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Home My WebLink About040-214-006040-214-006 06-1191 i SMITH a 9393 GOODSPEED ST, DURHAM Cont: POLIQUIN ELECTRICA ELECTRIC-200AMP L� S•23.Ob � . P11 - ti Am� K., r . ; Y„) i;lid t'i.� { �Y•i }, i M _ -s� tilPq, 1 i I f s ? ".VZ r ltg� i iy r^ �I c �,� `1 i s II ! �- III2' t Ii tt t f f: »orf ✓• 4t +' 1 ! tt t jl ikn�i'�i�_� ��}�j4 �..Xt°� �,i u ' !y!+ _ ; ti 11 ?. ,f� t •! .. t .6 '}+ 4 1 d � ! - I f -• Ff ! I r }?!f y{. j1 }f�^� >j i1 -, t r iS + i �� } �f .f'k1�) _. , 7 j { _ F� r�• �' ��r ) fS+i��}I{ !li r � y.,.� i' xj i 5}}?i {It'1 � t rt(!t t i�+{?.+! ? :- t`Y• °I '•f� YTa7 b Ft .�}lrl�l� at ,�.. I { j !h ��. t, t �} ltd �• R:�- a.s J• 3 n,1 { � 7{t r� ITa If I ! � ��pY f �� I �� t�y If ' � �� i{ 1 1 �� t 1 LKS} __ Y• .. { 1 ,Sa�,d `� � t � t Y �,'!'��lt 7 s._., } t :r I �t l�f f13 �{�I �iZ �P��-it t,.�_'• � t 1s�F tf� �. • �'� !t Y'�-r'��'�`iE� �lil� :. ' x t -; •{ttj t''�i � lt��t`+��fls�t �i f f _ , 1 � .F Y^{ ''� ti� ;, Y,.. � '} � ff••1 i �Y. Et �� 1 � KI { f.� ! i �,., {a a �t' Y �P. �� r�i.' •' v ? r 1 -;-'+41� > i x ��"�_ b m�-t"• 'lu`l��i,:i``r f It r � f r• .; is}fitt�'n, !y �:�'�t� c F { .. Status: FINALED l APN: 040.214 006-000 Site Address: 19393 GOODSPEED ST OUR I Map Index: Owner (Title): ISMITH DONALD K J Project Title: 1 Contractor: IFOLIQUIN ELECTRIC_ _ _ I Applicant: IRPLIQUIN ELECTRIC_.___, Contr Phone: 530-228 1-715 Architect: 1 Contr. Lic. # 1657192 I Engineer: f Description:UPGRADE PANEL TO 200AMP _ 1 Fee Summary Permit Issuance Fee: $0_00 Mechanical Fees:_ _ $0.00 Travel/Documentation: $0.00 Plumbing Fees: $0.00 Investigation Fees: F ---$D —05 Electrical Fees: $55.0Q Total MPE Fees: $55.00 TOTAL FEES:$5500 Fees Paid: $0.00 Balance Due: ;0-00 Key Dates Applied: 05/19/2006 BP Renewal: _!_/_J Approved: J Expired: _/_!_J Issued: 05/19/2006—J Voided: _/_/_J finaled: 05/23/2006 j Census Data Census Class Code: Update+ Exit Back Permit Type: ELEC 1 Commercial (WN): D Required to Issue Contractor Lic: Pre-Insp: U Planning: {� Owner/Builder: Health: (� Water: Fire: rl NPDES: FW -Land Dvlmt: Workers Comp: PW Encroach: Sign Authorization: Plan Check: I� Special Districts Tax Rate Area 1070015 I High School District: DURHAM I Elementary School District: INOT _FOUND IN TABLE Water: �— 1 Sewer: II Rec Dist: 1 Intialized: 05/19/2006 KJONES I r.....:, • .1-Dcvd6pMent Services",, Wednesday, September 20,"2006 _ _ . \ ... .. 81191-•t�IN!' iiIVlSlI"i'�I � 7ar. 1 n Counter Karen I Person Fund 10 (Bldg Permits) $55.00 17 SRA Fees (Fire) $0.00 Payment Date 5/19/2006 I SHR Fees (Sheriff) $0.00 Permit Number 061191 j I SMIP $0.00 Receipt Number 450603 I Copies/Document Sales $0.00 Check Number or Cash CUA (Chico Urban Area) $0.00 Parcel Number 040-214-006 I TUA (Therm. Urban Area) $0.00 Applicant SMITH ( Water Tender Btln # = $0.00 West Chico Fire Station $0.00 Received From - FPOLIQUIN ELEC AVA Restitution Payment $0.00 I , Total Received --- $$55.00 - Recorders Fees (N.O.C) = $0.00 Thermalito Drainage $0.00 Total Fees To Collect $55.00 Oroville Area Traffic $0.00 Notes: NSF (Non Sufficient Funds) $0.00 I Notice of Violation $0.00 NCSP Trails SystemF $0.00 NCSP Roads/Bridges $0.00 NCSP Storm Drainage $0.00 NCSP Fire Station $0.00 NCSP Parks Type $0.00 Value $0.00 DATE: BAG NUMBER: RANGE OF RECEIPTS: MONEY COLLECTED: DESCRIPTION BLDG PERMITS REMOVE NOTICE OF VIOLATION CHRG ON RET CHECK AVA COURT ORD RESTIT REIM COPIES WITNESS FEES RECORDERS FEES DEVELOPMENT SERVICES - CWIF PROC FEE AUDITORS - CWIF PROC FEE FIRE COMMCL PLNG REV FEES FIRE PLNG APPL FEE (SRA) SMIP FEES SHERIFF DEVELOPMENT (SHR) CHICO URBAN STREET IMPROVEMENT OROVILLE AREA TRAFFIC CHICO VECINO