Loading...
HomeMy WebLinkAbout041-420-028T `p. �._ - -- -- --- - - - - - 41-42-28 Merton Short S/S @ end of West Branch Lare, app. 2 mi.W.of Clark Rd., Oroville contr: Dale Rogers, Chico Permit #3995-81B;P/,E,M(newp�single • family) a% I04:1--420-028 00-0560 BLAUVELT, CHERY/WALKER 3001 CLARK ROAD,, OROVILLE: RE.ROOF - - 41-42-28 M.D. Short West Branch Lane, Oroville Permit#78-83A{a ricultural B� exemp permit for, hay storage c 11 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERM�,T NO.,� Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. 1-/- Z-� 2� ZONING A iZ 3 f-�- OWNER / PHONE NO.g,/S _ LIZ �/- OWR'S ADDRESS -O.6oX IgO A D yie NAM04 LOCATAONJGR BUILDING _ //`J�//�`�,1 /( �///fff / /per++ `Ss ��" b O" [�V ES IVI AA � % 1'VI //��D r 4r I �Z_ USE OF BUI DING SIZE OF STRUCTURE SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME ✓ STEEL CONCRETE OTHER (Specify) TYPE I I G L 007 ROOF COVERING ' i FLO T E. SM/AI Lam'�1 ESTIMATED COST OF CONSTRUCTION $ AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows: , ICod! FRONT ,� SIDES REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and a occupancy. Date //-7__9—,973 Signature of Owner Permit Fee - $25.00 The above described AG Building is exempt from a building permit. Receipt No.' ®�s�f Director of Public Works -By Date White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Applicant 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 CORRE TION NOTICE ,� �.-,J— .-e/�-' BUILDq(G OR PROPERTY ADDRESS 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 y�heny estion pertaining to this or ed additional explana ' this of_icfice immediately. 7. , 2 V, 1 � �— Y�' , — �V, r, 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 CORRECTION NOTIC Lam.&~/,t- "--jg / BUILDING OR PROPERTY ADDR S 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 Inspector Date 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 CORRECTION N BUILDING OR PROP ERT VADDRESS 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. PERMIT 3995-81B,P,E,M NO. PERMIT EXPIRES- Merton XPIRES Merton Short OWNER CONTR. Dale. Rogers, Chico 41-42-28 ASSESSOR PARCEL LOCATION SIS @ end of WQst Branch Ln. ,app_Z mi.W.of Clark Rd., Oroville E: A rE �t�� Al. Temp. Power Pole Called PG&E Temp. Elec. Service b Called PG&E O T O dh�a� Temp. Gas Service Called PG&E JOB FINALED (Date) Signature = OK = Not OK = Not Applicable = Not Ready 00, RESIDENTIAL'(Single and Duplex) Date UNDERFLOOR Plans OK exce t#'s Date FRAA NG (Continued) 1. Zoning requirements -Setbacks -Easements 48�Pr rty Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 4 xt. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Fig., Garage; Soils -Steel- / /" Ftg. Depth 50. S ' s; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51#1Kywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel -B lockouts -Wrapped -S lab 52. Siding -Nail' g-Venee 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco' sh-Drip creed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Wal ; 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 and -BI Date c,zz .4AXZ N Zz-- L� r- -dc Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI l5ate Date FIMAJ. (Olap)-6K except N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK exce t q E�teps-Door & Sidelight Protection -Landings S moke Detector _ 14. Water Ht.; Vent -Ac bust ion Air s -Clearance -Comb. Air -Connector - In rage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Teste Anc -Nail Protection 1 .W.V.; Test-Fttngs & Anchors -Nail Protection 4i!gEmm Exiting 1 hower Pan; Test, First Floor -Tub Access 6 F & Bath Fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 61. lec. Trim & Subpanel; Breaker Sizes -Labels _ Gas Pipe; Size & Anchors 6 s ireplerce or Stove; Clearances -Hearth ___19. 64 es,.Qutlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65• ixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date _ L /Q and -BI Date 6c. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK exce t k's 61'-. Garage Fire Door; Swing -Landing -Closer n Garage -Damper 20. Fixture & Transfor ce Ins. P coon 69 r. Htr.; Vents-Clearance-Comb.'Air-Connector-P.R.V.