Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
041-420-014
0 41-42-14 P.A. LAWRENCE &-WILLIAM BE RD �o1ii1 3110 Clark Rd, Paradise, /► Permitl13397-83E(ele ser ch & mjsc wir)SF 41-42-14 Per ' #625-86P,E(MH(MH Uti�l) ELEC. , 04 . AS 3V SUPPORT STRUCT REQ., COMPACTION TEST RE b 4`i'>42, ` - Permit' #626-86B(demolish 41-42-14 Contr; Gera oremu- Permit�k 6-86MHI su Ssu .y `. '� r ., �- �,�-m�:ti:�-: • PERMIT NO. ' ' 66j25-86P,E(MH) PERMIT EXPIRES (/ OWNER WILLIAM BET HARD CONTR. OWNER - ,+ ASSESSOR PARCEL 41-42-14 LOCATION 3110 Clark Rd., Paradise f t z l e a f 1 t Temp. PoH"?" moi) ,+ , •r : 7# k~OFFICE COPY. r "..:,kti Called Address r t ` ' Temp. Eler .,l< •, .� zh d "a3, ;tri t l�gc�rY Called.�Meter'By Datil ELEGZ910�/ �f , WA Temp. Gasl Meter Dat V = ,OK O = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) * = Not Ready r Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Fig., Main; Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 49. Ext. Doors -One 3' -Check Garage=3rd.story, 2 exits 3.-Ftg., Garage; Soils -Steel- / /" Ftg. Depth 4., Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 50. 51. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection Plywood on Roof Overhang-Attic..Vents-Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers-Fireplace.Ftg.-Steel 54. Glazing Area -Glass Protect ion=Skylights-Plast ic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector Card -BI - Date. Card -BI Date Date PLUMBING (Permit) OK except M's _ 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection _ 16. 17. D.W.V.; Test-Fttngs & Anchors -Nail Protection Shower Pan; Test, First Floor -Tub Access 59. Bedroom Exiting 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels _ 19. Gas Pipe; Size & Anchors 62. Stairs & Rails _ 63. Fireplace or Stove; Clearances -Hearth 64. Elea Outlets at Wood Panel; Int. & Ext. Card -BI Card -BI Date Card -BI Date Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except p's 67. Garage Fire Door; Swing -Landing -Closer - 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection _ 21. 22. Elec. Receptacles Spacing -Lights & Switches at Doors Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. _ 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72, 73. Insulation -Foam -Looked in Attic ❑Yes Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl `sole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ;_,Yes El No Service -Riser Conductors & Ground -Main Disconnect 75. 76. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters Dyes ❑No Stucco; Brown -Finish 29. Equip. Clearances: Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet -30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. Card B -I Card B -I - - i - ------ t Date _ Card -BI Date Date Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Perrr,it) OK except N's, 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ 31. 32. 33. A.C. Ducts: Insulation &Support Vent -Fan: Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 85. Water & Sewer Connected -C/O to Grade -HD Approval 86. Energy Compliance Certificate -Other Certificates Card -BI Card -BI 34.• 35. Furnace -Vent Access -Comb. Air -Return Air Vent -115V outlet Attic Access & Platform if Furnace in Attic �- -Date Card -BI_ Date- Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: _ _ 36. 37. 38. 39. 40. Sills; Proper Material & Anchors__ Walls: Studs -Nailing, Spacing _& Bracing -Plates -Sound Bearing Walls over Girders & Floor_N_ailing_ _ Draft Stop in Walls (rat proof)_ _ Fire Stops: Furred Ceilings -Stairs -Chases -Tub 41.7Header 42. 43. 44. 45. 46. 47. & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnp.-Rfnp Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiling Doors -Sill Hgt. T5"- Garage Fire Protection Framing - (NOTE: Anentry must be made each time you visit jobsile) J J = OK 0 _ Not OK- Not K- NoReady MOBILEHO/�E1ES I MISCELLANEOUS Y - • r -n, Date MOBILWOME UTILITIES (PI s) 9K except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s P4ortiag Requirernents—Se cks—Fesement6 1. Zoning Requirements—Setbacks—Easements rt—Sketch 2, Footings; Size—Depth—Spacing—Connectors wer; Location—Test—F0 —Concrete j Q 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails @ter; Location t h) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rig.—Bracing le tricity; Location— C ear ces— d.