DRAINAGE TRUST THERMALITO DRAINAGE DRAINAGE DEPOSIT TRUST SUB -DIVISION DRAINAGE TRUST NCSP - TRAILS SYSTEM NCSP - ROADS & BRIDGES NCSP - STORM DRAINAGE NCSP - FIRE STATION NCSP-PARKS CWIF - GENERAL GOVT. FACILITIES CWIF - GENERAL GOVT. EQUIPMENT CSD #770 -BUTTE CREEK CSD #771 - COMANCHE CREEK CSD #772 - LITTLE CHICO CREEK CSD #773 - BIG CHICO CREEK CSD #774 - LINDO CHANNEL CSD #775 - S.U.D.A.D. DITCH CSD #776 - MUDD-SYCAMORE CREEK CSD #777 - P.V. DITCH CWIF - LIBRARY - FACILITIES CWIF - LIBRARY - MATERIALS CWIF - LIBRARY - VEHICLE & EQUIPMENT CWIF - ROADS & BRIDGES (NCSPICUA) CWIF - SHERIFF - FACILITIES CWIF - SHERIFF -VEHICLE & EQUIPMENT CWIF - FIRE - FACILITIES CWIF - FIRE - VEHICLE & EQUIPMENT WATER TENDER FEE REQUESTFOR AUDITOR'S CERTIFICATE AND TREASURER'S RECEIPT DEVELOPMENT SERVICES - BUILDING DIVISION 5/22/2006 328 450297.00 5/21/2006 FUND TITLE BLDGINSPCTN GENERAL FUND BLDGINSPCTN AVA CRT ORD COPY SALES BLDGINSPCTN GENERALFUND DEV SRVCS - CWIF PROC FEE AUD - CWIF PROC FEE FIRE PROTECTN FIRE PROTECTN SMIP FEES SHER DEVL FEE CHICO URBAN AREA OROVILLE TRAFFIC CHICO VECINO THERM. DRAINAGE DRAINAGE DEP. TRUST SUB -DIV. DRAINAGE TRUST NCSP -TRAILS SYSTEM NCSP - ROADS & BRIDGES NCSP - STORM DRAINAGE NCSP - FIRE STATION NCSP-PARKS CWIF-GEN. GOVT. FACILITIES CWIF-GEN. GOVT. EQUIP CSD #770 BUTTE CREEK CSD #771 COMANCHE CREEK CSD #772 LITTLE CHICO CREEK CSD #773 BIG CHICO CREEK CSD #774 LINDO CHANNEL CSD #775 S.U.D.A.D. DITCH CSD #776 MUDD-SYCAMORE CREEK CSD #777 P.V. DITCH CWIF-LIBR - FACILITIES CWIF-LIBR - MATERIALS CWIF-LIBR - VEH & EQUIP CWIF-ROADS & BRIDGES CWIF-SHR - FACILITIES CWIF-SHR - VEH & EQUIP CWIF-FIRE - FACILITIES CWIF-FIRE - VEH & EQUIP BATTALION #7 FUND DEPT ACCT CASH CODE CODE CODE CODE AMOUNT 1 0010 440001 4210500 $ 101001 $ 0010 440001 4350903 0010 440001 4610105 0010 440001 4617252 0010 440001 4711910 0010 440001 4712523 0010 470001 4613701 0010 440001 4617999 0010 050 4617998 0100 $ 4617237 0100 1011824 4617240 1001 $ 280 1800 1011890 280 1800 $ 280 1800 101001 280 1800 $ 502.58 280 1800 1011971 280 1800 $ 280 1800 1011974 280 1800 $ 280 1800 1011977 280 1800 $ 394.85 280 1800 1011828 280 1800 $ 1,916.65 280 1808 1011842 280 1810 $ 600.49 280 1821 1011867 280 1821 280 1821 280 1821 280 1821 280 1821 280 1821 280 1821 280 1825 280 1825 280 1825 280 1831 280 1840 280 1840 280 1851 280 1851 280 1851 280 Revised 11/22/2005 PREPARED BY: Gwyn Benedict ext 7604 101001 $ 5,594. 101001 $ 101001 $ 101001 $ 101001 $ 2.23 101001 $ 101001 $ 101001 $ 100.00 101001 $ 100.00 101001 $ - 101001 $ 95.00 1011298 $ 28.66 1011811 $ 514.00 1011815 $ 1011817 $ 1011821 $ 1011822 $ 1011823 $ 1011824 $ 1011888 $ 1011889 $ 1011890 $ 1011891 $ 1011892 $ 101001 $ 1,089.70 101001 $ 502.58 1011970 $ 1011971 $ 1011972 $ 1011973 $ 1011974 $ 1011975 $ 1011976 $ 1011977 $ - 1011826 $ 394.85 1011827 $ 265.61 1011828 $ 7.92 1011001 $ 1,916.65 1011841 $ 513.03 1011842 $ 250.33 1011852 $ 600.49 1011853 $ 1,159.14 1011867 $ TOTAL $ 13,134.76 Revised 11/28/2005 DATE 5/22/2006 BAG # 328 RANGE OF RECEIPTS: 450297 MONEY COLLECTED: 5/21/2006 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION Page 1 of 4 ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ Page 1 of 4 Revised 11/28/2005 DATE 5/22/2006 BAG # 328 RANGE OF RECEIPTS: 450297 MONEY COLLECTED: 5/21/2006 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION Page 2 of 4 STREET IMPROVEMENT ��WMTTRMOXVMZ THERIVIALITO DRAINAGE Page 2 of 4 Revised 11/28/2005 DATE 5/22/2006 BAG # 328 RANGE OF RECEIPTS: 450297 MONEY COLLECTED: 5/21/2006 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION Page 3 of 4 EQUIPMENT ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ Page 3 of 4 Revised 11/28/2005 DATE 5/22/2006 BAG # 328 RANGE OF RECEIPTS: 450297 MONEY COLLECTED: 5/21/2006 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION GRAND TOTAL TO BE DEPOSITED $ 13,134.76 PREPARED BY: Page 4 of 4 Gwyn Benedict ext 7604 DATE: 5/22/2006 DRAIN AREA 777 ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ GRAND TOTAL TO BE DEPOSITED $ 13,134.76 PREPARED BY: Page 4 of 4 Gwyn Benedict ext 7604 DATE: 5/22/2006 Butte County Department of Development Services NOTES 7 County Center Drive, Oroviile, CA 95965 ouN •l• (530) 538-7601 www.buttecountyneUdds RESIDENTIAL APN: -040-.714-006 -- — ..w "'06-'1191 Owner: SM'f T >?> GOODSPEED ST, DURHAM I _I Cunt:'POLIQUIN ELECTRIC_____ __ I Site Address: � I' 1'.'fECTRIC-200AVIP Contractor: I Type of Permit: OFFICE COPY Address GAS Meter By Date ELECT -- Meter Bylsl_I1Y�(1�Date�Z{�(o -------------- SPECIAL CONDITIONS CHECKED BY Q SRA Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED Q SPECIAL INSPECTION ITEMS Q VERIFY USE PERMIT CONDITIONS a SUBSTANDARD HOUSING LETTER 0 ENCROACHMENT PERMIT " 0 REINSPECTION FEE PAID Q ENV HLTH CLEARANCE. ED DATE JOB FINALED: SIGNATURE: �JCS2J`t if�jVt(/I L4 sa +=OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR I DATE PLUMBING 1 ZoningSetbacks-Easements-FloodSlope 2 Ftg Main; Soils-Elec Grnd Fig Dpth 3 Ftg Garage; SoilsSteel-Elec Grnd Ftg Dpth 4 Fig Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwails Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 WV Pipe; Test-Anchrs-RgltrService Test 12. Elec Undrgrnd 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Acc & Vntttn 16 Insulation DATE IFRAMING 17 Sills Proper Materials & An 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops,' Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams -'Si & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Area -Glass PrtctnSkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace InUExt Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration -Walls -W ndws o' m`s oar DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Egp Grnd made up w/Mech Fstnrs rndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or ❑ AL AC Wire Sz 9a [::ICU or DAL 48 Range Circ ga ❑ CU or ❑AL Oven Circ 9a [::ICU or ❑-AL I"ted Neutral ❑ Yes ❑ No Se a -Riser Cndctrs & Grnd Main Dscnnct w,-qp Cirncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr. Nail Prtctn 56 Shwr Pan; Test, First fir -Tub Acc . 57 Test Tull & Shwr, 2nd fir - Tub Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping DATE IMECHAKICAL 61 AC Ducts Insultn & Support " 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrfiw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic FINAL 66 Ext Steps -Door & S1deLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr In Garage; abv-fir-Ducts-Mach Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault ec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvi 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler b'-�\S 100 o`er` 40 +=OK 0 - Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FalUC/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer. Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D E C K S'C O V E R S'C A R P O R T S'G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-DpthSpacing-DnnctrsSteel 3 Decks, Girders/Joists-0cking-Brcing . Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Fang; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing-VeneerStucco-Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Dnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcitng Eqp-Pool Ightg Boxes-Encisrs-pnlboards4nsultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Encisr; Fencing -Alarms 13 Bonding, Diving board or Slide ops 0'� o's o`er �10 °�, ��, Pool Drawing BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP061191 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/19/2006 APN: 040-214-006-000 the Business and Professions Code, and my license is in full force and effect. License Class : C t O License Number: 65"Z l9 a Site Address: 9393 GOODSPEED ST DUR Date: c; a- t Contractor:rt a Q .J i ---u r-+(i Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: UPGRADE PANEL TO 200AMP Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: SMITH DONALD K to its issuance, also requires the applicant for such permit to file a BOX 93 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section DURHAM, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95938 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: POLIQUIN ELECTRIC owner of property who builds or improves thereon, and who does PO BOX 1199 such work himself or herself or through his or her own employees, PARADISE, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95967 year of completion, the owner -builder will have the burden of 530-228-1715 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: POLIQUIN ELECTRIC and who contracts for such projects with a contractor(s) licensed PO BOX 1199 pursuant to the Contractors' State License Law.). PARADISE, CA ❑ I am Exempt under Article 3 of the Business and Professions Code 95967 530-228-1715 Date: owner: License #: 657192 WORKERS' COMPENSATION DECLARATION I 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. Architect: ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' com nsation coverage is unlawful, and shall subject an employer to crimi I penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees., r �O-46 CONSTRUCTION LENDING AGENCY This permit is h r o ms a under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) Resolution o oll ' icated-ab ve for which fees have been paid. performance permit By: Date�-101 LLLJJJ Name: PERMIT EXPIRES ON. V Address: to ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Signature: Date: S - a. \ - OG ❑ Owner VContractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE C (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION. Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name- irst Name Address 3 A eC) City, 0- � Zip .1 S Phone StatQ Zip Fax E-mail. . .S Fax APPLICANT SIGNATURE X 1 For orrice use only: CONTRACTOR Name n ^ Address Address 0- �a City i Zip StatQ Zip Phone Fax .S Fax — aa-� �� 5 State License Number E-mail Lic. # Class APPLICANT SIGNATURE X 1 For orrice use only: ARCHITECT/ENGINEER Name n ^ Address Address CityState City Type Const. Zip Phone Phone Fax E-mail E-mail State License Number APPLICANT SIGNATURE X 1 For orrice use only: APPLI26NTINFORMATION Name n ^ Address Occ• City Type Const. State Zip Phone Page Fax E-mail APPLICANT SIGNATURE X 1 For orrice use only: Zoning Flood Zone SRA v No Occ• Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: UVtK Ir -Cl SUBMITTAL REQUIREMENTS K WORMSOUILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2 PERMIT )kC\ I BP BIN # LENDING AGENCY Name Address Description or Scope of Work: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Cq* Receipt #: Date: 61 9 G� Amount: LJ ✓ Bldg SRA Sheriff SMIP Total REV B-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR . Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (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. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process;. please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action . on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05