HomeMy WebLinkAbout041-460-01741-46-17
398h
Way, Pardiise
Contra K.E. Th "er Const
Pemit#3241-83B $E,M(new single family)
41-46-17
Contra. •E• Thacker c3JJtr1gt�
Per it#9p-84B(add wood stove/SF) 1
41-46-1.7.
Permit#697-84B(add deck/SF) 3241-83 _
j-
J = OK
O = Not OK !
= Not Applicable
= Not Ready MOBILEHOMES- MISCELLANEOUS i
�- ..
Date
MOBILEHOME UTILITIES (Plans) OK except N's
Date
E C VERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements1,.
i Requirements—Setbacks—Easements
2. Soils; Special MH Support—Sketch
2, of s; Size—Depth—Spacing—Conneclors-
3, Sewer; Location—Test—Fall-C/O—Concrete
3 ecks; 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; Local ion—Clearances—Grnd.—/ / Amp—.Concrete
5, Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
6. Gas; Location—Test—Wrap:/ /"L" ft:/ /"Nat. or/. /"L"ft./ /"LPG
6. Carports; Windows—Doors
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
[Card-131,"ll-'
4dZate Card -BI Date
Card -BI
Date Card -BI Date
_
Date Card -BI Date,
Date
MOBILEHOME INSTALLATION (Plans) OK except N's
1, Zoning Requirements—Setbacks—Easements
Date
_
POOLS (Plans) OK except ti'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—Enclosures—Panel boards—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-1
Date Card -BI Date
Card7B1
Date Card -BI Date
r
V - 0K
0 - Not OK
= Not Applicable
* Not Ready RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR Plans OK except#'s
Date
FRAMING (Continued)
1.
Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
2.
Ftg., 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
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
51.
52.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
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 Protection -Skylights -Plastic
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
Card -BI
Date Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
_
Date Card -BI Date
PLUMBING (Permit) OK except q's
14. Water Ht.: Vent -Access -Combustion Air
15. Water Pipe; Test & Anchors -Nail Protection
57.
58.
Smoke Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Meth. Protection
16.
D.W.V.: Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
Shower Pan; Test, First Floor -Tub Access
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.
63.
Stairs & Rails
Fireplace or Stove; Clearances -Hearth
_
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
it. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except ll's
67.
Garage Fire Door; Swing -Landing -Closer
68.
69.
A.C. Duct in Garage -Damper
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
20. Fixture & Transformer Clearance -Ins. Protection
-
21.
Elec. Receptacles Spacing -Lights &Switches at Doors
70.
71.
72.
Plb., Elec. & Mech. Equip. Listed for Location
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
Insulation -Foam -Looked in Attic E] Yes
22. Size Boxes & No. of Conductors -Stapled
23. Romex Installed Close to Edge of Studs & C.J.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
73.
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 Al.
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At,
Insulated Neutral ❑Yes ❑No
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes ❑No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
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.
------------
--
79.
Water Well; Disconnect, Electrical, Plumbing
Card B -I
--
_Date Card -BI - Date -
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
81.
Ventilation throughout House
Card B-1
Date Card -BI Date
82.
Glass Protection
Date
MECHANICAL (Permit) OK except p's
83.
_
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
31.
A.C_. Ducts: Insulation & Support
85.
Water & Sewer Connected -C/O to Grade -HD Approval
-
_
32.
_33.
Vent Fail; above Insulation
Condensate Drain _& Overilow; Size & Grade
86,
Energy Compliance Certificate -Other Certificates
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
Card -BI
Card -BI
35.
--
- _
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 N's
_3_6. _Sills; Proper Material & Anchors
Comments at Final:
_ 37.
38:
39.
_
Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls over Girders & Floor Nailing.-
Draft Stop in Walls (rat proof)
40.
-41.
_Fire Stops; Furred Ceilings -Stairs -Chases -Tub
42.
43.
44.
45
46.
47.
Header & Beam -Size & Bearing_
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rfir. Ties-Purlin-Roof 8rac.-Truss-Shthng.-Ring.
