HomeMy WebLinkAbout041-110-025a' �' � e, 1.�"� i 4 mac! � � , - r #�!�' � 1�F` -r Y! p� hi.'J��a�f��.'.,}afei 1 J' t4...t �`� �•.'t ` } - r ErC� i%, `.Fk•�' (��'x"C� 3T'{ F.
j :.t�t F ,r} r :. f .. • tk;' H �+y#, t , i<• tl i _. �: ^' - t y .. i• !} d e :t rFFp f�rS.,},i>,
} c:. �,u..•"... � tae: il:..:' � ,» a _ t:ra, n +CI ` ,li-,s• � t i � 1 ^ 1 1 1 1 � •_ � ! t C �r � { ,F kt Cr rL � ;. F� Y Yf� ;i'
e.If3j} rIOWA
a }tit;
COMPLAIN' t i _'i -Fs z t-
!a 4
�1 � r � `;,' • � r 1!t I�i�!!a r it � €,' i � 7•;�a K+ y
�{r1 1 r / In,
Sr, � ijp ,a 4't' j.iar•t �' x �..-t4Ft,� ; , > yt. � S '
1 DAY LETTER3r1;"i r t •-'{ '; t Gl t' F t r{} 4a _' '�.
i s' hi . int �a it r( 7� xn �1 l,; t Ift t Iz t f t� x
3.' `- P 1 4k Stti t a t 4 i-' t r
' � }' it 4 Cr I
ABATED OR CLOSED
Building 1 4•ViolationIC jGr r y j tC a
+ Complaint
30 day violation letter
1 1 day violation
• .. -. or • -.-
•
••i f., t ry 1. r tf,. r-
77
a S
t
x el
4.-+r^a.ix+_..a.•--. � .rt•. e.-.• .a.s� { +. 3.— a i-" �.. v 4k iR },. !• {� 4 F...
t
� a �1 • x ,, �� t' � 4
04
'O•
a ,. 4 q t'S,,.. t x L
{ ! '1 •t,+y)" t + Aey} t-.. mow.: +`tel. _ 7 `:i t �3 '9� 't lar ; Tfy z; F a ` 'i`r
it `{ '`;h5 t 1 S ` ta"..', e .lr44t3 t ���;. t.^:•�, 3.,c Irf Tr ,t', '�,_•. - i - 'F""i,. 4y4d:. h.�xp� ,'.: •. ahit �t' •dCf .- t .. 'r as'.
041-110-025 06-2039 S.
MAAS, ANDREW
'. 2833 MESSILL•A VALLEY RD, oTrf� wF"
NOTES OROVILLE , .. _
Cont: OWNER
;. y. 4ELECTRIC x ''
H. RESIDENTIAL
AP N: i ,Permit No
.Owner
Site Address:
F
Contractor_
t
i Type of Pemtit.-
i
- i
f OFFICE COPY
Address
77 GAS Date-,
Meter By
' ELECTRIC pat
Meter By
J
SPECIAL CONDITIONS
CHECKiED BY
SRA
FLOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUBSTANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
M
n<s ` DATE JOB FINAL ED: � t ' (
------------
r „ �. � ;'SIGNATURE: -
+=OK
-
a =. Not OK -
-
.
