HomeMy WebLinkAbout040-640-009COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 • Telephone (530) 538-75 1 RMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT r
ASSEbgbl 1M �
LL�Fvv VVDEORGE
ZONING
BUILDING PERMIT
owN
' AND KELLI 3
5TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNS IrMfi R PLACE CHICO CA 95928
coNrl�HK1�SFI�ZEE POOLS 342-4
33 HONE
CONT TORS MAILING ADDRESS
ALYSSUM WAY CHICO CA 95928
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $ 26,000.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filinq Fee
$ 20.00
Permit Fee'
$ 258.50
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 23.00
BUILDING ADDRESS
6 NEW FOSTER PLACE CHICO
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 30 0
LOT NO.
NE
SUBDIVISION'S AM
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
1 7.00
Solar or heat pump water heater
23.00
Water piping
15.0015,00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: GUNITF. P001 MASTER 502-01
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home IS I GI W
1@120.00
PERMIT FEE
S 35,00
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service eo.OR LESS
zoOA OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencingwith Section 7000 of Division 3 of the Business and Professions Code,
)
and my license is in full force and effect.
License Class C - 53 Lic. No. 38cs c� 2 [�
OWN WILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ [,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
reason50.00
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
erformance 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.
Caworkers' cgrfi ' n ins Ace carr ier and policynumber are:
nsa rrier J_�p
Policy Number / --Qi
(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
e,fQowith comply with those provisions.
X Date
Signature of Applicant - ❑ Ownero�C ntractor ❑Age
An OSHA permit is required for excavations over 60" deep and demoliti or construction/
of structures over 3 stories in height.
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUR so
OR ADDNS. ( s ACC. BLDS. 3.50Fr;
NEW CONST. MULTI.OUTLET
NON-NON@7.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. OCCU OUTLET OR FIXTURES a20 @ 1 .000
Ex. Occup. o' D'(RR'.,6.0Ea 1 5.00
Temporary Service 1 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
POOL ELECTRIC ho, 00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
ooc
coL�sT. TYPETOT L FEE $ 386, 50
HAZ.
D. FEES IM9tl FLOOD
CDF
PARC
PD
HD SU
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
-
PERMIT EXPIRES ON
I i
the applicable provisions
Resolutions to do work.
been paid.
Dat 6
ha
Ilbate)
Receipt No.
WHITE-D.D.S.-B.D. CANA -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Feb 01 02 08:13a 1
P -
COUNTY OF BUTTE - DEPARTMENT OF DEV LO ENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 I Telephone (530) 538-75 , r get IT N0.
swooptRev.12/96) APPLICATION AND PERMIT Ci l�r (� , /1
0EL1
ASSESSORPARCNUMBERUW / NoL/0 ZONNOSR_ �. BUILDING PERMIT
-l� un I • ' HON SO. FT. OCC. B ILDING VALUATIO
OWNERS
C01{TIii1C7`R'S(1e(Ne��j�NO� l/L//$ 1 ✓ JY� L
..CONTnTORS isWUNO%dOS/� vl
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER LICENSE
ARCMTECT OR ENGINEERS MAILING ADDRESS
BUILOING ADORESS
_C3 -I SlJ_ tj '
LOTNO. SUAONL9,�ONS 1{A(AEE L�+ as PARCEL APAP
3 �J (/� USEOFSTRUCTUR 133 A C
SF ❑ Duplex ❑ Mobilehome p Other
SPECIFY
TYPE OF WORK
New 13 Addition 13`Remodel El Utilities Uufapation ❑ Other ❑
Describe Work:
> 7�. VSJO 0 _
"PERAIT FEE PAIS $ � o � •� �
SRA
SHERIFF
OTHER
AMourrr aecMVIEo $-3 S b .S 0
'R&Mrr Nv�ee iOS �
To nrr srrro coMnnM �
Fireplace I
Total Valuation
Fling Fee
Permit Fee
Plan Checkina F
Energy Plan Ch,
PLUMBIN
Each Trap
Solar or heat pu
Water piping
$ v00_ L
$
a,5
$
Jng Fee $ -
$
PERMIT FEE $
PERMIT Filing Fee
water heater
Each gas water heater or vent
Gas piping system 1 - 5 outlets
Mobile Home
PERMIT FEE $
ELECTRICAL PERMIT
Main Service 000Y OR LESS
20.OR LESS
Main Service 200A TO 1000A
NEW CONOT. I DWELLING OCCUP.