- In G age; Above Floor-Mech. Protection 21. EI . Receptacle S a ights & Switches at Doors 22. Si .Boxes & No. of Conductors -Stapled 70. .mac. & Mech. Equip. Listed for Location 71, ec. Receptacles in Garage; (G.F.I.)-Ro x Protec. 23. o Called Close to Edge of Studs & C.J. tp. Ground made up w/Mech. Fasteners -Bond Gas & Water 72• �a2.- Insulation -Seam -Looked in Attic Yes ttar "Rails & Deck Construction -Post Caps 2 Appliance Circuits i Kitchen & ductor Size 26. Subfeed Wire Si e / a. Cu o I A.C. Wire Size / / ga. Cu or At Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under loor ❑Yes 27. Range irc. / ga or AI -Oven Circ. / / ga. Cu or Al, ated Neutral Yes ❑No 75. Following instld.: Driv ❑ Yes o; Walks ❑ Yes No; Planters es o 28 ervice-Riser Conductors & Ground -Main Disconnect 76. Stucco; Br n-Fi iatl 29. Equip. Clearances; Panels-Motors-Mech. Equip.-77iFit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet - -- 30. Clothes Closet Light -Shower Light 7 e Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. - 7 Well; Disconnect, Electrical, Plumbing Card B -I �`' Date- and BI Date 80 for Elec. Trim; G.F.I. Receptacle -Underground 814 t ati throughout House Card B-1 Date �(� rd -BI Date 82. la rotection Date MECHAN AL (Permit) OK except k's 83. rreclions from Previous Inspectio 84. asst -Meters Tagged; Gas -Electric 31.. Ducts; Insulation & Support S Connected -C/0 to Grade -HD Approval - ent Fan; Exhaust above Insulation 8 Energy Compliance Certificate -Other Certificates _._33. Condensate Drain & Overflow; Size & Grade _ 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Card -BI Date and -BI Date Date Card -BI Date Card -BI Card-i t -- ------ Date ' - te �tf� b -Card -BI Date DateEard61 Date Card -BI Date Card -BI Date Date FFJAM(Plans) OK except H's Comments at Final: 3 Sil , Proper Material & Anchors 37.��a ; NaStuds-iling, Spacing & Bracing -Plates -Sound 38.��'�g Walls over Girders & Floor Nailing-- 39.rfr Stop in Walls (rat proof) - ` -Z- - � f, A /Y _O 40Stops; Furred Ceilings -Stairs -Chases -Tub -_-44. 41.AKeader & Beam -Size & Bearing 42. Ha rs-Post Caps -Anchors -Connectors 43. Ing. Joist-Rftr. Ties-�P n -Roof Brac.-Truss-Shthnq.-Rinq� F' place Ties or Typ?A Flue -Fireplace Throat - r/ _;7 --- - ccess: Size & Romex Protection -Draft Stop -Ins. Baffles 46Windows or Exiting Doors -Sill Hgt. & Dimensions 47 Fire Protection Framing 4Fara�ge (NOTE: Anentry must be made each time you visit job site) = OK = Not OK = Not Applicable MOBILEHOMES MISCELLANEOUS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTb, CTC. (Plans) u,• o: cept n 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size-Depth-Spacing-Conriectors 3. Sewer; Location -Test -Fall -C/O -Concrete _ 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4, Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg. Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns-Connections-Splice-Decal-En(.,us,.res 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance 6. Carports; Windows -Doors 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date _ POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances _ 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date RFS TnVVI'TAT. ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT West Branch Lane, Ornui l l e CA (location) Z 2 BUIZDING PERMIT N0. (1( A.P. NO. T THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: GLAZING: Slab Edge NA Single Glazed NA Fdn. Walls Special (Insulated) _ Floors NA CERT..,.,&. LABELED WDS. Walls ,.. R-19 800 0 & SLIDING. DRS. Ceiling/Roof_ R-30 2380'o WEATHERSTRIPPED DRS,. Ducts ; BACK DAMPERED FANS Circulating Pipes NA INTERMITTL'NT IGNITION DEVICESNA __ APPROVED HEATER ' CERT.. APPLIANCES APPROVED WTR.HTR. I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name Hawkins Inaulation Co Inc (please rint) Signature of �/ Insulation Applicator State Contractors License No. 378407 General Contractor/Owner Name s4A (please print) Signature of General Contractor/Owner Date 5/14/82 State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL: BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/ 4 4 . APPLICATION AND PERMIT // n/ A SSTSSORV CEL N MBER — 'f, Z N G A j�jl, H BUILDING PERMIT ow�REQ� AI S 9 /C)� 3Ey�_oryEZ2 