—/ / Amp on 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures ocatio s / /"L"ft./ /'Nat-or/LPG 6. Carports; Windows—Doors tility Clearance 7. Elec. Card -BI Date Card -B1 Date Card -BI Date Card -BI Date Card -BI at Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except b's o 'ng Requirements—Setbacks—Easements Date POOLS (Plans) OK except N's 1. Setbacks—Easements ootings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. s MH Test—Demand—Valve—Connector 4 le Wcity; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4, Elec.; Receptacles and Lighting; Distances—GFI 5k6raIX MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. a)er; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7"atepend Sewer Connected—C/O to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater nd Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit E ' ; Insp.—Sketch 1 Ce of Occupancy 9. Health Department Approval i 10. Plumb; Cir. Test—Water Supply Test Card B -I Date,!r--(Q-r, Card -BI Dat Card -BI Date Card -BI Date Card B-1 Dat Card -BI Date Card -BI Date Card -BI Date AV l/ ( { r �OJSS -,7Z-- 11411il Cc.F�i Oil' /��djf•NJ ��u7��Le./ sA(v�AV9 /cvsE c�wr ? 5C ��tvd hof r COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 A routine Inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. if you have any question pertaining to this matter, or need additional explanation, please contact this office Immediately. Ing nar.trnr 0 / \,I — nate COUNTY OF BUTTE ' DEPARTMENT OF PUBLIC WORKS . 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and.Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Cid i / 4-7z df // f e 'j �i/ // / f /I'� Inspec r_ / Date ll G MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS. — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 PERMIT N0.'_ Address or location of mobilehome Owner's name Owner's address Insignia or hud number Manufacturer's name Serial number of V.I.N. (Official Approving Installation Year of manufacture — (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 2 APPLICATION AND PERMIT ASSE SO _PAPNU27 -[—lr !v�'/ /_L'/[� ZO Itj(Ki BUILDING PERMIT owN t fT _ E HONE SQ. FT. OCC. BUILDING VALUATION OW ER'S MAILI ADDRE S vl/ tea F CO ACT,O^^R' NAME Y/ & fT TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONST UCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 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 ADDRESS 61 to Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 rSolar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME { RCEL MAP rP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[]Mobilehome Other --SPECT FYd Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G 10.00 ea TYPE OF WORK ! New Addition ❑ Rel[-] Utilities Installation[-] Other E:1Permit Describe work: ��11.(/1�/✓✓\ 1 _ �/A 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 4 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): F1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. ense No. Classification RRI'l, 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., OR ADDNS. EI ACC. BLDGS. /20sq ft NEW CO ID R. BMU RANCH CIRCTITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(ALOUTLETS OR FIXTURES S @00 ALeso FIXED APPLNS. R Ex. Occup. OUT LETS IIRESID IEAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ V. 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. 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.shail be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 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 Countyot 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 @aid County in consequence of the granting of this permit. ' XI�,✓-4-R- ��I�-/�iA_ Date ~ �d , Signature of Applicant — Owner8Contractor ❑ 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 $ TOTAL PERMIT FEE $ Via. occuP. CONST,TYP1J FLoo ARCE PD J:of Is This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF BLIC .--� BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS —Date .46 Receipt No. _i 6 �S2 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT d. To: Building Department From: Environmental Health Subject: Sanitation Clearance Owner Location Plan Approved for: Sewage disposal Hold final for: Final clearance O.K. for: Clearance for �bedroom e home. NOTE *** Other S anit ari an. 57 Ll;2-/y AP// water supply water supply water supply TO: Building Department FROM: Encroachment Permit Section RE: 'Difteway Clearance VI 611 a vvl z ,- 1A eF,- 3110 /id '40-4-12- %/Y owner location AP # Driveway permit Aly been issued for the above property. number A—, oe signat a date OWNER 3 COUNTY OF BUTTE - DEPARTME•NT•OF PUBLIC WORKS - BUILDING DIVISION 1 4 7 COUNTY CENTER DRIVE - OROVILLE, CKtIIF©Rr�T& 95965 -` TELEPHONE: 916!