t
MANUFACTURED HOMES
MI=SCELLANEOUS-,.,
DATE I Li PERMANENT FOUNDATION SOFTSETs
"'--DATE
IDEC K S'C O V E R S'C A R P O RT S *G A R A G E S
1 ZoningSetbacks-Easements
1 ZoningSetbacks-Easements
2 Soils; Special MH Support Sketch
2 Figs; SoilsSz-DpthSpacing-CnnctrsSteel„
3 Sewer Loctn-Test; FalUC/0-Concrete
"3 Decks, G1rders1Joists4Dc1gng-Brcing
4 Wtr; Loctn-Test-Easement Needed -Regulator
'Amp
Stairs-DuardlHandralls . -
4 Wood Awn; Posts-Beams-RftrsSnnctrsShthg,
5 Elec Loctn-DImcs-Gmd -Concrete
6 Yard Gas; Loctn Test -Wrap Nat Q or LPO
Frmg-Brcng -
Inch Sz Ft Lngth
5 Alum Awn; Columns-Cnnctr sSplice-Decal-Encism
7 Blckng; SzSpadng-Marriage Llne
6 Carports; Wndws-Doors R
8 Gas; MH Test-Demand-Valve-Cnnctr
7 Electric
9 Ekec MH Cntnty Test•Crossovers-Breakers-Clmcs '
.8 Frmg; Sills-AnchrsStuds4birs Tnisses
10 Drain; MH Test -Fall -Flex Cnnctr�
9 Siding; Nailing -Veneer -Stucco -Lath
11 Wtr & Sewer Connected -CIO to Grade
10 Roof; Shthg-Roofing
12 Gas and Electricity Tagged
1
Al Ezt; Steps-Doors-1andditgs
13 Tie Dowgs, Q Foundation ❑
12 Braced Wall pnis ;
14 Exits '
15 Cert of Occupancy
16 HUD Label/insignia Numbers Serial Numbers
DATE
POOLS
1 Setbacks -Easements
}
2 Soils; Compaction -Structure Stability
-
3 Pool Structure; Steel-Cnnclus-Thickness
Dead .-Men-fining'-.'
4 Elec Rcptdsllting; D•rstance-GFI
5.E(ec Pool I ting;15 volts -GR
6 Elec.Enclsrs; Conduit Entries-Tgradnals-Disted
7 Elec Bonding; Metal w1.7-Crdtag EW-Htr
•
8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg
E =%es ncisrs-pnlboards4nsultn-to Main Conduit
'
t
' 9 Health, Dept APpM
10'*Plmb; Cir Test4ft Supply Test
4
.
• 11 Lt Niche ,
12 Enclsr, Fencing Alarms
13 Bonding, Diving board or Slide
.
