HomeMy WebLinkAbout041-420-03741-42-37
Robert Brown
S%Runaway Rd., app.4/10 mi.W.of Clark
Rd. , r i116--- - -e
Jim S//��8'.3
contra Jim Bsuce, Chico
Permit #1370-8 ,,,E,M(new single family
41-42-33�
Permit. _ $64:-$,
('and renewal 1370-81)SF ,
IM
41-42-37
ROBERT BROWN ,fr,
3748 Run -A -Way Rd, Oroville'
Permit#11-85A (Agricultura I Bldg Exemp
stg of aeauio) = 2
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
AGRICULTURAL BUILDING EXEMPTION PERMIT
PERMIT 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 oT a place of employment where agricultural products are processed, treated,
or packaged, nor shall it be a place used by the public.
ASSESS PARCEL O.
ZONING
0 ER
PPt+ONE NO.
dro
_
cl s
OWNER'S ADDRESS
- W
/
LJ % et- A c
)rot) l
LOCATION OF BUILD G
-tV 4J
liex
cv, U
USE O BUILDING
fT Flra
t
SIZE OF STRUCT RE L
T� X C) r
D SO. FT.
_
TYPE OF CONSTRUCTION:
WOOD FRAME_ K—STEEL CONCRETE
OTHER (Specify)
TYPE OFCBING
ROOF CO RING
FL00 YPE
00 C1
C Ire C'-'
ESTIMATED COST OF CONSTRUCTION.'
$
AG Buildings shall comply Withbuilding front, side,
and rear yard requirements of the applicable County
Ordinances as fol o s: r4ol . 0
.4
FRONT - SIDES
REAR
AG Buildings shall be a mini um of five (5) feet fr m any se p c k or leach fields.
A,,� to :�--�— �-¢ ,
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 mobilehorrie, 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 before occupancy.
Date �_—� �S Signature of Owner
Permit Fee -$25.00 The above described AG Building is a pt from a building permit.
Receipt No. `�d'T Director of Public Works
By Date j .-
White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 : TELEPHONE: 916/534-4541
PERMIT APPOCAtION.-DATA SHEET
Permit No.
OWNER �Oi1(�ff (0117 Vt _ A. P. No. L11 - / P 1,3
-
Proposed Building Use�G
Permit Fee Based Upon: Complete Contract Price DPW Valuation
Dther Explain) /
Building Inspector /���,11 ,I�c' Date � % -
At time of/permit. application, I was advised the following data must be submitted prior to permit processing
andJor i2suance: DATE RECEIVED APPROVED
_ 1. All items have been submitted. . . . . . . . . . . .
2... Plot plans in duplicate./triplicate. . . . . . . . . . .
3. Complete plans in duplicate. /triplicate. . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Pians with Energy Design Compliance Statement. . . . . .
6. State Energy Forms No.
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. . . . . . . . .
.
Pre-Inspec. request to
17. 'Pre -Inspection for Required. Building Inspector
(Date)
18 Recorded c of Agricultural cknowl dgment Statement.
ther
her you issue the permit, process as follows: Mail to owner. Mail to contracto
Telephone and hold for pickup at office. Deliver w./inspector.
Other
Applicant./y` -�t� 0 ��C Date
Copy of plans sent Health Dept., Fire Dept., Other U 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 pplication, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Desig
advised of above required data by
By
ele
Plans checked by Date
Plans approved by Date
Other:
Copy—DPW
-Mail Other
Date
iTS
a .
1370-81B,P,E.,M
'PERMIT NO.
PERMIT EXPIRES Z%y3
OWNER Robert Brown
CONTR.
ASSESSOR PARCEL
LOCATION
Jim Bruce, Chico
41-42-37
SIS Runaway Rd.. app.4/10 mi.W.oi
Clark Rd., Oroville
6
Gx� Uca
Temp. Power Pole
Le'�'
Called PG&E '� 9 g� '944s./��
Temp. Elec. Service �
.a
Called PG&E !o -17 1
n.
Temp. Gas Service
CalledPG&E
G
t JOB FINALED (Date)
i?
Signature
= OK
= Not OK
= Not Applicable RESIDENTIAL (Single and Duplex)
= Not Ready
Date
UND RF OR Plans OK except N's
Date
FRAMING (Continued)
1. o ing requirements -Setbacks -Easements
4t oftoperty Line Firewall & Openings
2 tg., Main; Soils -Steel -€ice- / Ftg. Depth
xt. Doors -One 3' -Check Garage -3rd story, 2 exits
g., Garage; Soils -Steel - /I /' Ftg. Depth
60--%airs_W4dO-Headroom-Rise-Run-Landing-Fire
Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
i<
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5L81emwalls, Main; Steel-Blockouts-Wrapped-Slab
02-3llTffg-t4
ailing -Veneer
emwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucc esh-Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fireplace Ftg.-Steel
.
