HomeMy WebLinkAbout040-330-024\
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40-33-24
Gary Paul Jacobs
Permit #6852-79B P,&M4new singl'e
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420 PASEO COMP HICO
ADD FTG TO EXTEND 2'BEDROO
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Bob Speer
�RMIT 97-168
Roy
P co
GROSSMAN Roy
Co'nt: Butte R6oiinj Co."
040-330-024 06-1-737,
Cont: MCCLELLAND AIR COND'
HVAC
AV
040-330-024 06-2091
BLAINE, DAVID
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PE MIT NO.
APPLICATION AND PERMIT 9g_ O�Z
ASSESSOR PARCELNUMBER D <<0 330 _ 0.;2—
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
Sp_ FT, OCC. BUILDING VALUATION
( 55�2_
OWNER'S MAIU G ADO ESS
a0 s o � Ne Kos�
CONTRACTOR'S NAME
� N2iiLS
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UN"OWN
Total Valuation $
55
Filing Fee ,� •—
� 20.00
LENDER'S MAILING ADDRESS
Permit Fee $
DO
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
23 po
ARCHITECT OR ENGINEER'S MAILING ADDRESS
_
Penalty
BUILDING ADDRESS n O Soo CJ /' p O 5
p(
PERMIT FEE $
&
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAMEPARCEL
777TEach
MAP
gas water heater or vent
15.00
USE OF STRUCTURE
SF Duplex ❑ Mobilehome O Other
sPECIFv
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G I W
@20.00
TYPE OF WORK
New O Addition Remodel O Utilities ❑ Installation O Other ❑
Describe Work: %� t-�hl D'c
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service ( BDDV OR LESS )
2WA OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. OLDS. )
3.50 FTSO, •
NEW CONST. MULTI.OUTLET
NON.RESID. ( BRANCH CIRCUITS )
@7.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
O I 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.
License No. Classification
O 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)
O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
EII am exempt under Sec. Business and Professions Code
forthis reason
( POWER APPARATUS
8 SINGLE OUTLET CIR. /
Ex. Occup. ( OUTLET OR FIXTURES )
@ 1:0000
B 20 50
Ex. Occup.FIXED APP'S. OR
( OUTLETS IRESID.1 EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23 00
WORKER'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
O This permit is for $100.00 (valuation) or less.
❑ I 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
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 ac rue agai st said
County in consequence of the granting of this permit.
X Date C
Signature of Applicant - O Owner El Contractor C3 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 $ r✓
OCC
CONST. TYPE
TOTAL FEE $ /! -2 %,"7
HA2.
D. FEES
IMP
��
D
CDF
PARCEL PD ND
ISSUE
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.
BY Date
PERMIT EXPIRES ON
IDerel
b o �
Receipt No. co(
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
D•--•..��,�,,,1.yy„�:,r.3pe'�it �.r,a.�,��..I.r�_.,,�„�,.�..�.6,,,cv�,�,�`.,r-,�..,,,,.,,K,,,�,.,.:,,,,..� ....-_..-._
COUNTY OF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER `f 1(9(,4 (`r ('0 SSM A iJ A. P. No.
Proposed Building Use )q DD E- SOM. Building Inspector G-t� Date g
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 . ......... °Nt.`{.............. .
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 required. .. o Build g �spa� (Date
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance. / ......... .
L- 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. PI;An check list. ................ .
✓ 33.2l
34.
When ou issue the permit, process as follows: Mai to owner. Mail to co ractor.
_�
Telephone .3_ � -1508 and hold for pickup at �� ice. Deliver with inspector.
11
Other
Parcel Creation
Acreage ApplicantW Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING DIVISION
NOTICE
Post this lob card In a safe conspicuous place. Do not remove
until all required Inspections are made and building Is
son roved_for_occunanc.v._P_lans_must-be_avaIla ble_on.lob_site._`
—' 040=330702494-04.6.6B,E.
GROSSMAN ROY
0420-PASEO;,COMPANEROS,,,-CHICO
ADD FTG'TO EXTEND 2 BEDROOMS/SF.
Permit No. Expires
PERMITTEE MUST CALL
FOR INSPECTIONS
ers
INSPECTION I DATE I INSPECTOR
nite
Do Not Pour Concrete Until Above Signed
Underfloor Plumbing
unaerttoor tlectrical
Underfloor Mechanical
Underfloor Framino
Do Not Install Floor or Slab Until Above Si ned
Rough Plumbing
h Mechanical
am
ower ran
Do Not Cover Until Above Signed
Fireplace Footing
Fireplace Throat
Do Not Continue Fire lace Until Above Signed
Stucco Lath
Scratch and Brown
sewer service
Water Service
cal Final
Building or M.H. Final I 1 SII
DO NOT OCCUPY UNTIL
ALL THE ABOVE IS SIGNED
AND THE BUILDING OR MOBILEHOME
IS APPROVED FOR OCCUPANCY
Info ( 24 -Hr Insp )
Oroville . 7 County Center Dr. 538-7541 (538-7636)
Chico 1469 Humbolt Rd. -891-2751 (891-2751)
Paradise 747 Elliott Rd. 872-6307 ( 872 - 6307 )
Revised 12/93
040-330-024
GROSSMAN, ROY 94-0466B,E
420 PASEO COMPANEROS, CHICO
ADD FTG TO EXTEND 2 BEDROOMS/SF
is
040-330-024 94-0466B,E
GROSSMAN, ROY
420 PASEO COMPANEROS, CHICO
ADD FTG TO EXTEND 2 BEDROOMS/SF
tJ
Dear Property Owner:
butte 160
L A N D O F NATURAL WEALTH A N D BEAUTY
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965.3397
TELEPHONE: 1916) 538-7541
FAX: (916) $38.2140
We have issued a permit to construct a new building, an addition,.
or to do remodeling on your property.
This letter is to inform you we have approved the building plans
submitted for conformance with code requirements. We will only
inspect the construction for conformance with code requirements.
It is your responsibility to see that the building conforms to your
plans and expectations.
Should you have any questions concerning this letter or any other
matter pertaining to the construction, please do not hesitate to
contact this office.
MCV:ahb
Yours very truly,
Michael C. Vieira, C.B.O.
Manager, Building Inspection
1
Dear Property Owner:
butte 160
L A N D O F NATURAL WEALTH A N D BEAUTY
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965.3397
TELEPHONE: 1916) 538-7541
FAX: (916) $38.2140
We have issued a permit to construct a new building, an addition,.
or to do remodeling on your property.
This letter is to inform you we have approved the building plans
submitted for conformance with code requirements. We will only
inspect the construction for conformance with code requirements.
It is your responsibility to see that the building conforms to your
plans and expectations.
Should you have any questions concerning this letter or any other
matter pertaining to the construction, please do not hesitate to
contact this office.
MCV:ahb
Yours very truly,
Michael C. Vieira, C.B.O.
Manager, Building Inspection
RE:` Attached Building Permit
Dear Permittee:
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (916) 538-7541
FAX: (916) 536-2140
BEAUTY
Attached is your building permit along with the approved set of plans
and a job card. Please post the job card on the job site in a
conspicuous location for the inspector to sign during the various phases
of construction, and also have the approved set of plans on the site at
all times. Inspections will not be made if the job card and approved
plans are not on the job at the time of inspection.
Please review the approved set of plans before construction and make
note of any corrections made in red. If any of these notes or
corrections are not clear to you, please contact this office - do not
proceed with the work without making the correction.
The job card must be signed by the inspector before proceeding with each
item listed. Should he not sign the card, a white correction notice
will list the corrections to be made and a call back inspection must be
made before going any further. Please allow 24 hours for inspection
service.
As a reminder to you, it is illegal to occupy this building or portion
of building for which this permit is issued without approval from this
office. On certain occasions a temporary occupancy will be permitted.
Please do not confuse gas or electrical service to the building as an
occupancy clearance. Before occupancy, all of the "final items" listed
on the job card must be signed by the inspector or special permission
given.
Your permit expires one year from date of issuance. If the work has
started, but is not completed and finaled by the expiration date, a
renewal permit is required. If the renewal application has not been
made within 30 days of the original permit expiration date, or if the
work has not commenced, a new permit application and fees will be
required.
URgn completion of the work covered by this permit, please contact this
office for final inspection.
Should you have any questions concerning this letter or any other matter
pertaining to building construction, please do not hesitate to contact
this office.
Micliael C. Vieira, C.B.O.
MCV:ahb Manager, Building Inspection
Attachments
V=OK ., ,
O = Not OK
Not ' = Not Reeaadyable 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 -Teat -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
S. Electricity; Location-Clearencea-Grnd-/ /Amp -Concrete
6. Gas; Location -Teat -Wrap: / /"L"ft.
/ /"Net. or/ /'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 Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Teat -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; Inap.-Sketch
10. Cert. of Occupancy
MISCELLANEOUS
Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a
1. Zoning Requirements -Setbacks -Easements
2. Footings; Sol ls-Size-Depth-Spacing-Connectors-Steel•
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posta-Beams-Rftra.-Connectors
Shthg.-Rfg.-Bracing
S. Alum. Awn.; Columna -Connections -Splice -Decal -Enclosures
6. Carports: Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Truases
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date/Initials POOLS (Plans) OK except #'a
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main In Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
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., Main; 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 -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 -Nail 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 / / 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. 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 Walls over Girders & Floor Nailing
42. Draft Stop in Wells (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-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-Underfir. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls; Nailing -Bolts
59. Insulation -Walls -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 -Meth. 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 -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-Clearence 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:
4f
-4
CtF ics�
4o -3a- �
RESIDENTIAL-
.
040- 36-624 PER MIT#97-1458
GROSSMAN, Roy
420 Paseo Companeros, Chico
PERMIT N& Cont: Bob Speer—
Add Bedrm Area & Dryrot Repair/SF
PERMIT EXO,". -
OWNER 'Mys; d%Q &95D- 19
CONTR. (0%
U
ASSESSOR PARCEL
"'LOCATION
f7
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
—Temp. Gas Service
Called PG&E
JOB FINALED (Date)
Signature
` COUNTY OF BUTTE n
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT, S'ERVICES ..
1469 Humboldt Road, Chico, CA -,(91'61'89:1-2751 ~
7 County Center Drive, Oroville, CA - (91'6.r538-7541 "
747 Elliott Road, Paradise, CA - (916).872-6307
CORRECTION NOTICE
VER 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.
A--A,D Liv` J2U�
Date — Inspector r _
REV 10/9
V=OK
0 = Not OK
•=NottRealdyble MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
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-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap; / /'LYt
/ /Nat or/ /"L'ft./ /LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements- Setbacks Easements
2. Footings; SU eSpacng•Marriage Line
3. Gas; MH Test DemarKWaloe-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/0 to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert of Occupancy
12. Permanent Foundation Only: License Decal
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'a
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils-Size-DepthSpacing-Connectors-Steel
3. Decks; Girders and/or Joists-Decking-BracingStairs-Rails
4. Wood Awn.; Posts-Beams-Rttrs.-Connectom
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Cdumns-ConnectionsSplice•Decal-Enclosures
6. Carports; Windows -Doors
7. Electric
8. Fnng.; Sils-AnchorsStuds-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext; Steps -Doors -landings
12. Braced Wall.Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'a
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts -GA
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/8 Circulating Equip. -Pod Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10.'Pl6mb.; Cir. Test -Water Supply Test
11. Light Niche
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
ti
=No
O = Not OK RESIDENTIAL
- = Not Applicable
= Not Ready
Date,,UNDERFLOOR (Plans) OK except #'s
ingSetba asments-FloodSlope
tg., Main; ils-Elec. Gmd. / Ftg. Depth
__3.-Ftg-•Garage; Soils-Steel-Elec. Gmd/ / Ftg. Depth
des & Decks; SoilsSteel-/ /' Fig. Depth
-4-Ztemwalls; Main;'Steel-BlockoutsANrapped
S_.Stem�val s, Garage; Steel-Blockouts- Wrapped
,&a -Bold Downs and Special Anchors
a , S�t,.WMrapped
8. P�ireplace Ftg.Steel
.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test
10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11. V , Eipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. ' ie Ducts; Clearance-MaterialSuppon-Ins.
