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HomeMy WebLinkAbout040-660-005t 40-30-42 Dick Meline W/S Midway,app.2/10 mi.N.of overpass, >Chico Permit #1642-78B(add c rport/SF) 40-30-42 Permit #3190=78B(add boat to age > atta e to pri:garage 40-3042 Dick M dwl��Q 1.0005 Midway, Durham IN -1J Constr-. Concrete Forms, Chico Permit#3645-83 (install solar WHsystem) 40-30-42 3097-91B MELINE,-Richard# 10005 Midway, .Durham (reroof/sf) I 040-660-005-T- MELINE, DICKS t - 10005 -MIDWAY, CHICO.; r. , '�Corit:-FOUR'COUNTIES REROOF' , �y: y�3� .Z *. r ".j ! i •K I7 f • it,.r .�..� -. tri 11 i �.. ' 040 660 005" 3 x'06=1126 w` :MELINE: ^10005 MIDWAY, DURHAM ` i wCont ELEC POLE AND SERV+ B08-1131- ' R.. .040-660-006 • MISCELLANEOUS ' ;,Re -Roof. REROOF W/COMP (35 SQ) HOUSE ON, 10005 MIDWAY ME LINE ROBERT J, �.... - MELINE, Dick 5823E I � 0-30-4 7 w/s Midway j t north of S.P. Railroa ,Durham14 (addition) ��OJ-�. �_ �I��I ii BUTTE'COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 10005 MIDWAY Owner: Permit No: B08-1131 APN: 040-660-006 MELINE ROBERT J, Issued Date: 06/16/2008 By KEJ Permit type: MISCELLANEOUS 10005 MIDWAY Subtype: Re -Roof DURHAM, CA 95938 Expiration Date: 06/16/2009 Description: REROOF W/COMP (35 SQ) HOUSE (530) 342-9117 Occupancy: Zoning: A20 Contractor Applicant: Square Footage: FOUR COUNTIES ROOFING FOUR COUNTIES ROOFING Building Garage RemdUAddn 3 CRUSADER COURT 3 CRUSADER COURT CHICO, CA 95973 CHICO, CA 95973 Other Porch/Patio Total (530) 343-1416 (530) 343-1416 FEE INFORMATION DBMSC Re -Roofing $204.50 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires FOUR COUNTIES ROOFING 905126 / C39 / 10/31/2009 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X � /e i 06/16/2008 Contlactor's6ignature Date WORKERS' COMPENSATION DECLARATION I 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. I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of 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: State Fund Policy Number: 272-0000661 Exp. Date:10/0112008 (This section need not be competed if the permit is or one hun red dollars ($100) or ess. ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 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. / X ' 06/16/2008 Signatuy Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) s Lender's Address City - State Zip Balance Due: $0.00 Receipt No: B7672 OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: ❑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 Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the 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 improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). I AM EXEMPT under Section B. & P.C. for this reason: Owner's Signature 06/16/2008 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or authorized to act on the property owner's behalf. 1 " 1.19 :o,7 v 1� 1l,n Z,, 06/16/2008 Owner Contractor 00 DAgent for Owner ElAgent for Contractor FILE COPY. v.. ajb- 75a � �pCQa "y BUTTE COUNTY .o0\��TTF0 DEPARTMENT OF DEVELOPMENT SERVICES o �, '' o BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o A FEE WILL BE REQUIRED AT TIME OFAPPLICATION 0 r� " o Website: www.buttecounty.netldds (JN yPLEASE PRINT CLEARLY —When riled, this application and all supporting material becomes subject to the California Public Records Act. All pug related to this application is subject to public inspection and will be posted on the County's website for electronic access. APPLICANT INFORMATION . OWNER INFORMATION Last Name / N E I Address 3 c & S .a C First Name C Mailing Addressp v 1'y► � r� City 0 / Phone State A Zip g Phone 3q 2 911/1 Fax E-mail Class _ V a APPLICANT INFORMATION . CONTRACTOR Name Low? ' vl-t / oc L, , Address 3 c & S .a C City NI -co State C Zlp Phone Phone Fax �3 s� '� E-mail E-mail Lic. # 9os-1 Class _ APPLICANT INFORMATION . ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail Sq FT- Living Garage State License Number APPLICANT INFORMATION . Name _ n Address City State Zip Phone Fax E-mail P CANT SIGNATURE X PROJECT LOCATION AP# 1 , d - G C) Cp Property Address 10 0 Q to Qw city r� PERMIT NO. A BIN # WORKER'S COMPENSATION Policy Number O Carrier 5 tf 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 E O RK: t� oIcF /4 ss /t c wr t1i Co Sq FT- Living Garage Open Cov ❑ 'Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): V a For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. ti 040-660-005 T� 06-1126 t'i • Butte (;cMELINt rm.-4 ct pc O gtsk:.cryie:. "�2 Haan NOTES ljT7Courtl0005,MIDWAYjDUlPdlAM 1 Cont: OWNER.., r) J t )(530) 5 L': .