SO. FT. OCC. BUILDING VALUATION O ER' MAILING 1-0ADDRT7- /> D• Ewe /fimi Com/ / s- 570.0d C CVT r 2:,V S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace /000. O d CONSTRUCTION LEND UNKNOWN Total Valuation Is , p O Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ U-. —0-0 ARCHITECT OR ENGINEE LICENSE No. Plan Checking Fee $ d ,pp Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ Do BUIL ING ESS S SAC li OF 4WE5% ASPAAJC,4 PLUMBING PERMIT Filing Fee 10.00 n /Z / OF e&4P_� , Each Trap 2.00 Z OL7 Repair drainage or vent piping 5.00 ®e0U/LLC_ Water piping 5,00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets �,/ USE OF STRUCTURE SF LJ Duplex F-1 Mobilehome❑ Other SPECIFY Building sewer , Q p Lawn sprinkler syste 5.00 SM)"4 - 8 k 0.�% TYPE OF WORK New Q Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ , D0 O Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS T •��- , Qr% Main service EA. ADD'L 100 AMP 2.50 2, i''0 NEW CONST.DWELLING OR ADDNS. ACG. BLDG CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): El am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect.I ` License No. Classification B 1, 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) 11 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 CONSTF U T -OUTLET 12.50 ea NON.RESID BRANCH CIRC ITS NEW CONSTFL / POWER APPARATUS .&) NON-RESID. -SINGLE OUTLET CIR. I . ExOccup.(OUTLETS OR FIXTURES g L�j APPLNS. OR Ex. OCCup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ 7,/Q 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 W00b I-AEi¢% NAfU/ZAc- 60AIVEZ-976 Cooling deed- 3.00 3. O D Ventilation Permit Fee $ , O� 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 S7 Si.rure of Applicant — Owner ^ Contractor E] Agent E] C� An OSHA permit is required for excavatio s over 5'0" in d 1 lon r c$?1kst� ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ KP. GROUP i,Z` VF OF CONST. �� /aW1 PAR L P HD Ivs—E V/ This permit is hereby issued under sions of the Butte County Code work work indicated above for which DIRE A OF PUBLIC By P I EXPIRES Date�— the or rsoot Injtg4o fees H �b �nOpd. U d 'Q 1 Date Ly�f- Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PIN INSPECT R, R - GOLDENOAPPLIC NT Return to..DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT?r.CORE,.,,,`,__.LD FOR RESIDENTIAL DEVELOPMENT itss VrrL ?iQ Section 26-8.1of the Butte County Code requires this acknowledgement10 IG 50 ��lIQRI bereed prior to issuance of a building permit. CLAF?K A. P,ELSo.,4[- CLERK -RECORDER The property described herein is adjacent to land or included 91 ' F E within an area zoned for agricultural purposes, and residents of �.5 this property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa- sionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have' as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: SEE EXHIBITS "A" A ' ATTACHED HERETO. PROPERTY OWNERS: State of California ) On this the I6:Lb day of NQv _mh r ) SS. before me, the undersigned Notary Public, personally County of Butte ) appeared OFFICIAL SEAL 3 . NOTARYD�A,SL' /S�PRAGU�./E�eNry� �<. J M► N�"�IlnIf1��tYf 1}''}IG�W #jj . g.2& 11� JUEL R. SHORT and M. D. SHORT known to me to be.the person(s) whose name(s) are subscribed to the within instrument and acknowledged that theme_ executed the same for the purposes therein contained.' IN WITNESS WHEREOF, I hereunto set my hand and official seal. ' Not y Pu.lis,. Present A.P. NO. -50- -1/2 — Z T - "i' I ON F;X.}IILIT "A" ORDER AIO. 25138-0 nl that Aertain real property situate in the County of Butte, State of Ca if o.nia, described as follows: 1'Ai'C11, ONE: i;e.i nf; a` portion of the North half of the Northwest quarter of Section 22, Township 2.1 North, Range 3 East, M. D. B. & M., and more particularly des- cribLd as follows: BEGINNING at the Northwest corner of said Section 22, and thence following along the Westerly boundary line of said Section South 00 33' 54" West for 920.85 feet to the true point of beginning for the parcel of land hereig described; thence from said true point of beginning, continuing South 0 33' 54" West for 400.00 feet to the Southwest corner of the North half of the Northwest quarter of said Section 22; thence following along the South- erly boundary line of said North half of the Northwest quarter of said Section North 89° 20' 54" East for 653.40 feet; thence North 0° 33' 54" East for 400.00 feet; thence South 89 20' '54". 