14. Girders. -Sills -Anchor Bolts -Joists Vents-Crippies
15. Access & Ventilation
16. Insulation
Date X/7/ Z Card B-1 / ^ Date Card B-1
Date 1 11 Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except ft
--7-tlVater .; Vent -Access -Combustion Air Baffle
Water Pipe; Test & Anchor -Nail Protection
Test Fittings & Anchor -Nail Protection
how Pan; Test, First Floor -Tub Access
Tub & Shower, Second Floor -Tub Access
ipe; Sixe & Anchors
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ItILECTRICAL (Permit) OK except #s
23,A%ture & Transformer Clearance -Ins. Protection
2 ec. Receptacles Spacing -Lights & Switches at Doors
Boxes & No. of Conductors Stapled
Romex Installed Close to Edge of Studs & C.J.
qw . Ground made up w/Mech Fastners-Bond Gas & Water
k-28_2Appliance Circuts in Kitchen & Conductor Size GF
--29_$&bfeedWiire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
�8--Range Circ. / / ga Cu or Al -Oven Circ. / / ga Cu or AI
Insulated Neutral Q Yes p No
Riser Conductors & Ground -Main Disconect
X32. Equip. Clearances Panels -Motors -Meeh. Epuip.
,-33. Clothes Closet Light -Shower Light -Spa Light
/Smgke'Deteotor
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except ft
35. A.C. Ducts Insulation & Support
36. Vent Fan, Exhaust above insulation
37. Condensate Drain & Overflow, Size & Grade
38. Fumance-Vent Access -Comb. Air Return Air Vent 115 outlet
39. Attic Access & Platform if Furnace in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except ft
Proper Materials & Anchors
IIs Studs -Nailing Spacing & Braces -Plates -Sound
4 . $earing Walls over Girders & Floor Nailing
4,f Draft Stop in Walls (rat proof)
44. Fre Stops, Furred Ceilings -Stairs -Chasers -Tubs
ders & Beams -Size & Bearing
(Single & Duplex)
Date FRAMING (Continued)
46. Hangers -Post Caps -Anchors -Connectors
47. Cling. Joist -RW. Ties-Purlin-roH Brac.-TrussShting.-Rfng.
48. Fireplace Ties or Type A Flue -Fireplace Throat clearance
49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50. Bdrm. Windows or Exiting Doors -Sill Hgt & Dimensions
51. Garage Fire Protection Framing
52. Property Line Firewall & Openings
53. Ext Doors -One 3 -Check Garage 3rd Story, 2 Exits
54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56. Siding -Nailing Veneer
57. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
58. Glazing Area -Glass Protection -Skylights -Plastic
59. Shear Walls; Nailing -Bolts
60. Brace Interior / Exterior Wall Panels
61. Insulation -Walls -Ceilings
62. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FINAL4Plans) OK except #'s
Steps -Door & Sidelight Protection -Landings
��9moke Detector
65. Furnace; Vents -Clearance -Comb, Air-Conector-
In Gara a .Above Floor -Ducts -Meth. Protection
edroo�ting
6 I 3ath Fixtures & Tub Access -Spa
6t_-Slec. Trim & Subpanel, Breaker Sizes & Labels
ai s
ce-Hearth
ec. Outlets at Wood Panel, Int. & Ext
32 -Ki -t Fat. & Appliance; Ground. -Air Gap -Cooking Clearance
.3 -fl E. Outlets & Recepticales at Kit. Counter
74 -Garage Fire Door; Swing -Landing -Closure
c m ara e -Damper
ents-7e-Comb. Air Connector-P.R.V.
In Garage; Above Floor -Meeh. Protection
ech. Equip. Listed for Location
es in Garage G.F.I. -Romex Protection
ation-Foam-Looked in Attic
80. ction-Post Caps
84 -'rd -n. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor p Yes
a2--fol-lowing Instld./Drive es 0 No/Walks B'Yes enters 0 Yes 0 No
Mcco
9iseennect, Electrical -Plumbing
85. -Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
next, Electrical, Plumbing
.FI. Receptacle -Underground
oug t 135use
SOr.'Corrections from Previous Inspections
egged, Gas -Electric
onnected-C/O to Grade -HD Approval
rgy Compliance Certificate -Other Certificates
Dat and B-1 Date Card B-1
Date Card B-1 Date Card 9-1
Date Card B-1 Date Card B-1
Comments at Final:
:,N:,RG•.-?NJ.ALLAIION CERTIFICATE
Building Owner 6 RC 1' Building Permit # ( (—
Building Location qzn> isL-_D
DESCRIPTION OF INSULA,.ION
ROOF
Mate .al
Thi=kaess (:L=h ) /0
F=..RIOR WALL
Material
Thi.ckaess (laches)
CrIL�IG
Batt cr Blanket Type
Thickness(inches)
Loose Fill Type
X -4 -4 -mu" Thi.cknesf(Inches)
Area covered(ft. )
FLOOR, ELEVATED
Material C�
Thickness (inches)
FLOOR, SLAB
Material
Thickness(inches)
Width (Lnehes )
FOMMATION WALL
Material
Thickness (inches)
Brand Name 1'
The=al Resistance (R Value)
Brand Nage ZA
The --mal Resistance(R Value)
Brand Name
. Thermal Resistance(R Value)__ f
Brand Name .
Number of Bags Wt. per bag Ib.
Thermal Resistance(R Value)_
Brand Name
Thermal Resistance(R Value)
Brand Name
The`maflResistance(R Value)
Brand Name
Thermal Resistance(R Value)
I hereby ce--_r••y that the above insula tion was installed in the above building,
- 'is consistent with approved building` department -plans --and attachments snd con-
forms with requirements of Chapter 2-53 of State of California Energy Requiremen
FIRM NAME/OWIMR
STATE CONTRACTOR'S LICENSE NO.
SIGX&TURE OF ItssretON APPLICATOR -- DATE
I hereby certify the required features, devices, and , equipment, .aw shown on the approvec
Building Department plans nd attachments have been•installed and .conform to the appli-
ance standards and Chap a 2-53 of the State of California Energy* ,equirements.
RoY GROssM��
BUILDING CognufCTOVOWNER,01ease Print) STATE CONTRACTOR'S LICENSE NO.
HVAC FIRM NAME/OWNER (Please Print)
SIGNATURE OF HVAC CONTRACTOR/OWNER
DATE
STATE CONTRACTOR'S LICENSE NO.
DATE
THIS CERTIFICATE "fL'ST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION
APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING.
cro•r^Mnr'D 1 ORA
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 -Telephone (916) 538-7541/PERMIT
ER tT_ NQ
/
(Rev. 12/96) APPLICATION AND PERMIT �' �W
ASSESSOR PARCEL NUMBER'
ZONING
Ak
BUILDING PERMIT
OWNER
ROY GROSSMAN
TELEPHONE.51AZ
SO. FT. OCC. BUILDING VALUATION
OWNERMAILING ADDRESS
'S
144 R 7,776.
EST 300.
CONTRACTOR'S NAME
BOB SPEER
TELEPHONE '
345-7034
CONTRACTOR'S MAILING ADDRESS
1122 NORMAT. ST CHIM, CA 99928
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $ 8,076.
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
108.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Plan Checkin Fee $
70.20
BUILDING ADDRESS
Energy Plan Checking Fee $
23,00
$
PERMIT FEE S
221.30
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SFS Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat'pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition)R Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: ADD BEDROOM AREA & DRY ROT REPAIR
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISIG W1
@20.00
" PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service a00V OR LES9
noon 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.
6 �' S
License Class f� Lic. No. J
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
Main Service 200A To 1000A
46.00
NEW CONST. DWELLING OCCUR
OR ADDNS. ( d ACC. BLDS.
3.5¢SOs,
NON•R SND.T MULCH CIRCUI TS
@7.50
a PSINGLE OUTLET CIR.OWER APPARATUS
Ex. Occup. OUTLET OR FIXTURES
00
20 @';50
BAS
Ex. Occup. ouxTLEEDTSAP ESSID.OEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
T�
PERMIT FEE $
'
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
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
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
forthwi h comply with those provisions.
�.,r
X Date. _� LU
Signature of Applica V- ❑ Owner XCOntractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction��
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ 46.00
OCC
CONST. TYPE
TOTAL FEE $ 292.34
HAZ.
FE IMP FL OD DF
' _
PARCEL
p0
H ISS
This permit is hereby issued u' er the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By �j ate ?. Q 7' fig'
D
PERMIT EXPIRES ON /���C7
Date
ReceiptNo. - 1-9 `vo' o g / 8 ,,
WHITE. PINK -INSPECTOR GOLDENROD
-D.D.S'-B.D. I I -APPLICANT
COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 C901TVENTER DRIVE - OROVIE>LE; GALIFORNIA 95965 - TELEPHONE (916) 538-7541
i
OWNER: y +�_1e�t'�,� ASSESSOR PARCEL NUMBER: L/ Q' ' 3 - 7_
Proposed Building Use: Building Inspector: Date:
At time of permit applicat on, I was advised the following data in be su miffed prior to permit ces ing-and/or issuance:
------'. Date eceived By
El 1. All items have been submitted .---------------------------------------------------------------------=---------
PERMIT APPLICATION DATA SHEET
❑2. Plot plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------
❑ 3 . Complete plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------ e ----------
❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.----,,r--t
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------------==--
G-k-PEnergy Design Compliance and supporting documentation.---------------------------------------------------- 1-23 -c �
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. -"-7 ---------------------------------------------------
El8. Hazardous Material Form. ------------------------------------------------------------------------------------------
❑9. ufactured Home data and installation/ instructions including Tie Down SpecificItions.------------------
Feesof $-��-i--------------------------------------------------------------------- ~%
. Impact fees as shown on the attached schedule. -------S C LIO-Q-t------------------------------------------
12. California Department of Forestry plan approval/fees. ---------------------------------------------------------
;If
elevation certificate. --�:$C 41a1it14f_------------------------------------------------------- = ------ �7—(?3_,V
n and plot plan apprval G (/i� Health Departmerit. -------------------------------------------
15. oChico plumbing permit. -----------------------------------------------------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------------------------------
❑ 17. Planning approval for (A) Use: (B) Parking: --------------------------
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. -----------------------
❑ 19. Encroachment Permit for driveway construction approval prior to occupancy)
----------------------------
El 20. Pre -inspection for required Request to Building Inspector on (Date)
021. Contractor's license information. (Number, Name Style, Classification). ------------------------------------
El 22. Workers' Compensation carrier and policy number. -----------------------------------------------------------
❑23.Owner-Builder Verification (Given to owner ❑, Mailed to owner 0) - --------------------------------------
024. Letter of signature authorization. --------------------------------------------------------------------------------
❑25. Recorded copy of Agricultural Acknowledgment Statement. --------------------------------------------------
026. Letter of intent on building use.-----------------------------------------------------------------------------------
27. Manufactured Home utility clearance. ---------------------------------------------------------------------------
28 Existing violations and/o ex fired ermits.--------r-'-- -------------------------------------------
9. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .---------------
fter: J(t.Ar WkLL &4CLS C J. S 14L t SPA CtdG-------
When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor.
Telephone 0 W and hold for pickup at (f &/ 4- office. ❑ Deliver with inspector. -
Applicant:___ lip— Date: 7A/p
Copy of Haz-Mat form sent ❑ Health Department, 11 Fire Department, ❑ Air Peut4ion JBy:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
-.� J.Adex permit application for the above items numbered: I,�[) , Zg El Plan Check List
2. Additional items required: �- -''7` 'T �r
"�"� on actor esigner, owner, was advised of the above required data by)0hone, ❑ mail, ❑ Building Division counter, by Date: - 6_97
Con or, esigner, owner, was advised of the above required data by ❑ phone, ❑ mail,tBuilding Division counter, by Date: :L_ j
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building D' 'sion counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold iiWPlan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
H.H. Y
Plot PI. Att�dbed
M.. PI. Att.W
.. Set to B.D.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
O . ner Location AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance forb&home -Other a T r
Hold final for.
Final clearance O.K. for:
NOTE:
Specialist .
8/92
ate
` r
�iti��..�}"",�'!r'.,�'{�rFi7��i7rJ,71•,^'N•T `.�,e•Iir�Lr.•ii��t%i.M✓�+rsT� 'M7k�'f'�S'��r ��•�7'itin�7[+'j'EYc.'p�''7"�.i7(��+4•+�•.�F�PT(C't'+����'�°��i.j+.yi".^.i�r.^yrr�
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District. C kle -C 'Building Department No. G A �.
A.P. Numberji2.Jurisdiction: City County
'Property Owner
Property Location/Address �L 0 hl�SO �'��D�g•✓?S
Subdivision Lot No.
