HomeMy WebLinkAbout042-300-009L
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042-300-009 00-e�
HARRIS, DALE
3596 HWY 32, CHICO
CONTR:OWNERF///AG �De,2Y�0
PARTIAL REROOF & REPAIRS
042-300-009 01-0488
HARRIS, DALE
3596 HWY 32 CHICO
CONT: OWNER
COMPLETE RE ROOF
042-300-009 01-1731
GREEN,ROY /
3596 HWY 32 CHICOA 9q�
CONT: OWNER J7
ELEC UPGRADE/MISC WIRING SQ
042-300-009 04- JO6-
FLOWER, GERALD IhE
3596 HWY 32, CHICO
Cont: OWNER
UPGRADE MAIN SERVICE(20
042-300-009 04-2867
DOSSIE, ANTHONY
3596 HWY 32, CHICO
Cont: OWNER
RE -ROOF (15 SQ)
042-300-0094,94-.1,68
DOSSIEI
3596 HWY 32, CHICO
Cont OWNER
REPLACE HVAC GROUND UNT
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NOTES RESIDENTIAL
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PERMIT NO. C4Q ?W
Replace c- C y_awd ,MCWT
11 SPECIAL CONDITIONS 11
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (D ) o
Signature I
CHECKED
BY
COUNTY OF BUTTE • • -
'' e ti BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
OWNER PERMIT NO.
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 cont the Building Inspect a indic below.
O/C i l %
Date / G� Inspector
REV 4/05 Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.neAdds
PERMIT NO.
BP042868
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: 09/30/2004 APN: 042-300-009-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 3596 HWY 32 CHI
Map Index:
Date: Contractor:
Description: REPLACE HVAC GROUND MOUNT
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
Owner: ANTHONY DOSSIE
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
3596 HWY 32
signed statement that he or she is licensed pursuant to the provisions of
CHICO, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95926-8710
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
Applicant: ANTHONY DOSSIE
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
1
proving that he or she did not build or improve for the purpose of
sale.).
O I, as owner of the property, am exclusively contracting with
I
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
Contractor:
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.).
❑ 14am Exemptunder Article 3 of t e Busine9s�s1 and Professions Codi
I �0 D / '
Date: Own
License #:
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
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ 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:
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy #:
Census Code:
No�
y\ 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 37009f the Labor Code, I shall
forthwith comply those provisions.
with
Date:
Applican y�
WARNING: Failur 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
This permi '. hereb issued under the applicable provisions of the Buft Cnunty�CodR and/or
I hereby affirm that there is a construction lending agency for the
of the work for which this is issued (Sec 3097 Civ.)
Resoluti s o ork indicated abgxe for which fees have been paid1 (/\) i
performance permit
B Date'
y
Name:
r
PERMIT EXPIR( N:
Address:
Date
❑ 1 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. 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 an fficI I form or document of Butte County. 1 hereby
authorize representatives of Buttteef County to enter uppn the above mentioned property for inspection purpose
Print Name: /0L& q 0 '55 —4L Signature -
Date:
Qwner Cl Contractor ❑ Agent for Owner ❑ Agent for Contractor
J=OK
0 = Not OK
. = Not Readyabte
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
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)
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / /" L "ft./ P LPG
7.
Well Clearance & Disconnect
8.
Utility Clearance
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
Date
12.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Card B-1 Date Card B-1
1.
Zoning Requirements -Setbacks -Easements
Card B-1 Date Card B-1
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
12.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Card B-1 Date Card B-1
1.
Zoning Requirements -Setbacks -Easements
Card B-1 Date Card B-1
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-GFI
5.
Elec.; 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 Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4.
Ftg., 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 -Fitting -Test -2 Way C/O -Sewer Test
10.
UF, Gas Pipe; S ze Anchors -Yard Gas Piping; Size Test
11.
Water Pipe; Tess -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)
Date
Hangers -Post Caps -Anchors -Connectors
Card B-1 Date Card B-1
Date
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
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 Fitti-igs & 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
57.
Siding -Nailing Veneer
Date
58.
Card B-1 Date Card B-1
Date
59.
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Shear Walls; Nailing -Bolts
24.
Fixture & Transformer Clearance -Ins. Protection
Brace Interior/Exterior Wall Panels
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
Insulation -Walls -Ceilings
26.
Size Boxes & Nc. of Conductors Stapled
Infiltration -Walls -Windows
27.
Romex Installed Close to Edge of Studs & C.J.
Date
28.
Equip. Ground rrade up w/Mech Fasteners -Bond Gas & Water
FINAL (Plans) OK except #'s
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
Ext. Steps -Door & Sidelight Protection -Landings
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
Smoke Detector
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral O Yes O No
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
32.