OUTLET OR FDRURES
7.00
23.00
15.00
15.00
15.00
15.00
@20.00
20.00
20.00
J 'V✓
Tg Fee 20.00
23.00
46.00
@7.501
CX. uccu DurLETcilio. EA 5.00
Temporary Service 23.00 _
Mobile Home Facilities 20.00
Misc, Wiring 23.00
PERMIT FEE $ &r�o . J J
MECHANICAL PERMIT Rling Fee 20 00
Heating I
6.50
PERMIT FEE I S
Mobile Home Installation Fee $
Energy Inspection Fee $ _
occ CONST. TYPE. TO AL FEE $
NAj• D. FEES �P FLOOD CO ELI ISS
This permit is hereby Issued under the applicable pfovrsr(5n-s
of the Butte County Code and/or Resolutions to do work
Indicated above for which fees have been -paid.
By Date _
ReceiptNo. PERMIT EXPIRES ON
WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD•APPLICANT
NOTES
t
f
RESIDENTIAL
040-640-009 01-0376
ANDERSON W. M. i
16 NEW FOSTER PLACE CHICO
CONTR: OWNER I
CONVERT GARAGE TO LIVING SPACE
11 SPECIAL CONDITIONS II
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
. M
y
S
I JOB FINALED (Date
4
Signature
CHECKED
BY
V = OK
0 = Not OK
- = ftotApplicable MOBILE HOMES
= Not Ready
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
2.
1. Zoning Require ments-Setba^ks-Easements
3.
2. Soils; Special MH Support Sketch
4.
3. Sewer; Location -Test -Fall -C/O -Concrete
5.
4. Water; Location -Test -Easement Needed (Sketch)
6.
5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
7.
6. Gas; Location -Test -Wrap; / /" L'ft.
/ P Nat. or / /"L"ft./ PLPG
8.
7. Well Clearance & Disconnect
9.
8. Utility Clearance
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
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; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test-Crossove,,s-Breakers-Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
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 #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-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
FINAL (Plans) OK except #'s
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-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
11.
Light Niche
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J = OK
0 = Not OK
- = Not Applicable = Not Ready
FFRAMING
RESIDENTIAL (;
Date
46.
Underfloor (Plans) OK except #'s '
1.
Zoning -Setbacks -Easements -Flood -Slope
lec. Outlets at Wood Panel, Int. & Ext.
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
arage Fire Door; Swing -Landing -Closure
4.
Ftg., Porches & Decks; Soils -Steel-/ f' Ftg. Depth
lro/` /_' 1
jz ��`✓
5.
Stemwalls, Main; Steel-Blockouts-Wrapped
Elec. & Mech. Equip. Listed for Location
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
6a.
Hold Downs and Special Anchors
r 'Rails Deck Construction -Post Caps
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftg.-Steel
8rR=Fa 0WMU4r+WK/Drive J Yes J No/Walks J Yes J No/Planters J Yes J No
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10.
UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
85. ens Above Roof, Plbg-Appliance-Fireplace-Clea rance to Openings
11.
Water Pipe; Test -Anchors -Regulator -Service Test
12.
Electric Underground
enti ationThroughout House
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
dr-Gas__Te_sT"Mters Tagged, Gas -Electric
15.
Access & Ventilation
16.
Insulation
Date
Card B-1 Date Card B -t
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
Ext. Steps- or &Sidelight Protection- Landings
PLUMBING (Permit) OK except #'s
6
17.
Water Htr.; Vent -Access -Combustion Air Baffle
oz.
18.
Water Pipe; Test & Anchor -Nail Protection
-8C'D8CY6 !mxiting
19
D.W.V.; Test Fittings & Anchor -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
23.
Fixture & Transformer Clearance -Ins'. Protection
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
25.
Size Boxes & No. of Conductors Stapled
26.
Romex Installed Close to Edge of Studs & C.J.
27.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or At
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral ❑ Yes U No
31.
Service -Riser Conductors & Ground Main Disconnect
32.
Equip. Clearances Panels-Motors-Mech. Equip.
33.
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
35.
A.C. Ducts Insulation & Support
36.
Vent Fan, Exhaust above insulation
37.
Condensate Drain & Overflow, Size & Grade
38.
Furnace -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 (Permit) OK except #'s
40.