� » .. � � . • ELEC POLE AND SERV RESIDENTIAL APN: Permit No. rOwner- Site Address: Contractor: ` :!Type of Permit: C)4 ti OFFICE COPY t Address GAS 4 - Meter By Date ' s ELECTRIC 1 s �; �• ~ , 'x Meter By;27-Date(k2-6 f� 1 SPECIAL CONDITIONS CHECKED BY SRA K' Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED `\Q SPECIAL INSPECTION ITEMS VERIFY Q USE PERMIT CONDITIONS Q SUB -STANDARD HOUSING LETTER Q ENCROACHMENT PERMIT REINSPECTION FEE PAID 11-P r -7 DATE JOB FINALED: SIGNATURE: 4 I. o=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Li SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd "Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat Q - or LPO Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers DATE D E C K S'C O V E R S'C A R P O R T S'G A R A G E S 1 ZoningSetbacks-Easements 2 Ftgs; SoilsSz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing . Stairs-Guard/Handralls 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Fnng; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls �00 o`er DATE JPOOL,S 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lti_ng; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec.Enclsrs; Conduit Entries -Terminals -Listed 7'Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Egpw/5'.Crcltng Eqp-Pool Ightg Boxes-En6lsrs-pelboards4nsultn to Main Conduit 9 Health Dept Apprvl " 10 'Plmb; Cir Test-Wtr Supply Test 11 Lt Niche ,. 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide opo �s o0 d Pool Drawing = OK O = Net OK - . RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR TDATE IPLUMBING 1 Zoning-Setbacks-Easements-FloodSlope 2 Ftg Main; Soils-Elec Grnd Ftg Opp 3 Ftg Garage; Soils-Steel-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-Frpic 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-RgltrService Test 12. Elec Undrgrnd 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Acc & Vntltn 16 Insulation DATE IFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops,'Furred CeilingsStairs-Chasers-Tubs 22 Headers & Beams -,Si &•Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frpic Throat Cirnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Area -Glass PrtctnSkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration -Walls -W ndws DATE JELECTRICAL 40 Fxtr & Trnsfrmr Cirnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga OCU or ❑AL AC Wire Sz ga OCU or ❑AL 48 Range Clic gaEl CU or Q AL Oven Circ ga [—ICU or DAL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr. Nail Prtctn 56 Shwr Pan; Test, First fir -Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping 1614114ii_1211101i3 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 FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mach Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frpic or Stove, Clmc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cirnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Cirnc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drn e & Wood -Earth 86 Cirnc Drnge Planters E3 Yes Q No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frpic-Cirnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT BP061126 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/15/2006 APN: 040-660-005-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 10005 MIDWAY DUR Date: Contractor: Map Index: Description: NEW ELEC POLE AND SERVICE 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 Owner: MELINE, DICK to its issuance, also requires the applicant for such permit to file a 10005 MIDWAY signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section DURHAM, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95938 she is exempt therefrom and the basis for the alleged exemption. Any 530-342-9117 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 (8500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: MELINE, DICK owner of property who builds or improves thereon, and who does 10005 MIDWAY such work himself or herself or through his or her own employees, DURHAM, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95938 year of completion, the owner -builder will have the burden of 530-342-9117 Proving that he or she did not build or improve for the purpose of sale.). 1� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: BEN'S ELECTRIC and who contracts for such projects with a contractor(s) licensed PO BOX 1027 pursuant to the Contractors' State License Law.). DURHAM, CA ❑ 1 am Exempt under Article 3 Business and Professions Code 95938 of.the - / s" Downer: 530-521-0299 Date: J` License #: 627804 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 Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 .®• 1 certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that. if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' 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. /- 4✓ LJ_ CONSTRUCTION LENDING AGENCY This permit is y ' sued u er the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) Resoluf t d indicated bove for hich fees have been paid. 1 oo�/' ' performance permit By. D �- 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 19627.5 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 1 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 purpo�eS Print Name: /C°fir''—�-�C/ IILle Signature: Date: j Ib Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 4 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. BP061126 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/15/2006 APN: 040-660-005-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 10005 MIDWAY DUR Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW ELEC POLE AND SERVICE Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MELINE, DICK to its issuance, also requires the applicant for such permit to file a 10005 MIDWAY signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section DURHAM, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95938 she is exempt therefrom and the basis for the alleged exemption. Any 530-342-9117 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: MELINE, DICK owner of property who builds or improves thereon, and who does 10005 MIDWAY such work himself or herself or through his or her own employees, DURHAM, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95938 year of completion, the owner -builder will have the burden of 530-342-9117 proving that he or she did not build or improve for the purpose of sale.). 