Service -Riser Conductors & Ground Main Disconnect
Bedroom Exiting
33.
Equip. Clearances Panels-Motors-Mech. Equip.
G.F.I. & Bath Fixtures & Tub Access -Spa
34.
Clothes Closet Light -Shower Light -Spa Light
Elec. Trim & Subpanel, Breaker Sizes & Labels
35.
Smoke Detector
Stairs & Rails
71.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
74.
36.
A.C. Ducts Insulation & Support
75.
37.
Vent Fan, Exhaust above insulation
76.
38.
Condensate Drain & Overflow, Size & Grade
77.
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
78.
40.
Attic Access & Platform if Furnace in Attic
Date
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
Card B-1 Date Card B-1
Date
Insulation -Foam -Looked in Attic
Card B-1 Date Card B-1
Date
FRAMING (Permit) OIC 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, Furrec 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.
Bdrm. 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
Card 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 Cl Yes
_
83.
Following Instld./Drive 0 Yes O No/Walks 0 Yes 0 No/Planters 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:
f
NOTES
RESIDENTIAL
PERMIT NO. 8p 09- n b (D
3 sCI(o i4 w y 32-
C.H-1C®I CA �S Z(o-S7Ib
UPGRAbE rnli/N SE(ZU/C&
To 200 A-rvk P
1
oL( - Z8(01
0 Ll - 2g (08
SPECIAL CONDITIONS
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
CHECKED
BY
OFFICE COPY
Address
` GAS
Meter By
` ELECTRICS Date=
t Meter By���
—� DatsS
1 JOB FINALED ( )
Signatur
COUNTY OF BUTTE '
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
"Uow 09-110(0
OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed: If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately. (p��
(� Y6
Date — 2Q ` J InspectorgG
REV 10/92
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041706
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
Issued Date: 06/14/2004 APN: 042-300-009-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 3596 HWY 32 CHI
Date: Contractor.
Map Index:
Description: UPGRADE MAIN SERVICE TO (200AMP)
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: FLOWER GARALD A JR
to its issuance, also requires the applicant for such permit to file a
3596 HWY 32
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
CHICO, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95926-8710
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
Applicant: FLOWER GARALD A JR
pp
owner of property who builds or improves thereon, and who does
3596 HWY 32
such work himself or herself or through his or her own employees,
CHICO, CA
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
95926-8710
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.).
❑ 1, 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,
Contractor:
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 Pe Business a d Professions Code
&L .
Date:Own r:
License #:
WORKERS'COMPENsAflON 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
Architect:
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
Engineer:
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:
Total Square Ft: 0 S. F.
Policy#:
Valuation: $0.00
1 certify that in the performance of the work for which this permit is
Census Code:
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
forth�jwit comply with those provisions.
/ C/A
Date: "'
�—
Applica
WARNING: Fai ure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
/7 �(; �j� .. 00
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
J
code, interest, and attorney's fees.
V L C
CONSTRUCTION LENDING AGENCY
This permit is hpNby issued under the applicable provisions of the Butte County Code anrVor
1 hereby affirm that there is a construction lending agency for the
Resolutions t do r rk indica ab ve for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
By: Date: v
Name:
PERMIT EXPIRES ON:
Address:(Date)
❑ 1 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. 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 form or document of Butte County. I he
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Na//me:, i� 1 / Gss t Signature:
/
Date: (� ! / ! LG 7 �–
4owner ❑ Contractor 0 Agent for Owner 13 Agent for Contractor
J=OK
=Not OK
• = Not Ready bie
. =Not Ready
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)
5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or/ /" L "ft1 P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1.. Zoning Requirements -Setbacks -Easements
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-Connectoe
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
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1. Zoning Requirements -Setbacks -Easements
2. Footings; Stze-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 Cana 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. Bec.; Receptacles and Lighting, Distance-GFI
5. Elec.; 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
6* s A
-4=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. Gmd.-/ P' Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /" Fig. 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 -Fitting -Test -2 Way C/O -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 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
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. Grol:nd 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 -AC. Wire Size/ /ga Cu or Al
31. Range Circl-/ /ga Cu or AI -Oven Circ. / /ga Cu or AI
Insulated Neutral I] Yes 0 No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
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. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
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 AFlue-Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdnm. 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. Dud 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 (FFI.)-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 InstldJDrive 0 Yes D No/Walks D Yes O No/Planters D 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 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netldds
PERMIT NO.
BP042868
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: 09/30/2004 APN: 042-300-009-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 3596 HWY 32 CHI
Date: Contractor.