'nest for 653.40 feet to the true point of beginning.., PARCEL TH'0 A non-exclusive easement for roadway and public utility purposes to be used in common with others over a strip of land 60 feet in width lying 30 feet on each side of a line described as follows: COP•fiMICING at the Northeast corner of the herein described property and running thence North 89° 20' 54" East a distance of 189..94 feet to the We boundary line of Clark Road and the end of said line; PA 1 CEL `1'Kit�: An easement for road and public utility purposes over a strip of land situated in Parcel 2 of a Map filed November 8, 1977 in Book 63 of Maps at page 9 and being more particularly described as follows: COMMgCING at the Northeast corner of a Parcel of land described in Deed to Alvin Dale Rogers, et ux, recorded October 29, 1979 in Book 2456 of Official Records at page 647 and thence running North a distance of 30* feet; thence West and parallel with the North line of said Rogers Parcel, a distance of 35 feet; thence South distance of 30 feet to a point in the North line of said Rogers Parcel; thence East along the North line thereof, a distance of 35 feet to the point of beginning. 0 :mac All No. 041-42-0-028-0 Et�v 0F i 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 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 materials for construction of the proposed property improvement (yes or no) 00 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 W r rA L►G13,.,S e p Got-�T " U►J4,j0w J AT T -4i S r(&4 G 7-o Do ey V 0,710 IJ LeT - 3 L -O G 14- W µ1't 415G4AMjO& C W ! 2l *,& 0-00 0 L.,J M g, #,z . P LA nJ -rO 00 P B -c " A d o Lb ► 6MVAZ.c o JL ,1gt%j1 wolL _ . Signed Property Owner Social Security number + - Date_ t!- 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. .. .. 14�w RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX, & MISC. ONLY) Bldg. OWNER G� A. P. A. 'GENERAL zoning requirement sideyar and parking).) �-�Valuation. ..' Signature by R.C.E. or Architect (if required).. B. PLOT PLAN ,.1-' Complete parcel size and dimensions, � Setbacks, sideyards, easements, eta+ • �! Other buildings or structures: Grading, fills; drainage. , 1 Pe �k tJ �v # as C.. FLOOR PLAN t ' ~ Complete to scale plan with dimensions. Required windows for light and ventilation (Sec. --1405). -e Required windows for second exit (Sec. 1404). 000 A owa e g azing for energy requirements (20% max. per.State law). J�Human impact glass (Sec. 5406). Required room sizes, ceiling heights (Sec. 1407). yG.F.C.I.'s in baths and exterior outlets (Sec. 210-8). Is 8' Light fixtures, switches,,receptacles, and exterior receptacles for maintenance of mechanical equipment. Locations of water heater, heating & cooling equipment, other electrical or gas equipment, and plumbing fixtures. /Garage firewall, door size, and closer (Sec. 503(d)(4)). Li' 1 - 3'0" exterior exit door (Sec. 3303d). L2: Fireplace location. Smoke detectors (Sec. 1413).- D. S-TRUCTURAL DETAILS (E2,./ Foundation plan complete enough to construct building: Eloor construction details complete enough to construct building. levations and wall construction details complete enough to construct building. © Roof construction details complete enough to construct building. f . Fireplace construction details and calcs if over one-story in height. Sufficient data and details to satisfy energy insulation requirements (State law). E. MISCELLANEOUS ITEMS TO LOOK OUT FOR CCX plywood on exposed locations and overhangs. .2� Stairway details (Sec. 3305). /o Guardrail details (Sec. 1716). !+f Brick or stone veneer (Chapter 30). &'��Exterior plaster - weep screeds (Sec. 4706 & 4708.). 6 Proper roof pitch for roof covering (Chapter 32). ,Y. Rafter ties or bearing ridge beam. AB . Garage door or porch header sizes. Adequate bracing. Living area over garage.