Sills Proper Materials & Anchors
41. Walls Studs -Nailing Spacing & Braces -Plates -Sound
42. Bearing Walls over Girders & Floor Nailing
43. Draft Stop in Walls (rat proof)
44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45. Headers & Beams -Size & Bearing
jingle & Duplex)
Date
FFRAMING
(Continued)
lec. Trim & Subpanel, Breaker Sizes & Labels
46.
Hangers -Post Caps- Anchors -Connectors
47.
Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rfng.
lec. Outlets at Wood Panel, Int. & Ext.
48.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
arage Fire Door; Swing -Landing -Closure
50.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
lro/` /_' 1
jz ��`✓
51.
Garage Fire Protection Framing
Elec. & Mech. Equip. Listed for Location
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
r 'Rails Deck Construction -Post Caps
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
8rR=Fa 0WMU4r+WK/Drive J Yes J No/Walks J Yes J No/Planters J Yes J No
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
85. ens Above Roof, Plbg-Appliance-Fireplace-Clea rance to Openings
58.
Glazing Area -Glass Protection -Skylights -Plastic
59.
Shear Walls; Nailing -Bolts
enti ationThroughout House
60.
Brace Interior/Exterior Wall Panels
61.
Insulation -Walls -Ceilings
dr-Gas__Te_sT"Mters Tagged, Gas -Electric
62.
Infiltration -Walls -Windows
nergy Compliance Certificate -Other Certificates
Date
Card B-1 Date Card B -t
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
Date
FINAL (Plans) OK except #'s
Comments at Final:
Ext. Steps- or &Sidelight Protection- Landings
6
m -oke Detector
oz.
rumaue-Vewt6-clearance-Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
-8C'D8CY6 !mxiting
. _G_rr_ C' a6'1ii Fixtures & Tub Access -Spa
lec. Trim & Subpanel, Breaker Sizes & Labels
ads
7 irep ace or Stove, Clearance -Hearth
lec. Outlets at Wood Panel, Int. & Ext.
1�.liance; Ground -Air Gap -Cooking Clearance
79-E'IrC9QUWq & Receptacles at Kit. Counter
arage Fire Door; Swing -Landing -Closure
7 A.C. Duct in Garage -Damper
lro/` /_' 1
jz ��`✓
7.6. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
Elec. & Mech. Equip. Listed for Location
e e eptacles in Garage (F.F.I.)-Romex Protection
79 -.'-in su iatio n- Foam- Looked in Attic
r 'Rails Deck Construction -Post Caps
n. VBen s & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor C) Yes
8rR=Fa 0WMU4r+WK/Drive J Yes J No/Walks J Yes J No/Planters J Yes J No
tucco Brown -Finish
A. m nnect, Electrical -Plumbing
85. ens Above Roof, Plbg-Appliance-Fireplace-Clea rance to Openings
M. Disconnect, Electrical, Plumbing
Ext for Elec. Trim, G.F.I. Receptacle -Underground
enti ationThroughout House
Glas Protection
Corrections from Previous Inspections
dr-Gas__Te_sT"Mters Tagged, Gas -Electric
9 ater & Sewer Connected -C/O to Grade -HD Approval
nergy Compliance Certificate -Other Certificates
94.,.G.dr3r Osted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
jo G o I J P f
/S� . r..y..-..•.�..�-'� -�.v+�-�-,, •,Y,r. "^"^.-w. ..-.'..".�-...+-r�`�-r�....- ^......,. -,. -.�-� •.-�-w--r++v..r•. vi+..,M-iti ^--.�..-••---......-....,- -..- 1-.�...^
! 9
•.4 -COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMT NO.
(Rev. 12/96) APPLICATION AND PERMIT �✓�-��
A
ASSESSOR PARCEL NUMBER
040-640-009
ZONING
SR 1
BUILDING PERMIT
OWNER AhmW-01085
SO. FT. OCC. BUILDING VALUATION
. OWNERS MAILING ADDRESS
6
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDERS MAIUNG ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Flirt Fee $ 20.00
Permit Fee $
00
ARCHITECT OR ENGINEERS MAILING ADDRESS
_R1
Plan Checking Fee $
BUILDINGADDRESS
NEW FOSTER PLACE CHICO CA 95923
Energy Plan Checking Fee $ 23.00
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME CHAMBERS
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF 13� Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00 .
TYPE OF WORK
New ❑ Addition ❑ Remodel O Utilities O Installation O Other ]
Describe Work: CONVERT PORTION OF C;ARAC;F. TOO
HABITABLE SPACE.
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home IS I GI WF_ @20.00
PERMIT FEE $
ELECTRICAL PERMIT Fling Fee 20.00
Main Service 200AoRLESS 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:
TU 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.
O I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is Issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permitis Issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLINGoCCUP. 3.5¢so.
OR
ADONS.
MU COUTLEr
NON•RESID. @7.50
POSER APPARATUS
S SINGLED T. CIR.
20 @ 1.00
Ex. Occup. OUTLET OR FDLTURES B,L @ ,50
Ex. Occu . ouT> rs RAID) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation 4.50 9.00
PERMIT FEt S 29.00
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
IPI I certify that in the performance of the work for which this permit is Issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
fA��,
X Date �26 O
Signature f Applicant - Owner O Contractor O 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 $00
occ
R 11
CONST. TYPE
V TOTAL FEE $ 281.6 01
HAZ.
X
D. FE IMP
X
FLOOD
X
CDF
X
PARCEL PD
X
HD ISS
This permit is hereby issued under the applicable provisions
of the B tte County ode and/or Resolutions to do work
inch c d o or i�h fees have been paid.
/�
By 4' \� Date
PERMIT EXPIRES ON 3//, D 2�
Date
Receipt No. 3 09 411-15- / 9 ?1 _ F,(1
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
OWNER -BUILDER ;VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and reran this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit will be issued until ' this
verification is received.
1. I personally plan to provide the jor labor and materials for construction of the proposed
property imF�Cment ,YES 13... NO a
2.'1 HAVE C HAVE NOT C3 signed an application fora building permit for the proposed work.
3. I have contracted with the following person. (fur) to.ptovice,ttie, proposed construction:
NAME. - ,.,► . -�•.
ADDRESS: CM:_ .
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired -the following person to coordinate,
supervise, and provide the major work:
NAME: .
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the workbut I have contracted (hired) the following persons to provide,
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
<ROPERTYOWNER: �c
SOCIAL SECURITY NUMB R:
/<DATE: 4 -ZZ& b/
NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to Issue the permit.
OVER
OWNER BUILDER INFORMATION
Dear Property Owner:
x•8.-1
An application for a building permit has been submitted in your name listing yourself as the builder of propeity
improvements specified
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
Ifyod pled to dd jn(» r own•woric, with the exception of various trades that you plan to subcontract YOU Id
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including -materials
and other costs) is $300 or mon for the entire.project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ Then may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your oblipbons under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an `owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
rely,
IMal
el C. Vi ira, C.B.O.
ger,Building Inspection
NOTE: This Owner -Builder Information it required by Section 19830 of lite CaWornla Health and Safety Code.
A;;
`l^%' Cj�TI'+iil�!'i��` .. .�`v�, �j'ta71f4��►� A4y�N�it�►s "�,..� t.r � ^ . ' +". ,- ti' '-
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
, PERMIT APPLICATION DATA SHEET
OWNER: �r�C! ��y�-� ASSESSOR PARCEL � ER:
Proposed Bii lding Use: Q V Building Inspector: Date: ca -a"/
At time of permit applica ont Was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All iiems have been submitted --------------------------------------------------------------------------------------
El 2. Plot plans, 3/4 sets, signed by the preparer of plans.
E13. Complete plans, 3/4 sets, signed by the preparer of plans. ----------- 7
En ' eered,plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.
XnOnergy
' eered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
Design Compliance and supporting documentation. ----------------------------------------------------
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
138. Hazardous Material Form. -------------------------------------------------------------------------------------------
❑9. Man actured Home data and installation instructions including Tie Down Specifications.------------------
❑ 1 ees of $ --------------------------------------- =--------------------------------------------
11. Impact fees as shown on the attached schedule. -b---------------- ----------------
❑ 12. California Department of Forestry plan approval/fees. ----------------------------------------- ---------------
11 13,,Z.Iood elevation certificate. ----------------------------------------------------------------------------------------
4 Sanitation and plot plan approval(? --j Health Department. -------------------------------------------
❑ 15. City of Chico plumbing permit. -----------------------------------------------------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------------------------------
0,17. 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
❑21. Contractor's license information. (Number, Name Style, Classification).
022. Workers' Compensation carrier and policy number. -----------------------
023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). -
E124. Letter of signature authorization. -------------------------------
025. Recorded copy of Agricultural Acknowledgment Statement.
❑26. Letter of intent on building use. ---------------------------------
027. Manufactured Home utility clearance. --------------------------
028. Existing violations and/or expired permits. --------------------
029. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
,,1130, Other:,
When you issue the permit, process as follows Ivlail to owner, ❑Mail to contractor.
❑ Telephone and hold for pickup at office. ❑ Deliver with inspector.
(Date)
Applicant: Date: 2LZtpLOI i
Copy of Haz-Mat form sent o Health Department, o Fire Department, o Air Po tion Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Oth Date: By:
1. Index permit application for the above items numbered: t ❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, o Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by o phone, ❑ mail, o Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner was adi 'sed of the abovewired data by 13phone, iimail, o Build' ((is,io�ncounter, by Date:
Plans reviewed by: Date: '0 Plans approved by: D' Vw Date:
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
r-•
E.H. USE ONLY
Plot Plan Attached
Floor Plea Attached
Sent to B.D.
�.
� aria (� ,��, ) �,�-oo h
T
Owner Location AP#
Plan Approved for: Sewage Disposal Pf Water Supply: Public Private Well t/
Clearance for dwelling. Other
Hold final for:
Final clearance O.K. for:
NOTE:
Environ mentaf Health Specialist
8/96
Date
March 5, 2001
Wm. Anderson
6 New Foster Place
Chico, CA 95928
•
Department of Development Services
Building Division
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 (530) 538-2140 FAX
Parcel Number: 040-640-009
Building Permit Number: 01-0376
This office reviewed building plans for the permit application referenced above. The plans
examiner's comments are listed in Part I below. Please respond in writing to each comment in
Part -I by completing and returning the enclosed PLAN REVIEW RESPONSE FORM. Indicate
which detail, specification or calculation shows the requested information. Additional response
information is included on the response form. Your complete and clear response will expedite the
recheck and approval of this project. If more than one party is responsible for plans, all party's
must respond on the PLAN REVIEW RESPONSE FORM.
PART -1
Provide additional information and/or make revisions to plans, specifications and calculations as
follows:
NO ITEMS THIS SECTION
Plan check will continue upon receipt of all of the above items. Additional comments may be
generated from your response above where the plan documents were incomplete, inconsistent or
not adequate to depict code compliance.. If you wish to discuss any requirements, you may
contact me at (530) 538-7541 between 1:00 P.M. and 4:00 P.M., Monday through Fridays.
PART -Il
The items identified below must be submitted prior to permit issuance. These items were noted at
the time of permit application on the PERMIT APPLICATION DATA SHEET.
1. Complete and return the'�
pchool Impact Fee form. •
2. Health Department clearance has not been received as of this date.
incerely,
arth hitney `
Plans xaminer
APPLICANT:
OWNER: •.
PERMIT #:
A. P. #:
WORK DESCRIPTION:
PRJ -ECT
PROCESSING RFCORD
�V1G�Pr�s�l i
DATE pM RrPMN OF STEP `
40
BUTTE. COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District ((�/,,(�( r (Q Building Department No.,
A P: Number"T`' �+'`T�S ' t%� R "1, Junsdiction.' Glty. ' County '
Property C+wrier lf�✓ ' '+f �fw= fr1 tt, .�
Property Location/Address
Subdivision ., 1 i-� f't'(l,%'$ G �� 1 D I U I ((� 1y Lot No.
Residential Development
Commercial/Industrial
Building Department
11
.,,.,.:-«.—
Date
(Floor Plans reviewed by School District Personnel)
District Identification No. N 1 ' .
C U,:!� School. District certifies that
rr. t4pPlicant)
17
'R
(Street Address)
(Phone Number)
(City)
has complied with the requirements of Resolution No.
representing U 4 square feet
School District Representative
Paid by Check # IV 6- Remarks:,,--
IState) (Zip Code)
by payment of $^
2926 s
FULL MITIGATION $
Date
1h
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 660201a), 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) feeformAs (10/98)dmm
r
_..... _..__._.. _.._ G......._...........................................................
Sq. Footage c
No of Living
Mobile Home
Addition
'Supplemental to (Group R)
Units
Installation
Conversion .
Permit #
i
:......................................... .........................................................................
*(No foundation inspection): }
Sq. Footage
-New `
Addition t f�
"` '(Including Exterior
Roofed Areas)
0/
Date
(Floor Plans reviewed by School District Personnel)
District Identification No. N 1 ' .