Glazing Area -Glass Protection -Skylights -Plastic
V.: Fall -Fittings -Test -2 way C/O -Sewer Test
St.
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
C d -BI
15�Date
Card -BI Date
Card -BI
Date Card -BI Date
11
Card -BI
Date Card -BI Date
Card -BI
Datet't -VCard-BI Date
Date
FINAL Ian K except N's
Card -BI Date — Card -BI Date
Date
PLUMBING (P t) OK except #'s
56.
eps-Door & Sidelight Protection -Landings
57.
moke Detector
4-4.-�CtztP,LHt.; Vent -Access -Combustion Air
58
Furnte-Comb. Air -Connector-
ln_Garage; Above Floor -Ducts -Meth. Protection
*! 'Water Pipe; Test & Anchors -Nail Protection
1D.W.V.; Test-Fttngs & Anchors -Nail Protection
59..
Blom Exiting
1V--6hewer1P'dn; Test, First Floor -Tub Access
60.
.FSI-. & Bath Fixtures & Tub Access
16r-XesL7.4 & Shower, 2nd Floor -Tub Access
61A1f5-1e
im & Subpanel; Breaker Sizes -Labels �� s
18r-@as'Plpe; Size & Anchors
6
irs & Rails V
61.
F' ace or Stove; Clearances Wart r
6 .
E!qAeOutlets at Wood Panel; Int. & Ext.
C -BI
Date 46 — ::;RCard-BI Date
65A,'Rit
t. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
, Ii. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL P OK except q's
67
arage F' oor; Swing -Landing -Closer
.CPff6t in Garage -Damper
2 xture & Transformer Clearance -Ins. Protection
69.
Nfir. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
I arage; Above Floor -Meth. Protection
2k--Sizc. Receptacles Spacing -Lights &Switches at Doors
70
P ., Elec. & Mech. Equip. Listed for Location
2k --Size Boxes & No. of Conductors -Stapled
71
Receptacles
let. Receptacles in Garage; (G.F.I.)-Ro rotec.
�!Romex Installed Close to Edge of Studs & C.J.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72,.
I�Sc.
—Looked in Attic es
73.
Guard Rails & Deck Construction -Post Caps
26� Appliance Circuits in Kitchen &Conductor Size
74.
. rawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑Yes
26. Subfeed Wire Si e / / ga. Cu o A.C. Wire Size /Ad ga. Cu o
27. Range Circ. / / ga. Cu or ven Circ. / / ga. Cu or AI,
Insulated Neutral es No
75.
Following instld.: Div E] Yes alks ❑Yes
Planters ❑Yes No
28, Service -Riser Conductors & Ground -Main Disconnect
7
.
7
Stucco; Br n -Finish
C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
equip. Clearances;'Panels-Motors-Mech. Equip.
*-,Clothes Closet Light -Shower Light
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
er Well; Disconnect, Electrical, Plumbing
terior Elec. Trim; G.F.I. Receptacle -Underground
Car6B I
Date Card BI Date
a ,
V ation throughout House
Card B -I
Date
Date Card -BI Date
MECHANICAL (P it) OK except q's
8
s Pro ction
8
Cor ions from Previous Inspections
8
a es -Meters Tagged; Gas -Electric
3 A.C. Ducts; Insulation & Support
854AIrajoel
Sewer Connected -C/0 to Grade -HD Approval
3 nt Fan; Exhaust above Insulation
g
nergy Compliance Certificate -Other Certificates
_
3�. Condensate Drain & Overflow; Size & Grade
3ent; Access -Comb. Air -Return Air Vent -115V outlet
3 Attic Access & Pla urnace in
Card-BIDate
Card -BI Date
C d -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI.