Map Index:
Description: REPLACE HVAC GROUND MOUNT
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
Owner: ANTHONY DOSSIE
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
3596 HWY 32
signed statement that he or she is licensed pursuant to the provisions of
CHICO, CA
the Contractor's Slate License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
95926-8710
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
Applicant: ANTHONY DOSSIE
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
Contractor:
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 tre Business and Professions Co
Date: 30 B y Own YL �e
License #:
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
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ 1 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:
Total Square Ft: 0 S. F.
Valuation: $0.00
Census Code:
Policy #:
� '
Q\ 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 complywiththose provisions.
�e//o
Date: / [ /
pt
Applican 1 t'
WARNING: Failur to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars($100,000),in addition 0 the cost of
0 for
provided
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
IV �
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
This p irmi 's hereby issued under the applicable provisions of the Butte Count C.OdP. ?nrUor
Resoluti s o ork indicated ab a for which fees have been paid
performance of the work for which this permit is issued (Sec 3097 Civ.)
v D L
�)
Name:
By: Date
( 10
Address:
PERMIT EXPIR N:
Date
❑ 1 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. 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 an fficial form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purpose
�
Print Name � 99 5 5 Signature•
Date:
AQwner 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE M (530) 538-7541
A FEE WILL BE REO UIRED AT TIME OF APPLICATION
"PLEASE PRINT CLEARLY"
OWNER
Last Name DO
SS ��
ost Nam Ul.
Addr
City �,) I (�
Stately �
l�t�
2
ZP U6Y 73
J
Phon�� g _Z Z�5
Fax
E-mail
CONTRACTOR
Name. O tljkv ly-
Address
City
State
Zip
Phone
Fax
E-mail
Uc. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
city, -t r \ CU
lam'`
Address
Q
zjp ! S�
City
Fax
State .
.Tip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name AA,i
Address 3� � � •r:.1 � . �Z
l
city, -t r \ CU
lam'`
tateCl�
Q
zjp ! S�
Yes
Fax
E-mail
APPLICANT SIGNATURE
For office use' nly:
Zoning
Propertyjddress
S
Flood Zone
Cross Street
SRA
Yes
No
Occ.
Type Const
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
01-0
BP
BIN #
LOCATION
AP# � y Z - 3av-oo9
Propertyjddress
S
711
Cross Street
Sq. Foota e
WORKER'S COMPENSATION
Policy Number N - /1 `
v�
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time ofpermit issuance.
LENDING AGENCY
Name
Address
Desc ' tion or Scope of Wo • `
V
Sq. Foota e
O Structure Built vrithout Peits
0 Proposed Change of Occ an
(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
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: Amount: ✓ Bldg
SRA
Receipt #: �] J) Sheriff
�l—"MIP
Date: ��j Other
Total
O.B.-1
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit' will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
13property improvement: YE01-- NO 0
I HAVE tk- HAVE NOT ❑ signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction:
AME: -
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4.)plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
--
,5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SI NE
PROD: PERTYOWNERf
DATE: 3�
NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Bealth and Safety Coda This verification must be completed and
returned to our office before we are permitted to issue the permit
OVER
O.BI- I
OWNER BUILDER INFORMATION
Dear Property Owner.
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit Building permits are not required tole signed by property owners unless they are personally performing their
own work If your work is being performed by someone other than yourself; you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply
If you plan to do your own worm with time exception of various trades timet you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate f anmly, and the work (including materials
and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors; then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation mmuaace, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not cam+ out these obligations, and these risks are especially serious
with respect to w0rimes compensation ko ance.
♦ For more specific m i amation about your obligations under Federal Law, contract the Internal Revenue Service (and,
ifyou wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact tine Department of Benefit Payments and the Division of Industrial Accidents.
If the strvctrae is intended for sale, property owners who are not licensed contractors are allowed to perfoan their
work personally or through their own employees, without a licensed contractor or subcontu actor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
Permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless
they are p erfo
rmmg their own work personally.
Infixi a4ion about licensed contractors may be obtained by contracting the Cantractots State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned
C9Nfhc 1 C. Vi iia, C.B.O.
Building Inspection at
NOTE: YkIs Owner -Builder fizforrnation is required by Section 19830 of the California Health and Safety Code
O.B.- I
OWNER-BUII.DER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit' will be issued until this
verification is received
1personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES I NO D
I HAVE, HAVE NOT 13 signed an application for a building permit for the proposed work.
3. I have contracted.with the following person (firm) to provide the proposed construction:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. plan to provide portions of this work, but I have hired the following person to coordinate,
.supervise, and provide the major work:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
NOTE. This Owner -Builder Verifwation is required by Section 19831 and 19832 of the
California Health and Safety Code. This verilcadon must be completed and
returned to our office before we are permitted to issue the permit
OVER
0 E:-.1
OWNER BUILDER INFORMATION
Dear Property Owner.