Residential Development Sq. Footage
No of Living Mobile Home Addition
Units Installation
Commercial/Industrial
New Addition
ng Department Representative
y�
(Group R)
Sq. Footage
(Including Exterior
Roofed 'Areas)
Date
moor Fians revEewea oy 5cnooE uEstnct versonneq
District Identification No. A jt
v
School District certifies that
( pplicant)
(City) -
has complied with the requirements of Resolution No.
representing square feet
Paid by Check # �%%7 Remarks:
(State)
(Zip Code)
�— by payment,of S'.
Fffxltol
B 2926 - $
ULL MITIGATION $
Date
Not(ce: You may protest the imposition of the fees identified above by submitting a written protest to the I
Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely,
you from challenging the imposition of the fees in any court action. ,
strict, in compliance with
_� ,w ... l. I
vritten protestfwill prohibit
r•, ,
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, `the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act ICEGA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. <"
White (applicant), Yellow (building department), Pink (school district) feeform.xls (2/97)dmm
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541a/y 1 pEPMl� vg.
(Rev. 12/96) r APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBERL(40, r%� ��/
`
zONINO 4'
.BUILDING PERMIT
OWNER
20 .1;_<MTELEPHONE
0 �
SO, Fr, OCC. BUILDING VALUATION
OWNERS MAILING ADD Ess
C> �.✓ _
7 6
est"
3��
CONTRACTOR'S NAME TELEPHONE '
Jelo /0Sl° /�� 0
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO. ,.
Filing Fee
$ 20.00
Permit Fee
$ (fl 43
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ Z
BUILOINGADDRESS
2 C>�eSS e v � nor i✓,f
Energy Plan Checking Fee
$ 2 12
$
PERMIT FEE
S
LOT NO.
SUBDNISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
1
New ❑ Additionlo/Remodell❑ Utilities ❑ Installation ❑ Other 13
Describe Work: #64 XGA' d �ap� ,/�itt�j-
Gas piping system 1 - 5 outl9d
15.00
Building sewer
15.00
Mobile Home I S W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 800VOR LESS
2ooA 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
Main .Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a Acc. Bms.
3.5¢sox:
NEW CONST. MULTI.OUTLET
NON-RESID. c
@7.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
SAL 4';�
Ex. Occup., oFlxLITLEEDrs. R6 D,°E
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
$ Z >; .
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I 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
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.56
Ventilation
PERMIT FEE
$
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.)
❑ 1 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 Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ y�
FOCC
CONST. TYPE
TOTAL FEE $ 9 ?-(,p
'
HAZ. I D. FEES
ID
MPFLOOCOF
o HD
PARCEL PISSUE
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
Date _
(Data)
ReceiptNo. Pi' I /0: O ZZ
WHITE-O.D.S.-B.D. CANARY -ASS SSO PINK -INSPECTOR GOLDENROD -APPLICANT
FLOOD PLAIN DECLARATION
I. declare the actual value of the proposed construction work under building permit
application number:
at the location of 4-Z0 elg51-0 � -moi P,QvV,0
Assessor Parcel Number: 4-c�) -3 3 - 2-`f' for the construction of an addition
for f� D/Lao.wS
does not equal or exceed the definition of "Substantial Improvement'"
I am aware the building site is in a flood - plain area, even though I am not required to
comply with the flood plain management criteria.
Property Owner:
RoI-C C R6 cz�s m 14N�
Address: -1
PhoneNumber: 2) `l S- IFS -0 9 Z
Date: 7 r 2- — f
Substantial improvement is defined as follows: Any. repair, reconstruction, or improvement of a
structure, the cost equals or exceeds 50% of the market value of the structure either, (a) before
improvemenfor repair is started or (b) if the structure has been damaged, and is being restored,
before the damage occurred.
NOTE: Documentation may be required to. substantiate
RECEIVED
JUL 2,3 1991
BUTTE COUNTY
BUILDING Di ;rISIOV.
BUTTE COUNTY SCHOOLS IMPACT FEE &RTIFICATION FORM
(One form per Building)
School District CKIt- 7 Building Department No. C L.-
A.P. Number l ' ?j�j�1-.� Jurisdiction: City County
Property Owner
Property Location/Address �yZ O C>S
Subdivision j Lot No.
Residential Development
Commercial/Industrial
ng Department Representative
No of Living
Units
MobilbilleeHoHome
Installation
New
� Sq. Footage //VV -
1 --Addition (Group R)
Addition
ICL.,.. DI -.e.,, e..,n.l 1.., cz .kn l r%;�*,;..+ 0.- -11
Sq. Footage
(Including Exterior
Roofed `Areas)
Date
7
District Identification No. N I
School District certifiesfthat
( pplic nt)
(Street Address) (Phone Number)
lm
(City) (State) (Zip Code)
has complied with the requirements of Resolution No. Lf � 04 , by payment of $
representing square feet. ELL
6 $
MITIGATION $
Schooi istrict Representative Date
Paid by Check k AJ%I Remarks:
Notice: You may protest the Imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 660201x), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the Imposition of the fees In any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate Its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls (2197)dmm
Al
7�(019� •• PERMIT N0."6852-79B,P,E,M
4'-ft ye PERMIT EXPIRES %/��/�/ ♦ '
�.,i _• e
OWNER Gary Paul Jacob`s
CONTR. owfier
)""OCATION (A.P. XSR 40-33-24 )
.; W/S Paseo Companeros, app.175'S.of
Centerville Rd., lot 44, Chico
00"
1..
VuXI
Z%,
4 .
Temp. Power Pole
a I eTVt&E
1 em Elec. Serv.
Called PG&E
-.. Gas Serv. g .
e
Called PG&E
JOB �J
f, FINALED
t♦ (Date)
(Sien t
Heint. steel Final Fixtures
Bond Beam FIRE SPRINKLERS Motors
Framing Test Water Htr.
Stucco Final Subpanels
Mesh "MECHANICAL Gird. Fault Prot.
Scratch Heatina Service
Brown Cooling Temp. Pole 6
Finish Ducts Z C Underground
Interior Lath Ventilation Permanent
Door Closer Final Yva
Final
MOBILEHOME UTILITIES ------------------ Elec. Service V LO,Elec. Pedestal
Water Piping Sewer Gas Piping
MOBILEHOME INST&L}6AION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
Gr�Ur.Q / a&�,���d Y�y� Bit. 4�0
2
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
' BUILDING INSPECTION'RECORD
BUI
DING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
rj
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
sie=xa II
Siding
To out
Slab -2/z6
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
lab / 6
rt
Footings
Prov. for physically
handicapped
Conformance of ex.
structure goTemp.
Appliances
Gas PI In
Gas
& Test
Slab
Final
Sanitation
Patio
IR LACE
Final
Footings
Footina /-17— O'er
ELECTRICAL
Heint. steel Final Fixtures
Bond Beam FIRE SPRINKLERS Motors
Framing Test Water Htr.
Stucco Final Subpanels
Mesh "MECHANICAL Gird. Fault Prot.
Scratch Heatina Service
Brown Cooling Temp. Pole 6
Finish Ducts Z C Underground
Interior Lath Ventilation Permanent
Door Closer Final Yva
Final
MOBILEHOME UTILITIES ------------------ Elec. Service V LO,Elec. Pedestal
Water Piping Sewer Gas Piping
MOBILEHOME INST&L}6AION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
Gr�Ur.Q / a&�,���d Y�y� Bit. 4�0
2
(NOTE: An entry must be made on this form each time you visit the job site.)
P L U M B I N G
Check List
❑ P it
Underfloor Stage
❑ D.W.V.: (1) Sizing. (2) Materials. (3) Fittings. (4) Grade & Support.
(5) Cleanouts & Accessibility. (6) Clearances. (7) Rough -in Locations.
®* (8) Wrapping. (9) Test - including "Ts". (10) Additional test not
required.,
❑ Water: (1) Sizing. (2) Materials. (3) Support. (4) Test. (5) Wrapping.
(6) Dissimilar metals. (7), Service regulator installed or not required.*
® Gas: (1) Sizing. (2) Materials. (3) Support. (4) Log Lighter. (5) Wrapping.
❑ Framing Stage (Top Out)
�-D.W.V.: (1) Size. (2) Vent Area & Termination. (3) Materials. (4) Fittings.
(5) Grade & Support. (6) Cleanouts. (7) Traps. (8) Nail Protection.
(9) Plumbing Access. (10) Toilet Clearances. (11) Shower size.
(12) Shower Pan Test. (13) Vents - turns, horiz., runs, loop, wet, etc.
❑' (14) Additional 2nd floor test not required.*
❑ Water: (1) Pipe Test. (2) Mixer Valves. (3) Support. (4) Roof drains.
❑ Gas: (1) Size. (2) Materials. (3) PR Valve Drain.
❑ ter Heater: (1) Vent. (2) -Location. (3). PR Valv6 Drain.
nl
D.W.V.: (1) Connected to sewer system. (2) Special systems.
❑ Water: (1) Water Source. (2) Shut-off. (3) Anti -siphon Valves.
n
❑ Gass (1) Test. (2) Connectors.'
❑ Water Heater: (1) Location. (2) Accessibility. (3) Clearances. (4) Stability.
(5) 18" Garage Floor. (6) Mechanical protection. (7) Combustion Air.
(8) Draft Diverter. (9) Vent Connector. (10) Vent. (11) Shut-off and
connector. (12) PR Valve & Drain.
❑
Fixtures: (1) Approved. (2) Stability. (3) Clearances. (4) Trapped.
(5) Connections. (6) Cross -connections. (7) Dishwasher Air Gap.
R
5/79
& Foundation Vents & Underfloor Access
7A
n1 •• J -
—�a-5-� r tection if required
r1 Sign Job Card
ABOVE LISTED CORRECTIONS COMPLETED SIGN JOB CARD,.
-Signed: Date:
-2-
r
- FRAMING
Permit -2.
1. Plans
F
2. VISills--Proper Material and Anchors
3. ails--Studs--Nailin & Spacing & Bracing--Plates
F •
4.L/4aring Walls over Girders & Floor Nailing
Draft Stop in Walls rat roof
FFiire'Sto s--Furred Ceilin s--Stairs-Cha es -Tub
7. ✓Header & Beam --Size & Bearing
8. an ers--Post-a s--Anc oH'rs--Connectors
".;ft:eies
CeilingoO ists Purlins Roof Bracin Tr ses
hea Roo ing
16. Fire lace Ties or Type A Flue--Fireplace Throat
Attic Access --Size'& Romex Protection
--•-
12.itedroom Windows or Exiting--Doors--Sill Hgt. & Dimensions
Garage Fire Protection Framing
aration Walls--1 hr. Fire--2 hr. Fire
& Foundation Vents & Underfloor Access
7A
n1 •• J -
—�a-5-� r tection if required
r1 Sign Job Card
ABOVE LISTED CORRECTIONS COMPLETED SIGN JOB CARD,.
-Signed: Date:
-2-
All
UNDERFLOOR Permit No.
1. Plans
2. Setbacks --Easements
3.' Soils --Footings & Stemwall--/ /" Fill Required--Steel--Block-outs--Elec.Ground
4 Piers --Fireplace Footing & Steel
S Plumb ing- -Drain--F all -Fittings--Wrapped in Concrete 42" test/ /
6 Gas Pipe --Size & Test
7 Water Pipe --Test & Anchors --Regulator
8. Electrical
9 Plenums & Ducts—Clearance—Material & Support & Insulation
10 Girders--Sills--Anchor Bolts--Joists--Vents--Cripples
11 Sign Job Card
ALL OF ABOVE COMPLETED / / EXCEPT
Signed• Date•
ABOVE LISTED CORRECTIONS COMPLETED SIGN JOB CARD
Signed• Date:
-1-
FINAL Permit No.
