HomeMy WebLinkAbout040-140-050040-140—UJU
LOGAN, KENNETH & REBECCAh
9193 ESQUON RD., DURHAM
CONV. GARAGE TO SHOP/UTILITY RM
040-140-050 9 -OOZE
LOGAN, KEN 0"
CONT CAREFREE POOLS /o A3
9193 ESQUON RD., DURHAM
NEW SWIMMING POOL'
B08-2308 040-140-050
MISCELLANEOUS Electrical
ELECTRICAL SERVICE FOR SPA
9193 ESQUON RD
LOGAN REBECCA ANN,
C
D�o- i�IJ-CSS
Al
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 9193 ES UON RD
Q
Owner:
Permit No: B08-2308
APN: 040-140-050
LOGAN REBECCA ANN,
Issued Date: 11/13/2008 By KCG
Permit type: MISCELLANEOUS
9193 ESQUON RD
Subtype: Electrical
DURHAM, CA 95938
Expiration Date: 11/13/2009
Description: ELECTRICAL SERVICE FOR SPA
Occupancy: Zoning: A5
Contractor
Applicant:
Square Footage:
ABLE HOME SERVICES INC DBA ABL
ABLE HOME SERVICES INC
Building Garage Remdl/Addn
PO BOX 7907
PO BOX 7907
CHICO, CA 95927-7907
CHICO, CA 95927-7907
Other Porch/Patio Total
(530)899-9009
(530)899-9009
FEE INFORMATION
DBE Swimming Poot/Spa $59.00
Total Charged: $59.00 Fees Paid: $59.00
Balance Due: $0.00 Receipt No: B9117
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
ABLE HOME SERVICES INC DI 627760 / C36 C10 / 02/28/2009
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 0 PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 70gp) of Divi o of the Business and Professions Code, and my license
is in full force a ffect. �//
pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000)
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 11/13/2008
the applicant to a civil penalty of not more than five hundred dollars ($500);
Please check one of the following:
tractor's Signa ure Date
❑ 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
WORKERS' COMPENSATION DECLARATION
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
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.).
HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
LJ 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
DELOS INSURANCE 01DKRM7200010 05/01/2009
Carrier: Policy Number: �xp. Date:
Contractor's License Law.).
(This section need not be completed if the permit is for one hundred dollars ($100) or less.
❑ I AM EXEMPT under Section B. & 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 I should become subject to the workers'
'
X 11/13/2008
compensation provisions of Se n3700 t Labor Code, I shall forthwith comply with those
Owner's Signature Date
provisions.
X 11/13/2008
;�
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 State laws relating to building
Sign a Date
ARNING: 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
a arising out of, in any way connected with
HUNDRED THOUSAND DOLLARS 5100,000 , IN ADDITION TO THE COST OF COMPENSATION,
( )
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
t is a
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 the above boned property for inspection purposes. I hereby certify that I am the
prop rt owner o m a ¢ed to act on the property owner's b elf.
S�t44i.,i 1/13/2008
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name of Permittee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
❑ Owner ❑ Contractor OR. Agent for Owner EgAgent for Contractor
FILE COPY
Lender's Address City State Zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES PERMIT
BUILDING PERMIT APPLICATION* * NO.
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 ; 2AV_—
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds g� #
PLEASE PRINT CLEARLY
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application. is subject to public inspection and will be posted on the County's website for electronic access.
OWNER INFORMATION
Last Namej
L O V
Firsame
G /C
Mailing Addressl C// T3
`IG
City D (-t r p r"t
Zip t� �3
Phone g _ 0,)q
Phone do,� I _
Fax
E-mail
CONTRACTOR
Name 41, W*P 1
Address 3 IfG 541-e„6e,1 fid. /Z�
City u . d
St to
Zip t� �3
Phone g _ 0,)q
Fax
E-mail /t1 IM (9 Gq I f' cr b I fiT► r.