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 not apply to an owner of property who builds or improves thereon, Contractor: BEN'S ELECTRIC and who contracts for such projects with a contractor(s) licensed PO BOX 1027 pursuant to the Contractors' State License Law.). DURHAM, CA ❑ I am Exempt under Article 3 -the Business and Professions Code 95938 of- Sr_/ M 530-521-0299 Date: wner: License #: 627804 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. .Architect: ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy#: Valuation: $0.00 .S- I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' 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 f code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is e y- sued ur er the applicable provisions of the Butte County Code and/or 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.) Res! t d indicated ��ich fees have been paid. ^ l Name: By: D 6 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 inspection purposes (�� Print Name: / //(°/_��//✓� Signature: Date: Owner ❑ Contractor ❑ Agent for Owner Cl Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds -1**p SEMCLE ** q _ r ,�6 IN RMATION Last Name irst�eOWNER a� Address %©off S' N -t 0 Wb,/ City SL004 Faxes Phone���0�Z_ Fax E-mail CONTRACTOR Name ' - Z FC i fi) Address V P)L G Cit R , Stag Z0, Phone w �a Faxes E-mail LiQ.v Cla�,� APPLICANT SIGNATURE r X For office use only: ARCHITECT/ENGINEER Name Flood Zone Address—.. SRA City I No State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT SIGNATURE r X For office use only: APPLICANT INFORMATION Name Flood Zone Address SRA City I No State Zip Phone Map Book Fax E-mail Planner APPLICANT SIGNATURE r X For office use only: Zoning Property Address loc Flood Zone Cross Street 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 a PERMIT NO. P o �� BIN it . PROJECT LOCATION AP# Property Address loc City ,/J Cross Street WORKER'S COMPENSATION Policy Number Carrier t_ 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 Scope of Work: /-'o LC-/ /V&7.1V Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Page 1 of 2 REV 8-12-05 Amount: W Bldg SRA Receipt #: Sheriff s� SMIP f Other Total Page 1 of 2 REV 8-12-05 y SUBMITTAL & PERMIT REQUIREMENTS. The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No 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 manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate , ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning . review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization ,(if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 NOTES PERMIT NO. iE RESIDENTIAL 0123 MEuns, Drcr I 003aq cl+t�p rx Ecor as -sq II SPECIAL CONDITIONS II CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER + JOB FINALED (Date) 1 ' Signature�`�`-`'"� (� J=OK 0 = Not OK r = NotReadyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 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-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L -ft. / P Nat. or / /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office 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 POOLS (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- Panelbcards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms 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 RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ P' 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 -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 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 Stairs & Rails 23. Fire Sprinkler; Test Fireplace or Stove, Clearance -Hearth 72. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 75. 24. Fixture & Transformer Clearance -Ins. Protection 76. 25. Elec. Receptacles Spacing -Lights & Switches at Doors 77. 26. Size Boxes & No. of Conductors Stapled 78. 27. Romex Installed Close to Edge of Studs & C.J. 79. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 80. 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 81. 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 82. 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No 32. Service -Riser Conductors & Ground Main Disconnect 83. 33. Equip. Clearances Panels-Motors-Mech. Equip. 84. 34. Clothes Closet Light -Shower Light -Spa Light 85. 35. Smoke Detector 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Date Water Well, Disconnect, Electrical, Plumbing Card B-1 Date Card B-1 Date Exterior Elec. Trim, G.F.I. Receptacle -Underground Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date 95. Card B-1 Date Card B-1 Date 96. Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Card B-1 Date Card B-1 41. Sills Proper Materials & Anchors Card B-1 Date Card B-1 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Card B-1 Date Card B-1 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Wal Is -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. Following Instld./Drive O Yes 0 No/Walks O Yes O No/Planters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler 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: 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.buttecounty.net\dds PERMIT NO. BP043375 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 11/29/2004 APN: 040-660-005-000 the Business and Professions Code, and my license is in full force and effect. � ,! License Class :c3%,6/ Li e Number Site Address: IOWA �r,V > � Dates oZ Conin c r: . Ma Indexv p i Description: re roof, 25 SQ OWNER-BUILD& DECORATION/ 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: MELINE, DICK permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 10005 MIDWAY signed statement that he or she is licensed pursuant to the provisions of DURHAM, CA 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 95938 she is exempt therefrom and the basis for the alleged exemption. Any 530-342-9117 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).): ❑ 1, 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: FOUR COUNTIES ROOFING 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, 3 CRUSADER COURT provided that such improvements are not intended or offered for CHICO, CA 95973 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530) 343-1416 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: FOUR COUNTIES ROOFING 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.). 3 CRUSADER COURT ❑ 1 am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 (530) 343-1416 Date: Owner: License #: 774554 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 Architect: * is issued. Engineer: I have and will maintain workers' compensation insurance, as quired 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: J •%U/ Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: Policy #:2-- 72 —0 9,= --© ❑ 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: '� (% 7 7 Applica ure worker compensation coverage is WARNING: ailure/eect unlawful, and shall sun employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of L? compensation, damages as provided for in Section 3706 of the Labor � code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte Cnunt Cody . nrt/or I hereby affirm that there is a construction lending agency for the Resolutio 6 do ' ^work 'n cated a ve r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) O Name: By: Date: PERMIT EXPIRES ON: O (Dalo Address: ❑ 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. 1 hereby authorize representativesofButte County to enter upon the above mentioned property for inspection pu S. Print Name: -� Signatur v C�L���l ,�S %����f [LN Date: ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor . BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT'SERVICES NO. BUILDING PERMIT APPLICATION * AND SUBMITTAL REQUIREMENTS, BPCV5377, 24 HOUR INSPECTIONM OROVILLE::(530) 53877636 �,CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 BIN # A FEE WILL BE REQ UIRED AT TIME OF APPLICATION APPLICANT NAME OWNER Namen -e Address croc) �. City [) Fax State "'959 3d Phone 34d - q 1 I 1 Fax E-mail Planner APPLICANT NAME CONTRACTOR Name FOuf COU tf I'1 ,°S Ua F Address 3 C a,4_Sode. C •T City U Fax State C A Zip qS Phone 343 — 1 LA Ito Map Book Fax 3 y 3-- 5 3Q y E-mail Planner Uc. #17y 155q Class C 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 _ Address City State Zip Phone Fax E-mail LOCATION AP#. o,y 660 Property Address dui Cross Street WORKER'S COMPENSATION Policy Number - o0C)o5"13 —200 Carrier rif hiring anyone other than license contractors, a certificate of worker's ompensation must be shown at the time of permit Issuance. LENDING AGENCY Name Address Description or Scope of Work: rwf wjcoLtj2o&- b Sq. Footage -� ❑ 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 - 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 APPLICANT SIGNATURE - I r I refundable. For office us onl : Zoning Flood Zone SRA Yes No Occ. Type Const Subdivision Name Map Book .Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS Received by: Amount / S"z'� Bldg r�� c Receipt #: q15 6. II Date: 1112 �Lo�l Total I I K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 4-30-04 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7.County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. D 9 7=9f ASSESSOR PARCEL NUMBER 40-30-42 ZONINfo . . BUILDING PERMIT OWNER E. Richard Meline TELEPHONE 342,-9117 SO. FT. DCC. BUILDING VALUATION 42 150 6,300.00 OWNER'S MAILING ADDRESS 10005 Midway, Durham 99538 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 1$6,300.00 Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 62.