- complete 1 -hour separation required including supporting ,,walls and posts, etc. . Two (2) exits on three-story dwellings (Sec. 3302). jir-- rim Merton Short 9575 Lott Rd.' Durham, CA. 95938 Dear Mr. Short: November 20, 1981 RE: Building Permit Application No. 3995-81 (AP 41-42-28) .With reference to the above subject and the permit application you made to construct a new house at the end of West Branch Lane, we need the following additional informa- tion before we can issue the permit: c/i The plans returned and revised together with all requested changes and 2T 2calculations (plans given to Dale Rogers on 11/17/81). Sewage and water supply approval from the Butte County Health Department. .A copy of the deed to Alvin Dale Rogers recorded in Book 2456, Page 647, to determine if we have the required 60 ft. right of way to Clark Road. ✓4. On the building permit application, you list Dale Rogers as the contractor and also, indicate you are exclusively contracting with licensed contractors; however,'on the Owner -Builder Verification Form, you indicate you are personally doing the work and hiring some licensed contractors. The permit and,this'form must be in agreement. Please contact me directly regarding .this matter. As soon as the above data has been submitted, we will continue to process your permit application. Should you have any questions concerning this, please contact me. JFG:dd Yours very truly, Clay Castleberry Director.of Public Works J.F. Glander Chief Building Inspector File No. .i... _.G BUTTE COUNTY (For Action 1, 2, 3) Public Works Dept. (For Information ✓) Director Dep. Dir. Sec. Rd. & Br. Mtce. Shop & Yards Bldg. Insp. Admin. ,4• D&C / Traffic Const. - Rd. Des. Br. Des. Sur. & Loc.. Transp. y R/W ` Mapping , Land Dev. VeV Ref. Disp. Drrig. / S. 1. Sub. & PCI. Maps Perm its • s N 0 ,A H F F W WW W WW W) in VI 000 An 00 .� N �- !V V aaa N A N N N N a WALL_ R E00acGi"70N-5 FOP" '30 P.G.-P ogU1v. Ft --v 1 D .63:3 K: r • S+tc.4R /,-j 3o t -34' • wat�.S .)72, 4v\ .46�K 9 )Sa = ?•�'�`�-�`r- C3�. _ �-vG L..ENGr� of ENa 3Zo'9/r o ,9/APH!,GM C^PAc.lTY w/S�B pL)'wC 1D = 2�5 -P* O_K I :5w -z- 7b MA::-orI RY \.,-A -L- corjr/ &C --n o n/ ,4. Li . f'tLLOwA[3` E SNE�r� -" SSc�IE/} USG %� A. L3 G Z'-oo.c. . OcD7-rDM of �Nl� TR��S 7� Slt_L G©^i^/EGT7pn/ fug WAt,4 7WR wCi'1iSi�l'DS le. Orr �'^ I�{aWOop SLl SH�AIZ cAP/�ctTy 16d Toen/Ai<EQ _ 5X (6S-) = 73- 3- 00*Jt_ 73 _ zs' o.� /(&1 4'� a O SNE/�fZ GAPAc-rrY aF S)MP.5or�:► A --,-S 470' _ /.65 195E S/n�PsvN ft3S �.a C OtMtT MEMISIMMIMEMMIN MEMMIMMINIMISIMMEN ME MINIMMEME 0 M IMINIMME M, MMIMMMIMMMMI.mll ME MMIMMEMMMEMMIN MMIMMIMMMIMMMEIMMIMMIMEIMMMIN MIMMIMMEMMIMMEMMEM MIMIMMISIMIMMIMMEMEMIMMIMME MMEMIMMIMMMMIMIMIMMMIMIMMMMMMMIM ME I 111IMMEMMM 0 M Mm MOMMIMMIMMIN MEMEMIMMIMMIMMEMMIMMEMOMMIMMMIMMEMEME IMMEMEME IMIME MMMMMMmMm MIMEMEMMI m ME IIIMMMMMMMIMMIMMIMIMIMMIMM MOSIMMMINE EMMIMEMMM MMIMMMMMMIMMMIMIMMMEMMMIMMMIMIMMM mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmommmmmmmmmmmmmmmIMIMMMMMIMIMMIMMIMMM IMMEMEMMIMMEMMINIMMMEMmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmlmmmmmmmmmmmmmmmmm MIMMUMMIMMEMEMIMISM MIMMMISIMMEMMEMIMMMIMMISMmmmmmmmmmmmmmmimmmmmmmmmmmmmmmmmmmmMMIMMMIMMMMMMMMIM MIMISMMMMMMMMMIMMMMMIMmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmommmmmmmmmmmmmmmmmmmmmmmmmmmmmMMIMIMMMMMMMMIMMIMMMMIIMMMMMMIMM mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmMIMMEMMIMMEMEMMIMMIMEMEMMIN m I MEM MMIMMIMMME IMMIMM IMMMENIMME ME MIMMIMMIMMEmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm ME MEMEMMINIMMEmmmmmmmmmmmmmmmmmmmmmummummmmmmmmmmmmmmmmmmmmmmmmonommmmoommmmoommommmmmmmmmmmmmmmmmmmmmmmmmmmmmommmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmumMMMMMMMMMMMMMMEMMMMMEmommmmmmmommmmmmmmmmmmmmmmmmmmmmmmmmmommmmmmmmmmmmommmmmmmmmmmommmmmommmommmmmmmmmmlmmmmmmmmmmmmmmmmmmmmmmmmommmmmmm MIMEMEME M MENEM ME M MISOMME i MmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmimmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmommmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmI • • 0 rn 1 7 m U1 22-141 50 SHEETS • •AMPAD 22-142 22-144 100 SHEETS 200 SHEETS • � rn 1 7 m U1 C 11 ° � w 0 - ' 0 C r N N `J D A � ?z � � 3 � � -o Z A rn c � n rn n � � kA Z 0-61 n n c� rn 1 7 m U1 C 11 ° � o �► 3 - ' 0 C r `J o o � � 3 � � -o Z w n � � kA li A A O � m. 0 m a 2 rn 1 7 m C 11 ° � o �► 3 - ' 0 C r C 11 ° � m N No M ONO No OEM 0 NOON I mom NOON mom M 0 0 M ME ME NOMMMEMEMIN NONE No NOON MEN ONE OMEN mom NONE MEMO OMEN 0 MEMMIMM MOON ONE mom MMMMIMMMMMMMMI No mom NONE ON mom MENEM 0 mom MEMME No 0 ON a NONE NONE 0 0 MEN MEN MONO 0 ON ME mom 0 �...