Lc.* -27760
776O
Class C_ D
AP , ICAN .SIGNATURE
X
PROJECT LOCATION
AP# Otto _ l v-050
Property Address q G -3�! $ D 1
City '1 ( t') d
LA r6t"
I WORKER'S COMPENSATION
Policy Number 02 a K A M 1'2000 100 I
Carrier
Delo s • �hS. C� h
If hiring anyone other than licensed contractors, a certnate of
worker's compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
rr&LA P V i Ciro tc i �- ohc% r
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
ARCHITECT/ENGINEER
Name
r � w u SO �
Address
SRA
City
I No
State
Zip
Phone
Fax
E-mail
State License Number
AP , ICAN .SIGNATURE
X
PROJECT LOCATION
AP# Otto _ l v-050
Property Address q G -3�! $ D 1
City '1 ( t') d
LA r6t"
I WORKER'S COMPENSATION
Policy Number 02 a K A M 1'2000 100 I
Carrier
Delo s • �hS. C� h
If hiring anyone other than licensed contractors, a certnate of
worker's compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
rr&LA P V i Ciro tc i �- ohc% r
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
APPLICANT INFORMATION
Name Ale
D
r � w u SO �
Address
SRA
City
I No
State
Zip
Phone
Fax
E-mail
AP , ICAN .SIGNATURE
X
PROJECT LOCATION
AP# Otto _ l v-050
Property Address q G -3�! $ D 1
City '1 ( t') d
LA r6t"
I WORKER'S COMPENSATION
Policy Number 02 a K A M 1'2000 100 I
Carrier
Delo s • �hS. C� h
If hiring anyone other than licensed contractors, a certnate of
worker's compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
rr&LA P V i Ciro tc i �- ohc% r
Sq FT- Living Garage Open Cov
❑ 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.
PLUMBING & ELECTRICAL
Serving Butte, Yuba, Sutter, Glenn & Tehama Counties
To Whom It May Concern:
I, Victor Simenc, President of Able Home Services, Inc., Contractors
License Number: 627760, hereby authorize the following to act as my
agent(s) in obtaining permits:
Bryan Aldred
Brian Bocks
Michael Bowling
Nick DeSpain
Ramon Ferguson
Dale Olson
Tom Shotwell
Kay Simenc
Tom Simenc
Hope Stambugh
Joseph Steed
Greg Vincent
Shawn Hudson
Nicole Devine
This authorization is to remain in effect until 10/30/09 unless notified in
writing.
ABLE HOME S€RVICES, INC.
c�
Jl
Con actor's Signature
'::"l�sn)siracr,c1u!�':r !)lu:)�;hinz°}.l;iec:�ric�! fn.fi>nr,�tc�z:`.l::I:�carica - l�-i�rms`.t:;lcctr;.cal L'e�rai; lrrt�,n�aaiio�?:1';r�nit
AUjjl()rizii6on Utter Current.d(v
Phone (530) 899-9009 • Toll Free (888) 321 -ABLE • Fax (530) 893-4787
Lic. # 627760 o P.O. Box 7907 s Chico o .California • 95927
040-1.40-050 94-0057B,P,E
LOGAN, KEN
CONT: CAREFREE POOLS
y 9193 :ESQUON RD . , DURHAM
NEW SWIMMING POOL 7
GG��a
VIA
408 FINALED (pate)
Signature ,
V=OK
O = Not OK
Not = Not Ready MOBILE
MOBILE HOMES
Date/Initials MOBILE HOME UTILITIES (Plana) OK except #'a
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Teat -Wrap: / /" L" ft.
/ /"Net. or/ P'L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date/Initials MOBILE HOME INSTALLATION (Plana) OK except #'a
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3.. Gas; MH Test-Demand-Valve—Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
v
MISCELLANEOUS
Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg: Rfg.-Brecing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date/Initials POOLS (Pians) OK except #'s
LY.' Soils; Compaction -Structure Stability
,3,Pool Structure; Steel -Connections -Thickness
and Lighting, Distances-GFI
Pool Lighting; 15 volts-GFI
Conduit Entries -Terminals -Listed
04x74 3*'Elec.; J36nding; Metal w/5' -Circulating Equip. -Heater
If 1 8. Ele .; Grounding; EauiD. w/5' Circulatina EauiD.-Pool Lahta.
! eaith Department Approval
1 umb.; Cir. Test -Water Supply Test
to Main in Conduit
V=OK
O = Not OK
- = Not Applicable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date/Initials UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Mein; Soils-Elec. Grnd. / P' Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd./ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Plenums & Ducts; Clearance -Materiel -Support -Ina.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
D_ ate/Initials PLUMBING (Permit) OK except #'s
16. Water Htr.; Vent -Access -Combustion Air -Baffle
17. Water Pipe; Test & Anchor -Neil Protection `
18. D.W.V.; Test -Fittings & Anchor -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
Date/initials ELECTRICAL (Permit) OK except #'a
22. Fixture & Transformer Clearance -Ins. 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. Fastners-Bond Gas & Water
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ge.