t
1
= Not OK
RESIDENTIAL
DATE JUNDERFLOOR
1 ZoningSetbacks-Easements-FloodSlope
2 Ftg Main; Sails-Elec Grnd Ftg Dpih
3 Ftg Garage; Soils-Steel-Elec Grnd " l-tg l)pth
4 Ftg Parches/Decks; Soils -Steel Ftg Dpth
5 Stemwalls Main; Steel-Blockouts Wrapped
6 Stemwalis 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 AnchrsSzTest
11 Wtr Pipe; Test-Anchrs-RgltrService Test
12 Elec Undrgmd
13 Plenums & Ducts; Clrnc-MaterialSupport-Insults
14 GirdersSills-SillsBoltsJoists Vnts•Cripples
15 Acc & VnUtn
16 insulation
DATE 1511AMING
17 Silts Proper Materials & Anchrs
18 Walls Studs -Nailing Spacing & Braces-PlatesSound
19 Bearing Walls ovet Girders :P, ftr Nailing
20 Draft Stop to Walls (rat proof),
21 Fue Stops; Furred CeitingsStairs-Chasers Tubs
22 Headers & Bearhs.a! &•Bearing -
23 Hangers-P•osf'Caps-Anchrs.Cimc6ns
24 CeI1iing JoW-RitrTi s-Purl'i--Roof Brac TnusShthg
25 Frple Ties or Type A Flu'&F ' le Throat Clrnc
26 Attic Act~ Sz &'Rimi Pith -Draft Stop -Ins Baffles
27 Bdnn Wndws or. Exiting Doors -Sill Flt & Dimensions
28 Garage Fire Prtchi Framing -RCC CFrarlrtel
29 Prprty Line Firewall & Opngs' .
30 Ext Doors -One 3' -Check Gauge 3r4 Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Run-Landiing-Fire Prtctn
32 Plywd on Roof Ovrhng-Attic Vnts4ft Outrgrs
33 Siding -Nailing Veneer
34 Stucco Lath Weep Screed-Fndtn Vnts-Undrfir Acc
35 Glazing Are PrtctnSkyLts-Plastic
36 Shear Walls; Nailing -Bolts
37 Brace Int%Ext Wall pnis
38 Insulin Walls -Ceilings
39 Infiltration Walls-Wndws
DATE JELECTRICAL
40 Fxtr & Tmsfmu Clrnc-Ins Prtctn
41 Elec Rcptcis Spacing-Dts & 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 to Ktchn & Cndctr Sz GFl
47 Subfeed Wire Sz Qa QCU or [_
AC Wire Sz ga D CU or ❑ AL
48 Range Circ oa ❑ CU or ❑ AL
Oven Circ pa [ICU or QAL
Insulated Neutral F-1 Yes 0 N
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp Clmes pets -Motors -Meth Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
ooe 0 941
Single & Duplex)
DATE PLUMBING
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr Nail Prfctn
56 Shwr Pan; Test, Fust fir -Tub Acc
57 Test Tub• & Shwr, 2nd fir - Tub Acc
58 Gas Pipe; Sz & Anchrs
59 Fire Sprinkler; Test
60 Yard Gas Piping
o'
Ile
DATE
�s
0
DATE MECHANICAL
61 AC Ducts Insulin & Support
62 Vent Fan, Exhaust abv Insulin
63 Condensate Drain & Ovrfiw, Sz & Grade
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrin if Furnace In attic
o+t mss}—� o' Sys
DATE FINAL
66 Ext Steps -Door & SldeLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Clmc-Comb, Air-Cnnctr
In Garage; abv-fir-Ducts-Meeh Prtctn
69 Bedroom Exiting
70 GFl A Bath Fxtrs & Tub Acc-Spa
71 GFl Arc Fault
72 Elec Trim & Subpnl, Breaker Szs & Labels
73 Stairs, GuardlHandrails
74 Frplc or Stove, Cimc-Hearth
75 Elec Outlets at Wood Pnl, int & Ext
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc
77 Elec Outlets & Rcptcls at Ktchn Counter
78 Garage Fire Door, Swing -Landing -Closure
79 AC Duct in Garage -Damper.
80 Wtr Htr. Vnts-Dimc-Com Air Cnnctr-PRV; abv fir
Mech Prtctrr; LPG Appince Undr House 3' drain
81 Plmb; Elec & Mech. Eqp Listed for Loctn
82 Elec Rcptcls in Garage (GF) Romex Prtctn
83 Insultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth
86 Clmc Dmge Planters Q Yes 0 No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, PImb.Appinc-Frplc-Cimc to Opngs
90 Wtr Well, Dsennc% Elec, Pimb
91 Ext Elec Trim, GFl Reptcl-Undrgmd
92 Vntltn thru House
93 Glass Prtctn
94 Corrections from previous litspctns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99 Fire Sprinkler
BUTTE COUNTY PERMIT NO.
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT BP062039
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: 08/24/2006 APN: 041-110-025-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Site Address: 2833 MESSILLA VALLEY RD ORO
Date: Contractor:
Map Index:
Description: INSTALL NEW ELECTRIC
p
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
SERVICE/MAIN BREAKER
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
Owner: MAAS, ANDREW
signed statement that he or she is licensed pursuant to the provisions of
4973 DURHAM PENTZ RD
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
OROVILLE, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95965
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
Code: The Contractors' State License Law does not apply to an
owner of property who builds.or improves thereon, and who does
Applicant: MAAS, ANDREW
such work himself or herself or through his or her own employees,
4973 DURHAM PENTZ RD
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
OROVILLE, CA .
year of completion, the owner -builder will have the burden of
95965
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor:
pursuant to the Contractors' State License Law.).
under Article 3 o th Bsines a Professions Code
❑ I=Tt
Date:N caner:
ORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #:
❑ 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
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
-Total Square Ft: 0 S. F.