/53 4-4541 PERMIT APPLICATION DATA SHEET jt ° - I Permit No. r j /lI 42 01 A_ f � a ✓') A. P. No. Proposed Building Used Permit Fee Based Upon: Complete Contract Price DPW Valuation Building Inspector/ uate � L -1y C./ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED All items plans n been submitted . . . . . . . . Plot plans in-dupa:icate replicate 3. Complete plans in duplicate/tri.plicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid'' 'Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . .0"Letter of signature authorizati itation approval from �Ov�, Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to ownerEl 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . . Pre-Inspec. request to NF_ Pre -Inspection for Required. Building Inspeytpr (cote) �C f Record 1ceLpt�zo A�f gird ,t k,.,onstruct�onmapproval required prior to occupancy r Other l When you issue the permit, process as follows:_ Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other �; Applican_D J��-e.�,�-1,L�, Dated Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above t tAme li a tion, cipcie item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by By Plans checked by - Plans approved by Other: Copy—DPW Telephone Mail Date Date . Date Other COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916=534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and,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. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) 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 — _--0 -. g ('� 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. NOT'. --All Materials & Accordance with Workmanship Of a qualit Recognized Good Prc Y Prescribed for the S ecified Uniform Building, Plumbingp the National Electrical Code. Mechanical This sef of plans ana specificofio kept on the job at all times and it ' make any changes or alterations ons written permission from the Departmi Works, County of Butte. Utility connections shall be within 4 ft. of the mobilehome, either directly behind or within the rear half of the roadside (left) of the mobilehome. A permit will be required for the Wdt-dation of the mobilehome. ge to s and in the �s and VIUST bE lawful to e without of Public ( P L A UT� , MR. W I L L i A M A. E3 E `i H�- RoUte1 fox I rad Orv,i'l I C Ca l t*, o Porf Ict, of +-k p- N. E. % of the N.vj. %4- [Iat�& wmE AAk3nf �� o %-N 2.1 , 1-,?, 1 tai . , R.3 5 . X14 v tot I~EBRUARY 19 4 SCALE i" A setback of)rft. from the property Innes and a setback &,2,s-8( of 50ft. from the road BUTTE COUNTY centerline shall be clear of structures or equipment except WILDING DEPARTMENT for a 2 ft. eave overhang. 4 `-oFA" 906e**'wa APPROVED 7E S.E. Cornar of N e.� N. 5c) 0' 54" E. of . N.W. /4 Sec. ZZ JOHNi W. I-IAMQY AND P,SS3C LICE-NSE1) LIEN 1� SJRVt Y ` r f V) IAA. T51 nc Return to DPW AGRICULTURAL STATEMENT OF.ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT '�} - _I',L II,`COF.,D':, Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. {ot'��RT `'SHOWN 'S6 -10G13 19:30 APR - 7 !;I I I I � ! The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this: c,.:�. �_ �- property may be subject to inconveniences or discomfort arising from LL�ttl�ui� Pr ���� - the use of agricultural chemicals, including, but not limited to herbici es pesticides, and and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should benorma re ared to accept such inconvenience or disconform from l P P P I.,. necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Being a portion of the Northeast quarter of the Northwest quarter of Section 229 Township 21 Northhange 3 ,East, ii, l). B. and more particularly described as follows: Beginning at the Southeast corner of said Northeast quarter of the Northwest quarter of Section 22• thence along the east line of said Northeast quarter of the Northwest quarter, North 00°49'10" 'a: 172,00 feet; thence North 80157'05" 11jest, 144.79 feet to the Tact line of Clark load; thence along said 1=ast 3_ine, along the arc of' a 5530.00 foot radius curve to the right, whose tangent at this point bears South 10032'53" West, through a central angle of 02.°21'18", an arc distance of 227.30 feet to the South line of said Northeast quarter of the Northwest quarter of Section 22; thence along said South line, North 89°20154" East, 181.52 feet 'to the point of beginniil, Date . _! y - �L State of ) On this SS. me, the County of ) A PROPERTY OWNERS: the f------- day of _�'� , 19 94, before undersigned Notary Public, personally appeared OFFICIAL SEAL / / Personally known to me. /;Y/ Proved to me on the basis DORo'fHY A. WISE Notary Public -California of satisfactory evidence. BUTTE COUNTY to be the person(s) whose name s ( ) 'moi subscribed to My Comm Exp Aug 6, 7958 the within instrument and acknowledged that r4 executed the same for the purposes therein contai d. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No V otary Public OWNER PERMIT MH UTIL.CLEARANCE D TE S�%-�So INSPECTOR ELECTRIC GAS Support Struc. Compaction Test eq. Service Size -Other- Load Type Pipe Size -Length YES NO • YES NO Zoo ��o �P� -5/q 3(� - , • ✓' h.. _y COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, CafiU)rnia 9,965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL UMB Z BUILDING PERMIT OWNER G T PHoy,E ., SQ. FT. OCC. BUILDING VALUATION OWNER' I LING AD R 5S a9 L CO TR AC OR NAME - /,D (� T L PHONE si7 CO`� RACTOR'5 MAILING ADDRESS _ /_ 0 p -Z Fireplace CONSTRUCTION LEND R 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 ADDRESS ict^ Permit fee $ \aol PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 t Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PAR EL 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 G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Rem del ❑ Utilities ❑ - Installation Other ❑ 1 # Describe work: — Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 n K. Main service Boov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declar nder penalty of perjury (check one): Llf I am licensed under provisions of Chapt. 9, Div. 3 of the BuslnesS and Professions Code and my license is in full force _and effect. r j. 7 License No./(Z� Classification C l ❑ 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 LIN CCUP.ad\ oR T DWELGS'/zQsgft / ADDNSNEW CONSTR.ULT'-OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea, (POWER APPARATUS 6) SINGLE OUTLET CIR. ®yoe Ex. Occup OUTLETS OR FIXTURES 1.20AL@30 FIXED LNS EX. Occup. OUTLETS (PRES'D IKEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare and penalty of perjury (check one): ❑e 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 Filing 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. 1 also agree to e, indemnify and keep harmless the County of Butte against all liabi 'ties, lud ents, costs, and expenses which may in any way accrue ainst aid C unty I consequence of the granting of this permit. r %� D to—f '" Sign ure of Ap icant - Owner ❑ Contractor Agent ❑ An SHA perm t is required for excavations over 5'0" deep and demolition or construct- ion of structur over 3 stories in height. Mobile Home Installation Fee $ (� Energy Inspection Fee $ TOTAL PERMIT FEE $ �Dt 196 occuP. CORST.TYPc 11'...1PARCELI PD MD, ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO OF PUBLIC By PERMIT XPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date - -11K Receipt No. \ WHITE-D.P.W.. YELLOW-ASSr3.0R, PINK -INSPECTOR, 60LDENR0D-APPLICANT COUNTY OF BUTTE DEPARTMENT.OF Py LIC WORKS - BUILDING DIVISION j 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/-4541 PERMIT APPLICATION DATA SHEET Permit No. OWNER l r Cf I/!/1 P Gt ✓CA. P. No. 4/ - �d Proposed Building Use Permit Fee Based Upon: Complete Contract Price DPW Valuation Building Inspector /i%,y_-- —, r _ - - uaie / / ( -) t� At time of per it application, I was advised the following data must be submitted prior to permit processing and/or ISS nce: DATE RECEIVED APPROVED __A,_XAII items.have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification(Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . 17. Pre -Inspection for Required- BuildingPre-Insp request to (Date) p q Building Inspector 18. Recor A$ f t�rri t�yr I Acknowledgment Statement 19. OtherYh�tt� l�onstruction approval required prior to occupancy) When ou issue the a mit, pr cess as follows: Mai t owner. Mail to contractor. Telephone ��% and hold for pickup at office. Deliver w/inspector. Other 47. Applicant �,Y"zt� Gam. �l r r f ��Date Copy of plans sent Health Dept., Fire Dept., , Qjher Date During the plan checking process, the following data must/be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone By Plans checked by_ Plans approved by Other Copy—DPW Date Date _Mail Date Other 43 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Cen er:Drive, Oroville, CA 200C.- 71,534-4541 MOBILEHONE INSTt LIATION SHEET w 1. owner'a, �a�.ipe- . Y // 4 L r moo,l3T 2. InstalleF,, S. Name: 3. Is the s to currently under permit? Yes No r; i (If Ar yep furnish permit number ) OR Is the site an existing site? Yes F No (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No (If no, clarify 5. What i.s.the mobilehome electrical rating? --------------- �Amps 6. What is the mobilehome site service rating? < C% 0Am s - P 7. What is the mobilehome site circuit breaker rating? ----- . 5 Q Amps S. Is there any other electric load to be served by the mobilehome site service? -------------------------------- Yes EJ No (If yes, identify the load and size; (Load) (Maps) 3 9. What is the mobilehome site gas pipe size? -------------- (in.) 10. What is dea..type of gas 'service? -------------------- Natural LPG 11. What is the gas pipe length from meter or tank to.the mobilehome?