1. Plans
2. Entrance Steps, Door & Sidelight Protection
3. Smoke Detector
4. Furnace --Vents Clearances Combustion Air :Connecto Garage -Height & Mech.Protection
5. Bedroom Exiting
6. G.F.I. & Bath Fixtures
7. Electric Trim & Sub Panel --Labels
8. Stairs & Rails
9. Fireplace or Stove --Clearances, Hearth
10. Electric Outlets at Wood Panel --Int. & Ext. `
11. Fixtures & Appliances in Kitchen--Grounded--Air Gap --Cooking Clearance
12. Electrical Outlets & Receptacles at Kitchen Counter
Mech.Protection
16. Firewalls & Openings --Area Separation Walls
17. Electrical Receptacles in Garage (G.F.I.) Romex protect
18. Insulation--Foam--Looked in Attic / / Yes
19. Steps at Ext. Doors & Landings
20. Guard Rails and Deck Construction
21. Foundation Vents &.Crawl hole Door --Drainage & Wood -Earth Clearances
Looked Under Floor �% Yes
22. Following Installed: Drive Lf Yes j No; Walks L__j Yes L_j No; Planters or
23. A.C. Unit --Disconnect, Clearances, Breaker & Conductor Size --115V Outlet
24. Vents Above Roof --Plumbing, Appliances, Fireplace --Clearance to Openings
25. Water Well -Disconnect, Electrical, Plumbing
26. Exterior Electrical Trim & G.F.I. Receptacle
27. Ventilation Throughout House
28. Glass Protection
'31. Water Supply,& Sewage Connected
32. Energy Compliance Certificate
33. Sign Job Card
ALL OF ABOVE COMPLETED / / EXCEPT
Signed: Date:
ABOVE LISTED CORRECTIONS COMPLETED SIGN JOB CARD
Signed: Date
-4-
PLUMBING --,Above Floor
Permit No.
i!K water heater- -ven ticce-ss-uomDus•Lion
'2: • er Pipe-' Te & Anc -:,Nail Protects
3. rain Pipe- -Tet--Fitts & An rs--Nail PrAte6tion 42"- Test
wer Pan --Test, First floor --Tub Access
±� ie'Tsf Tub & Shower, second floor --Tub Access
6.` as Pipe --Size & Anchors
7. Sign Job Card,
ALL OF ABOVE COMPLETED EXCEPT
Signed: Date: -,7
I
ABOVE LISTED CORRECTIONS COMPLETED Date:
f� ELECTRICAL --Above Floor Permit No.,�Gfetk.-
1.1-Srlearance & Insulation Protection at F1ush.Light Fixtures
2.1 Feec-,.,-Receptacles S acin--Likhts & Switches at Doors
3. ,€'Boxes & No. of Conductors --Stapled
4.iXqmex Installed Close to Edge of Studs & C.J.
5 u'.. Ground made up w/Mech. Fasteners
liance Circuits iq Kitchen & Conductor Size
Sub Feeders --Wire size LW ga. Cu or 01 Breaker Size Q Amp.--
sulated Neutral, Yes No
Range Circuit f:F ga. Cu or Al Breaker Size (� Amp. --Oven Circuit ga. Cu o A1,
Breaker Size = Amp.
9. a ice --R' GendeeteFg & Gro nd
10 and Gas & Water Pipes
11. C1 ht --S
12.1,eign Job Card
ALL OF ABOVE COMPLETED EXCEPT
Signed: Date: o
ABOVE LISTED CORRECTIONS COMPLETED Date:
... ... . .. .... ... ..........-----.._......•......-
MECHANICAL --Above Floor Permit No.,,,4%y�
6 Sign Job Card -
Y
ABOVE LISTED CORRECTIONS COMPL
-3-
vale:
Date:
ME -C H A N I C AL
Check List
❑ Permit
Underfloor Sta a :
❑ Underfloor Supply Plenum: (1) One-story. (2) Clearances. (3) Combustible
material. (4) Insulation and vapor barrier. (5) Access. (6) Catch .
receptacles and registers. (7) Fire -stopping. (8) Boots. (9) Supply.
ducts. (10) Gas lines and plumbing cleanouts.
® Ducts: (1) Size. (2) Materials. (3) Support. (44) Fittings. (5) Wrapping.
(6) Insulation. (7) Clearances - ground, crawlspace, cleanouts,
plumbing, etc.
❑ Combustion Air: (1) Size.
❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (4). Insulation.
Framin Sta e
❑ Heating: (1) Approved appliances. (2) Accessibility..(3).Clearances.
(4) Combustion air.
❑ Vent and Connector: (1) Approved., (2) Size. (3) Clearances. (4) Cap.
(5) Termination.
❑ Ducts: (1) Materials. (2) Size. (3) Support. (4) Fittings. (5) Insulation.
(6) Fire Damper. '
❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (4) Insulation.
(5) Condensate drain.
Final
❑ Heating: (1) Accessibility. (2) Combustion air. (3) Safety controls.
(4) Electrical connection. (5) Fuel shut-off.
❑ Cooling: (1) Accessibility. (2) Support. (3) Controls. (4) Pressure- relief
valves. (5) Class 2 refrigerant.
5/79
- _ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
' 7 County Center Drive - O;z)viIle, California 95965 i
Telephone: 534-4541
APPLICATION AND PERMIT
"UU-11— IVF 1Vc Ulllauvc0 UI UIG VUUlily UI OULLU LU CIIICI UFJUII Lilt:
above- entioned property for inspection purposes. —1
aalwwm,�� Date
Sig ure of Pe m' ee or Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
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 Datel/—��
wilding permit expires Date
BUILDING
Owner �(
SQ. FT. OCC. BUILDING VALUATION
Q o�
Mailing Address � I S ( vi
L
Ct* eo �4e�e�—�ly�is'
r
'�
'75 PLI-/150
Contractor 000y �
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee 2-00
t'' neQ ase
Building Address W S Ne� Pf vaos
Plan Checking Fee&/or Penalty
Permit Fee-72—.Op
7 0(
APPPDV of CcNT—aRU(c.Lff
PLUMBING No. @ FEE
al)
PERMIT FILING FEE $3.00
Each Trap 1.50 3.50
T
1 id L4�
Repair drainage or vent piping 1.50
A. P NO. ��'
Zoning & P nning
Water piping 1.50
Each gas water heater or vent 1.50
F es
S I ion
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking Parcel
Plans Declaration
Parce
60' R/W
Improvements
Each additional outlet .30
BV ilding sewer 5.00
131dYIPlon ec'd
Parcelp roval
Plans Approv
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $ . (:)
.$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 /QU
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER e00V 25.00
100 AMP OR LESS
+ ,
Main service EA. ADD'L 100 AMP 1.00NEW
CONST./
OR ADDNS. SCCUP. B\ •20 sq ft 4
I
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
le of:
style
NEW CONSTR. MULTI-OUTL T
NON-RESID BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS a
NON-RESID. SINGLE OUTLET CIR.
Ex. Occup{OUTLETS OR FIXTIIRES BAL1P �
Ex. OCCU FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ 53, /
$ '9'31/
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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 Workmen's Compensation Laws of
California.
MECHANICAL No. @I FEE
PERMIT FILING FEE $3.00 3, W
Heating /y(,4� U,00 W�()O
M) pfic
Cooling -r 17, $a %,,j d
Ventilation
2,00
Hood 41d,
Permit Fee (0.,50
$
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
Land Development Fee
$ 2--5.co
TOTAL PERMIT FEE$,,Y%
i
C
"UU-11— IVF 1Vc Ulllauvc0 UI UIG VUUlily UI OULLU LU CIIICI UFJUII Lilt:
above- entioned property for inspection purposes. —1
aalwwm,�� Date
Sig ure of Pe m' ee or Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
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 Datel/—��
wilding permit expires Date
RESIDENTIAL PLAN CHECKING GUIDE
0 (S.F. -DUPLEX, 4 MISC.' ONLY) / r
Bldg. Permit # C� oS�• 7
?I A. P. #k 70s
.A. GENERAL J
zoning requirements (side ds and parking).
Valuation.
Signature by R.C.E. or Architect (if required).
B. PLOT PLAN
Complete parcel size and dimensions.
Setbackq, sideyards, easements, etc. �oi-r
Other buildings or structures.
Grading, fills, drainage.
44L -
C, FLOOR PLAN
Complete to scale plan with dimensions.
,�� Required windows for light and ventilation (Sec. 1405).
�-_,� Required windows for second exit (Sec. 1404).
Allowable glazing for energy requirements (20% max. per,State law).
Human -impact glass (Sec. 5406).
�l Required room sizes, ceiling heights (Sec. 1407).
,7! G.F.C.I."s in baths and exterior outlets ('Sec. 210-8).
Light fixtures, switches, rece tacle , an exterior ��receptacles for maintenance of
mechanical equipment. NO/
Locations of water heater, heating & cooling equipment, other electrical or gas
equipment, and plumbing fixtures.
10. Garage firewall, door size, and closer (Sec. 503(d)(4)).
W. 1 - 3'0" exterior exit door (Sec. 3303d).
2-, Fireplace location.
woke detectors (Sec. 1413).
D. STRUCTURAL DETAILS
Foundation plan complete enough to construct building.
Floor construction details complete enough to.construct building.
Elevations and wall construction details complete enough to construct
Roof construction details complete enough to construct building.
,h. Fireplace construction details and calcs if over'one-story in height.
b! Sufficient data and details to satisfy energy insulation requirements
building.
(State law).
E. MISCELLANEOUS ITEMS TO LOOK OUT FOR
CCX plywood on exposed locations and overhangs.
<,--Stairway details (Sec. 3305).
Guardrail details (Sec. 1716).
Brick or stone veneer (Chapter 30).
Exterior plaster - weep screeds (Sec. 4706 & 4708).
Proper roof pitch for roof covering (Chapter 32).
7 Rafter ties or bearing ridge beam.
-:i�. arage door -or porch header sizes.
Adequate bracing.
—TO;' Living area'over garage - complete 1 -hour separation required including supporting
walls and posts, etc.
Two (2) exits on three-story dwellings (Sec. 3302).
Gary Paul Jacobs RE: Building Permit No. 6852-79 (SP)
1301 Sheridan # 91 Expired 11/26/80
Chico' CA 95926 (A.P. No. 40-33-24 )
With reference to the above subject, our records indicate that your building permit
has expired. Building permits are valid for one year and should construction not be
completed at the expiration date of the permit, the permit shall be renewed for 1/2
the original fee.
Kindly contact this office within ten (10) days to renew your permit. Should our
records be in error or should your construction be completed, please advise this
office immediately.
Thank you in advance for your prompt attention concerning this matter.
Yours very truly,
Clay Castleberry
Director of Public Works
F . G1 nder
JFG:dd Chief Building Inspector
Attachments
P.S. For your convenience, we are attaching a renewal application form which may
be completed and.signed by you where indicated and returned to'this office
mee her with the fee shown. Je are also attaching an Ormer—Builohr Information
and an Owner -Builder Verification Formol :Please complete the Owner -Builder
Verification Form and return it with the renewal application and fees,.
Chico
cc: Building Inspector 7
w
tte un
LAND
OF NATURAL WEALTH AND BEAUTY
DEPARTMENT OF PUBLIC WORKS
a�
CLAY CASTLEBERRY, Director
_
7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965
Telephone: (916) 534-4541
H. W. McDONALD
Deputy Director
Dec. 31, 1981
Gary Paul Jacobs RE: Building Permit No. 6852-79 (SP)
1301 Sheridan # 91 Expired 11/26/80
Chico' CA 95926 (A.P. No. 40-33-24 )
With reference to the above subject, our records indicate that your building permit
has expired. Building permits are valid for one year and should construction not be
completed at the expiration date of the permit, the permit shall be renewed for 1/2
the original fee.
Kindly contact this office within ten (10) days to renew your permit. Should our
records be in error or should your construction be completed, please advise this
office immediately.
Thank you in advance for your prompt attention concerning this matter.
Yours very truly,
Clay Castleberry
Director of Public Works
F . G1 nder
JFG:dd Chief Building Inspector
Attachments
P.S. For your convenience, we are attaching a renewal application form which may
be completed and.signed by you where indicated and returned to'this office
mee her with the fee shown. Je are also attaching an Ormer—Builohr Information
and an Owner -Builder Verification Formol :Please complete the Owner -Builder
Verification Form and return it with the renewal application and fees,.
Chico
cc: Building Inspector 7
s
f
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!,
t
s
f
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Va to
[Vw„� ,. .."..•ise. $...rC:. }.!k rr� i�. �:T.1 f'l..:i; v , .1 .X ..���.
4. � .moi f _ _ _1...__._...
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COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive.- Oroville, California 95965 - Telephone (916) 538-7541 / ERMIT NO.
APPLICATION AND PERMIT
-,�-�°�
ASSESSORPARCELNU ER .�. .� �,
1
f71J1 -- ..- I
ZONING
BUIL ING PERMIT
OWNERTELEPHONE
•
SO. FT. OCC. UILDING VALUATION
40 bF 104241) G�
OWN 'S MAID AO RESS ;
CONTRACTOR' NAME I
,
TELEPHONE
"3
MAILING ADDRESS
) >
;W2
Fireplace
CONSTRUCTION LENDER
l n,'
UNKNOWN
Total Valuation $ ow
Filing Fee $ 20.00
LENDER'S MAILING ADDRESS
Permit Fee $ d►Q
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS�
� I
a t'�=�.