Date Card -BI Date
Comments at Final:
Date
-1740 ZV—
FRAMING PJs) OK except N's
3 ills; Proper Material & Anchors
3 W IIs; Studs -Nailing, Spacing & Bracing -Plates -Sound
_
30'—Bearing Walls over Girders & Floor Nailing
3 raft Stop in Walls (rat proof)
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
eader & Beam -Size & Bearing
_
ngers-Post Caps -Anchors -Connectors
4 Cing. Joist-Ritr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Ring. _
44. Fireplace Ties or iypfA-r,lue-Fireplace Throat
—
4 flit Access; Size & Flomex Protection -Draft Stop -Ins. Baffles
—4 rm. Windows or Exiting Doors -Sill Hgt. & Dimensions
4 ,arage Fire Protection Framing
(NOTE: Anentry must be made each time you visit jobsite)
V OK
0 = Not OK
= Not Applicable MOBILEHOMES MISCELLANEOUS
= Not Ready
Date
MOBILEHOME UTILITIES (Plans) OK except H's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1, Zoning Requirements=Setbacks-Easements
2. Soils; Special MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -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.-Rig.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ P'L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
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 H'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/O 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 -Enc losures- Pane lboards-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-1
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B-1
Date Card -BI Date
Card -BI
Date Card -BI Date
U
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFOItMA WITH CURRY ENERGY CONSERVATION REGULATIONS
(location) U
BU ILD ING PERMIT NO. X370 -'�7 / A.: P . NO.��--�7��
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED.,PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge
Fdn. Walls v
Floors
Walls
Ceiling/Roof
Ducts L�
Circulating Pipes
APPROVED HEATER
APPROVED WTR.HTR.
GLAZING:
Single Glazed
Special (Insulated)
CERT. & LABELED WDS.
& SLIDING DRS. v .
WEATHERSTRIPPED DRS.
BACK DAMPERED FANS
INTERMITTENT IGNITION DEVIC
CERT. APPLIANCES
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
Signature of
(please print)
Insulation Applicator
State Contractors
License No.
General Contracto /Owner Name -SV\k Le �CtL:�JYU
(pl e print)
Signature of
General Contracto /Ownegr .�'` - e
State Contractors
License No.
THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
v.
COUNTY OF BUTTE - DEPAF,.TMENT9�OF;PUBLIC WORKS ERMIT N0. -
7 County Center Drive - Oroville, California9�965 - Telephone 916/534-4 1 (PQ �
APPLICATION AND PERMIT
ASSESS R PAR EL NUMBER
�- -3
ZONING
BUILDING PERMIT
O R
g aJQ�
O86�`j173
TELEPHONE
5 O4,
'57404,
SQ. FT. OCC. BUILDING VALUATION
^r/zllr��
�tJ R'S MOAILI�irNG ADDRESS 1739X ✓/� ��/V ✓�^'/V l�/W �V J7f
�/e
CONTRACTOR'S NAME
TELEPHONE
[' d
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDE
UNKNOWN
Total Valuation $
Filing Fee
gi
$ 1G,00
LENDER'S MAILING ADDRESS
Permit Fee 7
$ tU
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGIN 54R'S MAILING ADDRESS
fee
$
BUY
BUI G ADDRES/(Js
S ,e�/rPA_ r"q
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
5,00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer 411
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ , rRe�m-ooddeell ❑ Uti litiq/s ❑ instal latio ❑ Other
Describe work: �Nsr� 0xwa�/p
SCJ/ '* /L - �//
Permit Fee
$ -00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1100V OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD'L 100 AMP
2.50
DWELLING OCCUP.)
NEW CONST. ( b
OR ADDNS. ACC. BLDGS.
22 sq ft
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
Y
for this reason
-NNEW ON R. BRATCH CIRCTITg 2.50 ea
NEw CONSTR. (POWER APPARATUS 6)
NON-RESID. (SINGLE OUTLET CIR,
EX. OCCUp OUTLETS OR FIXTURES_ 50 @ 25
L@ 10t
IXED APPLNS. OR
EX. OCCUp.�OUTLETS (RESID,) EA.
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee
$ /01400
Contractor -
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
�j 1 shall not employ any person in any manner so as to become subject
j� 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 shal I be deemed revoked.
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$ Q,Ov
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.
`y" • Date �_ �7--�
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
TYPE OF CONST,
I
PARCEL
PD
HD
SSUE
This ermit is hereby issued under
sion f the Butte County Code and/or
wor i d ove for which
I CT�OR OF PUBLIC
PERMIT EXPIR!_ ES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
r7
Date /' L d Z
.�Z7 8'3
P
Receipt No. 81�. 7v
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
r
COUNTY OF BUTTE - Departfient 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 ye 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
4.
Address City
Phone Contractors License
I plan to provide portions of this work, but -I have hired the following
person to coord' te, supervise, and pro 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
v
Social Security_ number \
Date L
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.