Policy #:
Valuation: $0.00
I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
Census Code:
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 compl with th se 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.
c — j
CONSTRUCTION LENDING AGENCY
This per is her�b sue under tfLplicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutions to dd\w rk i cated above r which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By: Dat
Address:
PERMIT EXPIRES ON: V
DateJ.'
❑ I 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
autfforize represen #lives f Butte County to en er upon the above mentioned property for inspection purposes
Print Name: Signature: _J/ 4�/'/
Date:
Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor -
B. C. Building Permit 01-16-04 pg 1
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.
BP062039
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: 08/24/2006 APN: 041-110-025-000
the Business and Professions Code, and my license is in full force and
effect. -
License Class: License Number:
Site Address: 2833 MESSILLA VALLEY RD ORO
Date: Contractor:
Map Index:
Description: INSTALL NEW ELECTRIC
p
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
SERVICE/MAIN BREAKER
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
Owner: MAAS, ANDREW
signed statement that he or she is licensed pursuant to the provisions of
4973 DURHAM PENTZ RD '
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
OROVILLE, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95965
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).):
J 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
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
'Applicant: MAAS, ANDREW
such work himself or herself or through his or her own employees,
4973 DURHAM PENTZ RD
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
OROVILLE, CA
year of completion, the owner -builder will have the burden of
95965
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor:
pursuant to the Contractors' State License Law.).
❑ I am xe t under Article 3 o th B sineWal Professions Code
Date: N caner:
ORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft:' 0 S. F.
Policy #:
Valuation: $0.00
I certify that in the performance of the work for which this permit is
issued, I shall not, employ any person in any manner so as to
Census Code:
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 comp) with th se provisions.
Date: '7
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.
`
l j-(/ p o�
t
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
This permit is herb sue under t plicable provisions of the Butte County Code and/or
Resolutions to dr�o rk i ca ed above r. which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
to
Name:
BY Dat .
PERMIT EXPIRES ON: V
Address:
Date) ' -
❑ I 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 represen atives f Butte County to en er upon the above mentioned property for inspection purposees
Print Name:Signature: 4!-9�'�
Date: s
Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR 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.neVdds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name .44
irst,IJ� l � ar�g E (,A)
"/)
Address �
q0 -71N C -,e Z
City J %`�
12tan, �� -
Zip J C, �, s
Phone Q3 - t 76
Fax —_—
E-mail
APPLICANT SIGNATURE
X a U ' _� W t_�
For office use only:
CONTRACTOR
Name
ow
Address
J�
City
Zip,, S
SII kS
State
Zip
Phone
E-mail
Fax
E-mail
Y�
Lic. #
Class
APPLICANT SIGNATURE
X a U ' _� W t_�
For office use only:
ARCHITECT/ENGINEER
Name
t1M,
Address
J�
City
Zip,, S
SII kS
State
Zip
Phone
E-mail
Fax
E-mail
Y�
State License Number
APPLICANT SIGNATURE
X a U ' _� W t_�
For office use only:
APPLICANT INFORMATION
Name
Address
t1M,
City
J�
Sate_
Zip,, S
SII kS
Phone
Map Book
Fax
E-mail
Planner
APPLICANT SIGNATURE
X a U ' _� W t_�
For office use only:
Zoning
Flood Zone
SRA
I Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
6-)b 6-3
BP
BIN #
PROJECT LOCATION
AP# L� �
W- O �
PropZ Ad3re3ss ' l[ L of
C' �P
Receipt #:
Cross Stet j
Z
WORKER'S COMPENSATION
Policy Number
Carrier
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
Descrip 'on r Scope of Work:
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: Amount:
Bldg
(�� X
SRA
Receipt #:
Sheriff
yj to
SMIP
Other
Date? aL � V�
Y�
Total
Page 1 of 2
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The.following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No 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
K WORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05