Penalty $
BUILDING ADDRESS
PERMITFEE $ DD
PLUMBINGIPERMIT, . Fling Fee 20.00
Each Trap 7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater 23.00
Water piping 15.00
USEOFSTRUCTURE
SF )ir Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent 15.00
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Otherx
r /
Describe Work:a�-rQrjT �1. /9/��
Mobile Home ITTG W @20.00
PERMITFEE $
Contractor
ELECTRICAL PERMIT Filing Fee 20.00
Main Service e00v OR LESS
( 2o0A OR LESS ) 23.00
Main Service ( 200A TO I000A ) 46.00
i
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 �f rce and effect. ^
License Class -Sl Lic. No. ,051, Cn
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. i
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUP. SD.
OR ADDNS. ( a ACC. BLOS. ) 3.50 FT.
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS ) 97.50
ER
(a SIINLE OUTLETT CIIR. )
Ex. Occup. (OUTLET OR FIXTURES) BAIL @ 50
Ex. Occup. ( , FI ELEf8 PLNS. R I 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMITFEE $
' Contractor '
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
r performance of the work for which this permit is issued.
( I 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 insuranc carrier and policy n mber are:
Carrier — t n/h x!j1
MECHANICAL PERMIT Filing Fee 20.00
g
Heating
Cooling
Hood 6.50
Ventilation
PERMITFEE $
Contractor
_s -
Policy Number J -7,2 • 7
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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.
J y ,'4 _�;---
`
X j1L�t. ,��ti�/i'ti ``a' Zgen/
Signature of Applicant - ❑ Owner ❑ Contractor
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ AM. Ao
HA2.
I D. FEES
I IMP I FLOOD
I CDF
PARCEL
PD HD
ISsyF
This permit is hereby issued under file applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
A.e
^ N`r
By ��' •" �r �: �:✓ Dated •` ��, .
PERMITEXPIRESON
(Date)
Receipt No. `
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
�> o COUNTY OF BUTTE :
BUILDING DIVISION.
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt. Road, Chico, CA (916)"8`912751 `
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
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.
k4
t t
t
.y
Aa
N.:
aj
-
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t;
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r
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Date % r/a �%� Inspector >
REV 10192 rv'
a
Y . ,. ',•"�"'4'�;{p�w�,.,,p..lye•;���,.;rpY_vcy�!*�+!t1S19`.aF'.i `.,.... x
07/,t;.0 x;98, 08 : 35 '& 5303428657 BUTTE ROOFP\G
�, :s, - �1�;�'.��,4•„�aat�s, . �. :„ [a 00.1
T 4
i
r .
Butte Roofing Co. September 8, 1997 ' f
P.O. Box 557
Chico, CA. 95927
Subject: Structural Roof Inspection i
420 Paseo Camponeros
Chico, CA. 95926
Pursuant to your request, Anderson Engineering Consultants performed a visual structural
inspection at the subject site on August 29, 1997_ The roof structure is partially comprised of
2x6 rafters at 24" o.c, at a 4:12 pitch with a maximum span of 11'-0", 2x8rafters at 24" o.c.
with a maximum span of 12'-0". The manufactuerer's�span table lengths are; 12'-4" and 15'-7"
respectively.The roof is also partially Constructed of Douglas Fir gangnail trusses with a 2x6
T.C. and U4 B.C.. The remaining portion of the house 1ijs open beams with 2x6 T&G
decking. The attached calculations indicate that the existing beams have the capacity to carry
the new lightweight tile weighing 7.4 psf. The roof structure was found to be in sound
condition.
It is our opinion, based on the site inspection and calculations, that the structural integrity of.
the roof will.. not be compromised by using your proposed reroof system using ,Monier
r, lightweight tile weighing 7.4 psf.
1
Should you have any questions, please do not hesitate to contact us.
t' 1
Sincerely,
aJ.r t '
Carl Anderson, P.E.^�/
L.? ND. C4W r'
Q,
' Vt i.
CAL
bigrsnwn. wri
57'f lu'rnwood Court Chico, -CA -95928 6ti.S /'FAX (916) 543-0500
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07/L0/98, 08:36 e5303428657 '` '°.: BUTT9, ROOTSI.N-G
i
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2002
`•
•
4
. Cantilever Roof Beam[ 94 UBC (91 NDS) ]Ver. V4031279
By: CCA, ANDERSON ENGINEERING CONSLTS
Project: GROSSMAN - Location: GARAGE OVERHANG
on. 09-08-1997
r
Summary:
3.50 IN x 5.50 IN x 6.5 FT l #2 - DOUGLAS FIR -LARCH - Ory Use
Section Adequate By: 362.1% Controlling Factor: Area /Depth Required 3.03
In
Deflections:
Cant Tip 1 Live Load:
Cant Tip 1 Total Load:
LLD1=
-
0.02
IN
Interior Span Live Load:
TLD1=,.
LLD
0.04
i . 0,00
IN
IN = U105U
Interior Span total Load:
End Reactions:
TLD=
4. -, -0.01
IN = U5286
Left End Total Load Reactions:
R1max=,
442:
LB
Right End Total Load .Reactions:
R1 min=
R2max=
0
F
L8..
LB
Note;Design For Uplift Loads
Dead Load Uplift F.S.:
i2mins
.6
.
Bearing Length
FS=
•.
Bearing Length Regd.:
_ 6L1_
-0.20.
IN
Bearing Length Reqd.:
BL2=
0:00
IN
Beam Data:
Span:
Maximum Unbraced Span:
L=
Lu=
f 4.0
' 0.0
FT
FT
Pitch Of Roof:
Live Load Deflect. Criteria:
RP=
r. 4..00
-12
Total Load Deflect. Criteria:
U
Uy°:.,y"
240
180 .
Beam Loading:
_ I
,
Live Load:
Dead Load:
LL=
16 ` ,
'PSF
Beam Self Weight:
DL=
SSW=
15
�_ 5
PSF
PLF
Roof Loaded Area:
RLA=
10
SF
Live Load Method: 1
..
Cantilever End One:
End Span:
CS1=
- 'u 2;5
'FT
Tributary Width:
Interior Span:
TW1=
' 4.0 ,
FT
Tributary Width:
Beam Uniform Loading Summary:
TW=
0:0
F1'
End One: Dead Load:
wD1=.
I
68
PLF
End One: Live Load:
wL1=
;' 64
PLF
Interior Span: Dead Load:
wD=
5
PLF
Interior Span: Live Load:
wL=
0
PLF
Properties For: #2- DOUGLAS FIR -LARCH
i
Bending Stress:
Fb=
875
PSI:
Shear Stress:
Fv=.
95
PSI
Modulus of Elasticity:
Stress Perpendicular to Grain:
E=
1600000
PSI
Adjusted Properties
Fc_perp=
625
PSI
Fb' (Tension):
Adjustment Factors: Cd=1.25 Cf=1.30 -
Fb'=
t 1422
PSI
Fb' (Compression Face in Tension [End 1]):
Fb'1=
1416,
PSI
Adjustment Factors: Cd=1.25 CI=1.00 Cf --1.30
Fv':
Adjustment Factors:, Cd=1.25
Fv'=
1' 119,
PSI
Design Requirements:
Maximum Moment:
M=
-41,2
FT -LB
Over Left Support (End 1)
1
Critical M created by combining all dead loads and w1 live Toads:
Maximum Shear.
V=
330
LS
At Cantilever Edge of Left Support (End 1)
Critical V created by combining all dead loads and w1 live loads.
Comparisons With Required Sections:
Section Modulus:
Sreq=
3.5
IN3
Area:
S=
17.6
IN3
Areq=
4.2
IN2
Moment of Inertia
A=
Ireq=.
t ..i 19.2
8.1.
IN2
IN4
I=
48.5
IN4
41�_AMIP Q1
,., w.L•'IA!+� 1N . Mn�.,,. -•+, r....tw•nwna Jw^b!W Y; Y'F'T
07/l.0 08 3S '&5303428657 13117F ROOFING 2004
Adjustment Factors: Cd=1.25 Cf=1.00
Adjustment Factors: Cd=1.25
Design Requirements:
Maximum Moment:
9.0 FT From Left Support
Shear (Q d from beam end):
Comparisons With Required Sections:
Section Modulus:
Area:
Moment of Inertia:
106 PSI
M=
Multi -Lod Seam( 04 UBC (91 NDS) j Ver. V4031279
By: CCA dfC -•"VON ENGINEERING,CO*SLTS
FT -LB
, on; 09,08-1997
Project: GROSSMAN - Location: LIVING AREA BEAM
2534
^
Summary
9.50 IN 9.50
120.1
IN3
S=
x IN x 18.0 FT /#/l
- DOUGLAS FIR -LARCH - Dry Use
i
F
Section Adequate By: 19.0% Controlling
Factor, Section Modulus I Depth Required 8.71 In
90,2
r.
Deflections:
465.6
IN4
1=
Dead Load:
Live Load:
DLD=
0.43
t, IN
Total Load:
LLD=
0.39
IN = U554
End Reactions(Left Side):
TLD=
0.82
IN = U262
Live Load:
RL1=184
LB
Dead Load:
RD1=
i 1367
LB
Total Load:
End Reactions(Right Side):
RT
2551
LB
Live Load:
' RL2=
` 1184
LB
Dead Load:
_ RD2=
F 1367
LB
Total Load:
RT2=
2551
LB
Bearing Length Regd.(Left) :
BL1=
0.43
IN
Bearing Length Regd.(Right):
BL2=
0,43
IN
Beam Data:
Span:
Maximum Unbraced Span:
L=
Lu=0.0
I
18.0
F7
FT
Live Load Duration Factor:
Cd=
t 1.25
Live Load Deflect. Criteria:'
L/
240
Total Load Deflect. Criteria:
U
1
180.
Uniform Load:
Live Load:
Dead Load:
WL=
l
0,
PLF
Beam $elf Weight:
SSW_
l 22
PLF
Total Load:
WT=
22
PLF
Concentrated Load P1.
Live Load:
PL1=
1184
LB
Dead Load.
PD1=
,
11.70
LB
Total Load:
Location.
PTI=
2354
LB
Concentrated Load P2;
X1=
6.0
FT
Live Load:
Dead Load:
PL2=
,.
1184
LB
Total Load:
PD2=
1170 _.
LB
Location;
PT2=
2354
LB
Properties For: #1- DOUGLAS FIR -LARCH'
12.0
FT
Bending Stress:
Shear Stress:
Fb=
1200
PSI
Modulus of Elasticity:
FE=
1600000
SI
PSI
Stress Perpendicular to Grain:
Fc_perp=
625
PSI
Adjusted Properties:
Fb` (Tension):
Fb'=
1.500
PSI
Adjustment Factors: Cd=1.25 Cf=1.00
Adjustment Factors: Cd=1.25
Design Requirements:
Maximum Moment:
9.0 FT From Left Support
Shear (Q d from beam end):
Comparisons With Required Sections:
Section Modulus:
Area:
Moment of Inertia:
106 PSI
M=
15012
FT -LB
V=
2534
LB
Sreq=
120.1
IN3
S=
142.8
IN3
Areq=
35.8
IN2
A=
90,2
IN2
Ireq=
465.6
IN4
1=
678.7
INA
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDINGDIVION
''7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7 1/ ?—1 PERMIT NO.
APPLICATION AND PERMIT ``'77 !!
ASSESSORPARCELNUMB
"e- 3 3-d-- o;?
ZONING
BUI ING PERMIT
OWNER
TELEPHONE
SO. FT. OCC. JUILDING VALUATION
OWN M MAID RESS
RACTOR' NAME
. \
TELE ONE
C NTRACTMAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNIDJOWN
Total Valuation $
Filing Fee
$ 20,00
LENDER'S MAIUNG ADDRESS
Permit Fee
$ �p
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$ -
ARCHITECT OR ENGINEER'S MAI ADDRESS
fa
Penalty
$
BUILDING ADDRESS
PERMITFEE
$ !TD
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
1 7.00
LOT NO.
SUBDNISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF >( Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
1 5.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilites ❑ Installation ❑ `Other
Describe Work: � — flgnlc��� -Jh/�
Mobile Home S G W
@20.00
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
FilinQ Fee 20:00
Main Service EO eV OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO I000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I( 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. �'7GOL � /
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
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BUDS. )
SO.