Fireplace Ties or Type A Flue -Fireplace Throat
Attic Access: Size & Rom_ex Protection -Draft Stop -Ins. Baffles
Bdrm. Windows _or_Exiting Doors -Sill Hgt. & Dimensions_
Garage Fire Protection Framing i
_
(NOTE: Anentrymust be made each time youvisil jobsile)
V
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541 t'
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
ER
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 a/& onal explanation, please contact this office immediately.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATI OW AND -PERMIT
ASSESSOR P,�g CE UMBER
`�— _1
Zq�NING
cs►/f'.'
BUILDING PERMIT
OWN�S�Ij //��'' // •
/Y �l/C--166e
TELEPHONE
SQ. FT. OCC.BUILDING VAL A -ION
��C./✓
OW I LI %� i�[>I Gd" -6
co
Z_
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDE1
UNKNOWN
Total Valuation $
Filing Fee
$ 10.(]0
LENDER'S MAILING ADDRESS
Permit Fee
$ 25• IT t7
ARCHITECT OR ENGI
C
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ .570-0-16
BUILDINA 9SS PA✓I)E4 W7//&T
Ste779 S
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
��1�a/�/yt�^^Iyn� ( �-•
• ""' ylC)Lr.�
Water piping
5.00
LOT NO. SUBDIVISION NAMEPARCEL
MAP
Each qas water. heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF L. Duplex ❑ Mobi lehome ❑ Other
" SPECIFY
Building sewer
5.00
Mobile Home I S I G I W
10.00 e
TYPE OF WORK
New❑ Addition Remodel Utilities � Installation❑ Other
Describe work: /' A
/-D� 304-1
Permit Fee
$
contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 10ov OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST.// DWELLING OCCUP.&\
OR ADDNS. l ACC. BLOGS. I
t
2/20sq 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 m license is in full force and effect.
y
License No. Classification
❑ 1, as the owner, or my employees with wages as their sole compen-
sa ' n, will do the work,and the structure is not intended or offered
r 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 CIRCUITS)
NEW CONSTR POWER APPARATUS &')
NON.RESID. (SINGLE OUTLET CIR.
Ex. Occup(o OR FIXTURES .200530
zAL030
FIXED A
Ex. Occup. OUT OUTLETS P(RESID )LNS REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a ertificate of Workmen's Compensation Insurance or a Certificate
Consent to Self -Insure.
R110.1shall 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.
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 s id County in nsequence of the granting of this permit.
Date �� it
Signatur of Appl nt — caner❑ Contractor ❑ Agent
An OSHA permit' require for excavotions over 5'f)" deep and demolition or construct-
ion of structures over 3 storie in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
occuP. GROUP
/
I TYPE of ONST.
_VW
�
PAR 1.
PD
HD'
i
ISS E
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECT OF PUBLIC
By
PER E
T EXPIRES Date.
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date/��/
`7-1 � �+\�
I
Receipt No.ZZI—C
WHITE-D.P.W., YELLOW -ASSESSOR, PIN -INSPECTOR• 60LDENROD-APPLICANT
f -- E ---PERMIT NO. 3241-83B.,P,E,M
PERMIT EXPIRES
OWNER NANCY'EIGER
CONTR.K.E. Thacker Const.
ASSESSOR PARCEL 41-46-1.7
LOCATION 3998 Pardes,Way, Paradise _
',y_
OFFICE COPY
4
Temp. Powe
Address
Called F
GAS i
Temp. Elec.
M By Date
ELECTRIC- 2
Meter By Date
Called
F
Temp. •Gas Service
Called PG&E `
JyOB FININALED (Date)
�
Signature
OK'
0o Not OK
=NolApplicable MOBILEHOMES y MISCELLANEOUS
_
Not Ready
Date
MOBILEHOME UTILITIES (Plans) OK except #'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
12. Footings; Size—Depth—Spacing—Connectors
3. Sewer; Location—Test—Fall-C/0—Concrete
4. -Water; Location—Test—Easement Needed (Sketch)
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
4. Wood Awn.; Posts—Beams—Rftrs.-Connec.—Shing.—Rfg.—Bracing
5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete
6. Gas; Location—Test—Wrap:/ /"L" ft./ /"Nat. or/ /"L"ft./ /"LPG
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
6. Carports; Windows—Doors
7. Utility Clearance
7.. Elec. �' v
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
Card -BI
Date
_
Date Card -BI Date _
POOLS (Plans) OK except it's
- 1. Zoning Requirements—Setbacks—Easements
1. Setbacks—Easements t
2. Footings; Size—Spacing—Marriage: Line
3. 'Gas; MH Test—Demand—Valve—Connector
2. Soils; Compaction—Structure Stability
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-GF1
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
i
8. Elec.; Grounding; Equip. w/5'—Circulating Equip. -Pool _Lghtg.
Boxes—Enclosures—Panel boards—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
DateCard-BI ..Date -
Card BI
Date Card -BI -. Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
4
n
V = OK
0 = Not OK
- = Not Applicable
= Not Ready RESIDENTIAL (Single and Duplex)
� ,
Date
UND LOOR (Plans) OK exce tq's
Date
FRAMING Continued
1 Z ing requirements -Setbacks -Easements
48.
rty Line Firewall & Openings
Ftg., Main; Soils -Steel- - / Ftg. Depth4
t. ors -One 3' -Check Garage -3rd story, 2 exits
3 g., Garage; Soils -Steel- / G Ftg. Depth
5
S irs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /'' Ftg. Depth
5 .
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
_
Slee ails, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6!/Stemwalls, Garage; Steel-Blockouts-Wrapped-SI
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
ers-Fireplace Ftg.-Steel
D.W.V.: Fall -Fittings -Test -2 way wer T
54.
55.
Glazing Area -Glass Protection -Skylights -Plastic
Shear Walls; Nailing -Bolts
9. as Pipe; Size -Anchors
i
Water Pipe; Test -Anchors - u t est
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
ate � Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card BI
to Card -BI Date
Date
-�
FINAL (Plans) OK except N's
Card -B Date Card -BI Date
Date
_
PLUMBING (Permit) OK except q's
14 ter t.; Vent -Access -Combustion Air
56. Ext. s -Door & Sidelight Protect ion -Land in s
57.
58.
oke Detector
Vie; Vents -Clearance -Comb. Air -Connector-
In Ga age; Above Floor -Ducts -Meth. Protection
r Pipe; Test & Anchors -Nail Protection
16./ D Test-Fttngs & Anchors -Nail Protection
5
ed g� Exiting `
wer Pan; Test, First Floor -Tub Access
60."G.F.1.
& Bath Fixtures & Tub Access
_ __17f
18. Test Tub & Shower, 2nd Floor -Tub Access
.
Elec. Trim & Subpanel; Breaker Sizes -Labels
_
_
19. Gas Pipe; Size & Anchors
63t - tai s-&-Tfails
63.irepl or Stove; Clearances -Hearth
Card -BI
I ate�'�-�� and -BI Date
64,i lets at Wood Panel; Int. & Ext.
65'"Kit. . & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date
l Date Card -BI Date
ELE ICAL Permit OK except q's
66.
. utlets & Receptacles at Kit. Counter
6
Gar ire Door; Swing -Landing -Closer
68.
69.
.C. t in Garage -Damper
. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In G e; Above Floor -Meth. Protection
g
20. ure & Transformer Clearance -Ins. Protection
21. Receptacles Spacing -Lights &Switches at Doors
70
., jec. & Mech. Equip. Listed for Location
-
r
22. i Boxes & No. of Conductors -Stapled
71
ec. Receptacles in Garage; (G.F.I.)-Ramex Protec.
23. ex Installed Close to Edge of Studs & C.J.
24., uip. Ground made up w/Mech. Fasteners -Bond Gas &Water
72,
lotion-F.eaar-.booked in Attic es
-_
25. 2 Appliance Circuits in Kitchen & Conductor Size
3
uard Rails & Deck Construction -Post Caps
u eed Wire Size / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI
74.
Fdn. Vents &Crawl Hole Drainage &Wood -Faith Clearance ,
Flo
Looked under er Floor Yes
--
27-: Range Circ. / / ga. Cu or AI -Oven Circ. ❑/ / ga. Cu or AI,
Insulated Neutral Yes DNo
75.
Following Drive Yes o; Walks ❑Yes o;
Planters ❑Yes o
28. Service -Riser Conductors & Ground -Main Disconnect
7
u Brown Finish
-
29. Equip. Clearances; Pane ls-Motors=Mech. Equip.
30. Clothes Closet Light -Shower Light
77,
C nit; Disconnect- ces-Brkr. & Cond. Size -115V Outlet
78,
ents Above Ibg.-Appliance-Firepl.-Clearance to Opngs.