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ',$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 72.50 PLUMBING PERMIT Filing Fee 10.00 10005 Midway Durahom Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping - 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE '.SF [J Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer. 5.00 Mobile Home S I G I IN O.00ea TYPE OF WORK New ❑ Addition [:]Remodel [:]Utilities ❑ Installation❑ Other [ X Describe work: RecoOf Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service sooV OR LESS 100 AMP OR LESS 10.00 Main Service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p l y (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. ' (� I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. (DWELLING occuP.e,) OR ADDNS. \ ACC. SLOGS. , �20sgIt NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUSe SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES zoesoe eAL@30 Ex. Occup. out ETS P(RESID )REA.7 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ® The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. - ❑ Ishall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. ---��� r?-3(�-9� X Date Agent ❑ Signature of Applicant — Owner Contractor 11 Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ _ Energy Inspection Fee $ occ iTOTAL CONST TYPE FEE $ — 72.50 HAL. I I CUA I PARK I SCHL I FLo I CDF I PAR I PD ) HD. 111L I ISSLO This permit is hereby issued under the applicable provi- sions of the Butte County -Code and/or resolutions to do k indicated above for which fees have beenaid. p D:REirs'TIi F PUQ.0C4ORKS If BY r Date PERMIT EXPIRES Date - Receipt No. 9726& WHITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT ZCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 40-30=42 ZONING BUILDING PERMIT OWNER E. Richard Meline TELPPHONE 42-9117 Y SQ. FT. DCC. BUILDING VALUAT[O 42 ` 150 6,300.00 OWNER'S MAILING ADDRESS 10005 Midway, Durham 99538 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 1$6,300.00 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 62.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 72.50 PLUMBING PERMIT Filing Fee 10.00 10005 Midway Duraham Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping * 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other Describe work: Reroof Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUsIneSS and Professions Code and my license IS In full force and effect. License No. Classification. �] I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.M OR ADDNS. ACC. BLDGS. , /z¢sgft NEW CONSTR. ULTI.OUTLET NON.R ESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. p OUTLETS TLETS OR FIXTURES Ex. Occup( 20050C eAL*30 FIXED APPLNS. Ex. DCCUp. OUTLETS ((RESID )REA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): X The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date �'-3a-9/ Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TsOTAL FEE $ - HAL CUA PARK FLD cDF PAR PD l HD• ISS This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work ind' ed above for which fees have been paid. DIR,TPF PU 1 ORKS IAM 19 BY _ Dat Q PERMIT EXPIRES Date eceipt No. 97268 NI TE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT F 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 b d prior to permit issuance: (Circle new item not checked above). 1. Index permit for at ve ' s No. 2. Additional items- ouired:_. Contractor, designer, owner, was advised of above required data by_phone_-tlaiI—counter Contractor, designer, owner, was advised of above required data by—phone —mai I—counter Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder 1M ..date date Date COUNTY OF BUTTE. - DEPARTMENT OF PUBLIC WOIRKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLOCALI&PINIA 95965 - TELEPHONE: 916/538-7541 . i PERMIT APF.416"O "ON,, DATA SHEET I OWNER Permit No. o. Proposed Building Use Building Inspector Date At timXoErmit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 1. DATE RECEIVED APPROVED All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans......... 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ...................................... ' . . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ..........:... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation. instructions...................................................I.... 10. Fees of $ .................. r`r ... 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .............................................. 13. School District fees paid ............. . 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ................................:..... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: -4!(B) Parking:r...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval'required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications .. 22. Certificate of Workmans Compensation Insurance '....... 23. ........... Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement .:....... 25. Letter of signature authorization ......... ........................ 26. # 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for i,at office. Deliver w/inspector. Other + Applicant .Date Copy of Haz-Mat form sent Health Dept. - Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must b d prior to permit issuance: (Circle new item not checked above). 