--------------------------------------------- * 12. What is the mobilehome gas demand? ---- ------------------ (BTU) *(This information not required ,if pipe length less tha 6 ft. on natural gas or les$'khan 504"t'.1 on LPG.) BUTTE COUNTY BUILDING DEPARTMENT APPROVED MOBILEHOME SUPPORT DATA t �:r If other than single wide, Mobilehome Mfr. (j .� furnish Setup Model No. Year Width (ft.) Box Length (ft.) Tagalong or Expando Size ft. x ft. On all mobilehooes manufactured after October 7, 1973,.furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte).. FOOTINGS (check one) Wood -pressure treated or foundation grade. a 2. Other (specify) w SUPPORTS (check one)Concrete block. 2. Other ( CCspecify) a Pier Footing Sizes and Locations SINGLE -WIDE MULTI WIDE Line 1 — - � Line 2 Main Beams -i� _ _ _ Line 2 Main.geam=_s .� • i•n 1 .no 4 L ne Tog or Triple � Line 1 Lino 1 Piero: ),ins 1 Ooeainxs t Sise-Min.------------ ••� n ipseing-flex.----•---- , „ Eacb Side of openings From Sado-Mex.------- •. •• With Width Over —------ • u Line 2 Piero; Line 7 Piers: .(Under Searing Wall only) Site -Mia. ------ '•s 0" Size-Min ................... • . r•�Spacing-Ms. ....... Spaclog-1sx............... from Ende-Mss-------- from Ends -max ............ Line ] loot Roods: /ise-Min.---------•-- locetion (From Front) •.Sise-Nln.------------ •� u Spesing-Mas----------- From•--•--- From Lnb-flex.-.----- • ,r S1se-Mia. •---------- location (From Front) e S Piste: (Under gearing Wo s oo y Sise-Min..--.. .•x u Spacing -Max ----------------- From------------- Prom Enda-Max.------------- r. o • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, 0liforn495965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER - ZONING BUILDING PERMIT OWNER -SS TELEPHONE y„ SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADORE CONTRACTOR'S NAME TELEPHONE 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 ADDRESS r /.. Permit fee $ F., 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 SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lit,ies ❑ Installation❑ Other Describe work: �%% » Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6101 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): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the BuslneSS 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.&) y2¢sgft OR ACDNS. 1 ACC. BLDGS. NEW CONSTR. MULTI -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS POWER APPARATUS 6 (SINGLE OUTLET CIR. Ex. Occu1.20050t Occup(OUTLETS OR FIXTURES AL@30 FIXED APPLNS. R EX. Occup. OUT LETS (RESID.)EA.1 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 Filing 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 Countyot 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 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 $ TOTAL PERMIT FEE $ oCCUP, CONST.TYPC I I FLooO PARCEL I PC I ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. WHITE-D.P.W.. YELLOW-ASSF350R, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PEtMIT NO� 7 County Center Drive - Oroville, i,-alifa.Ema 959,5 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSES R PARC., E/. TUM ER {{.•..//..(( Of ZONING BUILDING PERMIT OW E I 1"C :�LEPHONE lJf SO. FT. OCC. BUILDING VALUATION OWN R'S MAILING A, ;ESS CO�A OR'S NAME CV TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONS CTION LENDER ©� F UNKNOWN Total Valuation $ Filing Fee g $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 6 ARCH ECT OR ENGINEER `1, F LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 0/4 . Permit fee $ D PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Og / C` 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 re SPECIFY Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 10.00ea TYPE OF WORK New❑ Addition Reniodey❑ Utilit'es❑ Instal Other IllYlll JI ` Describe work: L�6'YI i � f (2i� _ 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.SINGLE 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) ❑ 1, 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.Iti S. , h¢sgft New DCNS.A LDG ULTB OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) OUTLET CIR. Ex. Occup( ao a s0e p OUTLETS OR FIXTURES .20050t AL@30 FIXED APLNS.icense Ex. OCCUp- OUTLETS 1PRESID,IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 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 pf Consent to Self -Insure. VI 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 Filing Fee 10.00 Heating Cooling g 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 conse pence of the granting of this permit. Dat63—Z� _ g 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 $ TOTAL PERMIT FEE $ � : 0 0CCU1'-J CONST.TYPEJ I FI,00DJ PARCEL PD I ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work Indic d above for which DIRE OF PU By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. I WORKS ate Receipt No. �` �S WHITE-D.P.W.