An application for a budding permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit Building permits are not required to be signed by property owners unless they are personally performing their
own work If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply
If you plan to do your own work, with the exception of various trades that you plan to subcontract you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate braily, and the work: (Including materials
and other costs) is 1300 or more for the entire project; and such persons are not licensed as contractors or
subcontractors; then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
woti:ers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation msmance.
♦ For more specific information about ymutr obligations under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner budder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personalty. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Infarmafion about licensed contractors may be obtained by contracting the Contractors State License Board in your
oomrmmity or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matt. The building permit will not be issued until the verification is returned.
Mic 1 C. Vi ira, C.B.O.
er, Budding Inspection
NOTE: Ykb Owner -Builder Wbrmaimn is required by Seddon 19830 ofdie California Health crud Safety Code
OVER
X
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netWds
PERMIT NO.
BP041706
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: 06/14/2004 APN: 042-300-009-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 3596 HWY 32 CHI
Date: Contractor:
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: UPGRADE MAIN SERVICE TO (200AMP)
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: FLOWER GARALD A JR
to its issuance, also requires the applicant for such permit to file a
3596 HWY 32
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
CHICO, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95926-8710
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).):
1 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
Applicant: FLOWER GARALD A JR
owner of property who builds or improves thereon, and who does
3596 HWY 32
such work himself or herself or through his or her own employees,
CHICO CA
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
95926-8710
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.).
❑ 1, 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,
Contractor:
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am under Article 3 of Pe Business a d Professions Code
(Exempt
/ I12
Date: Own r.
License #:
WORKERS' COMPENS ION 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
Architect:
is issued.
❑ I have and will maintain workers' compensation insurance, as
Engineer:
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:
Total Square Ft: 0 S. F.
Policy#:
Valuation: $0.00
qAL I certify that in the performance of the work for which this permit is
Census Code:
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
forthwit comply with those provisions.
/
/ C�[ o
Date:
Applica /
WARNING: Fai ure 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 forin-Section-3706•of-the Labor
code, interest, and attorney's fees.
g,
Y
CONSTRUCTION LENDING AGENCY
This permit is h by issued under the applicable provisions of the Butte County CodR anryor
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 tdo rk indica ab ve for which fees have been paid. 69-
(�
Name:
By: // D/atte: ,l
-V
- �'
Address:
PERMIT EXPIRES ON: VJ )
Date
❑ 1 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. 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 form or document of Butte County. I he
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
ti��/i �� �'�
Print Name. \ /655 Signature:
<1/6
Date:1Q f 17,G 7
Ili -owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
in
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 APPLICATION
OWNER
Name S'K!-
Address 3S -q w _9 Z
City`C U
State
Zipq S-C)-
Phone536)9y_ZZsB
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
CONTRACTOR
Name
a 4 -
Address
City
Yes
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
Lic. #Class
Lot #
APPLICANT SIGNATURE
X
For office use only:
ARCHITECT/ENGINEER
Name
a 4 -
Address
City
Yes
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
State License Number
APPLICANT SIGNATURE
X
For office use only:
APPLICANT NAME
Name
a 4 -
Address
City
Yes
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
APPLICANT SIGNATURE
X
For office use only:
Zoning
Flood Zone
SRA
Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
�
, 110iv
BP
BIN #
LOCATION
AP# ()q2 oO— C7 C7
Property Address ��1 � q � � 2�
Cross Street > l ./
WORKER'S COMPENSATION
Policy Number
Carrier
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:
Up
(&J't m c" " n ✓'Ze ��-1--<--f
Sq. Footage T�o
❑ 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
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: r Amount: (D Bldg
�Y SRA
Receipt #: �'>� �°7i Sheriff
Date: � - I 1 -&4
OVER FOR SUBMITTAL REQUIREMENTS l'
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of - �F
SMIP
Other
- O Total
REV 4-30-04
SUBMITTAL REQUIREMENTS
I' . j
The following drawings and specifications must be submitted to the Building Division in order to apply
fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (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.
Mobile, Manufactured, or Modular homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.-
0
lans.❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1.
4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4.
Letter from Engineer or Architect for truss design review.
❑ 5.
2 Energy compliance design and supporting documentation (if required).
❑ 6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7.
Statement of Intent for Non -heated and A/C (if required).
❑ 8.
Metal Buildings: (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.
❑ 9.
Letter of intent.
❑ 10.
Hazardous Material Form.
❑ 11.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04
O.B.- I
OWNER -BUILDER VERIFICATION
Attention Property Owner
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit' will be issued until this
verification is received.