3.50 FT.
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
S
( POWER APPARATUS )
8 SINGLE OUTLET UCIR
Ex. Occup. (OUTLET OR FIXTURES
)
2U Q
BAL
FIXED
Ex. Occup. (OUTLETS (R SE S. OR
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
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' com ens tion insuranc carrier and otic n tuber are:
Carrier �r� ®yr, d. 1n
MECHANICAL PERMIT
Filing
9 Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
S
Contractor
Policy Number %c/23
(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 shellTOTAL
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 th se provisions.
X ate
Signature of Applicant - b Owner ❑ Contractor Agen
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.BY
Mobile Home Installation Fee
$
Energy Inspection Fee $
occ
CONST. TYPE
FEE $ 6111�)
HA2.
I D. FEES
I IMP
I FLOOD
I COF PARCEL PD HD
ISS
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
D to L/4h7
(Date)
ReceiptNo. j �-?�
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
+— a
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP061737
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
Issued Date: 07/20/2006 APN: 040-330-024-000
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.
Site Address: 420 PASEO COMPANEROS CHI
License Class : License Number:
Map Index:
Date: Contractor:
Description: HVAC REPLACEMENT(NEW)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: BLAINE DAVID & REBECCA
permit to construct, alter, improve, demolish, or repair any structure, prior
420 PASEO COMPANEROS
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
CHICO, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95928
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
( 530) 894-2142
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
Applicant: BLAINE DAVID & REBECCA
Code: The Contractors' State License Law does not apply to an
420 PASEO COMPANEROS
owner of property. who builds or improves thereon, and who does
CHICO, CA
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
95928
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she.did not build or improve for the purpose of
sale.).
fs) 1, 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
Contractor: MCCLELLAND AIR CONDITIONING, INC
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
,pursuant to the Contractors' State. License Law.).
801 MARAUDER ST.
El am Exempt under Article 3 of the Business Professions Code
CHICO, CA 95973
Date: Owner:
(530) 891-6202
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #: 345121
❑ 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:
❑ 1 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.
Z 12-0
Date:
�OIr
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal 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.
, � f7
`e
9
CONSTRUCTION LENDING AGENCY
This permit is her9by issued under tthe/ppli abl(eprovisions of theButteCounty Code.and/or
I hereby affirm that there is a construction lending agency for the
Resolutions to djYwork indicatbd above for hich fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
i/ ° 74_ ids
By: L Date:
Name:
Address:
PERMIT EXPIRES ON:
Date
❑ 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 & 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 �inspectionur ses.
Print Name: ��'/ Signature:
—0
Date:
Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY PERMIT
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION NO.
AND SUBMITTAL REQUIREMENTS t /
24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 P
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION BIN #
**PLEASE PRINT CLEARLY**
CONTRACTOR
Name
Mrio
Address nd. Inc
801 Maruader Street
city
Chico State CA ZIP 95973
Phone 891-6202 Fax 891-5137
E-mail uc. # 3 4 5121 Clasr_— 2
ARCHITECT/ENGINEER
Name
Address
"Ity State
Zip
Phone Fax
E-mail State License Number
APPLICANT NAME
Name
M` a an it
Phone
E-mail
State I Zip
APPLICANT SIGNATURE
:or office use onl
'oning Flood Zone SRA I Yes I No
�c Type Const.
ubdivislon Name Map Book Page Lot #
tanner
Approved:
)VER FOR SUBMITTAL REQUIREMENTS
:1FnPNAC1Rl III nwirr rr)r Acz,n., ,.n.,. 17,.r+....,._
LOCATION
AP# o (9Zy
ProperlyAddress City
Cross Street
�Af � S i �>✓ i
WORKER'S COMPENSATION
Pnliry Niimhar
div_ �v��yio-os�
Carrier
•4/he.2 dG A �tl ALL ,�! S 14 /�V S Cp .
If hiring anyone other than license contractors; a certificate of worker's
compensation must be shown at the time of permit Issuance.
Name LENDING AGENCY
Address
Descripjion or Scope of Work:
Sq. Footage
0 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
required.
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: Amount
Bldg
SRA
Receipt M �G� off, 77
Sheriff
SMIP.
Date: Other
KK��y jotal
OWNER
Last Name 3
Address
irst ame
City G 1
Phone lf_�
E-mail
S to
Fax
Zip [3
53�—ZB S
CONTRACTOR
Name
Mrio
Address nd. Inc
801 Maruader Street
city
Chico State CA ZIP 95973
Phone 891-6202 Fax 891-5137
E-mail uc. # 3 4 5121 Clasr_— 2
ARCHITECT/ENGINEER
Name
Address
"Ity State
Zip
Phone Fax
E-mail State License Number
APPLICANT NAME
Name
M` a an it
Phone
E-mail
State I Zip
APPLICANT SIGNATURE
:or office use onl
'oning Flood Zone SRA I Yes I No
�c Type Const.
ubdivislon Name Map Book Page Lot #
tanner
Approved:
)VER FOR SUBMITTAL REQUIREMENTS
:1FnPNAC1Rl III nwirr rr)r Acz,n., ,.n.,. 17,.r+....,._
LOCATION
AP# o (9Zy
ProperlyAddress City
Cross Street
�Af � S i �>✓ i
WORKER'S COMPENSATION
Pnliry Niimhar
div_ �v��yio-os�
Carrier
•4/he.2 dG A �tl ALL ,�! S 14 /�V S Cp .
If hiring anyone other than license contractors; a certificate of worker's
compensation must be shown at the time of permit Issuance.
Name LENDING AGENCY
Address
Descripjion or Scope of Work:
Sq. Footage
0 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
required.
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: Amount
Bldg
SRA
Receipt M �G� off, 77
Sheriff
SMIP.
Date: Other
KK��y jotal
=OK
0 = Not OK
MANUFACTURED HOMES
DATE I Lj PERMANENT FOUNDATION Lj SOFT -SET
1 Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Loctn-Test; Fall/C/O-Concrete
4 Wtr, Loctn Test-Easeinent Needed -Regulator
5 Elec Loctn-Clmcs-Gmd • Amp -Concrete
6 Yard Gas; Loctn Test -Wrap Nat ❑ or LPQ
Inch Sz Ft Lngth
7 Bickng; SzSpacing-Marriage Line
8 Gas; MH Test -Demand Valve-Dnnctr
9 Elec MH Cntnty, Test-Crossovers-Breakers-Cimcs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -CIO to Grade
12 Gas and Electricity Tagged "
13 Tie Downs Q Foundation ❑
14 Exits
15 Cert of Occupancy
16 HUD Label/insignia Numbers Serial Numbers
�4
0
MISCELLANEOUS -
ID
1 Zoning�Setbacks-Easements
2 Figs; SoilsSz=DpthSpacing-CnnctrsSteel
3 Decks, Girders/Joists-Dcking-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 Frmg; Sills-AnchrsStuds-Rftrs Tnisses
9 Siding; Nailing-VeneerStucco-l._ath
10 Roof, Shthg-Roofing
11 Ext; Steps-Doors-iandhgs
12 Braced Wall pnis
1 Setbacks -Easements
_ 2 Soils; .CompactionStructure Stability
_ 3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptds/Lting; Distance -GR
_ 5 Elec Pool Lting;15 volts -GR
_ 6 Elec.Enclsrs; Conduit Entries Terminals -Listed
_ 7 Elec Bonding; Metal w/5-Crcitng Egp-Htr
_ 8 Elec Grndng; Eqp w/T Crcltng Eqp-Pool ightg
Boxes -En. asrs-pnlboards. nsultn•to Main Conduit
9 Health Dept Apprvl
10 'Pimb; Cir Test-Wtr Supply Test
11 Lt Niche ,
12 Endsr. Fencing Alarms
13 Bonding, Diving board or Slide
Pool Drawing
RESIDENTIAL (Single & Duplex)
UAFt JUNDERFLOOR
1 Zoning -Setbacks -Easements -Flood -Slope
2 Ftg Main; Soils-Elec Gmd Ftg Dpth
3 Ftg Garage; SoilsSteel-Elec Grnd Ftg Dpth
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
5 Stemwalls 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 Wtr Pipe; Test-Anchrs-RgitrService Test
12 Elec Undrgmd
13 Plenums & Ducts; Clmc-MaterialSupport4nsultn
14 GirdersSills-SillsBolts-Joists-Vnts-Cripples
15 Acc & Vntltn
16 Insulation
DATE JFRAMING
17 Sills Proper Materials & Anchrs
18 Walls Studs -Nailing Spacing & Braces -Plates -Sound
19 Bearing Walls over Girders &flr Nailing
20 Draft Stop in Wails (rat proof)
21 Fire Stops; Furred CeilingsStairs-Chasers-Tubs
22 Headers & BearimsSz &-Bearing'
23 Hangers-PosfCaps-Anchrs-Cinnetns
24 Ceiling Jols;W tr Tjes-Purl-in-Roof Brac TnmsShthg
25 Frplc Ties or 7ypd A Flue=Frpic Throat Clrnc
26 Attic Acc; Sz & Rfnx Pitetp-Draft Stop -Ins Baffles
27 Bdrm Wndws or Exiting Doors -Sill tit & Dimensions
28 Garage Fire Prtcfiri Framing -RC Channel
29 Prprty Line Firewall & Opngs' .
30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Run4-anding-Fire Prtctn
32 Plywd an Roof Ovrhng Attic Vnts-Rftr Outrgrs
33 Siding-Naiing Veneer
34 Stucco Lath Weep Screed-Fndtn Vnts-Undrflr Acc
35 Glazing Area•Glass PrtctnSkyLts-Plastic .
36 Shear Walls; Nailing -Bolts
37 Brace Int%Ext Wall pnls
38 tnsultn-Walls-Ceilings
39 Infiltration -Walls -W ndws
DATE JELECTRICAL
40 Fxtr & Tmsfrmr Cirncdns 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 Eqp Gmd made up w/Mech Fstnrs
45 Grndng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFl
47 Subfeed Wire Sz w Q CU or ❑ AL
AC Wire Sz pa ❑ CU or ❑ AL
48 Range Clic 92 ❑ CU or ❑AL
Oven Circ w Q CU or F 1 AL
Insulated Neutral ❑ Yes ❑ No
49 Service -Riser Cndctrs & Gmd Main Dscnnct
50 Eqp Clrncs pnls-Motors-Mech Eqp
51 Clothes Closet LtShwr LI -Spa Lt
52 Smoke Detector
UAit JPLUMBING
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr-Nail Pr(ctn
56 Shwr Pan; Test, First fir -Tub Acc
57 Test Tubi & Shwr, 2nd fir - Tub Acc
58 Gas Pipe; Sz & Anchrs '
59 Fire Sprinkler; Test
60 Yard Gas Piping
o'
DATE MECHANICAL
61 AC Ducts Insultn & Support "
62 Vent Fan, Exhaust abv Insultn
63 Condensate Drain & Ovrflw, Sz & Grade
64 Furnace Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pitfrm if Furnace In attic
c� e* may'
DATE IFINAL
66 Ext Steps -Door & SideLi Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Clmc-Comb, Air-Cnnctr
In Garage; abv-flr-Ducts-Mech Prtctn
69 Bedroom Exiting
70 GFl & Bath Fxtrs & Tub Acc-Spa
71 GFl Arc Fault
72 Elec Trim & Subpnl, Breaker Szs & Labels
73 Stairs, Guard/Handrails
74 Frplc or Stove, Clmc-Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Gmd 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-Cimc-Com Air Cnnctr-PRV; abv fir
Mech Prtctn; LPG Appince Undr House 3' drain
81 Pimb; Elec & Mech Eqp Listed for Loctn
82 Elec Rcptcls in Garage (GFl) Romex Prtctn
83 Insultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth
86 Clmc Dmge Planters 0 Yes Q No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Pimb
89 Vnts abv Roof, PlmbAppinc-Frplc-Clmc to Opngs
90 Wtr Well, Dscnnct, Elec, Pimb
91 Ext Elec Trim, GFl Rcptcl-Undrgmd
92 Vntltn thru House
93 Glass Prtctn
94 Corrections from previous Inspetns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99 Fire Sprinkler
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP061737
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
Issued Date: 07/20/2006 APN: 040-330-024-000
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.
Site Address: 420 PASEO COMPANEROS CHI
License Class : License Number:
Map Index:
Date: Contractor:
Description: HVAC REPLACEMENT(NEW)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: BLAINE DAVID & REBECCA
permit to construct, alter, improve, demolish, or repair any structure, prior
420 PASEO COMPANEROS
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
CHICO, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95928
7000) of Division 3 of the Business and Professions Code) or that he or
530) 894-2142
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
Applicant: BLAINE DAVID & REBECCA
Code: The Contractors' State License Law does not apply to an
420 PASEO COMPANEROS
owner of property. who. builds or improves thereon, and who does
CHICO, CA
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
95928
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or shedid not build or improve for the purpose of
sale.).
j� 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
Contractor: MCCLELLAND AIR CONDITIONING, INC
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State. License Law.).
801 MARAUDER ST.
O I am Exempt under Article 3 of the Business Professions Code
CHICO, CA 95973
Date: 1 `zi' Owner: t2y
(530) 891-6202
License #: 345121
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:
❑ 1 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.
'7
Date:
`
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal 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.
/ / �'/7�j/� .' Gd
�
CONSTRUCTION LENDING AGENCY _ Y .
This permit is her y issued under the,appli able provisions of the Butte_ County -Code and/or__ _
I hereby affirm that there is a construction lending agency for the
Resolutions to work indicated above for hich fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
By' Date:
Name:
Address:
PERMIT EXPIRES ON: ot�G
Date
❑ 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 & 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.
raj C/
Print Name: �� V-1 `� �./}—t� i Signature: 'e` ._./�',_% r
Date:
Owner ❑ Contractor O Agent for Owner O Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
Date: 8/18/06 Job#: 06422
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R -
Project Address _
420 Paseo Companeros, Chico
Builder Name
McClelland Heating ant
Builder Contact Telephone
McClelland Heating and Air.
Plan Number
HERS Rater ' I Telephone
Mery Martin
Sample Group Number
Compliance Method (Prescriptive)
Climate Zone I I'
Certifying Signature�t . d, Digitally signed by Mervyn Martin Date
INIG4,4 /r {�Date: 2008.08.19 09:10:48 -0TOa
Sample House Number
F'm Energy Calculation Services
INRs Provider CHEERS
Street Address: 574 Manzanita Avenue, Suite 9 -
city/state/zip: Chico, Ca. 95926
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT a
The house was: ✓ C3' Tested ✓ ❑ Approved as part of sample testing,•but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies wiih
the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check and verify that the new
distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building The HERS
rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested
buildings. r
1n The installer has provided a copy of CF -6R (Installation Certificate).
❑ New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts).
❑ New systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in
combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.'
✓ 0 MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Procedures for field verification and diagnostic testing of air distribution systems are available in RA CM, Appendix RC4.3.
Duct Diagnostic Leakage Testing Results i
NEW CONSTRUCTION: `"I'
Duct Pressurization Test Results (CFM @ 25 Pa) -
Measured
Values
1
Enter Tested Leakage Flow in CFM:
At 4.
Fan Flow: Calculated (Nominal: %0' 13 Cooling ✓ ❑ Heating) or ✓ ❑ Measured
2
Enter Total Fan Flow in CFM:
2,000
✓ ✓
3
Pass if Leakage Percentage 5 6% [ 100 x [-(Line # 1) / 2.000 (Line # 2)]]
❑Pass ❑Fail
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out
Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to
4
Duct System Alteration and/or Equipment Change -Out.
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System
5
for Duct System Alteration and/or Equipment Chan a-Out.
230
Enter Reduction in Leakage for Altered Duct System F Line # 4) Minus 230 (Line # 5)]
6
(Only if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
✓ ✓
Entire New Duct System - Pass if Leakage Percentage 5 6%
O Pass [3 Fail
8
100 x 230 ine # 5 / 2 000 Line # 2
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out
✓ ✓
Use one of the following four Test or Verification Standards for coin liana:
9
Pass if Leakage Percentage:5 15% [100 x 230 (Line # 5) / 2,000 (Line # 2)]]
11.50
® Pass ❑ Fail
10
Pass if Leakage to Outside Percentage 5 10% [100 x F _(Line # 7) / 2.000 (Line # 2)]]
❑ Pass ❑ Fail
Pass if Leakage Reduction Percentage z 60% [100 x f (Line # 6) / (Line # 4)]]
E3 Pass [3 Fail
11
and Verification by Smoke Test and Visual Inspection
12
Pass if Sealin& of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
❑ Pass ❑ Fail
Pass if One of Lines # 9 through # 12 pass
® Pass ❑ Fail
Residential Compliance Forms April 2005
040-330-024 06-1737
�y u, BLAINE, DAVID
420 PASEO COIVIPANEROS; CHICO
NOTES ' `Cont: MCCLELL�?:ND'AIR`COND
+- J
RESIDENTIAL
APN: Permit No.
Owner.
Site Address-
Contractor.
Type of Permit
i
r
i
u
SPECIAL CONDITIONS
CHECKED BY
SRA
ROOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMfT CONDITIONS
SUBSTANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
j. DATE JOB F ALED•
i SIGNATURE
i !
t
.
SPECIAL CONDITIONS
CHECKED BY
SRA
ROOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMfT CONDITIONS
SUBSTANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
j. DATE JOB F ALED•
i SIGNATURE
i !
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REOUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
APPLICANT NAME
OWNER
Last Name
)
/
First Na
Address
Address if
V
City
State
SlatePA
Zip
Phone
i
Fax
E-mail
/ r
/
APPLICANT NAME
CONTRACTOR
Name
Name
/voof/,, f -)'7
b�
Address if
V
�,\/
State
City
Phone
State
Zip
I
E-mail
PhoneYA
/ r
/
Fax
/I
V
E-mail
Lic. #/ 1
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax.
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name Z& &A P
/l
Address
City
State
Zip
Phone
Fax.
E-mail
;r
���/ter/i.� ��u►
For ofkcj use only: UP
Zoning
Flood Zone
.
SRA I
Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
Page 1 of 2
PERMIT
NO.
BIN #
LOCATION
TU
Prope ress
Cross Stree /p
WORKER'S COMPENSATION
Policy Number,
Carrier
csV
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scopa of Work:
21d
Sq. Foo age
❑ 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
required.
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: Amount:
Receipt #:
Sheriff
SMIP
Other
Date: 010 ,
Total
REV 2-24-05
b,
SUBMITTAL & PERMIT REQUIREMENTS 4
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 faxes!
❑ 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 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.
❑ 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. Detached Accessory Building Form filled out by the owner (if required).
❑ 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. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑ 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 yeafs 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
K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecolinty.neAdds
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
the Business and Professions Code, and my license is in full force and
effect.
License CI ss : License Number:` l
Date: Jr Contractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
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,
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State 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 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
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
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. 7644, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
O 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
O 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.
I have and will maintain workers' compensation insurance, as
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: L ►-'
Policy #: /7-7 1n�
❑ 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'
compensation provisions of Section 3700 of the Labor Code, I shall
fort=.(
th thos provisions.
Date:
Applicant:
WARNING: Failur o secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal 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 aftomey's fees.
UUMIIKUUFIUN LENDING AGENCY.
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Address:
PERMIT NO.
BP062091
Issued Date: 08/29/2006 APN: 040-330-024-000
Site Address: 420 PASEO COMPANEROS CHI
Map Index:
Description: REROOF 40 SQ COMP
Owner: BLAINE DAVID & REBECCA
420 PASEO COMPANEROS
CHICO, CA
95928
Applicant: BAIRD ROOFING CO
11025 MIDWAY
CHICO, CA 95928
530-342=1631
Contractor: BAIRD ROOFING CO
11025 M I DWAY
CHICO, CA 95928
530-342-1631
License #: 631460
Architect:
Engineer:
Total Square Ft:
Valuation:
Census Code:
This
to do
PERMIT EXPIRES ON:
0 S. F.
$0.00
the applicable provisions of the Butte County CodA anrUor
bov for which fees have been paid.
7
Date:
r9 nti
O 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 & Safety Code is not applicable to the scheduled construction of this project.
O 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 sub+0fyial form or document of B eCounty ereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection
Print Name: / Signature:
Date:
0 Owner �I Contractor 0 Agent for Owner (Agent for Contractor
1 040-330-024 06-2091
BLAINS �•
R , DAVID
ri �_..
42G PASEO COMPANEROS, CHICO
NOTES IRO OFING00
p v.
RESIDENTIAL
APN: Permit No.
Owner:
Site Address:
Contractor. ;
Type of Pemtit•
SPECIAL CONDITIONS
CHECKED BY
Q SRA
Q FLOOD CERTIFICATE EQUIRED
Q FIRE SPRINKLERS REQUIRED
QSPECIAL INSPECTION ITEMS
"O VERIFY
Q USE PERMIT CONDITIONS .
Q SUBSTANDARD HOUSING LETTER
0 ENCROACHMENT PERMIT '
Q REINSPECTION FEE PAID '
Q ENV HLTH CLEARANCE
a " .
• +
DATE JOB.FIN.ALED: 3
• SIGNATURE - - �� �CQ.� \'�—'��-!'J Q ICS
r
{
SPECIAL CONDITIONS
CHECKED BY
Q SRA
Q FLOOD CERTIFICATE EQUIRED
Q FIRE SPRINKLERS REQUIRED
QSPECIAL INSPECTION ITEMS
"O VERIFY
Q USE PERMIT CONDITIONS .
Q SUBSTANDARD HOUSING LETTER
0 ENCROACHMENT PERMIT '
Q REINSPECTION FEE PAID '
Q ENV HLTH CLEARANCE
a " .