- YELLOW -ASSESSOR, PINK -INSPECTOR- GOLDENROD -APPLICANT .4 COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and 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. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 9` s 2. I (have/have not),.A_, 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 AddrPGG Phnnc Tc,no nF T.T^,6 Signed: Property Owner` Social -Security Number Date , --oZ C) R 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. ' e J 1 r 4 f I 1 OFFICE COPY Address - Dated M y EC -TRIC Date ' Meter By 1 y. f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS _ PERMIT NO. 7 dounty Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER �. ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS j- f CONTRACTOR'S NAME TELEPHONE 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 $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING SADDRESS ^T �` �` ` 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 [9' Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home ISI G W 10-00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti Iities ❑ `Instal lation ❑ Other g Describe work: �-r` .� �� M) Cr i t r' n f.) Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR L 00 AMP ORSLESS 10.00 /n.r�,l Main service EA. ADD'L too AMP 2.50 NEW CONST. / DWELLING OCCUP.& OR ADDNS. C ACC, BLDGS. 2t/20sgft CONTRACTORS LICENSE LAW I declare under penalty perjury p y of p erjy (Check One): F-1 I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. y 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 NEWCONSTR. ULTI-OUTLET 2.50 ea NON-RESID BRANCH CIRC Irs &'1 NEW -CONST R- (SINGLE OUTLET CIRPOWER APPARATUS . / NON RESID, Ex20e50e p�OUTLETS OR FIXTURES SAL@3O . OccuFIXED APPLNS. OR Ex. OCCUp- OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 rjn Permit Fee $_'� /1n Contractor MECHANICAL PERMIT Filing Fee 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 r _ 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. I 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 DIRECTOR OF PUBLIC - 1 1 By 1 7 /.., - PERMIT EXPIRES Date 1 the applicable provi- resolutions to do fees have been paid. WORKS ' Date i] v •r" _. �?�� r t Receipt No.1' WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT I!/ 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 OWilo TELEPHONE SQ. FT. OCC. BUILDING VALUATION ,QWN, R'S MAILING ADORES CONTRACTOR'S NAME TELEPHONE 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 $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS ^�C (� 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 G W 10.00 e TYPE OF WORK New F1 Addition❑ Remodel❑ U ilities I tallation❑ Other Describe work: it Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 e Main service 1000 0 AMP OR OR LEAMP10.00 1 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR AEONS. ( ACC. BLDGS. 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 MULTI -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS POWER APPARATUS &' NEW NON.RESID. CONSTR SINGLE OUTLET CIR. ( 20e50t Ex. Occup(o FIXTURES BAL®30 FIXED A POR R Ex. OCCUp. OUTLETS (RESID.)EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 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 � f Consent to Self -Insure. L� 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 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 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 ranting of this permit. ,� //))''� .� .� Date l� X�La-*^ �'Con`troc Signature of Applicant — Owner ror ❑ 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, PARCEL PD ND SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which TO OF PUBLIC BYLd A4c PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS 2 Date 3 Receipt No. �p WNITE-D.P.W., YELLOW' -ASSESSOR, PINK -INSPECTOR• GOLDENROD -APPLICANT COUNTY OF BUTTE -.,Department of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIF ICAT ION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and ma erials for construction of the proposed property improvement (yes or no) . 2. I (have/have not) signed an application for a building permit for the propos'ecl 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 ���dP�c-ri z� Social Secu: j�i.ty,number Date` 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 permitted to issue the permit.