0I personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES A NO 0
I HAVE �L HAVE NOT 0 signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work
NAN9:
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
NOTE: This Owner Builder Verification is required by Section 19831 and 19832 of the
California gealtlt and Safety Coda This verification must be completed and
returned to our office before we are permitted to issue the permit
•00
OWNER BUILDER INFORMATION
Dear Property Owner.
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner4 mlder" you are the responsible party of record on such
a permit Building perms we not required to 6a signed by property owners unless they are personally performing their
own work. If your work is being peai'omied by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own wmi; with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
Ifyou employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $300 or more for the entire project, and such persons are not licensed as contactors or
subcontractors; then you may be an employer.
♦ If you are an employer, YOU must register with the Statue and Federal Governments as an employer and you are
subject to seveial obligations including state and federal income tax wWxbolding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contnbuticu&
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to wooer's compensation insurance.
♦ For more specific in€ nmation about your obligations underFederal Law, contract the btemal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
Stage Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended fior sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
per, erroneously imps that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Infannadion about licensed contractors may be obtained by cont wtmg the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The budding permit will not be issued until the verification is reamned.
ly,
/x
M'ic 1 C. Vi ira, C.B.O.
a, Building Inspection
NOTE: Tl`r1t Owner -Budder fnforma8on is required by Section 13830 of the California Health mid Safety Code
OVER
A
Fidelity National. Title Company
m
OF CALIFORNIA
505 Wall Street, Chico, CA 95928
530 343-3716 • FAX 530 343-4410
DATE: June 14, 2004
ESCROW NO.: 04 -214598 -JT
LOCATE NO.: CAFNT0958-0958-0002-0000214598
ESCROW OFFICER: Jennifer Tunison
BUYER FINAL CLOSING STATEMENT
SELLER: Garald A. Flower, Jr.
BUYER: Tony Dossie and Linda Wineland
PROPERTY: 3596 Highway 32, Chico, CA 95973
TIME: 10:06 AM
CLOSING DATE: June 7, 2004
SAVE THIS STATEMENT FOR INCOME TAX PURPOSES
q•, .
(clsstmtfb)(07-02)
N
$ DEBITS
$ CREDITS
FINANCIAL:
Total Consideration
.,192,500.00
Deposit - Tony Dossie
2,000.00
Deposit - Linda Wineland
102,856.24
New 1st Trust Deed to Roy Green
88,688.99
PRORATIONS/ADJUSTMENTS:
Prepaid County Taxes at $570.97 Semi -Annual from 6/7/2004 to
76.13
7/1/2004
TITLE CHARGES:
01-0-CLTA Standard - 1990 for $192,500.00
359.60
Recording Deed
10.00
ESCROW CHARGES:
Escrow Fee to Fidelity National Title
166.50
Doc Prep Fees to Fidelity National Title
25.00
MISCELLANEOUS:
CSAA for Homeowners Insurance
375.00
Tony Dossie for Buyer Refund
33.00
tl
BALANCE DUE ESCROW
TOTALS _
$193,545.23
$193,545.23
SAVE THIS STATEMENT FOR INCOME TAX PURPOSES
q•, .
(clsstmtfb)(07-02)
N
'y+• .. �..:�w-�.._x. �-....cw vtw. ..;t �-•w.pr�'�t:���� ... .n ,,, v.., c�.'Yr�.
. � I
. .•-ems., ..,.�..q,.,.eV....Hn "+,79"+ t,h7�"'-. :..
,.�l.,y. A �M?1?va:
042-300-009
00 -2494 -
HARRIS, DALE
3596 HWY 32, CHICO
CONTR: OWNER
PARTIAL REROOF & REPAIRS
s:... JJW
an" :r:y€"'r �: .
COUNTY OF BUTTE - DEPARTMENT OIF DEVELOPMENT SERVICES - BUILDING DIVISION
�'>Fnounty Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 r PERIAT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER �/ n n r' f
042-3�J-009
ZONING
BUILDING PERMIT
OWNER DALE HARRIS
TELEPHONE
SO, Fr, OCC. BUILDING VALUATION
OWNERS MAILING ADOREaa3596 HIGHWAY 32, CHICO 95973
4 ROL
140
CONTRACTOR'S NAME
Ow1iF.R
TELEPHONE
-t L)CI
CONTRACTORS MAIUNG ADDRESS'
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
380
ARCHITECT OR ENGINEER
LICE .NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEER'S MAIUNG ADDRESS
Plan CheckingFee
$
BUILDING ADDRESS 3596 H6Y 32, CHICO
Energy Plan Checking Fee
$
$
PERMIT FEE
$
LAT NO. SUBONISICNS NAME. PARCE MAR
-
Each Trap
.. :. 2-Q;�QQ.,.