77
COUNTY OF BUTTE,- DEPARTMENT OF PUBLIC WORKS / PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND' PERMIT
ASSESSOR P CE��,�It:UMBER
%li' 2:
z
/ 14 3
BI.Ii6DING PERMIT
O �/
p?)BEQ27-' 15e66 f
�V
TELEPHONE
S0. FT. OCC. BUILDING VALUATION
� O/ x-00
OWNER 'S MAILING ADDRESS
sZ cov
z2
CO ACTOR'S NSA F, ,,�
/ M �/CC{llL/f�/V/
TELEPHONE
Sq3- 5/,3
8�
tw. ° v
CONTRA TDR'S MAILING ADDV/73P"T4 , L, 1L0 64 �
Fireplace;
o0 0
CONSTRUCTION LENDER'
UNKNOWN
,
Total Valuation $
3 08'.Ofi
Flling'Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 3 as
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ //-1.6-70
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 4'Z , S a
B L ING ADDRESS n
>�
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00 Ig. CD
-Repair drainage or vent piping#5
.00
,E—
Water piping
DO
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5,00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE'
�-,/ ❑ Mobi lehome ❑ Other Duplex
SFL7�
SPECIFY
Building sewer
�, �?90 ,
Lawn sprinkler system
5:00
s
TYPE OF WORK
New EIJ�Addition❑ Remodel❑ Utilities[] Installation❑ Other ❑
Describe work:
Permit Fee
$ , O
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP LESS
100
5.00 -00
7
' Main service EA. AOD'L 100 AMP
2.50 2150
NEW CONST. (DWELLING O S._ /
g
OR ADDNS. ACC. BLDG
2�sgft $ ,
•
CONTRACTORS LICENSE LAW
I declare der penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business80
and Professions de ,end my license is in full force and effect.
Co
��/�..i ,
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 .OU LET Q,50ea
NON.RES'D BRA CH CIRC TS
NEW CONSTR POWER APPARATUS 6
NON-RESID. (SINGLE OUTLET CIR. )'
@ 25C
Ex. Occup(OUTLETS OR FIXTURES BALP1
FIXED APLNS.
Ex. Occup.(OUTLETS P(RESID )R EA. 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
CSC—
Permit Fee R $
Contractor
MECHANICAL PERMIT
Filing Fee,,. 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ e permit is for $100.00 (valuation) or less.
Ilaplaced 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 Se 000
-OrJ
k7- POW.
Cooling -7
Hood
3.00 `�LOl7
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:
andeexpen eharmless
s which may in any wayof Butte sacc u13 ainst
abiilree to lit es, j dgments, costs, and
all liabilities,
against said ounty in consequence of the granting of this permit.
X Date T GU
Signor�efAppli cant - Owner ❑ Contractor Agent ❑
An 0rmit is required for excavations over 5'0" deep and demolition or construct-
ion oures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ g�
occuP.= ROUP
TYPE CONST.
PARC
PD
N�
Iesu
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREC OF PUBLIC
By
PER EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date C/_ 1-7-7
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
buiiaing :;eparzment
From: Environmental
Health
Subject: Sabitation Clearance
: v f - y z —37
Oa�n€r Location,./aK/� �p
Plans approved Ifor: Sewage Disposal 'eWater Suppler �
Hold final I,fof : mater Supply /K
Final Clearance O.K. for: dater Supply
Clearance for a bedroom home o Other
Clearance for addition of
Mote*
o 'an gat®
•i /
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
W76COUNTY CENTER DRIVE - OROVILLE, CAs;LIFDRNIA•95965 - TELEPHONE: 9,,%534-4541
PERMIT APPLICATION DATA SHEET
/ Permit No.
OWNER P09�( BEOW& A. P. No.
Proposed Building Use S F
Permit Fee Based Upon— Complete Contract Price � DPW Valuation
::::
Other (Explain)Building Inspector - Date
At time of permit application, I was advised the following data must be submitted prior to permit processing
=and/or issuance: DATE RECEIVED APPROVED
1. All 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. State Energy Forms No.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . , , . . ,
9. Letter of signature authorization. . . . . . . . . . .
1.0. 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 owner0, Mail to owner ❑,)
15. Improvements may be required. . . . . . . . . , . .
16. Mobilehome Installation Data. . . . . .
•. .
17. Pre -Inspection for Pre-Inspec. request to
Required. Building Inspector (Date)
18. Other
.P2 __
When yo issue the permit, process as follows: Mail t owner. _
Telephone $�/33 and 40for pickup at office.
Other__
Mail to contractor.
_Deliver w/inspector,
f
curing 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.j Index permit for above Items No.
2. .Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other
By
Date
Copy—DPW
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