1. Index permit for at ve ' s No. 2. Additional items- ouired:_. Contractor, designer, owner, was advised of above required data by_phone_-tlaiI—counter Contractor, designer, owner, was advised of above required data by—phone —mai I—counter Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder 1M ..date date Date COUNTY OF BUTTE - QOARTME OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT ASSESSOR P C L NUM —� ZONING `' BUILDING PERMIT OW R IrlC / / ii TELEPHONE a -9�/ SQ. FT. O BUILDING VALUATION OWNER'S MAILING ADDRESS o s Md g -1,44 yn CONTRACTOR'SNAME TELEPHONE Ste/ CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING _AD1�� (off SS / l Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping * 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFDuplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S FG FW 110.00 ea TYPE OF WORK New Addition❑ model UUttiliti ❑ Instal Other Describe work: ��(/ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. AOD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): r_1 I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCIJP.p DR ACDNS. ( ACC. BLDGS. , 2/z¢sgft NEW CONSTRESID, BRANUL CH NON-RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES eLO 2ALO 30 FIXED APLNS EX. OCCup. OUTLETS P(RESID.R IEA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subjec to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIirig Fee 10.00 Heating Cooling g I Hood 3.00 I Ventilation Penult Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or Construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CDNST TYPE TOTAL FEE $ HAL. I CUA I PARK SCHL FLc CDF AR PD I HD. ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. WHITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLD ENR00-APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive,'.Orbville, CA 95965 OWNER -BUILDER VERIFICATION Phone: 916-538-7541 Attention Property Owner: _ An 'owner -builder" building permit has been applied for in your name and bearing your signature. . 1 Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. -'l. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes ae--re) / 2. I (have/ham*)/v �. signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. )I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work /Signed: Property Owner Social Security Number - / Date 9"-,, iC9 — 9 / NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. 'PERMIT NO. 3190-78B PERMIT EXPIRES ©d�/ OWNER Dick Meline '-CONTR. owner LOCATION (A P. 40-30-42 W/S Midway, app.2/10 mi.N.of overpass,CHico t r y- i- r Temp. Power Pole` O E Called PG Temp. Elec. Serv. Calle PG&E Temp. as Serv. .,ailed PG&E J B FINALED (Date) (Signature) d�— . - � .� '- �. _ .. ..".r� � � �. L .� r ... .. r - t .. . �� ,� � .J�tnGt� .� 1� "�.�. �.�: rot � s � .��=•i: t,:%n + ,. �� _ .. e � �s i., . � '' t � � +� ,. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Atback 7 —'S` ^ Firewall SolI Piping rms ain Bldg. Para ets Restroom Finish 1st Floor 2nd Floor Footings Windows 3rd Floor Stemwall Sidina To out Slab Roof Sheathi Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings —j 8 Garage Vents Water Htr. Stemwa l l I Insulation Heaters Slab Carport Footings Prov, for physically handica ed Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIAEPLACE Final Footings Footing EL CTRICAL Aasonr Walls Throat Rough 11-1 Reinf. Steel Final Fixtures Bond Beam F E SPRINKLERS Motors Framing — Test Water Htr. Stucco Final Subpanels Mesh k MECHANICAL Grd. Fault Prot. Scratch J IV 1 Heatinn Service wn Cooling Temp. Pole inIS Ducts llndarnrmmd Interior Lath Ventilation F Permanent Door Closer Final Final MOBILEHOME UTILITIES -- Elec. Service Elec. Pedestal Water Piping I Sewer Gas Piping MOSILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec Continuity Water Piping Drainage Gas Piping •' OR • • T-2 / J (NOTE: An entry must be made on this form each time you visit the job site.) j CER IFICATE. OF CONFORMANCE HE UNDERSIGNED MANUFACTUREI- EB Y'CER TIFIES that the products identified below and on attached sheets Nos. are marked -with the collective mark of the American. Institute of Timber Construction (AITC) and are manufactured in accordance with .the manufacturing and fabricating provisions of Chapter 25 of the URMT Building Code, for glued laminated timber, -as modified by ICBO Research Report(s) No. and that such manufacture has been at our.plant in $ , which plant.has a quality.contr*,l system approved by the -Inspection Bureau of the American Institute of Timber Constraction"and, ftected,periodical ly_by such Bureau. The undersigned mariufacturer— - ---- further certifies that the w9rk 1iii been done in'a cordance with the applicable job specifications. Westetu Hemlock 40ties wM lk" OAA apecifte grwity tag cr =praaalon fate VVI 0.43 , 0 -0.40 tpecific gravities bottom or tonsiom face in ations. JOB NAME: Li ngfeZ`lem Lrw, to :it upet. No— iof Or JOB LOCATION:, Oft . SStd4 t -the Xt2 wy9 , nnj`h5o$# CA%, CUSTOMER'S ORDER NO. A DATE , # 8 MFGR'S ORDER NO. -151901'Q!.► —9 SIGNATUREF �^!•G"t'_ s:�.f1 �y� �S=r%✓!