7.00
USEOFSTRUCTURE
SF j 1 Duplex ❑ Mobilehome ❑ Other
SPECIFY
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: PARTIAL RE ROOF & REPAIRS
Gas piping stem 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I s I G I W
020.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service xo.A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
1 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:
gg 1, as owner of the property, or -my employeesmith,wages.as_tbei[sole gompe-D.sati�,
jS 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 iDECLARATION
I hereby affirm under -penalty of perjuryone-of the 16116wing'declakatione:
❑ 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
Main Service 200A To 1000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. BLAS.
SO
3.52FT.
NONJ•gE8ID. MU LT0.OVTLET
97.50
POWER APPARATUS
a 81NGLE OunET CIR.
OUTLET OR FIXTURES
Ex. Occup.BAL.
20 ®I. 0
.so
Ex. Occup. oinFIX�°PRESID.G�
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
_
'MECHANICAL PERMIT
Fling Fee 20.00
Heating'
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
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.)
I 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.
?. ,, r j i
X Date 40 .-. ,e i r �
Signature orApplicant - ❑ 0Yiner ❑ Contractor ❑ Agen
An OSHA permit is required for excavations over 5'0” deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 35.00
HAZ.
D. FEES IMP
I FLOOD
I CDF
I PARCEL
I PD
I HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
,W
By,; �1/L//%r•�
PERMIT EXPIRES ON�L
the applicable provisions
Resolutions to do work
been paid.
Date /
-y
ate
Receipt No. I
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
- , # -,
COUNTY OF BUTTE - DEPARTMENT & DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT &- PERMIT
ASSESSOR PARCEL NUMBER 042-30-0-009
ZONING
BUILDING PERMIT
OWNER DALE HARRIS
TELEPHONE
SO, Fr, OCC. BUILDING VALUATION
4 SQUARS
240
.OWNER'S MAILING ADDRESS
3596 HIGHWAY 32, CHICO 95973
4 ROLLE
140
CONTRACTOR'S NAME OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS r
I
W J
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
380
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
1500
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS 3596 HWY 32, CHICO
Energy Plan Checking Fee
$
$
PERMIT FEE
$39-00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 1 20.00
USEOFSTRUCTURE
SF R] Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
1 7.00
Solar or heat pump water heater
1 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: PARTIAL RE ROOF & REPAIRS
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI GI W1
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service zoOA 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.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Lf iAvw or the following reason:
I, as owner of the property,. age6as4hei -gnte cQmpens taLr
-�"
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 0
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCC P.
OR ADONS. ( 8 ACC. BUDS.
sG
3.5QFT.
NEW galpT MULTI -OUTLET
@7.50
POWER APPARATUS
a SINGLE OurL[.T CIR.
Ex. Occup. OUTLET OR FIXTURES
00
BA20 Q 1..00
Ex. Occup. DFIx�E�D�A A� DEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
-
AI
$
WORKERS' COMPENSATION DECLARATION
1 ereby 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.
❑ 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 worer kers' compensation insurance carrier and policy number are:
Carri
Policy Number
(rhe 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 ff I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
/
D e /h `� �Qi(i _
LSnature o 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.
MECHANi R, +yI n Fee 20.00
Heating u
Coolin
�r,'
Hood 6.50
Ventilation
TT a AI IS ON
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 5
HAZ.
D. FEES IMP
FLOOD
COF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
/
�9ate !L�
10 /P
Date
ReceiptNo, 70
HITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing` your
signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will
be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the
proposed property improvement : YES[ NO[ ].
*4 I HAVE[X ] HAVE NOT[ ] signed an application for a building permit for the
proposed work.
3. I have contracted with . the following person (firm) to provide the proposed
construction:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, -but I have hired the following ' person 4o
coordinate, supervise, and provide the major work:
'NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated: ....
NAME ADDRESS PHONE TYPE OF WORK-,
SIGNED:
4 PROPERTY OWNER: � _
DATE:
v
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health and Safety. Code.
This verification must be completed and returned to our office before .
we are permitted to issue the permit.
OVER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are personally
performing their own work. If your work is being performed by someone other than yourself, you may protect
yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all permits
for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection: .
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and other costs) is $300 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Service (and,'if you wish, the U.S. Small Business Administration). For more specific information about your
obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees, without a licensed contractor or subcontractor, only
under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
building permit, erroneously implying that the property owner is providing his or her own -labor and material
personally. Building permits are not required to be signed by property owners unless they are performing their own
work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned: ;
SWare I ,
Micha4l C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
APPLICATION AND PERMIT
PERMIT N0.