�oma ... �,- _ , : ..EMEMIMME ONENONE No ME MEMOMENOM MEMMOMMIMMMEMNONE EMEMMEM No OMEN MNONE MEN No 0 MEMMEMMEMEMMEN MOMMEMMEMME ON EMMEMOMMMENMEN MEMI • • TRESS TO �oP Sic L- C--oNN63C-ICOM t...2's C 71B' USE. S*t �, PSo N A3S 0 (� ESUovAL.Er-JT Ar JC-f4o RS F3 x l Yz" IVA r cS o N 8 y'S 3.S/8' C" r 1 11 Recorded at the request of NORTHWESTERN TITLE COMPANY 4erurn to Mr. and Mrs. Alvin Rogers - Rt. 1 Box. l78 L. _.._..,_._.................... Oroville_, Ca.. 9S°f,5 Ewou, No. - 20801-0 _ Grant DNd ueko Tenancy) OFFIC:At 13UTTL Coo yIr- vazzA&Winiz ciJP►y r &T l9 iG 21 NN 107q CLARK A Lc_'ON � � CLERK -RL GOri. Et: a 4948 E TRAN9a TAX PAID For value received DAVID A. SCHNITTER, who acquired title as, a single man ALRY GRANT S .... to ALVIN/ROGERS AND JOSETTE/ROGERS, husband and wife as JOINT TENANTS all that real prop" situate in the unincorporated area of the CountyButte , Ste" of California, described as follows: Chuecs of Owxr- st NO PARCEL ONE ,ad -C. 4Lb . & T Code) La.nt io rwd, g Being a portion of the North half of the Northwest quarter of Section 22 addron an Township 21 North, Range 3 East, M. D. B. h M., and more particularly des- cribed as follows: BEGINNING at the Northwest corner of said Section 22, and thence following) along the Westerly boundary line of said Section South 00 33' 54" West for 920.85 feet to the true point of beginning for the parcel of land herein described; thence from said true point of beginning, continuing.Scuth 03 33' 54" West for 400.00. feet to the Southwest corner of the North half of the Northwest quarter of said Section 22; thence following along the Southerly boundary lino of said North half of the Northwest quarter of said Section North 890 20' 54" East for 653.40 feet; thence North 00 33' 54" East for 400.00 feet; thence South 890 20' 54" West for 653.40 fast to the trua point of beginning. PARCEL TWO A non-exclusive easement for roadway and public utility purposes to be usud. in common with others over a strip of land 60 feet in width lying 30 feet on each side of a line described as follows: COMMENCING at the Northwest corner of the herein described property and run- nirg thence North 89 20' 54" East a distance -of 1850.94 feet to the Westerly boundary Jrne of Clark Road and the end or said line. Seta tax statements to AP No. 041-42-0-028-0 Grantee at address above. Doted �GS.o4.er...a.................. 19..7.9.... DAVID A. SCHNITTER STATE OF CAUfOMA OrovilleButte e" ,v 79 ,".. Betty Davis o Hotory Pub,k. DAVID A. SCER M and b wW Cwmy one Sate, va+oedM aPoeo,, .---.. _.. .__._.... _.. _..._._._._�----....... _..___.... .... ,..._._._._�__....__..___. Ww-n se rtu to be the Certo^ e,hm non,. eubrrked so Are vAINn Lannon(, and odmwIKIWd so me tW to eeecvad the eanr. 00, tiw OFFICIAL 5»AL DOCUMENTARY TRANSFER TAX $ 19,80_ . ••.,•. �, ,�} ..; EicTIY DAVIS V. Computed on Full Va:" of Property Conveyed or: o : `i;{t,�' It.. 4L r , . t I" jt ❑ Computed on Full Value Loss Leins and +est Encumbrances Remaining Therm at -Time of Sale.+ ""+• r...'°' 'wr/ z Northwestern T-itle Conpany. --•• •••• S.onoturo et derla-M o, oge,,4 determin;ng Te. > Firm Name 04D OF DOCUMEW otnxy Nubia Northwestern Title Company of Butte County e*00,1- �'V'k .1 GRANT to MERTON D. SHORT and J_UEL RAE SHORT, husband and wife, " S IE 0 E r, ca j . '2 C.10, -03 as JOINT TENANTS all that real property situate in the unincorporated area in the —0 ilC. 0 County of Butte ;j t State of California, described as follows: .0 Y DESCRIPTION ATTACHED HEREWITH AND MADE A PART HEREOF AS EXHIBIT "All STATE OF CALIFORNIA COUNTKOF ....... i.- . 1.�................ LeANNE M. KIBODEAUX 3. NOTARY P11131 -if. rPLIFORNIA COUNTY OF BUTTE: My Cornmisslon Fxpires July 13, 1984 ;.I lot so - - On this .... / .. Z.c �. .. day of ..... /qUL.U�57.. in the year one thousand nine hundred and ........ 5.'1............ before me, ....... 7.?AC,...Ujj a Notary Public, State of California, duly commissioned and sworn, personally appeared ..... AA-Clk) ...... ........ .. . .................. ........ U`Z. e;_.T7.7?5 ..................................... ............ known to me to be the pervom5.. whom nam* -5 ... At*ubscribed to the within instrument and acknowledged to me that .7—he..y. executed the same. . LIV WITNESS WHEREOF I have hereunto set my hand and affixed my official seal in the .......................... County of ... ..... the day and year in this certificate first above wee ..... �7 ia �bfi�citato%Cdijornia ,l My commission expires ... ....... Cowdery s rorm No. 32 -Acknowledgement -General (C. C. Sec. 1190a) Send tax statements,to Ab,,,.)ve address Dated ...... July...29 ........ 19--81---- ia . ......... . .. vin Da e- g&rs ................... ............. ............... .................... "Jo e .................................................... ........................ -STAT15 OF CALIFORNIA . ......... County of .......... --A On............ .. 1. ......... 19-31..., before me- -'r in and for said County and State personally appeared .......... Notary Public. ..... ......... .......... . . .................................................................................................................................... M ...... 4E4 .............. ... ......... known to me to be the person\5 ... .. whose name..A.J?J�-ubscrlbed to the within instrument, and acknowledged to n* .. 1h . a -T.he ....................... .............. executed the some. DOCUMENTARY TRANSFER TAX' $. . . -1 Computed on Full Value of Property Conveyed or: .......... Computed on Full Value Less Leins and Encumbrances Remaining Thereon at Time of Sale. , 6 ........ .......... S;qn')ttlrc Of dec!,,,,nt or agent determining Tax -Firm Name Northwestern Title Company Notary Public of Butte C o u n t—y k� f", -e SMI ExMIBIT "A" ORDER 140. 25138-0 All that certain real property situate in,the County of Butte, State of Cal. Jornia, described as follo,.Is: PARCEL ONE: Being a portion of the North half of the Northwest quarter of Section.22, Township 21 North, Range 3 East, M. D. B. & M., and more particularly des- cribed as follows: BEGINNING at the Northwest corner of said Section 22, and thence following along the Westerly boundary line of.said Section South 00 33' 54" West for 920.85 feet to the true point of beginning for the parcel of land herein described; thence from said true point of beginning, continuing South 0 33° 54" West for 400.00 feet to the Southwest corner of the North half of the Northwest quarter of said Section 22; thence following along the South- erly boundary line of said North half of the Northwest quarter of said Section North 890 20' 54" East for 653-40 feet- thence North 0o feet; thence South 8 0 �� ' 33' 5411 East for 400.00 9. 20t , 54. West for 653.40 feet to the true point of beginning.: PARCEL TWO A non-exclusive easement for roadway and public utility common with others over a strip of land 60 feet in width lllyinog 3 3 to0 feet eused i side of a line described as follows: Y t on each COMMENCING at the Northeast corner of the herein described property and running thence North 890 201 54" East a distance of'18t9,-94 feet to the Westerly boundary line of Clark Road and the end of said line; Pfi RCEL '11E( An easement for road and public utility purposes over a strip of land situated in Parcel 2 of a Map -filed November 8, 1977 in Book 63 of Maps at page 9 and being more particularly described as follows: COMMENCING at the Northe a Parcel of land described Deed to Alvin Dale Rogers, et ux recorded October 29, 1979 in Book 2 6 of official Records at page 647 and thence running North a distance of 30 feet; thence West and paralle -with the North line of said Rogers Parcel, a distance of 35 feet; thence South a distance of 30 feet to a point in the North line'of said Rogers Parcel; thence East along the North line thereof, a distance of 35 feet to the point of beginning. AP No. 041-42-0-02£3-0 rt4D OF ;,��,,,. ca 0 0 x CM co 4 J �s � 9 s 0 I i ttecorded at the 'request of Rort.hweste.rn_- Tile -- Company ------------•-- Return to Mr. and Mrs. M. D. Short .......................................................... -9.575... Road Durham, California 95938 ------------------ Escrow No. ---- 2.5138 -II...