� J COMPANY--- STMDARD STRUCTMS, I14C. TITLE QUAUtg C=trOl PlAtO ADDRESS 922 Shiloh iia DATE 7t!2/78 W AI TC HEREB Y CERTIFIES that the said company at its said plant is licensed by the AMERICAN INSTITUTE OF: TIMBER CONSTRUCTION to use the AITC Collective Mark in respect of products which comply with,applicable_provisions of said code -,and report(s), :that-the adequacy of`tI-e quality control system in effect at'said plant is period_ ically inspected and verified by the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and- that, in the judgment of the'undersigned, said company,is capable of complying with applicable manufacturing and testing provisions of said code and report(s) in respect of products mariufi" tured at said plant. Conformance with the said code and report(s) in respect of any specific,or particular product is the sole responsibility of the manufacturer; AITC's certificate hereunder being that the said company is qualified to produce a product meeting the said code and report(s) and that its plant is periodically inspected and verified by the AITC Inspection Bureau. {� AITC Certificate No. C 3UO3 Signed'for AMERICAN INSTITUTE OF TIMBER CONSTRUCTION Paul R. Beattie Jack Minneci Executive Vice President Manager, Inspection Bureau © 1977 AMERICAN INSTITUTE OF TIMBER. CONSTRUCTION AITC FORM IB -3-77 1: ~' IN".UICE 38 Structures once DnvelopmnBmte,Ways To Build ^uBOX ^ SANTA nvx^ c^u,oxwmvmv 1707) 544-2982 c^upunw.^cuwrn��onsuc�wss m NEVADA CONTRACTOR'S LICENSE NO. 10475 C40 RESIDENCE 1ST HOUSE NO OF OVERPASS ON W, SIDE THE MIDWAy DURHAM CA LONGFELLOW LUMDER 1388 LONGFELLOW CHICO CA 95926 ' AITC S IwSP. PAID BY I,�� ' wF «PPF --AR AR � FINISH LAM T�!CKmE��cpm��B 24Fos��DS JOB NAME LONGF.4O�7 ` JOB NO. V—H-159O1—IG-9 oArsomppsm �v/x SSI#17 CHECKED BY �XRIOR_ ' FOB TRK CLOSE TO JOB ---~--r� . «�SHIP------�--~�-�-----' . SPECIES ` wpAP. TREATMENT inuV WRA� NONE SP SPECIES .."".. TE ` ~ ID MARK ORDER DATE WIDTH C') YOUR ORDER NO. LAM LENGTH(' UNI I INGS REQUIRED oArsomppsm �v/x SSI#17 CHECKED BY �XRIOR_ ' FOB TRK CLOSE TO JOB ---~--r� . «�SHIP------�--~�-�-----' . SPECIES ` wpAP. TREATMENT inuV WRA� NONE SP SPECIES .."".. TE ` ~ ID MARK QTY. WIDTH C') DEPTH LAM LENGTH(' UNI I COUNTY OF -BUTTE — DEPARTMENT OF PUBLIC WORKS 7 -County Center Drive — Oroville, California 95965 Telephone: 544-4541 APPLICATION AND PERMIT (( A authorize representatives of the County of Butte to enter upon the �g above- ,pntioned property for inspection purposes. ' Date r✓ C Signature of Permitee or Agent Receipt No. / Z246149 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,RUBLIC WORKS BY a 4,17-7Z Building permit expires Date BUILDING Owner 16A SQ. FT. OCC. BUILDING VALUATION .&o C6,Q0 Mailing Address Telephone No. Contractor Mailing Addressot-cu NAJLl Fireplace Total Valuation 01 6 Telephone No. Permit Fee 045 ' Building Address2he 6, Plan Checking Fee &/or Penalty Permit Fee O PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. ©— SG _ Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F Sa Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Parcel Plans Declaration Parcel Map 1 60' R/W I Imp ro ments Each additional outlet .30 sewer 5.00 Bldg. ens Recd /Building ParcelLA roval ens Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ Permit Fee $ $ Z-7, ELECTRICAL No. @ FEE PERMIT FILING FEE - $3.00 Single Family Mobil Home Others ❑ � Main service 600V OR LESS loo AMP OR LESS 5.00 CSS Main service EA. ADD100 AMP 2.50 / Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONS. DWELING OR ADDNST ( ACCL BLDGS.CCUP. !) 20 Sq ft 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 style of: Y NEW CONSTR.S,D. -CUTLET NON.RESID ( BRANCH CIRCUITS) 2.50ea NEWCONSTR./POWER APPARATUS NON -RESID, \SINGLE OUTLET C.. Ex. OCCUP(OUTLETS OR FIXTIIRES BAL01W Ex. Occup. ( ) (OUTLETS P(RESID )REA 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 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. 1( 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 No4 @ FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 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 $ TOTAL PERMIT FEE $ �C authorize representatives of the County of Butte to enter upon the �g above- ,pntioned property for inspection purposes. ' Date r✓ C Signature of Permitee or Agent Receipt No. / Z246149 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,RUBLIC WORKS BY a 4,17-7Z Building permit expires Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR.PARCEL NUMBER ZONING BUILDING PERMIT OWNER •f , TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS ' / ; ! /I" , Fireplace CONSTRUCTION LENDER UNKNOWN_ _ Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 So l ar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W I 10.00 e T_ TYPE OF WORK New ❑ Addition ❑- Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: '' ' r - Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 • Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. t 2/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR U TI.OUTLET 2,50 ea NON-RES,.BRANCH CIRCUITS) NEW CONSTR / POWER APPARATUS & NON-RESID. %SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES .0@501 ALO 309t FIXED APPLNS. OR I Ex. Occup. OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ occUP. GROUP I TYPE OF CONST. F PARCEL PO HD SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By' f /. % PERMIT EXPIRES Date •� the applicable provi- resolutions to do fees have been paid. WORKS Date '•", �.