C U,:!� School. District certifies that
rr. t4pPlicant)
17
'R
(Street Address)
(Phone Number)
(City)
has complied with the requirements of Resolution No.
representing U 4 square feet
School District Representative
Paid by Check # IV 6- Remarks:,,--
IState) (Zip Code)
by payment of $^
2926 s
FULL MITIGATION $
Date
1h
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 660201a), 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) feeformAs (10/98)dmm
E.H. USE ONLY
PlotRen Attached 'e
Flour Ran Attached /7Pj
Seem to B.D.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
12ezJ
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for dweging. Other-✓lgro���� S�J�%y,�. �%�a �'r lsdt
Hold final for:
Final clearance O.K. for:
NOTE:
LIDEnvironm tal ealth Specialist Date
8/96
N090202
17o.11
13 e7'
NEW FOSTER PL
N090202
Z
.J
PLANNING DIVISION - BUILDING PLAN APPROVAI
Use: Date:-) -'Z±j O t l
Parking: Landscaping: --�—
Other.
Signature:
soz -01
OWNER:
TO DETERMINE APPROXIMATE ELEVATION NOTE
OF POOL ON DAY OF EXCAVATION.
OWNER:
POOL AREA TO BE FENCED, PER COUNTY
OR CITY ORDINANCE. GATES TO BE SELF
CLOSING AND SELF LATCHING.
BY OWNER
OWNER:
WET DOWN CONCRETE SHELL AT LEAST
TWICE DAILY FOR 7 DAYS.
DO NOT TURN ON POOL LIGHT WHEN POOL
IS EMPTY.
DO NOT USE RUBBER HOSE WHEN FILLING
POOL AS IT WILL MARK PLASTER.
SIB
SCALE 1/8" = 1' 0•
46EY�(-
PEBBLE -TEC
BUTTS GOUNT`(
BUyuDmG DIVISION
APPROVED
SALES OFFICE
PHONE NO.
JO B NO,
MAP BOOK NO.
LEGAL DESCRIPTION
I
AP 040-640-009
LOT NO:
TRACT NO
BOOK PAGE BLOCK
MAILING ADDRESS
PERMIT OFFICE
MGR.
SALESMAN
DATE
NAME-
-
AME_
❑WN. BY ADDRE
GENERAL SPECIFICATIONS
SIZE 24 x 40 AREA 7 5 5 ODEPTH 3`6,
TO
SHAPE CUSTOM PERIMETER
I 10
TEMPLATE NO. CUSTOM ,----
TILE SIZE 6 •• x 61,
TILE COLOR 0 T S
COPING NO
COPING COLOR N 0
POOL CAPACITY 31000
GALS.
PUMP CAPACITY ( (tD
G.P.M.
MOTOR H.P. ( 2
H.P.
FILTER 48
SO. FT.
FILTER RATE ( 0
G.P.M.
TURNOVER 51/3
HRS.
VACUUM LINE & SKIMMER 2
RETURN UNE 2
MAIN DRAIN I 1/2
SKIMMER -MODEL U-3
BACKWASH TO DIS LINE
30 ' OF %" FILL LINE
ANTI -SYPHON VALVE AUTO FILL
HEATER NO SIZE N 0 BTU
GASLINE BY: N 0 VENTED BY: No
LIGHT S O O ( w)
CLOCK 220 (V)
ELECTRIC BY: C t F P
ELECTRICAL BONDING BY: C A. F P
POOL CLEANER POOL -VAC
CHLORINATOR NO
BOARD -SIZE N O COLOR N 0
BOARD SUPPORTS- N 0
LADDER -Model N 0
SLIDE-# N 0 color
STUB PLUMB ❑ YES
WIN 0
TILE & COPING M ASAP ❑ OTN
DECK BY: C F P
TREES, ETC. III 0
CONCRETE REMOVAL BY: N 0
RAISED BOND BEA
YES ❑ NO HEIGHT WIDTH
SWIMMING POOL
GEORGE AND KELLI TRNK�
It 6 NEIN FOSTER P L
MICO CA
CROSS STREETS
:K'D. SY
RES. PHONE 34 S'-7 7 43 BUS. PHONE
§4INT5 CARE -FREE POOLS
SS _ #9 Alyssum Way
C _ Chico, California 95928
Bill Bell
Contr. Lic. #380826 Phone 342-4639