 exits Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding-Nailing-Veneerfro -�mwalls, Garage; Steel-Blockouts-Wrapped-S&WH­ 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underfir. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic - 8..D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe: Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric;'Underground _12, Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date C -BI Date f Card -BI Date Date FINAL (Plans) OK except q's Card -BI Date Card -BI Date Date _ PLUMBING (Permit) OK except q's 14. Water Ht.: Vent -Access -Combustion Air 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels _ __19_. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper --- 20. 21. Fixture & Transformer Clearance -Ins. Protection Elec. Receptacles Spacing -Lights & Switches at Doors 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meth. Protection 70. Plb., Elec. & Mech. Equip. Listed for Location 22, Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage (G. F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. _- - 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72, Insulation -Foam -Looked ' A tic E]Yes 73. Guard Rails &Deck Con cti n -Post Caps 25. 2 Appliance Circuits in Kitchen &Conductor Size - 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vent & Crawl Hole r -Drainage & Wood -Earth Clearance Looked u j FIoor,&7es r, - 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral `Yes ❑No Service -Riser Conductors & Ground -Main Disconnect 75. Foll wi g instld.: D�ri-i ❑Yes ❑ No; Walks ❑Yes ❑ PI ter ❑Ye -No h 76. St row- ' J h 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, iso n A.C. nit; ett-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light - 78. Ventg Above of; Plbg.-Appliance-Firepl.-Clearance to Opngs. -----------__--- Card B-1 Card B-1 ------Date ----_ __ _-- __Card -BI _ Date Date Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing yi 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Perrr,it) OK except N's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ - 31. A.C. Ducts; Insulation & Support _ 85. Water & Sewer Connected -C/O to Grade -HD Approval _ - 32. 33. Vent Fan_Exhaust above Insulation _ Condensate Drain _& Overilow; Size & Grade 86. Energy Compliance Certificate -Other Certificates (n - 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet Card -BI Card -BI 35. Attic Access & Platform -if-Furnace in Attic ---- - -- --- - - ---- ----------- - Date _ __ Card -BI __ Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: _ 36. 37. 38. 38. 39. Sills; Proper Material & Anchors _Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls _over _Girders & Floor Nailing Draft Stop in Walls (rat proof) -a-_ _ 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties- Purlin-Roof Brac.-Truss-Shthng.-Ring. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions__ Garage Fire Protection Framing _ (NOTE: Anenlrymust be made each time youvisit jobsite) COUNTY OF ,BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND gRMIT PERMIT NO... ASSESSOR PARCEL NUMBERZONING 3 _ Y7— - I BUILDING PERMIT OWN tN` L IM I TELEPHONE SQ. FT. OCC. BUILDING VALUATION 1, OWN R'S MAILI DDRESS • CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is 7V11 wo Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $-fi ARCHITECT OR ENGINEER INAY� ' LICENSE NO. Plan Checking Fee Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING DDRESS ,i2�� PLUMBING PERMIT FilingFee 10.00 ®t� ��S• tj `� • LAO Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other �" SPECIE Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New CK Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. / DWELLING OCCUP.& OR ADDNS. C ACG. BLDGS. 21/20sgft 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 m license is in full force and effect. y 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 CONSTR. ULTI.OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS NEW CONSTR. POWER APPARATUS &'� NON-RESID. SINGLE OUTLET CIR. Ex. Occu 20®608 P�o Ts OR FIXTURES BAL®30 FIXED APPLNS. OR \ FIXED EX. OCCUp- OUTLETS (RESID.) EA,/ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ .,Contractor ,mss I7 MECHANICAL PE�iwI1�IIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 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 s ounty inonsequence of the granting of this permit. X Date � Z� o Ignarure of Ap licant — Owner ❑ Contractor ElAgent Elwork 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 $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST, I I PARCEL PD H I99DE This permit is hereby issued under sions of the Butte County Code and/or indicated above for which DIRE OR OF BLIC o By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date •� '� Receipt No. '9"a iJ5_'D WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD- APPLICANT ;\ - - COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILL:E, CALIFOW;A 95965 - TELEPHONE: 916/534-4541 �? PERMIT APPLUT' 10N DATA SHEET VL, (�Permit No. OWNER J /I ! AP./ LL./� ✓� A. P. No..� Proposed Building Use A ?.Q DAA /-41-h "J_ Permit Fee Based Upon: rComplete Cjract Price X DPW Valuation Other -(Explain) f Building Inspector`' Date t 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. . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. , 7 Statement of Intent for Non -Heated and AC Buildings. _00 Fees of $ 62,2e,5 -n . . . . 9. Letter of signature authoriza ion. 1�.. Sanitation approval from elli It f 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 ownerEl, *Mai I to owner ❑•) 15. Improvements may be required. . . . . . . . . . .. 16. Mobilehome Installation Data. . . . . . . •Pre-Inspec. request to . 17. Pre -Inspection for Required. Building Inspector (Date) t 18. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. _ Telephone and hold for pickup at office. Deliver w/in'spector. Other �i Applicant„'''--- Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designe Owner s advised of above required databy Telephone Mail Other By ,0en Date Plans checked by Date Plans approved by Date Other: Copy—DPW r T0: Building Department FROM:- Environmental Health, Chico ' SUBJECT: Sanitation Clearance Owner Location �. r� Plann approved for; sewage disposal water supply Hold final for: water supply Final clearance OA. for: water supply Clearance for bedroom mobile home. Other t:Lr X'2 -'D 7' Note""' Sanitarian Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 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 in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing.and issuing your build- ing 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 improvement (yes or no)IES 2. I (have/have not) signed an application for a building • permit for the proposed work. 3. I have contracted with the following person '(firm) to provide the proposed construction: Name Address. City Phone Contractors License No. ' 4.} I plan to provide portions of.this work, but I have hired the following person to coordinate, supervise,.and provide the major work: Name Address City Phone Contractors 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 0 Signed: Property Owner . Social Security er Date 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 permitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PE MIT N ASSES SQR PA EL NUMBER v7J —` 7�/ 9• NING ZONING BUILDING PERMIT OWN x'11�'^ TELPHON 3�y SQ. FT. OCC. BUILDING VALUATION OWNE T5ING RESS t I T� V CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ vr- ARCHITECT OR ENGINEER V\) __, 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 SF ❑ Duplex❑ Mobilehome❑ Other -0 SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W O.00ea TYPE OF WORK New Lal Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work:Contractor 1 { ;L -410I ryr<b�v.W` )���,(�� / Permit Fee $ ELECTRICAL. PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD•L 100 AMP 2.50 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.N , OR ADDNS. ( ACC. BLDGS. h2Sq ft NEW CONSTR MULTI -OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS POWER APPARATUS ek (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20®e0C eAL(P30 FIXED APLNS. Ex. Occup. OUTLETS PR RESIO )EA.) 1 2.00 Temporary service 10.00 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. furl I shall not employ any person in any manner so as to become 'subject J� 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 of 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 liabilities, dgments, costs, and expenses which may in any way accrue against said my in cons quence oft a granting of this permit. X Date —Z�_8G 5' ture 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.TYP! FLOOD PARCEL PD HD 199UE This permit is hereby issued under sions of the Butte County Code and/or work indicated Bove for which DI CTOR OF PUBLIC BY PERMIT XPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS t� D to J 1 [�eceipt No. �ff 09 t� TC-O.P.W., YELLOW-A98[$90R, P11111 -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE- Department of Public Works 7 County Center Drive, Oroville, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-534-4541 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 improvement (yes or no S' 2. I (have/have not) 1-,4q!/dr— 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 l0. Address 34KIW r/NT/c'�—«O_ a 4e. City C"'Oleo Phone Contractors License No. 3 9'SSZO 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work butI have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner Social Security NumWr Date 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. � I -I ",, ", 1, , I , `I If , , I i 1;�,il��, I �': , I � ,� � , , � , . , I I 4 I, , j ,: I I '� j� , I I,�,� !I ] I! i , I I � jill ,,I I I -I, T, � I i III,, I I , 1 , I I , , Ji I if I, " I . ... .. �I', I. 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