ASSESSOR PARCEL NUMBER 042-30-0-009
ZONING
BUILDING PERMIT
OWNER DALE HARRIS
TELEPHONE
SO. FT. OCC. BUILDING
VALUATION
4 SQUAB S 240
OWNER'S MAILING ADDRESS
3596 HIGHWAY 32, CHICO 95973
4 ROLLE 140
CONTRACTOR'S NAME OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 380
ARCHITECT OR ENGINEER
LICENSE No.
Flan Fee $
20.00
Permit Fee $
00
ARCHITECT OR ENGWEERS MAILING ADDRESS
Plan Checking Fee $
BUILDWGADDRESS 3596 HWY 32, CHICO
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF XJ Duplex ❑ Mobilehome ❑ Other
ISPECIFY I J
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 O Instal ❑ er
Describe Work: PARTIAL RE ROOF &REP
Gas piping system t - 5 outlets
15.00
Buildingsewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200. OR LESS
23.00
LICENSED CO TR C S DECLARATION
ereby affirm under penalty of perju that I m licensed under provisions of Chapter
commencing with Section 7000) of Division 3 of the Business and Professions Code,
rand 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
w 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.
O 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO I000A
46.00
NEW CONST. DWELLING OCCUR
OR AOONS. ( a ACC. OLDS.
so
3.5¢Fr;
No R.,.. T. MULTMOIlTLET
@7.50
POWER APPARATUS
8 SWGLE OUTLET CIR.
Ex. Occup. OUTLET OR FOcruREs
20x'.00
BAL .w
Ex. Occu . °F"I„ ETS APPUNIS °El
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE $
I WORKERS' COMPENSATION DECLARATION
by affirm under penalty of perjury one of the following declarations:
I haveand will maintain a certificate of consent to self -insure for workers'
as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
haveand 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
(rhe 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, 1 shall
employ any person in any manner so as to become subject to workers'
laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shallforthwith comply with those provisions.
D�t�
[S�gnature of Applicant - O Owner O Contractor O Agent
An OSHA permit is required for excavations over 5'0° deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Fling Fee 20.00
Heating
Coolincompensation,
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 35. 00not
IMP
FLOOD
CDF
PARCEL
PDcompensation
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.
By Date
PERMIT EXPIRES ON
Da to
Receipt No.
HITE-D.D.S.-B.D. . CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
t Couni
�. u to
_ LAND OF NATURAL WEALTH AND BEAUTY
BUILDING DIVISION
'�'Y•'y`{ ` ~ r'_'.':'" DEPARTMENT OF DEVELOPMENT SERVICES
August 2S, 2000 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (530) 538-7541
FAX: (530)538-2140
Dale Harris
3596 Highway 32
t Chico, CA 95913
RE: Building Code Violation A.P. #042-300-009
3596 Hwy., 32, Chico
Dear Mr. Harris:
This is a courtesy notice 'to notify you that you are in violation of the Butte County Code, as
follows, at the above -referenced location.
Failure to obtain the required permits, inspections and approvals from this office for a re -
roof.
Since permits and inspections are required for the above work. Please apply for the required
permits, and pay the appropriate fees. All work must stop until these permits are issued and you
are'authorized by our field inspector to proceed. The field authorization cannot be made until the
existing work is inspected and approved.
It is the County's goal to obtain voluntary compliance with the Butte County Code. However,
you should be advised that Butte County has an, active Code Enforcement Program which
provides an effective means of enforcement if voluntary compliance is not obtained.
Enforcement may be pursued through the issuance of citations, fines and the recording of a
Notice of Violation including a description of the action necessary to abate the violation.
You have thirty (30) days to voluntarily comply with the above directions or to present an
acceptable plan for abatement or corrective actions to be taken by you. Should you have any
questions concerning this matter, please contact Scott Rutherford or Michael Vieira in this office
at the address or telephone number listed above.
Sincerely,
MCV:pa Mic el Vieir
Man ger, Building Inspection
cc: Assessor
-.
BUTTE COUNTY DEVELOPMENT SERVICES
Complainant:
Address:
Phone Number:
Other Comments:
.•..;.::, is3 P1 Wit i:'
. 3 .IWIMP: i . x 3:i'i::> NAY»„ .......::,'hi)ovif' d%ldt1► �€ s r 3 >,, ::: .