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
33. Smoke Detector
Date/Initials MECHANICAL (Permit) OK except #'s {
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date/Initials FRAMING (Plans) OK except #'s
39. Sils, Proper Material & Anchors
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Wells over Girders & Floor Nailing
42. Draft Stop in Walls (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
Date/Initials FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin=roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Wells; Nailing -Bolts
59. Insulation -W al Is -Ceilings
60. Infiltration -Walls -Windows
Date/Initials FINAL (Plans) OK except #'s
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Mach. Protection
64. Bedroom Exiting
65. G.F.I. & Beth Fixtures & Tub Access -Spa
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
68. Fireplace or Stove; Clearances -Hearth
69. Elec. Outlets at Wood Panel; Int. & Ext.
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door, Swing -Landing -Closer
73. A.C. Duct in Garage -Damper
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor -Mach. Protection
75. Plb., Elec. & Mach. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic ❑ Yes
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
81. Stucco; Brown -Finish
82. A.C. Unit; Disconnect, Electrical, Plumbing
83. Vents Above Roof; Plbg: Appliance -Fireplace. -Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
87. Glass Protection
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
Comments at Final:
/ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
�V 7 County -Center Drive—Orewille, California 95965 - Telephone (916) 538-754 PERMIT NO.
APPLICATION. AND -PERMIT
��'�����
ASSESSOR PARCEL NUMBER
040-14— —
ZONING
—
BUILDING PERMIT
OWNER
KEN LOGAN
TELEPHONE
891-4906
SQ. FT. OCC. BUILDING VALUATION
Est
16,nnn
OWNER'S MAILING ADDRESS
9193 EsquQn Road, Durham
CONTRACTOR'S NAME
Carefree
J LEPHONE
CONTRACTOR'S MAILING ADDRESS
0 'Roy 81989
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
16,000
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
12000
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
PERMIT FEE $
223.00
9193 Esquon Road, Durham
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00 15.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF ❑ Duplex O Mobilehome El Other POOL
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New CIX Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other O
Describe Work: New Swimming Pool
PERMIT FEE $
35.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Master 501-91
Main Service BOOV OR LESS
( 200A oR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONS. ( & ACC. OLDS. )
SO.
3.5C FT.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
Ceram a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force pd effect.
License No._�Q B��Classification ^�
C S,-3
❑ I, as the owner, 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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON -RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
B20 @ 1.00
Ex. Occup.FIXED APPWS.Ofl
( OUTLETS IRESID.I EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
pool
23.0
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
O alis permit is for $100.00 (valuation) or less.
'Phave placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
❑ 1 shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
43.00
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California 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 said
Cou t in consequence of the granting of this permit.
XDate / 1p — �g
Signature of Applicant - ❑ Owner Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
IHAZ• I D. FEES IMP
cOF PARCEL PO
Ho uE
PI V
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
DIRECTOR OF PUBLIC WORKS
PERMIT EXPIRES ON
ere/
provisions
to do work
paid.
Date
�
Receipt [ b
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
��. �, �`dc��-.':ti r�'C:'�•;•?{.:��s`^�' ir�'rc` a,r�r+-.xa"-''71-i�""':.."�!�"-.:y:Y��ti'�hs�'�°. �'"i-.:'h+.��.,; }-:' ;��:'a'"':_ ��S
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COUNTYOF BUTT4 - DEPAI.5k-NTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE-°OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 /
PERMIT APPLICATION DAT
DATA
OWNER 41ev L A. P. No. �� y yo - CSO
Proposed Building Use ha / Building Inspector C7 e-v,� Date %K S3
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1, All items have been submitted . ....................................... .
2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3_ Complete plans, 3/4 sets, signed by preparer of plans . ......................
A. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . .............................................. �►'�-
6. Energy Design Compliance and supporting documentation. .
7. Statement of Intent for Non -Heated and A/C Buildings . ......................�
8. Engineered truss details and layoutin duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $........................................ .
11. Impact fees as shown on attached schedule. ............................. .
12. California Department of Forestry plan approval/fees. ....................... .
11, -Flood elevation letter (100 year flood) by California Engineer . ................ ..
14. Sanitation and plot plan approval Department . ............��
15. City of Chico plumbing permit ..................................
6, Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. . .
20. Pre -inspection for Prey Building Ins pe Inspector . . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner ) ............
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .. .
27. Letter of intent on building use . ...................................... �. .
28. Mobilehome utility clearance . ......................................... .
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
-34.
When ou issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone ) y2 - yy. 3 and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submittedp r to permit issuance: (Circle new item not checked above).