--__-. q-? OFFIC:Ac RECORDS BUTTE COUNTY-'.'ALW. RECORDS REQUE=T4.0 By NORTHWESTERN TITRE CO An' !l 3 z2 PH 1911 CLARK A. NELSON CLERK-REGOROER S 81-27048 FEE Grant Deed (Joint Tenancy) TRANSFER - TAX PAID For value received ALVIN DALE ROGERS and JOSETTE REY ROGERS, husband and wife, GRANT........ to MERTON D. SHORT and JUEL RAE SHORT, husband and wife, r ~ < t0,8.G m F Z oc E o ti as JOINT TENANTS all '. � 6that real property situate in the unincorporated area in the c m - o County of -Butte State of California, described as follows: s DESCRIPTION ATTACHED HEREWITH AND.MADE A PART HEREOF AS EXHIBIT "At' STATE OF CALIFORMA COUNTY OF.......Q1ta.:T.T.... ........... .... 11 A ..................... 61u................ un uuuuunu/1■ LeAINNE M. KIBUDCA,UX ,`• NOTARI PiIRl.tr rrl'FORNIA COUNTY OF BUTTE My Commisslon F■Dirss July 13. 1993 ;..III0gas its 11111611111111111111111111{//1611111116111111110 On this ....... day of.; ... /k4&. 57". in the year one thousand nine hundred and ........5.. t ........:... before me, ....... a Notary Public, State of California, duly commissioned and sworn, personally appeared ..... .tg&4)1k�...... iAA.. ........R!., .................. ;w5c.7TH.........:....ACL?'.5........ .......................................... known to me to be the pemom5. whose name,--. .19AtUbscribed to the within instrument and acknowledged to me that .T.-he.Y executed the same. IN WITNESS WHEREOF have hereunto set my hand and affixed my official seal in the .......................... County of ... B.C,S..�...... the day and year in this certificate /fist above wren. otary Public, State ojCalifornia My commission expires ...- ....1. j.i„(,.':(,V....... Cowdery's Form No. 32 -Acknowledgement -General (C. C. Sec. 1190x) f r `'end ta, slatemenfs to Abuvu _Idurtz�Ss Dated ....... J.uly...?_9------. vin Da e ogers--- - Jose ----•------- ........................................ .`,TATE OF CALIFORNIA County of ...... s..�.rt:k.J.].�.. ....................................... aa. ..�.vv..'h='.s7?:^"i' Y �.' �.1'n� �s•'.��•.t�'. i,,y.tY.w}.r��;� �'�1,`!R'G' ��' �e.kV.� 41-42-0-28 00-0560 BLAUVELT, Cheryl/WALKER 3001 Clark Rd, Oro Reroof COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI N� 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER t-41-420-025 ZONING BU I 1 NG P ER M IT OWNER c ceryl blauvelt rend bunt welder TELEPHONE 891-5716 SO. FT. OCC. BUILDING VALUATION r60 2-760..00 OWNERS MAILING ADDRESS r Rn OR965 CONTRACTOR'S NAME CL TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 2.7W.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ -54, 00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS .it)t11 (:i UK RD, ORO 95965 Energy Plan Checking Fee $ $ PERMIT FEE $ 74.90 IAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other sPECIFv Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK (f'. ..r/ ;' #0 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: H ROOF COW Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ I } ELECTRICAL PERMIT Fling Fee 20.00 OA OR LESS Main Service 200AORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed, contractors to construct the project. 11 ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWEWIG OCCUP. OR ADDNS. ( a ACC. S. SO 3.5QFT: .1; ONT. MULTI.OUTLET @7,50 POWER APPARATUS B SINGLE OUTLET CIR. Ex. Occup. ourLEroRForTUREs 20 p 100 BAL 00 FU(ED APPINS. OR Ex. Occup. ovnF rs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations:' ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number ere: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FET= $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) >LI certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject'to workers' compensation laws of California, and agree that 0 1 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. 4 I/ -- X i'i / n., 11 Date {a Signature offApplicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 74.00 HAZ. D.FEES IMP FLOOD CDP PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By _ PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date - / w ate ReceiptNo. �r�'.Z �% �` WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT