HomeMy WebLinkAbout042-170-024J.
42-17-24
CHARLES ANDERSON
N/S -.tea e Way, app 1.000' E of
M Dairy Rd, Chico
Permit #2480-79B,P,E(addition &
elec. ser ch) SF
042-170-024 PERMIT#98-0078
ANDERSON, Larry
3212 Grape Way, Chico
Cont: North State -Electric,
Repair Ele Ser/SF'
042-170-024 05-1521
ANDERSON
3212 GRAPE WY, CHICO LE
Cont: BOE ROOFING
REROOV
042-170-024 06-1874
ANDERSON, RICHARD
3212 GRAPE WY, CHICO
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X042-170-024 PERMIT#98-0078
ANDERSON, Larry
3212 Grape Way, Chico
Cont: North State .Electric
�Repair Ele Ser/SF
0
OFFICE COPY
Address
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GAS a e___
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COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
W OW 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT qx-=gni `
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
TA RRY ANDERSON
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
-
OWNER'S MAILING ADDRESS
1.4345 MESA CT- RED B1 DR rA 5
�
CONTRALTOR' px.1 STATEpLECTRIC
VY1O5545
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation is
ARCHITECT OR ENGINEER LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS 3212 GRAPE WAY
Energy Plan Checking Fee
$
CHICO
$
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME •
PARCEL MAP
--_.
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF 91 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities [* Installation ❑ Other ❑
Describe Work: REPAIR ELECTRIC SERVICE
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home JILG W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200, OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.pow
License Class �' ' ir!- i 1fc Lic. No. i Y '?Sq
OWNER -BUILDER DECLARATION
I herebyaffirm under anal of perjury that I am exempt from the Contractors License
penalty p I ry p
Law for the following reason:
❑ I, 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.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service ( 200A TO 1000A
46,00
NEW CONST. DWG OCCUR
OR ADDNS. ( s ACC. BLD;
s0
NON-RESIDT CONSMULTI.OUTLET
@7.50
ER APPARATUs
8 SINGLE OUTLET C.
EX. Occup. OUTLET OR FIXTURES
20 Q 100
BAL @ .SO
EX. Occup. FIXED AppLNS.) E
p• ouTLETs RESS. 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 are:
Carrier t?fi , r`r / /1h
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
Policy Number C"r V - — 3 / — Cf X,
(The above sections need not be pleted if the permit is for wor< of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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 if 1 should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X xfTf�"•p i t' ��/ -'Q _ Dat,—L20-1 L_
Signature of Applicant 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 $ 66.00
HAZ.
I D. FEES IMP
I FLOOD
CDF
pARCEI
pD
HO
ISS
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 _
I
Date
ReceiptNo. 224919/166' OO
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
NOTES RESIDENTIAL
PERMIT NO. _' 042-170-024 05-1521
ANDERSON
3212 GRAPE WY, CHICO
Cont: BOE ROOFING
REROOF
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date)
Signature
BUTTE COUNTY PERMIT NO.
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT BP051521-
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
B. C. Building Permit 01-16-04 pg 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 06/13/2005 APN: 042-170-024-000
the Business and Professions Code, and my license is In full force and
effect.
License Class : License Number:
Site Address: 3212 GRAPE WAY CHI
Date: Contractor:
Map Index:
23 REROOF W/COMP
Description: ( )
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior
Owner: ANDERSON FAMILY TRUST
to its issuance, also requires the applicant for such permit to file a
ANDERSON RICHARD D & DELORIS F
signed statement that he or she is licensed pursuant to the provisions of
TRUSTEES
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
3212 GRAPE WAY
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO, CA 95973-9635
violation of Section 7031.5 by any applicant .for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work• and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
Applicant: ANDERSON FAMILY TRUST
such work himself or herself or through his or her own employees,
ANDERSON RICHARD D & DELORIS F
provided that such improvements are not intended or offered for
TRUSTEES
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
3212 GRAPE WAY
proving that he or she did not build or Improve for the purpose of
CHICO, CA 95973-9635
sale.).
I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor: BOE ROOFING
O I am Exempt under Article 3 of the B 'ness an rof ssions Code
3126 JOHNNY LANE
Date/�J��A e o5 over
CHICO, CA 95973
(530) 342-4919
WORKERS' COMPENSATION DEC RATION
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
License #: 820046
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier:
Policy #:
Total Square Ft: 0 S. F.
I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ.any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date: 7 r
A li
an
WARNING: Failure to secure wor rs' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), In addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
of the work for which this permit is issued (Sec 3097 Civ.)
Resolutions t wok Indicated above for which fees have been paid.
L . ) 3 .
performance
Name:
BY: %- Date:
l
PERMIT EXPIRES v
Address:
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage•
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and stale laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official for document of B C nty. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes
/
Print Name: P/ 6 e/ S'Up� Sature•
Dale:
.,kOwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
J=OK
0 = Not OK
= Not Applicable
. =Not Readyeady
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer, Location -Test -Fall -C/O -Concrete
4. Water, Location -Test -Easement Needed (Sketch)
S. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ /" L'ft.
/ PNat. or/ /" LW PLPG
7. Well Clearance & Disconnect
8. Utility Clearance
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Date
1. Zoning Requirements -Setbacks -Easements
Date
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water, MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche -
Date
Card B-1 Date Card B-1
Date
Cana B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Date
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Blocking
4. Gas; MH Test -Demand -Valve
5. Electricity; MH -Test
6. Water, MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
_ 10. License Decals
11. Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance -GA
5. Bec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche -
12. Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J=OK
0 = Not OK
= Not Appricable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Fig., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall-Frtting-Test-2 Way C/0 -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdnn. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Cana B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler, Test
74. Elec. Outlets & Receptacles at Kit. Counter
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral O Yes O No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels -Motors -Meth. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
89. Ventilation Throughout House
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet
Date
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. Fire Stops. Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdnn. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Cana B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit_ Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door, Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
83. Following InsUdJDrive 0 Yes 0 No/Walks 0 Yes O No/Plarrters O Yes O No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP051521
B. C. Building Permit 01-16-04 pg 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 06/13/2005 APN: 042-170-024-000
the Business and Professions Code, and my license is In full force and
effect.
License Class: License Number:
Site Address: 3212 GRAPE WAY CHI
Date: Contractor:
Map Index:
Description: REROOF W/COMP 23
p
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' Stale License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: ANDERSON FAMILY TRUST
to its issuance, also requires the applicant for such permit to file a
ANDERSON RICHARD D & DELORIS F
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
TRUSTEES
7000) of Division 3 of the Business and Professions Code) or that he or
3212 GRAPE WAY
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO, CA 95973-9635
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
Applicant: ANDERSON FAMILY TRUST
such work himself or herself or through his or her own employees,
ANDERSON RICHARD D & DELORIS F
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
TRUSTEES
year of completion, the owner -builder will have the burden of
3212 GRAPE WAY
proving that he or she did not build or improve for the purpose of
CHICO, CA 95973-9635
sale.).
I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor: BOE ROOFING
❑ I am Exempt under Article 3 of the Bijainess anrof ssions Code
�heo�
Date- �_ o ner:
3126 JOHNNY LANE
CHICO, CA 95973
(530) 342-4919
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
License #: 820046
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Policy #:
I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
A ' an
WARNING: Failure to secure wor rs' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
`
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there Is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Resolutions t wo k indicated above for which fees have been paid.
By: x / Date:
Name:
Gy
Address:
PERMIT EXPIRES
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage,
handling and use of hazardous materials.
O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
O Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official f or document of B C nty. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purp oses
�
Print Name: r �Y �/�/ e/' �i09� Sre• --
Date: �.t .L -e oZ • o
*Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF A PPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWN
Last Name
rvD'�?SOI/
i ame
�c AR a/
Address
City h/ G 0
State., jq
Zip _Y7
Phone _ 31/01- 7.73
Fax
E-mail N
CONTRACTOR
ARCHITECT/ENGINEER
Nary et,
O -C.L / O/� o a G
_
Address/,zgjo titi
Zip sys
City C 41'C- b StateC`4
Zi",�
Phone X30,t9j � j Fax
Zip
E-mail Lic.
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City / /C OC9
Address
Zip sys
City
Fax
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
State License Number
APPLICANT NAME
Nam!; -5-11
! C �'I iL d J%.r/ G'-4 SO
Address;A-� � �A
City / /C OC9
State
Zip sys
Phone 3y.�`7373
Fax
E-mail I'W
APPLICANTSIGaTU
RE
Lit 7091
or office use only:
AN
Zoning
City
Flood Zone
SRA
I Yes
I No
Occ.
LENDING AGENCY
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
BIN #
AL1
LOCATION ON
AN
Pro�� Q/ �.J
City
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier P -J pr-�
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
Z4 z' 9,v/? 7-/ Z,)Ido m
5 Al�l e,e -/ w/�
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
Page 1 of 2
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by
Receipt #:
f�AS
Date f 3�
Amount: r6-7, Bldg
SRA
Sheriff
SMIP
Other
v.
Total
REV 2-24-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required):
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County _ Center Drive - Oroville, California 95965 -Telephone (916) 538-7541 PERMI No.
(Rev. 12'/96) - APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
042-170-094
ZONING
BUILDINGPERMIT
OWNER -
LARRY ANDERSON
TELEPHONE
SO, FT, OCC. BUILDING VALUATION -
OWNER'S MAILING ADDRESS
14345 MESA CT RED 'RT_J_JFF CA 9608n
CONTRACTOR&MTH STATE ELECTRIC
V
9T1- 545
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER -
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
—Filing Fee $ 20.00
Permit Fee $ -
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS 3212 GRAPE WAY
Energy Plan Checking Fee $
CHICO
$
PERMIT FEE $
LOT NO.
SUBDNISION'S NAME -
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
USEOFSTRUCTURE
SF K7 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities It Installation ❑ Other ❑
Describe Work: REPAIR ELECTRIC SERVICE
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S I G I W F @20.00
PERMIT FEE t
ELECTRICAL PERMIT I Filing Fee 20.00
-
600VR UE
Main Service OA OR LESS 23.00
-
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my licenseis in full force and effect. 2 q
License Class — Q-' 1 Llc. No. 53 y / S J
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
1, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service ( 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUR O
OR ADDNS. ( g ACC. BLOB. 3.5¢Sx;
NON•.EStIF ANCI C'. UEIT.97.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURE 20 1'00
BAL .50
Ex. Occup. ourEiETs AEUs1ooERa 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
bb.UO
PERMIT FEE $
WORKERS' COMPENSATION DECLARATION
I 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.
❑ I 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' co pe sati insure ce rrier and policy number are:
Carrier�CJ/
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Policy Number $ — — I X,
(The above sections Ineed not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any mariner so as to become subject to workers'
compe tion laws of California, and agree that if I should become subject to the
wor rs' ompensation ovisions of section 3700 of the Labor Code, I shall
fo wit comply with s provisions.
�j
X _Date _ /
Si ur of A •" icant - caner ❑ Contractor ❑Agent
n OSHA permit is req ired 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 $ 66.00
HAZ.
I D. FEE IMP
I FLOOD
I CDF
PARCEL
PO
HD
IS
This permit is hereby issued under the applicable provisions
of the Butte County ode and/or Resolutions to do work
Indic d above for Qich fees have been paid.
��
By Date �7v /Gj _
PERMIT EXPIRES ON /. ?1 — /
(Date)
Receipt No. 221�g1g / �6 OO
WHITE-D.D.S.-B.D. CAN�R�1'-ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
(Rev. 12/96) -� y APPLICATION AND PERMIT
ASSESSOR PARCEL NUMB ]-7 D _ D�
4
(,�
ZONING
& Z)
BUILDINGPERMIT
OWNER /� `n� p ;p^ r 'n •,- �%
SIV/,`C/�(YF'i ////fir/I�V/�
TELEPHONE'SO.
FT. OCC. BUILDING VALUATION
OWN7S MAID ADDRESS
���✓ _
CONTRACT R'S NAME ��•''��',,��A �,( I/So f/n�
...1 V _ v `✓..
TELEPHOJJE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER ,
Fireplace
LENDER'S MAIUNG ADDRESS
'
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAULING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
(,v
Energy Plan Checking Fee
$
c
a&)$
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMITg
Filin Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utllilfies ❑ Installation ❑ Other ❑ p
Describe Work: % Ile`'��(� Go'L
Gas piping system 1 - 5 outlets
15.00
Buildingsewer
15.00
Mobile Home I S I G I W
Q20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
600V OR LESS
Main Service 200AORLESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
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:
❑ I, as owner of the property, or my employees with wages astheir 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.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
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 are:
Carrier
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.)
❑ 1 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 if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP. SO
OR ADONS. ( 6 ACC. BLDS. 3.50FT.
NEW
.ES.. T.MULTI-OUTLET @7.50
POWER APPARATUS
& SINGLE OUTLET CIR.
20
Ex. Occup. OUTLET OR FIXTURES 0''00
SAL 0 .SO
Ex. Occup. DFUTLE S A °� 5.00
Tem orar I y Service 23.00
Mobile Home Facilities 20.00
Misq. Wirin
23.00
lip 112
1
PERMIT FEE $
6ko
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
PO
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 _
Data
Receipt No.
WHITE•O.D.S.• .D. CANARY•ASSE SOR PINK -INSPECTOR GOLDENROD -APPLICANT
OWNER: L44X% l DATE: / 77222-0,–
t
222-0 –
LOCATION:'. - ,K 02 45egio—O W,-," C -i `O A.P.#: 657 o
CONTRACTOR: ZONING: Aleo
PRE -INSPECTION FOR: OAML��2ylGE-
DATE TO INSPECTOR:
PERMIT HISTORY: [ ]NONE [ ]AS FOLLOWS: 2 4 /l.
TYPE OF OCCUPANCY: 5 11`--1
BUILDING INSPECTOR'S REPORT
Building Description:
[ ] Commercial/Usage: �
[ ] Residential/# of Units: Mobile Home: Yes[ ] No[ ]
[ ] Currently Occupied.
[ ] AbandonedNacant.
lectric:
[ ] Yes [ ] No
Electric is currently : [ ] On [ ] Off
Condition of electrical?.
Natural( ] Propane[ ] None[ ]
Obvious problems:
anitation:
Plumbing working Yes[ ] No[ ]
Well: Yes[ ] No[ ]
Obvious Sewage Problems:
r
Recommended: [ ]Issue
r:
May 1995
Currently On[ ] Of ]
Potable water: Yes[ ] No[ ]
[ ]Hold for:i_
i
Date:
Cr /'�f Qom.
4.7
BUTTE COUNTY
_ DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT'NO.
BP061874
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF -ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class C "'W License Number::r7
Date: S 4 A%�O Contractor: KGCL&A✓41-,0o �r
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to Its Issuance, also requires the applidant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's Stale License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the. basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure Is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or Improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner. of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a 'contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner.
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Insurance carrier and policy number are:
Carrier:, 67472�G
Policy #: --7/— 2 3�
❑ 1 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 the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is Issued (Sec 3097 Civ.)
Name:
Issued Date: 08/04/2006 APN: 042-170-024-000
Site Address: 3212 GRAPE WAY CHI
Map Index:
Description: NEW HVAC UNIT
Owner: ANDERSON FAMILY TRUST
ANDERSON RICHARD D & DELORIS F
TRUSTEES
3212 GRAPE WAY
CHICO, CA 95973-9635
Applicant: MCCLELLAND AIR CONDITIONING, INC
801 MARAUDER ST.
CHICO, CA 95973
(530)891-6202
Contractor: MCCLELLAND AIR CONDITIONING, INC
801 MARAUDER ST.
CHICO, CA 95973
(530) 891-6202
License #: 345121
Architect:
Engineer:
Total Square Ft:
Valuation:
Census Code:
0 S. F.
$0.00
This permit is hereby issued under the app
Resolulio^stp do work indicated a`boye for
By:�L
PERMIT EXPIRES 0
provisions of the Butte County Code and/or
,,
fees have been paid. f�(�
9\1 Dater �� W
%r IJ r% 7
Address: I lud'C�
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification iri accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or t duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of y official form o ent of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes
Print Name:Gh��
Signature,
Dale:
0 Owner 0 Contractor 0 Agent for Owner gent for Contractor
BUTTE COUNTY.
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.butteco6nty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name
irst Name
Address 21 Z(�
CityCh
; C.o
State,,
1.
Zip jq
Phone 5";0 - SL Z 1565
Fax
E-mail
CONTRACTOR
Name {GC L
Name
Address A
City��
State /�
Zip �r —7,-2
Phone � �. 2
Fax
E-mail
Lic. #�y 2
Cla s
v
M
For office use only:
ARCHITECT/ENGINEER
Name
City
Address
Stated A
City
Phone
State
Zip
Phone
Page
Fax
E-mail
Date Approved:
State License Number
v
M
For office use only:
APPLICANT INFORMATION
Name ,
tT.
Address l
City
! t�
Stated A
Zip 4
703>
Phone
_ 00-Z
Fax !'
E-mail
Page
v
M
For office use only:
Zoning
Flood Zone
City
(� , �O
SRA
Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BIN #
PROJECT LOCATION
AP# 014
Property Address
2 r � LJ
City
(� , �O
Cross Street .�
WORK R'S COMPENSATION
Policy Number
Carrier T
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name .
Address
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Description or Scope of Work:
J t
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by.K,6 Amount: Bldg
SRA
Receipt #: )66 Sheriff
CW4MQ
Date: $ 4 _06
SMIP
Other
11�nks Total
REV 8-12-05
E
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORM BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
{ 042-170-024 06-1874
ANDE_RSO_N, RICHARDr
urT
3212 GRAPEWY;�CHICO
NOTES
cont: iVICLELL'AND'AIR'.
RESIDENTIAL
APN: Permit No.
l
Owner.
Site Address:
Contractor.
Type of Permit:
---------------
i
t
i
SPECIAL CONDITIONS
CHECKED BY
❑ SRA
Q FLOOD CERTIFICATE EQUIRED
0 FIRE SPRINKLERS REQUIRED
0 SPECIAL INSPECTION ITEMS
aVERIFY
Q USE PERMIT CONDITIONS
Q SUBSTANDARD HOUSING LETTER
Q ENCROACHMENT PERMrr
0 REINSPECTION FEE PAID
OENV HLTH CLEARANCE
DATE JOB HALED: I U�
SIGNATURE(3ft f
1 ,
f
,
r
f
SPECIAL CONDITIONS
CHECKED BY
❑ SRA
Q FLOOD CERTIFICATE EQUIRED
0 FIRE SPRINKLERS REQUIRED
0 SPECIAL INSPECTION ITEMS
aVERIFY
Q USE PERMIT CONDITIONS
Q SUBSTANDARD HOUSING LETTER
Q ENCROACHMENT PERMrr
0 REINSPECTION FEE PAID
OENV HLTH CLEARANCE
DATE JOB HALED: I U�
SIGNATURE(3ft f
1 ,
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
WC
06
OWNER PERMIT NO.• kr
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
ri e
Y Le s.
am
dc
/0/ D),
Date
Inspector
REV 4/05
Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
am
Date: 8/3/06 Job#:06398
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R
,Project Address
3212 Grape Way, Chico
Duct Pressurization Test Results (CFM @ 25 Pa)
Builder Name
McClelland Heating ant
Builder Contact
McClelland Heating and Air 530
Telephone
891-6202
Plan Number
HERS Rater
Mery Martin 530
Telephone
894-8466
Sample Group Number
Enter Tested Leakage Flow in CFM:
Compliance Method (Prescriptive)
Climate Zone 11
Dlpltelly-Mw nMervyn MeM
Certifying Signature — j,DN: CN•MervynMaNn,G. US rUn
IEwrgy Lalwlatbn Services
Data: 2000.08.04 09:10:27-07W
Date
Sample House Number
Firm Energy Calculation Services
Enter Total Fan Flow in CFM:
HERS Provider CHEERS
Street Address: 574 Manzanita Ave, Suite 9
3 1
City/State/Zip: Chico, Ca. 95926
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
The house was: ✓ B Tested ✓ ❑ Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with
the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check and verify that the new
distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS
rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested
buildings.
0 The installer has provided a copy of CF -6R (Installation Certificate).
0 New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts).
0 New systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in
combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.
✓ 0 MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Procedures for field verification and diagnostic testing of air distribution systems are available in RACM, Appendix RC4.3.
Duct Diagnostic Leakage Testing Results
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Values
I
Enter Tested Leakage Flow in CFM:
2
Fan Flow: Calculated (Nominal: ✓ 0 Cooling ✓ ❑ Heating) or ✓ ❑ Measured
Enter Total Fan Flow in CFM:
1,200
3 1
Pass if Leakage Percentage <_ 6% [ 100 x [_(Line # 1) / 1,200 (Line # 2)]]
❑ Pass ❑ Fail
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out
Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to
4
Duct System Alteration and/or Equipment Change -Out.
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System
5
for Duct System Alteration and/or Equipment Chan a -Out.
59
Enter Reduction in Leakage for Altered Duct System [ (Line # 4) Minus 59 (Line # 5)]
6
(Only if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
V/
8
Entire New Duct System - Pass if Leakage Percentage <_ 6%
4.9
0 Pass ❑ Fail
100 x 59 Line # 5 / 1.200 Line # 2
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out
Use one of the following four Test or Verification Standards for compliance:
9
Pass if Leakage Percentage <_ 15% [100 x [ 59 (Line # 5) / 1,200 (Line # 2)]]
❑ Pass ❑ Fail
10
Pass if Leakage to Outside Percentage <_ 10% [100 x [ (Line # 7) / 1,200 (Line # 2)]]
❑ Pass ❑ Fail
Pass if Leakage Reduction Percentage >_ 60% [100 x [_(Line # 6) / 1,200 (Line # 4)]]
11
and Verification b Smoke Test and Visual Inspection
❑Pass ❑Fail
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
❑ Pass ❑ Fail
Pass if One of Lines # 9 through # 12 pass
0 Pass ❑ Fail
Residential Compliance Forms April 2005
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERIVII I 'NU.
BP061874
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF -ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am licensed under
provisions 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.
License Class :C -2.0 License Number: .rl S" ( ZQ
Dale: 6W ob Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the
Contractors' Slate License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior
to Its Issuance, also requires the applicant for such permit to file a
signed statement that he or she Is licensed pursuant to the provisions of
the Contractor's Stale License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the. basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the properly, or my employees with wages as their
sole compensation, will do the work, and the structure Is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or Improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not Intended or offered for
sale. If however, the building or Improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or Improve for the purpose of
sale.).
❑ I, as owner. of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' Slate License Law does
not apply to an owner of property who builds or Improves thereon,
and who contracts for such. projects with a 'conlraclor(s) licensed
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit Is issued. My workers' compensation
Insurance carrier and policy number are:
Policy #:
❑ 1 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 the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Issued Date: 08/04/2006 APN: 042-170-024-000
Site Address: 3212 GRAPE WAY CHI
Map Index:
Description: NEW HVAC UNIT
Owner: ANDERSON FAMILY TRUST
ANDERSON RICHARD D & DELORIS F
TRUSTEES
3212 GRAPE WAY
CHICO, CA 95973-9635
Applicant: MCCLELLAND AIR CONDITIONING, INC
801 MARAUDER ST.
CHICO, CA 95973
(530) 891-6202
Contractor: MCCLELLAND AIR CONDITIONING, INC
801 MARAUDER ST.
CHICO, CA 95973
(530) 891-6202
License #: 345121
Architect:
Engineer:
Total Square Ft: 0 S. F.
Valuation: $0.00
Census Code:
00
Applicant: I�5v
WARNING: Failure to secure workers' compensation coverage is Q '�
unlawful, and shall subject an employer to criminal penalties and one tl` y PQ
hundred thousand dollars (8100,000), in addition to the cost of
compensation, damages as provided for In Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY This permit Is hereby issued under the app
fo
I hereby affirm that there is a construction lending agency for the Resolutions do work Indicated abo a r
performance of the work for which this permit Is Issued (Sec 3097 Clv.) t1
Name: By.
PERMIT EXPIRES 0
Address:
provisions of the Butte County Code and/or
fees have been paid.
Date:
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. ndtificalion forms.
I hereby certify that I'have read this application, That the above Information Is correct, and that I am the owner or t E duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge It Is unlawful to alter the substance of y official form do e of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes
y ��L Signature,
Print Name:
Dale:
❑ Owner ❑ Contractor ❑ Agent for Owner �igent for Contractor
c r D.—if M.1RAd nn 1
+=OK
o = Not OK
MANUFACTURED HOMES
DATE Lj PERMANENT FOUNDATION SOFTSET
1 ZoningSetbacks-Easements
2 Soils; Special MH Support Sketch
3 Sewer; Lorin Test; FaIIICIO-Concrete
4 Wtr, Loctn Test -Easement Needed -Regulator
5 Elec Loctn-Dimcs-Gmd 'Amp -Concrete
6 Yard Gas; Loctn Test Wrap Nat ❑ or LP❑
Inch Sz Ft Lngth
7 Bickng; SzSpacing-Marriage Line
8 Gas; MH Test-Demand-Valve-Dnnctr
9 Elec MH Cntnty Test-Crossovers-Breakers-Clmcs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -CIO to Grade
12 Gas and Electricity Tagged
13 Tie Downs ❑ Foundation ❑
14 Exits
15 Cert of Occupancy
16 HUD Labellinsignia Numbers Serial Numbers
o•� dy7 dA cT,�•
i
MISCELLANEOUS-
--DATE IDECKS'COVERS'CARPORTS•GARAGES
1 ZoningSetbacks-Easements
2 Figs; SoilsSz-DpthSpacing-CnnctrsSteel
3 Decks, Girders/Joists-Dcldng-Brcing
Stairs-GuardlHandrails
4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg•
Frmg-Brcng
5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs
6 Carports; Wndws-Doors
7 Electric
8 Frmg; Sills-AnchrsStuds-Rft m Trtisses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof; Shthg-Roofing
11 Ext Steps -Doors -Landings
12 Braced Wall pnls
DATE IP O O L S
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel-Cnnctris Thickness
Dead Men -Lining
4 Elec Rcptds/Ung; D"isiance-GR
5 Elec Pool Lting; IS volts-GF1
6 Elec.Enclsrs; Conduit Entries -Terminals -listed
7 Elec Bonding; Metal w/.7-Crcitng Egp-Htr
8 Elec Gmdng; Eqp w/S Crdtng Eqp-Pool Ightg
Boxes -Encisrs-pnlboaids-lnsuitn-to Main Conduit
9 Health Dept Apprvi .
10 Plmb; Cir Test-Wtr Supply Test
11 Lt Niche ;
12 Endsr, Fencing Alarms
13 Bonding, Diving board or Slide
Pool Drawing
0 = Nat OK
RESIDENTIAL (Single & Duplex)
DATE JUNDERFLOOR
1 Zoning -Setbacks -Easements -Rood -Slope
2 Ftg Main; Soils-Elec Grnd Ft4 Dpth
3 Ftg Garage; Soils-Steel-Elec Gmd Ftg Dpth
4 Ftg Porches/Decks; Soils -Steel Fig Dpth
5 Stemwalis Wain; Steel-Blockouts Wrapped
6 Stemwalls Garage; Steel-Blockouts Wrapped
6a Hold Downs and Special Anchrs
7 Slab, Steel Wrapped
8 Piers-Frpic FtgSteel
9 DWV-, Fall -Fitting -Test -2 -way CIO -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
11 Wtr Pipe; Test-Anchrs-RgltrService Test
12 Elec Undrgmd
13 Plenums & Ducts; Cirne-MaterialSupportansultn
14 GirdersSlits-Anchr BoltsJoists-Vnts-Cripples
15 Ace & Vntitn
16 Insulation
o'er eTa o'er 0`
DATE FRAMING
17 Sills Proper Materials & Anchrs
18 Wills Studs4 ailing Spacing & Braces-PlatesSound
19 Bearing Walls ovet Girders.,& fir Nailing
20 Draft Stop In Walls (rat Proof) '
21 Fire Stops; Furred CeitingsStairs-Chasers Tubs
22 Headers & BeariisSi &•Bearing' _
23 Hangers-P•osf:Caps Mchrs.Citnctns
24 Ceiling Joist-Rftr Iles-Purlii�-Roof Brac TnissShthg
25 Frpic Ties or Type A Flue=F is Throat Cirnc
�,
26 Attic Act; Sz &:Binz Pitch -Draft Stop -Ins Baffles
27 Bdrm Wndws or Exiting Doors -Sill Fit & Dimensions
28 Garage Fire Prtcbi Framing-ItC Channel
29 Prprty Line Firewall & Opnes' .
30 Ext Doors One 3' -Check Gauge 3rd Story, 2 Exits
31 Stairs; Width4idrm-Rise4tun4ianding-Fre Prtctn
32 Plywd on Roof Ovrhng-Attic Vnts-Rfir Outrgm
33 Siding -Nailing Veneer -
34 Stucco Lath Weep Screed-Fndtn Vnts-Undrfir Ace
35 Glazing Area -Glass PrtctnSkyLts-Plastic .
36 Shear Walls; Nailing -Bolts
37 Brace Int/Ext Wall pnls
38 Insultn Walls -Ceilings
39 Infiltration -Walls -W ndws
ya
DATE JELECTRICAL
40 Fxtr & Tmsfrmr Clmc-Ins Prtctn
41 Elec Rcptcls Spacing-t-ts & Switches at Doors
42 Sz Boxes & No Of Cndetrs Stapled
43 Romex Installed Close to Edge of Studs & CJ
44 Eqp Gmd made up w/Mech Fstnrs
45 Gmdng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFl
47 Subfeed Wire Sz 93 ❑CU or ❑AL
AC Wire Sz ga❑ Cu or Q AL
48 Range Clic w ❑ CU or F-1 AL
Oven Circ pa ❑ CU or QAL
Insulated Neutral ❑ Yes Q No
49 Service -Riser Cndctrs & Gmd Main Dsennd
50 Eqp Cimrs pnls-Motors-Meth Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
o'er
DATE IPLUMBING
53 Wtr Htr, Vent•Acc-Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr. Nail Pr(ctn
56 Shwr Pan; Test, Fust fir -Tub Ace
57 Test Tutt & Shwr, 2nd fir - Tub Ace
58 Gas Pipe; Sz & Anchrs
59 Fire Sprinkler; Test
60 Yard Gas Piping
o`
DATE MECHANICAL
61 AC Ducts Insulin & Support
62 Vent Fan, Exhaust abv Insultn
63 Condensate Drain & Ovrflw, Sz & Grade
64 Furnace -Vent Acc-Comb Air RtrnlVent 115 Outlet
65 Attic Are & Pitfrin if Furnace in attic
DATE FINAL
66 Ext Steps -Door & SldeLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Cimc-Comb, Air-Cnnctr
In Garage; abv-flr-Duds-Meth Prtctn
69 Bedroom Exiting
70 GFl & Bath Fxtrs & Tub Ace -Spa
71 GFl Are Fautt
72 Elec Trim & Subpni, Breaker Szs & Labels
73 Stairs, GuardlHandrails
74 Frplc or Stove, Clmc-Hearth
75 Elec Outlets at Wood Pnl. Int & Ext
76 Ktchn, Fxtr & Appinc; Grnd Air -Gap -Cooking Ctrnc
77 Elec Outlets & Rcptcs ai Ktchn Counter
78 Garage Fire Dobr, Swing -landing -Closure
79 AC Dud in Garage -Damper.
80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir
Mech Prtctn; LPG Appince Undr House 3' drain
81 Pimb; Elec & Mech Eqp Listed for Lorin
82 Elec RcpWs in Garage (GFl) Romex Prtctn
83 lnsultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth
86 Clmc Dmge Planters Q Yes Q No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Pimb
89 Vnts abv Roof, Plmb-Appinc-Frple-Cimc to Opngs
90 Wtr Well, Dscnnc% Elec, Plmb
91 Ext Elec Trim, GFl Rcptcl-Undrgmd
92 Vntitn thru House
93 Glass Prtctn
94 Corrections from previous Ihspc ns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99 Fre Sprinkler
dr 0�.r o' mss.
• , ``PERMIT NO. 2480-79B,P,E
ft
` PERMIT EXPIRES
i
i OWNER CHARLES ANDERSON
'' CONTR. owner
.LOCATION (A.P. 42-17-24
,NIS Grape Way, app 1000' E ofDairy Rd,Chic
t,
F
Is
Temp
C.
Power Pole
Call d PG&E
/Elec. Serv.� %
'falled PG&E
JJ
mp. Gas Serv.
Called PG&E
BFINALED
(Date)
(Sig ature)
t.
i
i
d�
.�1
i
r
f
•
l4
Temp
C.
Power Pole
Call d PG&E
/Elec. Serv.� %
'falled PG&E
JJ
mp. Gas Serv.
Called PG&E
BFINALED
(Date)
(Sig ature)
RESIDENTIAL
ENERGY CONSERVATION STANDARDS .
CONSTRUCTION COMPi.IANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS
AT a te'-. I- C - -
(location)
BU ILD ING PERMIT NO.2 i3 A. P. NO .& 2 ^ / 7—. y
THE FOLLOWING RAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or x,rrite N/A if not applicable)
INSULAT ION:
Slab Edge.
Fdn. Walls v
Floorsy
Wallsy
Ceiling/Roof
Ducts
Circulating Pipes
APPROVED HEATER
`APPROVED WTR.HTR.
GLAZ DtiG :
Single Glazed v
Special (Insulated)_
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS.
BACK DA2,iPERED FANS
INTERMITTENT IGNITION DEVICES
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 f7 d Y! /1" 1-7722-q-d'"s- 11
Signature of
(please print)
Insulation Applicator L' fzGl 'l,l-eS R 72 ckel-,tf07-2 0W-7)
State Contractors
License No. 'TL a7z.
.General Contractor/Omer Name' C h ex N 14's
Signature of
(please print)
_
General Contractor/O-mer Date
State Contractors
License No.
AL
THIS CERTIFICATE. MUST BE ON FILE -WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINIAL .INSPECTION -AND. SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
0
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION'RECORD
BUILDING
BUILDING (Cont'd)
PLUMBING
Setback
-FS*WW-
Soil Piping
7/j 7/p
Forms f
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
4
Footings
Windows ��
3rd Floor
Stemwall
To out
Slab
Roof Sheathing_ -`�
Water Pi in
Piers
Roofing '3 1 �`
Sewer
Garage—
L.ifs_ -
Fixtures
Footingsrage*lb
Stemwa l l
mft--'
Insulation
,VBeleH 1 h.
Heeters
Slab
CarportGaS-p
Footings
Ily
�fornta-ai>cce�e�c.
.Std
--ems
Slab
Final _ _�Zj
"Sanitation
Patio , /
FIREPLACE
Final
1
Footings
Footing
ELECTRICAL
Masonry Walls V
Throat
Rough
Reinf. Steel ZY T
Final
Fixtures
``m/om.�
FIR SPRINKLERS
<Motors—'
Framing `7 �%i '
Tpat 77—
ux#�
btucco Final / Sub anels v ,/ — v V
Mesh MECHANICAL Grd. Fault Prot.
ScratchHeating Service
Brown Cooling ` Temp. Pole
Finish Ducts Underground
<IntetliY Ventilation Permanent
DeerGleser Final Final
MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal
Water Piping Sewer Gas Piping
OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
P 9
DATE REMARKS OR CORRECTIONS
J�4� , L���',ss �y4✓ f��/G�v'l .�'G�� G-CVc`�r C s /rs'`.�t-'(/�(.CG'C.C.9� (�G1.�2�
Ile,
�
U�r�jIL mac'-7c��-rites
��� � .iG��iG�G°�� D l/i�l. �LILa•�/j�✓-h � 9 �l� /oo �y /��Vy A �'/,/6p -
. L J � Y "'J-'C�••C�L�i!.Q .-'�%f/�[y-'/ L^'C.' Ge-C-CXQ•�7'•'V��
(NOTE: An entry must be made on this form each time you visit the job site.) ��1
COUNTY OF BUTTE —. DEAA.RTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephpne:534x4541 r
APPLICATION AND PERMIT
�//d'0- 7i
M41d
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
c Dated " Z— / 7
Signature of Peerrmmitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF -.PUBLIC WORKS
By Date 6-6 -71f _
Bui ding permit expires Date
BUILDING
Owner 6114
SQ. FT. OCC. BUILDING VALUATION
00
Mailing*Address
,ec
Z L� l7
Telephone No.
Contractor
Mai I i ng Address
Fireplace
Total Valuation tj
Telephone No.
Permit Fee
Building AddressPlan
U
Checking Fee&/or Penalty
Permit Fee
C
PLUMBING No.1 @ I FEE
PERMIT FILING FEE $3.00
Each Trap 1.50 , Q
L GC�
Repair drainage or vent piping 1.50
A. P. No. , '� �L
0
Zoning 8 P arming
Water piping 1.50
Each gas water heater or vent 1.50
F sS
n t tion
FireDept.
Firezone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma
60' R/W
Improv ents
Each additional outlet .30
Building sewer 5.00
Bldg. Pans Recd
Parcel A val
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION P0 UTILITIES ❑OTHER ❑
permit Fee $
$
I
L& —L,,
ELECTRICAL No. @ FEE
V
PERMIT FILING FEE $3.00 L�
6001 OR LESS
Main service 100 AMP OR LESS 5.00 ,
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADO'L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service/ EA. ADD'L 100 AMP 1.00NEW
OR ADDNST \ ACC. CUP. S1 2P Sq ft V
/
CONTRACTORS LICENSE LAW
'
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
NEW CO ID � BRANCH CIRCUITS 2.50ea
NEW RESID, MU NCH CIRCUITS)
NEW CONSTR. POWER APPARATUS 8
NON.RESID. SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTIIRES 6 L2;
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
IT�j I certify that in the performance of the work for which this
permit is issued 1 shall not employ any person in any manner
Sas to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
Land Development Fee
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
c Dated " Z— / 7
Signature of Peerrmmitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF -.PUBLIC WORKS
By Date 6-6 -71f _
Bui ding permit expires Date
.. � �
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