1. Index permit for above items No. �
2. Additional items required:
Contf9co,tor, designer, owner, was advised of above required data byphone _mail Counter by rn ate Z -
Contractor, designer, ow r, w s advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by 7R� Date -I Z- Plans approved by Date'
Sets of plans on hold in' File cabinet AP folder
Copy - Department of Public Works
TO:
FROM
i
Building Department
Environmental Health
SUBJECT: Sanitation Clearance
F.H. USE, .";I,Y
1'10( I'hm Allachcd
Vhmr Plan Attach.d
Sent t0 11. 1). __%�/`,,�
a
04) 7�D- �
r Loca Von AP#/
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for bedroom mobile home. Other��
Hold final for:
Final clearance O.K. for:
NOTE: oc - (1)0 1,.;�
;�A�aL
Envi onmental Health Specialist
8/92
Date
E.M. 1111: ONLY
Plko Han Auaclrcd
Hoor Plan Attadmi��-
1.,111 to IU) /
TO: Building Department Cj
FROM: Environmental Health
SUBJECT: Sanitation Clearance
ner Locati AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for bedroom mobile home. Other 1
Hold final for:
Final clearance O.K. for:
NOTE
Environmental Health Specialist
8/92
LX -74
Date
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
L ��,0A/ q z1 --06y 7
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
.`Z� (�k�D.Q.! YL l h�► �l� [/�� D U N+. n ,t.% U,S!lr,�
Date o- [I -qInspector
REV 10/92
IN, Vi
ntl It
PROPERTY IS 5 ACRES
PLAN NOT TO SCCA LE
f
i
PROPOSED
POO l:�
GAR RES
0
i
ENVIRONMENTAL HEALTH
JAN 1 2 1994 '
CHIM CALIFORNIA ,
KE'N AICD BECKY LOGAN
AP 40'140-6,'50 ;
9193. ES O -AA RD DURHAM µ
,
wR+:7ruc. I.iuM.s•. rniity•rrMMIMAvafC`lxpt/,l vCY.�!'�J�htG'st"1MG11?4Wcr _ ; _z>""�.'il
V= OK
O=Not OK
Not ApplReady
MOBILE HOMES
Not Ready `
Date/Initials MOBILE HOME UTILITIES (Plans) OK except #'a
•1. Zoning Requirements -Setbacks -Easements
2 Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Teat -Wrap: / /" L"ft.
/ /"Nat. or/ P'L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date/Initials MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3.. Gas; MH Teat-Demand-Valve—Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
S. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
MISCELLANEOUS
Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
t"Eoningfieq u i rementa-Setbac ks-Easements
.Z.-fee4age;Soils-Size-Depth-Spac i ng -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posta-Beams-Rftrs.-Connectors
Shthg: Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carp ; Windows -Doors
ec c
rmg; Sils-Anchors-Studs-Rftre-Trusses
9 ding; Nailing -Veneer -Stucco -Mesh
19/hoof; Shthg-Roofing
t.; Steps -Doors -Landings
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date/initials POOLS Plans OK except #'s
tbacks-Easements
;201oilk Compaction -Structure Stability
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. E :;Enclosures; Conduit Entries -Terminals -Listed
J�� <s6.
—�
. Elec.; Bonding; Metal w/5' -Circulating Equip: Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Mein in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
V=OK
O=Not OK
- = Not Applicable RESIDENTIAL (Single & Duplex)
= Not Ready
Date/Initials UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils -Elea Grnd.-/ P' Fig. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd -/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
S. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouta-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -teat
11. Water Pipe; Test -Anchor -Regulator -Service Teat
12. Electric; Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date/Initials PLUMBING (Permit) OK except #'s
16. Water Htr.; Vent -Access -Combustion Air -Baffle
17. Water Pipe; Test & Anchor -Neil Protection
18. D.W.V.; Test -Fittings & Anchor -Neil Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
Date/initials ELECTRICAL (Permit) OK except #'a
22. Fixture & Transformer Clearance -Ins. 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/Meth. Fastners-Bond Gas & Water
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
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
33. Smoke Detector
Date/Initials MECHANICAL (Permit) OK except #'s
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condens to Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date/Initials FRAMING (Plans) OK except #'s
39. Sils, Proper Material & Anchors
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
42. Draft Stop in Walls (ret proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
Date/Initials FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties -Puri In -roof Bmc-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ina. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls; Nailing -Bolts