-
Card B -I
1 i1 �,
Date 1 -__ Card -BI Date
79.er
.
Well Discon lectrical, Plumbing
rior Elec. Trim; G.F.I. Receptacle -Underground
8
Ventilation throughout House
Card B -I
Date
Date Card -BI Date
M A CAL (Perrr,it) OK except q's
82.f
Gla rotection
8
orrect ions from Previous Inspections
84.
Gas Test -M agged; Gas -Electric
3 . _C. Ducts; Insulation & Support
Wa
ewer Connected -C/O to Grade -HD Approval
_
32. Vent Fart_Exhaust above Insulation
_33. Condensate Drain _& Overilow; Size & Grade
8
nergy Compliance Certificate -Other Certificates
34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35. Attic AccJess & Platform if Furnace in Attic
Card -BI
Card -BI
Card -BI
Date rd -BI Date
ate and -BI Date
Date Card -BI Date
Card -BI
__
Card -BI
Date
ate / /Ir- --"
�V(/ __r Card -BI Date
Date Card -BI Date
FR NG(Plans) OK except N's
Comments Final:
_
3 ills; Proper Material & Anchors
_ __
37/� Its: Studs -Nailing, Sp_acing_& Bracing -Plates -Sound
3S. aaring Walls over Girders & Floor_ Nailing____
3®aft Stop in Walls (rat proof)
4 re Stops; Furred Ceilings -Stairs -Chases -Tub
i'YL�,n/11JZM, ...
{
41. eader & Beam -Size & Bearing
4 aangers-Post Caps-Anc rs-Connectors
43! Ging. Joist-Rftr. Ties- urlin-Roof Brac.-Truss-Shthng.-Rfng.
Fir lace Ties or Typ Flue -Fireplace Throat
tic _Access; Size & Romex Protection -Draft Stop -Ins. Baffles _
6. Bdrm._Win_do_ws_o_r_Exiting Doors -Sill Hgt. & Dimensions _
Garage Fire Protection Framing
(NOTE: Anentrymust be made each time youvisit jobsite)
RESIDENTIAL ENERGY. PIAN CHECK/INSPECTION SUMMARY ®R
Owner. )Van Gtr _ _ C'li.mate Zone Permit No.
Floor Area
Compliance path:.
Package ❑ A ❑ B ❑ C Point System ❑ Budget ❑ Others- .
MIN
R -VALUE. DESCRIPTION
REQ'D
INSTALLED ITEMS
(1)- INSULATION:
Roo f/Ceiling_
Wall _ _ _-
❑
Slab Floor Perimeter
[
Raised Floor
(2) INFILTRATION:
❑
(A) A vapor barrier is required in climate zones, 1, 14 & 16.
(B) All manufactured windows and sliding glass doors shall meet the
1972 ANSI Air Infiltration Standards and shall be certified and
labeled.
(
(C) -All swinging doors and windows leading.to unconditioned areas
shall be fully weatherstripped.
Tight -the above standard features plus:
(D) Continuous infiltration barrier
❑ .
(E) Electrical outlet plate gasket
❑.
(F) Air-to-air heat exchanger
(3) GLAZING:
(A) Location
'
Area Glazing %Floor Area Single Double Triple
Total Bldg ie .
North d _ ' /� S-—
[.�'
East
r
South
[
West 77. Ste_ y
❑
Skylights
(B) Shading
Shading
Coefficient Description
❑
East
❑
South _
60
West 03(a Wi & A 716P rAAdox dip
11
,
Skylights
[.�
(C) South Overhang
Length of projection I_ft. Description
❑
(D) Moveable insulation: Area ftZ Description
(E) Thermal mass
Type - Are�Ft . 2 HC=_,&a!! R=,01
MC= 3,7 Loca'on
t
Type Area X Ft . HC=.? W R= •O
MC= Location �' �,/s •
Type AA - Area 12JX-Ft. HC= /j
MC= I g Location
Type L. -Area ��Ft . HC= Z ij &-R
MC=_2_3_ Loc tion W./I SAIt4[
❑
Type - Area Ft.2 HC= - R=
MC= Location
❑
Type - Area Ft. HC= R=
MC= Location
7/83
1 ' FORM 1
❑ (4) MASONRY AND FACTORY -BUILT FIREPLACES shall be equipped with tight
.- fitting closeable metal'or glass doors covering the entire opening
of the firebox; a combus%on air intake equipped with a readily
accessible, openable,.and tight fitting.damper to draw air from the
outside of the building; and a night fitting flue damper with.a
readily accessible control.
*1 (5) HEATING, VENTILATING, AIR COPIDITI.ONING..SYSTEM
(A) Heating
[] Central Gas Furnace _
' (brand and model number) ® SE
p t -u /hr S�c7A AYa � --�"®♦ c��„
(heating capacity)
Me Heat Pump
(brand and model number) ACOP
��Btu/hr
(heat' g capacity at 47°F)
❑ : Active Solar '
type (liquid or air)" Collector brand and
ft2
model number solar fraction collector area collector
orientation collector tilt rated y -intercept
rated slope
[per Other
(des ibe)' 77
*1 (B) Cooling
❑ Electric Air Conditioner
(brand and model number) (seasona/l� EER)
Btu/hrxj �er•T � � UFi�s �nw4
(cooling capacity at.95°F)
R000, Electric Heat Pump _ 7. r % $
EER
/®O Btu/hr
(cooling capacity at 95°F)
❑ Other
(describe).
(C),A TWO-STAGE THERMOSTXf which controls the supplementary heat on.
its second stage, shall be required for heat pumps.
❑. (D) AN AUTOMATIC SETBACK shall be provided for all thermostats, except
those controlling heat pumps.
❑ (E) AN INTERMITTENT IGNITION DEVICE shall be provided'for all gas-fired
fan type central furnaces, gas-fired fan.type wall furnaces and
gas cooking appliances
QO (F) BACKDRAFT DAMPERS shall be provided for all fan systems exhausting
air to the outside..
( (G) DUCT CONSTRUCTION &-INSULATION. All transverse duct, plenum, and
fitting joints shall be sealed with pressure sensitive tape or
mastic to prevent air loss and shall be insulated"to conform to
the provisions of.Section 1005 of the UMC, 1976 Edition. `
7/83 2.
_! U 1X VA
(6) DOMESTIC WATER SYSTEM
[1 (A) Gas Only Gallons
(brand andj_model number), (tank size)
❑ Heat Pump w/Electric Backup
(brand and model numbe /1 n
Gallons si ,�-. 4�� '#^f
(tank size)
Active Solar _
(collector brand and model number)
(rated y -intercept) (rated slope) (solar -fraction)
ft2
(backup heater type, brand and model number) (collector area)
(collector orientation) (collector tilt)
❑ Location of Solar Panels
0 Other _
-- ----(Describe) '.
(B) TANK INSULATION. Storage type water heaters and storage and
backup tanks for solar systems. shall be externally wrapped with
R-12 insulation or greater.
CEJ
(C) PIPE INSULATION. The five feet of pipe closest to the water
heater and outside conditioned space shall be insulated with a
minimum of R-3. Steam and steam conditioned space shall .be
insulated with a minimum of R-3. Steam and steam condensation
return piping and recirculating hot water piping outside the
building envelope shall be insulated in accordance with
T20 -1408.(d).
(D) FLOW RESTRICTORS shall.be provided for showerheads and faucets
as outlined in the new appliance efficiency standards and shall.
be certified to the Energy Commission.
(7) LIGHTING
(A) Lamps used in luminaries for.general lighting in,kitchens and
bathrooms shall have an efficacy .of not less than 25 lumens per
watt (usually florescent).
*1'..Submit documentation,of sizing heating and cooling equipment by Manual J, sizing
charts (form #4) or other approved methods, section 2-5352(g), and fill out the
following:
Heating: Winter design temperature °, elevation ', heating load BT.U_
elevation factor x heating load =_maximum outlet capacity gas furnace
BTU
Cooling: Summer design temperature cooling load BTU
*2 Submit T..I.P.S.E. chart or other approved system (form #5) to document sizing of
solar panels.
(�1 DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of
Title 24, Part 2, Chapter 2-53 of the Californ'a Admi i tration ode.
7/83 IG ATURE OV BU DING ESIGNER OR APPLICANT
• 3 .
..x ,�'• s � ii`�`.' �La •; :"n.,e� `� x',. v; '. � � �`1-�•, k� � � 2 W r � ..0 `t+. e s. ,»£ Ufa •'.r . �. ,a.,; � -. .,.
,•
Tv
RESIDENTIAL
ENERGY CONSERV.ATION STANDARDS N".
CONSTRUCTION COMPLIANCE CERTIFICATE,N
�• r �.� N.
/TH•IS IS TO CERTIFY THAT ENERGY,CONSERVATION REQUIREMENTS HAVEkBEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERG;Y:CONSERVATION REGULATIONS
AT ;; PardeesWaY
(location)
BUILDING PERMIT N0. O..
ti
THE.FOLLOWING HAVE BEEN INSTALLED; AS PER APPROVED PLANS:
(Check each item or write N/E, if not..yappli cable) ,
INSULATION: GLAZING
Slab Ed .
e n/ a
Edge -Z -.". gh Glazed.. t. n/a i. ,�
Fdn. Walls n a ,'...Special �(Jnsulated) t'.
Floors R-19 CERT.. & LABELED1,WDS;
Walls R-11 &F SLIDING DRSV�'c��i��`�� j FI-aD-0f
..
Ceiling/Roof R-90 WEATHERSFTRIPPED. DRS alf-
Ducts pyo BACK DAJ..1PERED FANS rte'
Circulating Pipes. P7,/----- INTERMITTENT IGNITION' DEVICES n/a
APPROVED HEATER, r� 1� ERT. APPPLIANCES xLL -
APPROVED WATER HEATER
t1
r
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 14ICHOLS0111 INSULATION, INC.
?(please print)
Signature of...
Insulation Applicator
General-Contractor/Owner
Signature of
General Contractor/Owner
State
1,,
ntractors
License No. D
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.
r
COUNTY OF BUTTE `
bl DEPARTMENT OF PUBLIC WORKS F
196 Membrial War,, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 5344541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
DC BAIT
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 rk is completed. If you have any question pertaining to this
matter, o nee dditional explanation, please contact this office immediately. `r
CJ
litw�'T��t/
Inspector
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
OWNER PE IT 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 rk is completed. If you have any question -pertaining to this
matter, r need dditional explanation, please contact this office immediately. .
Al
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS'
'196 -Memorial Way; Chico — Phone: 891-2751. .
7 County Center Drive, Orovi I le — Phone: 534-4541
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECTION NICE
6WLDING-7tthe
PROPERTY ADDRESS
A routine inspection indicates th 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
�.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
'7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND 'PERMIT
PERMIT NO. J
SAS S$O, PARCEL NI,JMBE R
'
ZO IN '
BUILDING PERMIT
OWNS
TELEPHONE
SQ. FT. OCC.1 BUILDING VALUATION
�-I/1�
OWN R 5 MAILING AtDDRESS
ZI0
CONT ACTOR'S NA E
1
TELEPHONE
CrONTRACTORIS PAILItTG AD RESS
e
Fireplac�j
C NSTRUCTION LENDER
UNKNow�,
Total Valuation Is
®-p
Filing Fee
$
10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
M,
�'P/C
$
n
klplI
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
i
BUILDING ADDRESS
PLUMBING PERMIT
Filing Fee
10.00
Each Trap
2.00
®p
Solar Water Heater 20.00
Water piping
5.00
LOT NO.SUBDIVISION
NAME
PARCE MAP
7
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
Buildin sewer
g
5.00
Mobile Home S I G I W 10.00 e
TYPE OF WORK
New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work:
Permit Fee
$!70,00
Contractor
ELECTRICAL PERMIT Filing Fee
10.00
Main service 600V OR LESS 10.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP
2'.50
NE W
OR ADDNST ( DWEACCLL -G .&\ 21/4sgft
//
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury (check one):
Cr 7am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
25 azo S�
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., ULTI.OUT T
NON.RESID BRANCH CIRCUITS 2 50e
NEW CONSTR POWER APPARATUS &
NON-RESID. (SINGLE OUTLET CIR.
20®50C
Ex. Occup(o OR FIXTURES BAL®30
FIXED A
EX. Occup. OUTLETS P(RESID )LISIS REA.) 2.00
_
Temporary service 10.00
Mobile Home Facilities 15.00
r
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee
10.00
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
�l 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
Q tMAO
Cooling
r�a
Hood 3.00
Ventilation I SAD
D
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
ag;;��nsequ nce ofthe granting of this permit.
XJ --__ Date �'— z '—
Signature of Applicant — Owner ❑ Contractor [9/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 PER'911f FEE Is
OCCUP. CROUP
TYPE OF CONST.PARCEL
PD HD
SS
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECT OF PUBLIC
By
T EXPIRES Date_
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. b%1
WHITE-D.P.W., YELLOW-ASSFSSOR, PINK -INSPECTOR, GOLDENROD-APPLICANTP
l
Rett -'n to DPW AGRICULTURAL STATEMENT OF .ACKNOWLEDGEMENT
FOR RESIDENTIAL DEVELOPMENT
,.Section 26-8.1 of the Butte County Code requires this acknowledgement
be'recorded prior to issuance of.a building permit.
g3 -32's(;►
SUTTf:
The property described herein is adjacent to land or included QCT 3 le 10 pr,1QH7
within an area zoned for agricultural purposes, and residents of this ELEANOR m. BE::ai:ROtt
property may be subject to inconveniences or discomfort arising from CLERK-RECOR6ic'Rthe 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 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 be prepared to accept such inconvenience or disconform from normal,
necessary farm operations.
911 that real property situate in the. County of Butte, State of California, described
as follows:
SEE ATTACHED DESCRIPTION
Date :
State of Calif . )
SS.
County of Butte )
.o,ra..�w_,n.,,+s:r�x.
y�
SEN
NOTARY PUBLIC -CALIFORNIA
l Cv to Ccunry
l
My Commission Expires Aug. 2, 1986
Present A.P. No. / ��-
IMP
I
PROPERTY OWNERS:
r ,
On this the- 22nd day of .September 19 83 , before
me, the undersigned Notary Public, personally appeared
Nancy Eiger
/X/ Personally known to me. / / Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose hame(s) is subscribed to
the within instrument and acknowledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Pub
r
DESCRIPTION:
All that certain real property•situate in the•County.bf Butte,
State of California, described as follows: `
A port'iori�of the Northwest quarter of Section 7, Township.` 21
North, Range 4 East,M.D.B. & .M..,more.particularly described
as follows.
Lot 2, as shown on that certain. Parcel Map-record ed in the
Office of the Recorder of the County of.Bu.tte, State of
California, on August 1, 1973, in Book 4:6of Parcel.Maps,
at page 70. _..W
TOGETHER WITH anon-exclusive-easement for road purposes
and 'pu'blic utility purpo-ses.over °a. strip of land 60..00 feet
in ,width, lying 30..00 feet:on each side of a line beginning
at the-Southeasterly corner of Parcel 1 on-said: Parcel Map;;
- thence North 20 58''261, East•287.65 feet; thence North 13"
24' 41" East 322.22 feet to the North line of.said Section
11, which connects w.th'that- certain. parcel o-.f hand' described
in Deed to County of Butte, recorded June 6, 1973, in. Book
1840, of'Butte County Official Records, 'at ,page 382.
Q
c
C
0
m
CIZ
Etch OF DOCUMENT
RESIDENTIAL PLAN CHECKING GUIDE ,
(S.F.,,DUPLEX, &'MISC. ONLY)
OWNER
A.' GENERAL
Zoni requirements (sideyards and parking).
2. Valuation. ;
Signature by R.C.E. or Architect , (if „required);.
'B: PLOT PLAN
Complete parcel size and dimensions.
;� Setbacks, sideyards, easements;tetc.
Other ,buildings or, structures:
Grading, fills, drainage.
. 1.
Bldg. Permit #oZs//-JIL
A. P. #
"IR
D. STRUCTURAL DETAILS
Foundation plan complete enough to construct -building'.
/ 2 F oor construction details complete enough to cons truct'building."
E evations and wall construction details complete enough to construct building.
Roof construction details complete enough to construct building. ,
Fireplace construction details and calcs if over one-story in height..,
6. Sufficient data and details,to satisfy energy insulation.•requirements (State law)'.
E. MISPZ.LIANEOUS ITEMS TO LOOK OUT FOR
CCX plywood on exposed locations and overhangs:,.
Stairway details (Sec. 3305): ,
Guardrail details (Sec.•1716).
Brick or stone veneer (Chapter -30).
Exterior plaster -weep screeds (Sec. 4706 & 4708)..
<% Proper roof pitch for, roof covering (Chapter 32) .
Rafter ties or bearing ridge ,beam. } r
_�arage door or porch header sizes.
_A Adequate bracing.
Living area'over garage - complete 1-h6ur separation required including.supporting
walls,and posts, - etc.
Two'(2) exits on three-s'_tory dwellings (Sec. 3302).
C. FLOOR PLAN
Completeto scale,plan,with dimensions`.
Required windows for `light and veritilation_(Sec...l'40.5).
Required windows for second exit (Sec•.' 1404) . . �•
''
S-
Allowable glazing for energy yrequirements. (20% ma-.State`law)..'
-
�!'
Human..impact glass-( 5406)`. y �+
�s
�i ARequired room sizes, ceiling heights (Sec. 1407). '
G.F.C.I.'s in baths and exterior outlets (Sec. -210-8)._
•
Light fixtures, switches, receptacles, and exterior recept_acles'formairitenance of
mechanical equipment.
.
A�
Locations of water heater,* heating & cooling equipment-, other electrical or gas
equipment, and'plumbing fixtures.
_JD-�
Garage firewall, door size,,.and closer (Sec..503(d)W(4)):`ti,..
1 - 3'0" exterior exit door (Sec. 3303d).
Fireplace location.
,Smoke detectors (Sec. 1413) . , �_ `. {•
' .�
D. STRUCTURAL DETAILS
Foundation plan complete enough to construct -building'.
/ 2 F oor construction details complete enough to cons truct'building."
E evations and wall construction details complete enough to construct building.
Roof construction details complete enough to construct building. ,
Fireplace construction details and calcs if over one-story in height..,
6. Sufficient data and details,to satisfy energy insulation.•requirements (State law)'.
E. MISPZ.LIANEOUS ITEMS TO LOOK OUT FOR
CCX plywood on exposed locations and overhangs:,.
Stairway details (Sec. 3305): ,
Guardrail details (Sec.•1716).
Brick or stone veneer (Chapter -30).
Exterior plaster -weep screeds (Sec. 4706 & 4708)..
<% Proper roof pitch for, roof covering (Chapter 32) .
Rafter ties or bearing ridge ,beam. } r
_�arage door or porch header sizes.
_A Adequate bracing.
Living area'over garage - complete 1-h6ur separation required including.supporting
walls,and posts, - etc.
Two'(2) exits on three-s'_tory dwellings (Sec. 3302).
♦ r
I
��� , � " 1. �. i I •�.
mlM
_-- A .
. i/
aaWs
� a v
ez,
/o/,/"
COUNTY OF BUTTE - DEPAR'TMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 _
APPLICATION, AND (PERMIT
ASSESSOR PARCEL UMB
_
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
.SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADD SS
CONTRACTOR'S ME ^
TELEPHONE
CONTRACTO 'S A LING AMRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ A51 -
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
.$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ ^—
BUILDING ADDRESS
PLUMBING PERMIT9
Filin 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 ❑ Addition ❑ R mod I , Utili s �[:]�nstallationQOther
Describe work:
• ��
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Maiserie SS
n service OOOV OR LE
100 AMP OR LESS
10.00
Main service EA. ADD'L t00 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
1
2�4sgft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
El 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.2C9 7 G � 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
NO N•RESID BRANCH CIRCUITS
NEW CONSTR POWER APPARATUS &'
NON.RESID. SINGLE OUTLET CIR.
Ex. Occu / 20®50C
P\o TS OR FIXTURES eAL.
FIXED
Occup.
EX. OUTLETS P(RESID )R
2.EA.) 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.
ave 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 yo(i 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
$
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 liabilitie judgmen S, costs, and expenses which may in any way accrue
agai st sa'�ty 'n consequenc of the granting of this permit.
%� Date / 2 s2
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 $
r ��
TOTAL PERMIT FEE $ �S _
OCCUP. GROUP
TYPE OF CONST.
PARCEL
PO
HD
9511E
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
IR CTO BLIC WORKS
BYIV D to /^
P RMI4 EXPIRES Date ® /
Receipt NO.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
II ,.
I
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