� �� / - Receipt No. .. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSES $,{SRC N11MBE U� (/// ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS C TRACT 'S NAME ITELEPHPNE QZ- CO TRAC R'S MAILING ADDR SS Fireplace CONSTRUCTION LENDER UNKNOW / .(/ Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER Ir LICENSE No. Plan Checking Fee $ Penalty $ ARC ITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water. heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W 10.00 Be TYPE OF WORK New ❑ Addition ❑ emmo�odel ❑ Uttii Iiitties ❑ Instal l'ation ❑ OtherR2_-Contractor Describe work: s-�it !�'� �/ Se'l�� G(�l �'� ••����G/// ! Permit Fee $ 740, 0 0 ELECTRICAL PERMIT Filing Fee 10.00 Main service 8 100000V OR LESS AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.11 OR ADDNS. ACC. BLDGS. t 2/20sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): EX�j I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professio s ode and my license is in f't�'aI, I force and effect. �j �`^ �( ^ ,) License No. �` 7 5711- Classification W w — \ -- Y `/ ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CO ID R. BRANCH CIRCTITS. 2.50 ea NEw CONSTR POWER APPARATUS &') NON.RESID. (SINGLE OUTLET CIR. / zo®s00 Ex. Occup(o OR FIXTURES SAL®ao FIXED FIXED APPLNS, OR EX. Occup. OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIirig Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, posts, and expenses which may in any way accrue again id ounty in sequence of the granting of this permit. %� Date ��rZ '� 3 Signature of Applicant — Ow r ❑ Contractor ❑ Agent ® An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ O v OCCUP. GROUP I TYPE OF CONST. PARCEL PD I ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which D CT R OF PUBLIC B PERMIT EXP the applicable provi- resolutions to do fees have been paid. WORKS Date '2 / Receipt No. X7-2 d ,/ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT vi PEr*.MIT NO. 1642-78B PERMIT EXPIRES _ OWNER Dick Meline. CONTR. owner LOCATION (A.P. 40-30-42 ) W/S Midway, app.2/10 mi.N.of overpass,Chico k ' lj ii b, ?.; - c' a • �C 4 I• r , Temp. Power Pole ?' Called PG&E J Temp. - ec. Serv. :. C led PG&E _ Tem . Gas Serv. Called PG&E - ti • OB FINALED • � (Date) - -- - - - -- - - (Signature) - - — COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS - BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) Setback PLUMBING 1-17 4. Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footin s Windows 3rd Floor StemwallE.E Sidin To out Slab Roof Sheathing Water Pi in Piers Roofing Sewer Gara e Final Sanitation ...dcco Fun. Vents Fixtures Footin s Garage Vents Water Htr. Stemwall Insulation Heaters Slab Prov. for ph sical Appliances Carport handica edy Under round Footings �-5��% Conformance of ex. Gas Pi in &Test Door Closer structure Temp. Gas Slab Final Sanitation Patio F EP &CE. Final Footin s Footin ELECTR 'Son r Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRESPRINKLERS Motors amin Test Water Htr. ...dcco Final Sub anels Mesh IdECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTI (TIES - - - - - - - - - - - - - - - - - - Elec. Service Elec . Pedestal Water Piping Sewer Gas Piping MsILEHOME INSTALLATION - - - - - - - - - - - -- - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY Ofi'BUTTC — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Tel ephone:.534,4561 /lo,Y�-7P APPLICATION AND PERMIT BUILDING OwnerG E SQ. FT. OCC. BUILDING VALUATION Q Mailing Address �D 3�� / Telep�_ne ��fL Contractor Mailing Address Fireplace Total Valuation Q, �jp Telephone No. Permit Fee O Building Address dr &ale Plan Checking Fee&/or Penalty Permit Fee 67 L i dl S'' PLUMBING No.1 @ FEE C PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 q A. P. Q Q �L Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 s C. Fire Dept. FireZone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 BI g. Plans Rec'd Parcel ApRLoval Plan Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 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 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 NEW CONST.( OR ADDNS. ACCLBLDGS.LING OCC UP. �� 20sq ft 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 $t %) le of: NEW CONSTR BRANCH CIRCUITS) NON.RESID (MULTI BRANCH CIRCUITS 2.50ea NEWCONSTR. POWER APPARATUS 6 NON .RES I.. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXT11RES g @2j E x. 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 $ $ 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 •tet 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. FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 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 $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above- ioned property for inspection purposes. X r- Date Signature -ooff ermitee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby is$ued 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 U- LIC WORKS By B tiding permit expires Date