HomeMy WebLinkAbout039-560-002059-5Co0--
EDMUND LEICHTER
NIS pri rd, 15001W Rose, Chico I
Permit#1757-86E(ele ser ch)SF
39-56-02 92=1209B
LEICHTER, Ed,
2295 Santa Clara Ave, Chico
cont: Nelsen Const
new windows/sfs 93
039-560-002 03- 4"r-
LEICHTER,
3" LEICHTER, RUTH ANAL
2291 SANTA CLARA AVE, CHI
Cont: ROLAND FLETCHER
C/O ELECTRIC SERVICE
039-560-002 03-3073
LEICHTER, RUTH
2291 SANTA CLARA AVE, CHICO
CONT: N/A
REPLACEWTRHEATER&FURN
s
'tA
-1
v
�39-5 3-3073
LEICHTEk, RUTH V,
2291 SANTA CLARA AVE, CHICO
CONT: N/A
REPLACEWTRHEATER&FURN
4
• - '° COUNTY 60 BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIONS
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 , /E IIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
Jfl✓✓
ASS ESSO R PARCEL NUMBER
21 ' �, " - I 1r- _ - "- r)
ZONING
BUILDING PERMIT
OWNER .
TELEPHONE
1
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS '
CO RA OR'S 'NAME 7HO
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $ -
ARCHITECT OR ENGINEER
LICENSE NO.
Filin Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS
2291 SNaA Q" AVE, all,100
Energy Plan Checking Fee $
$
PERMIT FEE $
IAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: REPLACE WATER HEATER & WALL
FUMCE
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE $
i
ELECTRICAL PERMIT Fling Fee 20.00
a00OR LE
Main Service 20.A VOR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.POWER
460-a
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
Q, I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A TO 1000A
46.00
NEW CONST. DWELIJNG OCS. SO
OR ADDNS. ( a Acc. BIDS. 3.5¢Fr.
1Npµq�lp. MULTBRANCI.OUTLET 97.50
APPARATUs
SINGLE OUTLET cIR.
su @ ,.50
EX. OCCU OUTLET ORFDRURES B20 00
Ex. Occup. Dunces aslD °Ew1
5.00
Temporary Service 1 23.00
Mobile Home Facilities
20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
W FUMCE 15.00
PERMIT FEE s 35 00
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X %. *` i ^� Date / ... (Li
Signature of Ap licant - ❑Owner ❑ Contra`cto AgentAn OSHA permit is required for excavations 5'0"dee and de n or construction
of structurs vvet'3 ss �I e�igh + p -
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 70.00
HAZ.
D. FEES IMP FLOOD _CD_ F HD ISS
-
THIS permit is hereby issued under the applicable provisions
of the'Butte�County Cod and/or Resolutions to do work
Indic te'd a +off which fees have been pa'
l
/ l
By r �b to
PERMIT EXPIRES ON
\ i Dete
Receipt No. 1 �_) �. f�
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
--COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, Galifornia 95965 • Telephone (530) 538-754103,30,73 (Rev.12/96) APPLICATION AND PERMIT
ASSESS RPARC NUMB
ZONING
BUILDING PERMIT
OWNE
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNERS MAILrht AD RESS
CO CTORS 44AVE
HOW
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15-66 1 9
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other ❑
Describe Work: REPLACE WATER HEATER & WALL
FURNACE
Gas piping syste!2 1 - 5 outlets
-no
15.00
Building sewer
15.00
Mobile Home IS I GI
@20.00
PERMIT FEES
ELECTRICAL PERMIT
Fling Fee 20.00
OR LE
Main Service . OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors license
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
�( I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
�/ 4 ,(")
.� Date J y v�
Ap licant - ❑ ner ❑ Cotrad-Ror AgentSHA permit is required for excavation60" deep and de n or construction
ructures I
t
Receipt No.
Main Service TO
46.00
CU00A
NEW CONST. DWELLING OCCUP. SO
W:
OR ADONIS. ( a ACC. BLDS. 3.50FT.
Ip"q�,p MULTI.OUTLETU. @7.50
POWER APPARATUS
a SINGLE OUREr CIR.
Ex. OCCu OUTLET OR FIXTURES j 20 @ I'50
SAL @ .30
Ex. Occup. ..E' B,=-.DERa 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
GAS FURNACE 119.00
PERMIT FEE S
Mobile Home Installation Fee Is
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 70.00
HAZ.