• +
DATE JOB.FIN.ALED: 3
• SIGNATURE - - �� �CQ.� \'�—'��-!'J Q ICS
+=OK
0 = Not OK
MANUFACTURED HOMES
MISCELLANEOUS -
r
DATE PERMANENT FOUNDATION SOFT -SET
-----DATE D E C K S`C O V E R S"C A R P O R T S •GARAGE S
i
1 ZoningSetbacks-Easements
1 Zoning -:Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Lodrt Test; FalUC10-Concrete
4 Wtr; Loctn-Test-Easement Needed -Regulator
2 Figs; SoilsSz4E)pthSpacing•CnnctrsSteel
3 Decks. Girders/Joists-Ocldng-Brcing
Stairs-DuardlHandratls
5 Elec Loctn-Clmcs-Gmd Amp -Concrete
6 Yard Gas; Loon Test Wrap Nat Q or LPQ
4 Wood Awn; Posts-Beams-Rftrs-CnncfrsShthg•
Frmg-Brcng
Inch Sz Ft Lngth
5 Alum Awn; Columns-CnncinsSplice-Decal-Encisrs
7 Blckng; SzSpacing-Marriage Line
6 Carports; Wndws-Doors
8 Gas; MH Test-Demand-Valve-Cnnctr
7 Electric
9 Elec MH Cntnty Test -Crossovers -Breakers -Gimes
8 Frmg; Sills-AnchrsStrids-PTTrusses
10 Drain; MH Test -Fall -Flex Cnnctr
9 Siding; Nailing-VeneerStucco-Lath
11 Wtr & Sewer Connected -CIO to Grade
10 Roof. Shthg-Roofing
12 Gas and Electricity Tagged
13 Tie Dowrls Q Foundation ❑ `
11 EA; Steps-Doors-1-andings .
12 Braced Wall pnls -
14 Exits
15 Cert of Occupancy
16 HUD Label/Insignia Numbers Serial Numbers
° �a oe #
DATE JPOOLS
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -lining
4 Elec RcptdstUng; Distance-GFI
5 Elec Pool lting; 15 volts-GFI
6 Elec.Enclsrs; Conduit Entries-Termtnals-Listed -
7 Elec Bonding; Metal w/5'-Crdtng Egp-Htr
8 Elec Gmdng-, Eqp w/5' Crcltng Eqp-Pool Ightg
Bargs-Enclsrs-ppIbaardsansultn-to Main Conduit
9 Health DeptApprvl
10 Plmb; Cir Test-Wtr Supply Test
11 Lt Niche
12 Encisr Fencing -Alarms
-
13 Bor}drng, Diving board or Slide
•
Q'`o °`� O'er r ��
r
i
= Nol
RESIDENTIAL (Single & Duplex)
DATE JUNDERFLOOR
1 Zoning -Setbacks -Easements -Rood -Slope
2 Ftg Main; Soils-Elec Gmd Ftg Dpth
3 Fig Garage; Soils-Steel-Elec Gmd Ftg Opth
4 Fig Porches/Decks; Soils -Steel Fig Dpth
5 SWmwalts Main; Steel-Blockouts Wrapped
6 Stemwalls Garage; Steel-Biockouts Wrapped
6a Hold Downs and Special Anchrs
7 Slab, Steel Wrapped
8 Piers-Frplc FtgSteel
9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test
a: —
10 UF, Gas Pipe; Sz Anchrs-Sz Test _
11 Wtr Pipe; Test-Anchrs-RgitrService Test
12 Elec Undrgmd
13 Plenums & Ducts; Cimc-MaterialSupportansulin
14 GirdersSlits-Anchr BoltsJoists Vnts-Cripples
15 Acc & Vntitn '
16 insulation
e`s•
DATE FRAMING
17 Sills Proper Mate rials & An
18 iM1lalts Studs -Nailing Spacing & Braces -plates -Sound
19 Bearing Walls over Girdert'4 fir Nailing
20 Draft Stop to Walls (rat proof)
21 Fire Stops; Furred CeitingsStairs-Chasers Tubs
,.,
22 Headers & BeamsSz &'Bearing'
23 Hangers-P•osf,'Caps-Anchrs:Cnnc ns
24 Ceiling Joisi:-ftitr T2s-Purl'y�;-Roof Brac TrussShthg
25 Frptc Ties' or Type A Flue=F ' le Throat Cimc
26 Attic Anti Si &lura pit�t-brafi Stop -Ins Baffles
27 Bdrm Wnor Exiting Doors -Sill fit & Dimensions
28 Garage F . ire Prtchi Framing -RC Chirinel
29 Prprty line Firewall & Opngs • .
30 Ext Doors -One 3' -Check Gaiage 3rd Story, 2 Exits
31 Stairs; VV dth-Hdrm-Rise4bm4.and`my-Fre Pitctn
32 Plywd on Roof Ovrhng-Attic Vnts-Rfir Oulrgrs
33 Siding -Nailing Veneer
34 Stucco Lath Weep Screed-Fndtn Vnts-Undrnr Acc
35 Glazing Area -Glass PrtctnSkyLts-Ptastic .
36 Shear Walls; Nailing -Bolts
37 Brace Int/Ext Wall pnls
38 Insults Walls -Ceilings
39 Infiltration Walls Wndws
ya
v' v? o' 0•
DATE JELECTRICAL
40 Fxtr & Tmsfmu Cimc-Ins Prtctrr
41 Elec Rcptcts Spacing-Lts & Switches at Doors
42 Sz Boxes & No Of Cndctrs Stapled
43 Romex Installed Close to Edge of Studs & CJ
44 Eqp Gmd made up w/Mech Fstnrs
45 Gmdng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFl
47 Subfeed Wire Sz Q, DCU or �AL
AC Wire Sz ga D eu or DAL
48 Range Clic _ o, D Cil or DAL
Oven Circ pa D CU or DAL _
Insulated Neutral ❑Yes F-1 No
dr -
49 Service -Riser Cndctrs & Gmd Main Dscnnct _
50 Eqp Cimrs pnts-Motors-Meth Eqp
51 Clothes Closet UShwr Lt -Spa Lt
52 Smoke Detector
DATE PLUMBING
53 Wtr Htr, Vent Arc-Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr_Naii Prtctn
56 Shwr Pan; Test, Fust fir -Tub Arc
57 Test Tub & Shwr, 2nd fir - Tub Ace
58 Gas Pipe; Sz & Anchrs
59 Fire Sprinkler, Test
60 Yard Gas Piping
m
DATE IMECHANICAL
61 AC Ducts Insulin & Support
62 Vent Fan, Exhaust abv Insulin
63 Condensate Drain & Ovrfiw, Sz & Grade
64 Furnace -Vent Acc-Comb Air RtrnlVent 115 Outlet
65 Attic Arc & Pltfrin if Furnace in attic
DATE FINAL
66 Ext Steps -Door & SideLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Cimc-Comb, Air-Cnnctr
In Garage; abv-flr-Ducts-Meth Prtctn
69 Bedroom Exiting
70 GFl A Bath Fxtrs & Tub AccSpa
71 GFl Arc Fault
72 Elec Trim & Subpnl, Breaker Szs & Labels
73 Stairs, Guard/Handrails
74 Frplc or Stove, Cunt -Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Gmd Air -Gap -Cooking Clrnc
77 Elec Outlets & Rcptcls ai Ktchn Counter
78 Garage Fire Dobr, Swing -Landing -Closure
79 AC Duct In Garage -Damper.
80 Wtr Htr Vnts-Cimc-Com Air Cnnctr-PRY; abv fir
Mech Prtctn; LPG Appince Undr House 3' drain
81 Plmb; Elec & Mech Eqp Listed for L.octn
82 Elec Rcptcis in Garage (GF) Romex Prtctn
83 Insuitn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth
86 Cimc Dmge Planters D Yes D No
87 Stucco Brown -Finish
88 Unit Dscnnct, Elec-Pimb
Vnts abv Roof, Pimb-Appinc-Frplc-Cimc to Opngs
90 Wtr Well, Dsrnnct, Elec, Plmb
91 Ext Elec Trim, GFl Rrptc-Undrgmd
92 Vntitn thru House
93 Glass Prtctn
94 Corrections from previous Irispctns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99 Fire Sprinkler
p c
zr�_�zcs S,t-,-G L,6 (f-yCle-
FSS I 'CC Ldp S Ca o W
Air .� ';Z.
at xuae
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: PETER CASTLE
ADDRESS: 1002 MAPLE PARK DRIVE
CITY & STATE: PARADISE, CA 95969 IMPORTANT:
DATE OF CLAIM: 3/8/94 SEE INSTRUCTIONS
ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
1 DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT
OWNER HAS CANCELED PROJECT (BLDG. PERMIT #94-0466, RECEIPT
#156077, DATED 2/24/94, AP# 040-330-024,OWNER: ROY-GROSSMAN).
TOTAL AMOUNT PAID..................................$401.25
i RETAIN REFUND PROCESSING FEE .............$25.00
RETAIN BLDG. PERMIT FILING FEE...... ...$20.00
RETAIN ELEC. PERMIT FILING FEE ............... $20.00
AMOUNT TO BE RETAINED...... ........................$ 65.00
TOTAL'AMOUNT TO BE REFUNDED.........................$336.25
f
I
=�T( AL
$336125
I, the undersigned, ieclare under penalty of perjury that the services or articles claimed hev n p c or elive this
claim is true and correct as stated. /�(/�/j/�-�
Dated this t� ................. day of ...7.1../.:"..1..-.�/'..1, 19q � .. � . .. .
................. at............t.`..1„�,........• Calif. ..... .... .. ...........................
Sign ure of laim ant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articl ecifie1 -bo ave een performed or de-
livered and that 8TH
is a Budget Appropriation Eu or Specific Board Approval TJ ((Check one fo .fd(/�'�//9')e. L�
Dated this......... f. lTH.................. day of ......l: MARCH 19... 9,Fet ....... QRO. .I.J.tLAL:, . Calif. ...... ..W .... ...... _......:
............................
ep artm en Head or Authorized D eputy
Dept' 440-002 Exp. 4210500 CONSTRUCTION PERMITS
Code............................................ Code ................................................PAYABLE FROM..................................................................................... . FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. I PROJ. I SUB. OBJ. I CLAIM NO. I INV. NO. I INV. DATE I ENCUMB. I GROSS AMT.
JA q()
C) 2- E*4 Lt -
8 Maa 94
KEEP F14!lAlgj JrfE S
P.VFuk,o Pocr. FEE
ZE7URAI RxavAav06e .
*,ax�
l
O � '
COUNTY OF BUTTE
Oroville, California
GENERAL CLAIM
CLAIMANT: BUTTE ROOFING
ADDRESS: P 0 BOX 557
CITY & STATE: CHICO CA 95927-557
DATE OF CLAIM: 9/8/97
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
IMPORTANT.•
SEE INSTRUCTIONS
ON REVERSE SIDE
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
CONTRACTOR. APPLIED FOR DUPLICATE PERMITS (A,:P. #040_330-0,24,
-
I
B.P. #97-1684, .#97-1684, RECEIPT. #224226, DATED 8/11/91, OIRtER:_ ROY
_-
GROS MAN
i
I
RETAIN REFUND PROCESSING FEE..............$25.00
TOTAL AMOUNT TO BE RETAINED .................. $25.00
!
TOTAL AMOUNT TO BE REFUNDED .....................$24.00
TOTAL
24.
00
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true
and correct as stated.
Dated this c:2-1 day of , 19-U, at � `L.D Cali ,!Y)
Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or a . le cified abov a be performed or delivered and
that there is a Budget Appropriation I I or Specific Board Approval I I (Check one) for the
Dated this RTH day of (;F.PT -, 19__Q7, at QRQyT1 IX , Calif.
D artment Head or Authorized Deputy
Dept. Code 440-002 Exp. Code 4210500 PAYABLE FR6M CONSTRUCTION PERMITS FUND
Dept. Code Exp. Code PAYABLE FROM FUND
Dept Code Exp. Code PAYABLE FROM FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT.
FOR BUILDING DIVISION USE:
Receipt Information:
Number:
Date:
Issued To:
Amount:
NUG 2 1991
BUILDINI f
UV
Fees P,etai, ed:
Processing Fee: $ C;
Bldg Filing Fee: $
Plbg Filing Fee: $
Elec Filing Fee: $
Mech Filing Fee: $
Energy P/C Fee: $
Plan Check Fee: $
Inspection Fee: $
SRA Fee:
Total Amount Retained
TOTAL REFUND DUE $ ��• G�
REFUND CLAIM APPLICATION
CLAIMANT'S NAME BUTTE ROOFING
MAILING ADDRESS P 0 BOX 557
CHICO CA 95927-557
ASSESSOR PARCEL #: 040-33-0-024
RECEIPT NUMBER(S) 224226
Request arefund of fees paid on the above recei t number(s) for the following reasons:
13 JeL
Please refund any applicable fees in the following categories: (Check those categories
which you wish to have refunded.)
Building Permit Fees ( ) Sheriff Fees
( ) SRA Fees (CDF Fire Planning) ( ) Urban Area Fees
Disposition of Plans:
( ) Plans returned to me at counter
(. ) Please mail plans to me at above address.
( ) Please dispose of plans.
SIGNATURE e�j
DATE
PLEASE DATE AND SIGN THE ATTACHED COUNTY OF BUTTE GENERAL CLAIM
FORM. DO NOT COMPLETE ANY OTHER INFORMATION ON THAT FORM.
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -
7 .County Center Drive - OrovUl e, CPlifornia 95965 - Telephone
APPLICATION AND PERMIT
BUILDING DIV ION
(916) 538-7 41 Q _ ��ERMIT NO.
ASSESSOR PARCEL NUM89
ZONING
BUIL115INGPERMIT
OWNER
TELEPHONE
SQ. FT. OCC. 'BUILDING VALUATION
OWNERS MAILING AiQRFSS
10
CONTRA I TELEPHONE
CONTRAC RSyptAILJNO ADDR S
�J U 7 D-11Fireplace
CONSTRUCTION LE DER
UNI<NOWN
Total Valuation $
Filing Fee $
20.00
LENDER'S MAILING ADD Ss
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAIUNG ADDRESS
Penalty $
BUILDING ADDRESS ,v
�(
PERMITFEE $
Q7j
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
LAT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump Water heater
23.00
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other
c —
Describe Work:
Mobile Home S G VJ @20.00
PERMITFEE $
Contractor
ELECTRICAL PERMIT Filinq Fee 20:00
Main Service / OOOV OR LESS
200A OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
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 lull force and effect.
License Class — 3 Lic. No. ,�� Z
O NER-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
NEW CONST. DWELLING OCCUP.
OR ( 8, ACC BUDS. )
SO.
3.50T.
CNS.
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
8 SINGLE OUTLET US
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.00
BAL 50
Ex. Occup. (OUTLETS (RES O.oEA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE $
Contractor
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.
f 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' compen ati insurance carrief and policy n mbar are:
Carrier /�
MECHANICAL PERMIT Filing
9 Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMITFEE $
Contractor
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.)
❑ 1 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
fort ith comply with those provisions.
1
V P-,
X Date
Signature of Applicant - ❑ Owner ❑ Contractor Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
I
TOTAL FEE $e OD
HAZ.
I D. FEES
I IMP
I FLOOD
CDF
PARCEL PO HD
ISS
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
-
BY DEtte
PERMITEXPIRESON
ate)
provisions
to do work
paid.
/
A7
qg
Receipt No.
WHITE-D.D.S.- .D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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