59. Insu lation-Walls-Cel II ngs
60. Infiltration -Walls -Windows
Date/Initials FINAL (Plans) OK except #'a
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
68. Fireplace or Stove; Clearances -Hearth
69. Elec. Outlets at Wood Panel; Int. & Ext.
70. Kit.Fixt. & Appliance; Grnd-Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door, Swing -Landing -Closer
73. A.C. Duct in Garage -Damper
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor -Mach. Protection
75. Plb., Elec. & Mach. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic ❑ Yes
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door-Drainagge & Wood -Earth
Clearance Looked under Floor ❑ Yea
80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
81. Stucco; Brown -Finish
82. A.C. Unit; Disconnect, Electrical, Plumbing
83. Vents Above Roof; Plbg: Appliance -Fireplace: Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
87. Glass Protection
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
Comments at Final:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
V, 7 County Center Drive - Oroville, CalifOlTlia 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 923-3
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
QYl 1 a
TELEPHONE
SQ. FT. OCC. BUILDING VALU ION
1 non
OWNER'S MAILI1,000
NGnnADDRESS
'1 S ✓
CONTRACTOR'S NAME
owner
TELEPHONE
'
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
2
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS ,7
PERMIT FEE $
68.00
/' ll 1
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF Duplex O Mobilehome O Other
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G I W
20'00
TYPE OF WORK
New ElAddition ❑ Remodel �L Utilities ❑ Installation 13Other 1:1Contractor
Describe Work: cmc UY f + 6,,.. 0a., m ✓art
—
PERMIT FEE $
ELECTRICAL PERMIT
Filing Fee 20.00
/
/
Main Service ( 10VORLEI )
200A OR LESS
23.00
Main Service ( 200A TO I000A )
46.00
NEW CONST. DWELLING OCC U
OR ADDNS. ( a ACC. BLOS. )
S0.P.
3.50 FT.
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and
/Professions Code and my license is in full force and effect.
�f/ License No. Classification
I, as the owner, 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)
Cl 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
El am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS )
@7.50
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
BAL @'.000
FIXED (RESIO OR
Ex. Occup.UT
( OUTLETS (RESID.1 EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00 23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
43.00
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California 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 % -'1 N — Gj 3
Signature of Applicant Owner Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. y�PE/
V
TOTAL FEES 111.00
HAZ.
I D. FEES
-
IMP
F.WOo
[i
CDF
PARCEL PD
HD
Iss
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date l2 a 193
PERMIT EXPIRES ON / 2 ) 3
IDate
Receipt No. 153609
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
.Y � ,.,j'. .. �r'w-.{`lr•..-',,,.�.�^.y r�-u_..+t.: i.r+ tom: ,..- �..�-'--c tel.-'�j^v. -r.r.. +.•��. _�i.�i,..r.•-�'rtii..+. ".ry .� .-.r.vr.... �i _.,,"..._.ti -.....-.
t,, � YMIi'arw�•
COUNTYOF BUTTE - DEPARTMENTOF D,EUff LOPMENTSERVICES -BUILDING DIVISION
7COUNTY CENTERDRIVE - OROVILLE, CALIFORNIA 95965- TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
1 11-11
OWNER P. No.0 4,�D-"/yo-
Proposed Building Use k, of 6 4Y Building Inspecto 2 Date - r
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted. .'.......................................
2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3_ Complete plans, 3/4 sets, signed by preparer of plans. .
.4. Engineered plans and calcs, 3/4 sets,,with wet signature on plans . .............
5. Hazardous Material Form . ..............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for"Non-Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ..........................................
11. Impact fees as shown on attached schedule. ............................. .
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . ............
15. City of Chico plumbing permit . ........................................ .
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . .........
18. Contact Land Development about (A) Improvements (B) Drainage. ....� ..... .
19. Driveway permit (construction approval required'prior to occupancy). .. .. .. .
20. Pre -inspection for i Preanspection reque-fs
p required. . . to Building inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workrnans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner . .......... .
24corded copy of Agricultural Acknowledgement Statement . ..................
F
et 'ter of signature authorization . ....................................... .
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
'Al . Existing violations/expired permits . ......................................
Plan check list.
33.
34.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pic pat office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant
Date -/.P " / q , 4 _11
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance
1. Index permit for above items No.
2. Additional items required:
(Circle new item not checked above).
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date "
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by -Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
C `
COUNTY OF BUTTE - Depar`tment of Public Works
7 County Center Drive, Oroville, CA 95965 Phone:' 916-538_7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied.for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
J. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no) v=!;
2. I (have/have not) Yel 0 r 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
S
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.