I D. FEES IMP FLOOD CDF PARCEL PD I HD I ISS yt
ermR is reby issued under the applicable provisions
of the uttunty Cod and/or Resolutions to do work
indic to ov ch ees have been paj'�
( L O
By to
PERMIT EXPIRES ON
Date
WHITE-D.D.S.-B.D. CANARY -ASSESS PINK -INSPECTOR GOLDENROD -APPLICANT
O.B.-1
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 permii' will be issued until this
verification is received.
('11), personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES ❑ NO RL
HAVE W HAVE NOT ❑ signed an application for a building permit for the proposed work,
I have contracted with the following person (firm) to provide the proposed construction.
NAME:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portionsof this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS:
CITY•
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
NOTE. Thu Owner Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to issue the permit
OVER
M
OWNER BUILDER INFORMATION i
Dear Property Owner.
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply
If you plan to do your own work; with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors; then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
wodcers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific khmration about your obligations Tinder Federal Law, contact the Internal Revenue Service (and,
ifyou wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
Permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is retmmed.
�� py
j
C. v n a, C.B.O.
BTnldng Inspection
NOTE. ?leis Owner -Builder rnformadon is required by Seddon 19830 of the California Health mrd Safely Code.
PRE -INSPECTION REPORT
OWNER
LOCATION: 1? 91
CONTR.ACTOR:--?,,4A
PRE-11METION
DATE TO
BuDding Descrlpdon:
c mmaysaWsage:
ResidmdW# of Units:__.
C=Mtly Oxupied
Electric:
G&s:
AbandonedNa=t
Yes_ � N
Condition of Electric
l .
PERMIT HISTORY:( )NONE K) AS
BUMDMG WSPECIOR'S REPORT
Electric currently, Oa Off
DATE: �L-(3- j
A.P. Xj
ZONING:
Natural � Propane None___ Currently Oa /Off
Obvious Problems.
Ssnkstion:
Plumbing Working(
Well Wori iaA Potable Water T GS
Obvious SewageProblems _ ►� o^ic
ACTION RECOMMENDED: ISSUE: HOLD FORy
9 C?A. "-, 1 -mac --G �-..)
Inspector:
Date
Sketch buildings on reverse and indicate location on proper
IWO.
Od . f Lo /1)
COUNTY OF BUTTE
BUILDING DIVISION
Ij DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street- Chico, CA - (530) 891-2751
7 County Center Drive - Oroville, CA - (530) 538-7541
CORRECTION NOTICE
4 OWNER PERMIT NO.
r ,d �nl 39- S60 - oo . i
k
A routine inspection indicates that the following violations of butte county Ordinances exist at the r
above address and should be corrected. Please notice this office when correction of work is
completed. It you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately. S
I
I ft.) 2J,& f' L -LA ) L/ -� r roe eded
f Date
i, REV 10/92
�r
�:• f
W—
.f
2'
'V2)
] 2) Inspector
- a r
39-56-02
92-1209B
LEICHTER, Ed
2295 Santa
Clara Ave, Chico
cont: Nelsen Const
new windows/sf
i
Twar
1 I l v COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N
Vv
J 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
.t
ASSESSOR PARCEL 4( 00,
��,yq�
.) � 9 -S l/.� V(/
ZONIKt(a}„'
BUILDING PERMIT _
OWNER - dt Ve , ,
,
Thi EPHON
SQ. FT. OCC. BUILDING VALUATION
I
OW �,E Rp'S�M�",�1I LING
�
�7.����
.
µ=T.1�RA
t6C('R'
TELEPHONE
'Va
C N�[JT I TOR'S (LING AD RES
- 0-
Fireplace
CONSTRUCT N `LENDER
�° � 1
UNKNOWN
Total Valuation $ V
I L
Filing
9 Fee
$ IU *&.m
LENDER'S MAID IgDD S
�1 1
Permit Fee
$ l
ARCHITECT OR ENGINEER
LICENSE NO.
f
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS j /� y 1 r
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 iGas
SFn Duplex❑ Mobilehome❑ Other
SPECIFY
piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
M.00 ea
TYPE OF WORK
NeW Addition[:] Remodel[] Utilities[] Installation❑ Other
Describe work: r _
(,1A �/L ------
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
_ I
Main service 600V 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):
a 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
El 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.a) yzQsgft
OR ADONS. ACC. BLDGS.
NEW CONSTR. U TI.OUTLET 2,50 ea
NO N.RESID .BRA C CIRC ITS
POWER APPARATUS 6
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES eA 0030
FIXED APLNS
Ex. Occup. OUTLETS P(RESID )REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00 (
Misc. Wiring 15.00
g
I I
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.
a-1 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.
MECHANICAL PE MIT
FiIingFee 10.00
Heating
Cooling
g
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 said County in consequence of the granting of this permit.
X__ Crl� �y.7 �✓' =-- Date J <i — &
Signature of Applicant — Owner❑✓ Controctor ❑ '-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 $ C U 1
OCCUP,
CONST.TYP!
SCHOOL
FLOOD
PARCEL
PV
ND
39UE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
RECTOR-OV PUBLIC/WORKS
/
BY k,4'11
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
41
Receipt No. ,41�
WHIT!-D.P.W., TLLOW-ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
MW �' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
AS O ARCEL NU R -D
zoNIN
i
BUILDING PERMIT
OWNER UAIRE
i�EP±j�! ^ 110
_j lU
SO. FT. OCC. BUILDING VALUATION'
O WJQE�'$�M ILI R SS ^.
't%1r' •/�
�(/J�1 �(R,/J-`/'act `ljL.r
v �
T L
Pi N E S
11
{�T, F�. TO NG AO S
(vJt1f"yt
Fireplace
CONSTRUCT N ENDER
UNKNOWN
Total Valuation 1 $
/
Filing Fee
$ ,%+e-00Permit
LENDER'S AIL S
Fee
$ L "6
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
0.00 ea
TYPE OF WORK
Ne Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other
Describe work:
1/21- j
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service GOOV OR LESS
100 AMP OR LESS
10.00
Maln service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
EQ -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. �S C(n ` Classification
El 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.y ,
OR ADDNS. ACC. BLDGS. /2¢sq ft
NEW CONSTR TI.OU LET 2.50 ea
NON-RESID .BRANCH CIRCUITS)
POWER APPARATUS e
(SINGLE OUTLET CIR.
zoesoe
EX. Occup OUTLETS OR FIXTURES eAL030
Ex. Occup. OUTLETSPIRESID IREA.) 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. 6Yirin 15.00
9
Permit Fee $
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.
gj,-rshall 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.
Contractor
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.
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
again said County in consequence of the granting of this permit.
X Date �
Signature of Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
OCCUP.
CONST.TYPEJ
SCHOOL
FLOOD
PARCEL
I PD
I HD
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indi d above for which
IREC PUBL
By
PE EXPIRES Date
the applicable provi-
resolutions to do
fee have been paid.
ORKS
Q
Date 6
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
I�. 7 _ -✓'_!' .. . r' � ,� . 1' •4.: , � ..�'��;,rCry. r t * . z..F .. � '� ;,�' r �l�.f.-. � .;fit `,at"
'r
r aj
DC
5a w
rt
I
s
i OFFICE COPY
]]]' Addresses
�. O .
i
� GAS
Meter By Date
ELECTRIC
Meter ByDate�j�/
.y
y
OFFICE COPY
t Address
t GAS
Meter By Date
ELECTRI
Meter By Date
r•
-' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
" 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 / i ';� f. /;/ '/x
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
--, a_. �j--.
ZONING
/0
BUILDING PERMIT
OWNER
TELEPHONE
S0. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
r.
C
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S' MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
i "4p
UNKNOWN
d
Total Valuation $
FilingFee
$ 10.00
LENDER'S -MAI LING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
`v' 'r -It?
LICENSE NO.
Plan Checking Fee
$ }
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS -
�� �►. r'..,. I,►e-1 <
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
<— o /
Each Trap
2.00
t
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,Z-- Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 i
Building sewer
5.00
Mobile Home S I G I W10.00
ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: I , i�=•f>. �..� C 1—r, ..,,
I~,r.. 1., ,c, f-►l1r� c��e��l (7, ��,i����r
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
...� t ^
� (_� � �'� C}��—�
A
Main service e101 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):
ElI 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.. ,zQsgft
A 2/
New
CONSTR� U TI OUTLET
NON.RESID BRANCH CIRC ITS 2.50 ea
POWER APPARATUS e
(SINGLE OUTLET CIR.
EX. Occup(OUTLETS OR FIXTURES eZOesot
AL@30
FIXED PR
EX. Occup. OUTLETS IRESID IEA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. byirin 15.00
g / L79
Dr, P.
f4,
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
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 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 -said County in consequence of"the granting of this permit.
X- Date - �^ r^
Signature of Appl.icant — Owner y Contracfor ❑ Agent ❑
An'OSHA permit is required for ex ovations 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 $ sa,;5(�
Occup.
CON5T.T7P_FJ
I
IFLOODIPARCELI
PD
NO
I ISSUED r
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 aid.
p
WORKS
Date 4_ _�/��/} ('(J
J"� `
Receipt No. -$'C>0
WNITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDEN ROD-AP►LI CANT
COUNTY OF BUTTE
G
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico - Phone: 891-2751
7 County Center Drive, Orovi Ile - Phone: 5344541
Skyway and Elliott Road, Paradise - Phone: 872-2961, Ext. 57
CORRECTION NOTICE
M
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.
Nd ALr 4-f-� n r -
f ,u'Ikc N ,X ti e-%
P/Jr�iU Q. 0 / Gt M sC'C6'VI
hip. b�NCC w�tc- SCA
f
-7A A�
Inspector ��:> Date
- i
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO/
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
.--.: O
ZON NG
-`d
BUILDING PERMIT
OWNER i TELEPHONE
e C
OWNER'S MAILING ADDRESS
SQ. FT. OCC. BUILDING VALU TION
CONT AC TOR'S NAME
TELEPHONE
CONTR TOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
c
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
n
RA r` A6, Vo / Ras
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
SFW�-Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G W
O.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: FI es,, - c`c, Q
,t��t�,�
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
- �Main
service 1 100V OR LESS
100 AMP OR LESS
10.00 f�
ytd9
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
'
T]I am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$
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
DWELLING
LIN OCCUP.e\
oR ADDNS,CONSTWEACCLG+/zQsgft
/
NEW CONSTR.MULTI-OUTLET
NON•RESID BRANCH CIRC ITS 2,50 ea
POWER APPARATUS e
(SINGLE OUTLET CIR.
20 0 sot
EX. QCCUp OUTLETS OR FIXTURES
eAL030
FIXED APPLES. OR
EX. Occup. OUTLETS (REST D.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00 (�
Z , �Uc�
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.
t�1 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.
I also agree t save, ' demnify and keep harmless the County of Butte against
all liabiliti , jud nts, costs, an ex enses which may in any way accrue
agai a' ou in consequ ce o the granting of this permit.
ZI �6 ��
r ❑ Agent ❑
ignor of App cant — Owner�tionsnovecr
OSHA permit is required for exc'0" deep and demolition or construct-
ion of structures/a—over3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
TOTAL PERMIT FEE $,,5'l�
OCCUP.
CONST.TYPEJ
JFLOODJPARrELJ
PO
ND
slue
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF P BLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.J 5 0
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
lu
COUNTY OF BUTTE - DEPARTMENT OF, PUBLIC WORKS - BUILDINGD��VISION
7 COUNTY CENTER DRIVE - OROVILLEVwCAkIF*RdhA 95965 - TELEPHONE: 9T34k4 541
PERMIT APPLICATION DATA SHEET
Permit No.
4
•', i r
OWNER �arh�rvc� etc -r-e,r- A. P. No. ��-�C_
Proposed Building Use S �'
Permit Fee Based Upon: Complete Contract Price CIZ DPW Valuation
_ Other (Explain)
Building Inspector IG Y/'-�/ Date
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.
A"' w 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./*'1
8. Fees of $ .
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. 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. . . . . . . .Pre- .
• 17. Pre -Ins ection for i��e�-��� S,2 G Ired. luilInspec. request to (Date)
p �"� Building Inspector
1 . Recorded copy of Agricultural Acknowledgment Statement . . .
19. Other Dritewav permit const approval re - 'red prior to ccc pa c_
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at offi �e. Deliver w/inspector.
Other %
A p p I is _ Date
Copy of plans sent Health Dept., Fire . ept., her 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
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
_, 0.
Z. NG
-gyp
BUILDING PERMIT
OWNER
• r
TELEPHONE
&
SO. FT. OCC. BUILDING
VALUATION
OWNER'S MAILING ADDRESS
CONT ACTOR'S NAME
7 G
TELEPHONE
CONTR TO 'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
L I Cij�NSE 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
PA r<,c4, J 19-L o kJy4—
Each Trap
2.00
V
Solar Of het ump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water p p
5.00
Eacyqa water heater or vent
5.00
USE OF STRUCTURE
SF J4-- Duplex ❑ Mobilehome❑ Other
SPECIFY
pi system 1 - 5 outlets
5.00
u• ing sewer
5.00
fv bile Home S G W
10-00 ea'.
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti Iities ❑ Installation ❑ Other ❑
r
Describe work: Inc
r
t; C trtL ,��it�a
Permit Fee
$
ontractor
LECTRICAL PERMIT
Filing Fee 10.00
- Ap
ain service e00v OR LESS
100 AMP OR LESS
10.00 0 Co
y
'n se I EA, ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LA
I declare under penalty of perjury (check one):
❑ I am licensed under provisions Of Chapt. 9, I 3 of the Ysiness
and Professions Code and my license IS In ull 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)0_JMisc.
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW. 5 DWELLING occuP.a
OR D S. ACC. BLDGS. 2/zesgft
NE C STR ULT1.0UTLET 2,50 ea
.RE ID BRANCH CIR ITS
POWER APPARATUS S1
SINGLE OUTLET CIR. /
200300
Ex. OCCLI) OUTLETS OR FIXTURES aAL030
FIXED APPLES. OR
Ex. C p. OUTLETS (RESID.) EA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Wiring 15.00 V
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 t save, • demnify and keep harmless the County of Butte against
all liabiliti jud nts, costs, an expenses which may in any way accrue
agai a' ou in consequ ce o the granting of this permit.
�� �/
Date�� /
ignot of App Cont - Owner Con octor ❑ Agent ❑
OSHA permit is required for e><covetions over 5'0" deer •I demolition or construct-
ion of structures ov*r 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
TOTAL PERMIT FEE $
OCCUP.
CONST.TYPE
JVL000JPARCrLJ
PD
RD
1l9UE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
Ct!
1 `3i�:Rr13T :=XPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. fro
WHITE -D. r. W., TELLO W-Aw eC3 SOR, PIN K•IN:.�!C'^iF C.., CLr /"' Al 1•l 'CA•"
RANCH SUS
NO. 2, FFIE
4 1
140 00
50 51'
.42:
4.311-1c
746.3
Is D7
-c le WXV
e
300-
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70
69
67
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66,
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401
6
IS 71
OU �4 c - 5.00,4C. :72
20.()()A C - 5.
74
75
300- -100
Tc. Area Code 62- 06
T300 5,'
Q;
7 ,7
.,50,4 c.
53 1
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24
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VE
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OFFICE OPY•
Address
GAS Date
Meter By
ELECTRI Datell
Meter By
03-2436
-- 11
160
AVE,�H
E
039-560-002
LEICHTER, RUTH
SANTA CLARA VE, CIUCO
2291 L
Cont:
LANDFL TCHER
Cont: ROLAND FLE
C/o ELECTRIC SERVICE
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
• 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 f 1 RMI N .
(Rev. 12/96) APPLICATION AND PERMIT Z J�%i
ASSESSOR PARCEL NUMBER
n20-5150-002
ZONING
BUILDING PERMIT
OWNER
R1n14 TFUTM LIVING TRUST
TELEPHONE
SO, FT, OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
Qi
CONTRACTOR'S NAME
ROLD FLE'TCHER 1`7F M' S
AN
TELEPHONE
343-3412
CONTRACTORS MAILING ADDRESS
PO Pox 1 95927
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
2291 &AEA CIARA AVEPERMIT
Energy Plan Checking Fee $
FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
-
Solar or heat um water heater 23.00
Water piping 15.00
Each as water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: C/O = SERVICE
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home ISI GI W1 1920.00
PERMIT FEE S
ELECTRICAL PERMIT Fling Fee 20.00
"'ORLESS
Main Service zo.A OR LESS 23.00 23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license •S I full force and effect. ///'''���
-7-7
% -7 q / b
License Class f � Lic. No. ! 2,qt
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
' I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
.forthwith comply with those provisions.
011.0
X )( �1 — Date 0' / �� _
Signature of Applicant - ❑ Owner Contractor ❑ Agent
An OSHA permit is required for excavati ns over 5'0"deep and demolition or construction
of structures covey 3 odes �n ig'ht1 ��� ..
Main Service 200A TO IOooA 46.00
NEW CONST.DWELLING OCCUP. SG
OR ADDNS. a ACC, BLDS. 3.52 pr:
== .T- MULTI.OUTLET 97,50
POWER APPARATUS
8 SINGLE OUTLET CIS.
E7(, OCCU ounEr OR FocruREs �,� ®': o
Ex. Occup. OUTLETSRM D.D.'A, 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00 23,00
PRE INSP 23.001
PERMIT FEE $ 89.00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC CONST. TYPE
TOTAL FEE $ 89.00
HAZ.
D. FEES IMP FLOOD CDF PARCEL pD HO
77
ISS
This permit is hereby Issued under the applicable provisions
of'the ButteiCounty Code and/or Resolutions to do work
indicated abrove Jol whi fees have beenp aid.
%
B I ` U Date
PERMIT EXPIRES ON 7r V
08 hi
Receipt No. % J �J C • i
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
, COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75410 7,.
(Rev. 12/96) APPLICATION AND PERMIT -
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
9995 SANIA CLARA AVE, M1120 9_5928
CONTRACTOR'S NAME TELEPHONE
ROLAND FLE'TCHER DYER'S 342-3412
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
99ql SANTA Q ARA AVE
Energy Plan Checking Fee
$
$
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat um water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: C/O ELEC SERVICE
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
000V OR LESS
Main Service zoOA OR LESS
23.00 23.0
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license ' i UI1 f rce and effect. ^-� n
License Class Lic. No. ! 7 Zi`1
'OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed I the permit is for work of a valuation
- n of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'.
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
ith comply with those provisions.
X Date 8-' / Z- 0 )
Ulf/2-0)
Signature of Applicant - ❑ Owner ontractor ❑Agent
An OSHA permit is required for excava ' ns over 5'0" deep and demolition or construction
of structures i !Ah
h'
?i
Receipt No.
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( a ADC. BLDs. 3.5¢FT:
* OUTLET
NON.RE ,D. MULTI.
97,50
F.10, APPARATUS
a swGLE ourLFT arL
Ex. Occup. OUTLEr OR FIXTURES BAIL 0 .50
Ex. Occup. our FIXEis qo °eA 5.00
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PRE INSP
23.00
PERMIT FEE $ 89.00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC CONST. TYPE
TOTAL FEE $ 89.00
D �� IMP FLooD CDF pgRCEL pp HD ISS
is permit is hereby issued under the
of a Butte unty Co and
indic ted a o w is fees have
By 1
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
v
Date z
�O cJ
(D, f
WHITE-D.D.S.-B.D.CANARY-ASSESSOR INK -INSPECTOR GOLDENROD -APPLICANT
�...Yr'=-�-`;�-r..r_,^,�v..ti� e,.- -' �.`*. .. �J .r ;. "�,_.';tiit; e`�,�•"t: +SY'R7�: �'+iL.}^.:6rrti.�re=_i1�r r,,.��'.......-. �=e••': .l: �.-•-•^•. ,. ri ..
t' COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: _) ASSESSOR PARCEL NUMBER i
Proposed Building Use: L / C/ Counter Technician: Date: ) G
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order Wapply.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Energy compliance design and supporting documentation in duplicate.
❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be
stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and
returned to the plan review line-up when required items are received.
Date Received By
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................
❑ 9. Site plan and business license approval from the City of Biggs ....................................
❑ 10. Letter of intent for non-residential buildings.........................................................
❑ 11. Detached Accessory Building Form filled out by the owner .....................................
❑ 12. Hazardous Material Form...............................................................................
❑ 13. Fire Sprinklers............................................................................................
❑ 14. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 15. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 16. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... _
❑ 17. Statement of Intent for Non -heated and A/C Buildings .............................................
❑ 18. Sanitation and site plan approval from the Environmental Health Department in _
❑ 19. City of Chico Plumbing permit........................................................... • ............ _
❑ 20. California Department of Forestry plan approval ❑ paid. Sent by: ......................
❑ 21. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: _
❑ 22. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... _
❑ 23. NPDES Form............................................................................................ _
El 2k Encroachment Permit f driveway fro th Publjc Works Dept ................................. _
25. Pre -Inspection for U required ................ _
❑ 26. Contractor's license nformation. (Number, Name Style, Classification) ...................... _
❑ 27. Worker's Compensation Carrier and Policy Number ............................................. _
❑ 28. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... _
❑ 29. Letter of Signature authorization.................................................................... _
❑ 30. Recorded copy of Agricultural Acknowledgment Statement .................................... _
❑ 31. Manufactured home utility clearance............................................................... _
❑ 32. Existing violations and/or expired permits......................................................... _
❑ 33. ❑ Grant Deed, ❑ M. itle/Statement of Facts, ❑ Letter from egal Owner, ❑ heck to H.C.D. $
❑ 34. Other. t
When issued Telephone _ and hold or peck p.
I have been
the above items and requ
obtaining a building permit.
Applicant: Date: U o, . `-' 1
1. Index permit application for the above items numbered: Plan Check Letter
2. Additional items required
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: Date:
Yellow: Building Division
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