Inspector must draw a plot plan with all building locations:
Additional comments from Inspector:
2
r-� -J
r1rlAllPJl17C-11/
Name HARRIS JOHN CURTIS & DALE A CP
Asmt#_� �� ��' �� Fee#
_ -
,
Status ACTIVE + Status ,: Date
Addrl 3588 HWY 32
jj
Tax, 000 NORMAL OWNERSHIP�JJTRA' 062 022
Addr2CHICO. CA 95926
Situs :3596 HWY 32 CHI
Base D t Ol !Ol !1982
. 4
Addr3
' ra
_ •
Land
AgPres
48,600
Addr4 j ��
•
Structure
r Etal Fixtures
r Notes Growing
26,125,'
0
0
Comments 4230000900 CONVERTED 09/08/88
Creating Doc# 198282694413 Date -
r Bonds Total L&I
74,725'
Current Doc# Date
Multi Situs Fix. RP
0
Killing Doc# _ _ Date
Asmt Desc 3596 HWY 32 SuplCnt 6 1
, Flagl MH PP
r FIag2 PP
0"
ZoningSR1 Dwell
r Asmt PP Pen Exempt
0
Net
`�'':'"=74;725'
Acres 1.00; NIC 042
r Tax PP Pen
RIC#[-
Appeal Pending T/R Dt
k
_ _ _ iSplit
-- Pending' RIC Stat
OWN
II� EXP I
TAX
I ATT
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SIT
I. APR.
I PCL
F-
7-Q-
� ►
�I
[0-:111,
1 s - IF 17. Find IL &N
`, 2000
sa, 08/08!2000 6:17:48 PM
a
fg,C,VAj!:E +,, jet AtL A, 'PEW i7 4 -PPL
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4- SQ u fte Colic p S t -w sjGtr c? O
MA -U- To-- bA�•C i-��sL
J
Eutt'd Count
L A N D O F N A T U R A L W E A L T H A N D B E A U T Y
``'A_=
4 .. �
iA
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
PROOF OF SERVICE BY MAIL
I am a citizen of the United States and employed in the County of Butte; I am,
and was at the time of the service hereinafter mentioned, over the age of eighteen
years and not a party to the within action. My business address is Department of
Development Services, Building Division, 7 County Center Drive, Oroville, California
95965. 1 am readily familiar with the County's practice for collection and processing of
correspondence/documents for mailing with the United States Postal Service and that
said correspondence/documents are deposited with the United States Postal Service in
the ordinary course of business on the same day.
On October 2, 2000, 1 served the foregoing 10 -Day Letter on the person(s)
named below by placing a true copy thereof in a sealed envelope, with first class
postage thereon fully paid, addressed as indicated below, and by placing said envelope
In the appropriate place within the Department of Development Services
where mail is collected for mailing with the United States Postal Services
on the same day.
X In the United States Postal Service Mail in Oroville, California.
Dale Harris
3596 Highway 32
Chico, CA 95973
I declare under penalty of perjury under the laws of
2, 2000, at Oroville, California.
v
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 01-1731
ASSESSOR PARCEL NUMBER 042-300-009
SR -1 ZONING
BUILDING PERMIT
OWNER
ROY GREEN
TELEPHONE
893-4956
SO, FT, OCC. BUILDING VALUATION
. OWNERS MAID REBS
MUIR AVE. CHICO CA 95976
CONTRACTOR'S N�LVJ:,I\
A�7M�E7��
0 W
TELEPHONE
CONTRACTORS MAIUNG ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ '
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee
$
BUILDING ADDRES596 14W 32 CHICO CA
3
Energy Plan Checking Fee
$
PERMIT FEE
S
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing 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 gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: ELECIPRIC SERVICE UP GRADE & MISC WIRING
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home IS I GI W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service s OR LEss
23.00 23.00
LICENSED CONTRACTOR'S DECLARATION
1 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,pOH
and my license is in full force and effect.POWER
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
' 0� 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
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
O 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 rovisions of section 3700 of the Labor Code, I shall
forthwith comply with se provisions.
X Date
Signature o Ap ' licant - Owner ❑ ontractor ❑ Agent
An OSHA per its requir for excavations over 5'0" deep and demolition or construction
of structures ooir 3 stor s in height.
Main Service 200A TO I000A 46.00NEW
CONST. DWELLING OCCUP. SO
OR ADDNS. ( a ACC. BUDS. 3.5¢FT:
IpT' MULTI -OUTLET
97,50
APPARATUS
n SINGLE ounEr C1 R.
Ex. Occup. OUTLET OR FIXTURES
e� @';0050
Ex. Occup.ouT1ETS R IESIES D.DEA, 5.00
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.00 3.00
PERMIT FEE S 66.00
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 $ 06.00
HAZ.
D. FEES
IMP
FLOOD
CDP
PARCEL
PD
HD
SSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated bove for which as eve been paid.
Date 7-13-2001
PERMIT EXPIRES ON 7-13-2002
Date
Receipt No. 324941 66.00 $
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
y LUUM I T Ur BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
�j y 7 Count Center Drive •
-41- ' Y Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO
Rev. 12/96) .,• APPLICATION AND PERMIT
ASBESSORPARCELNUMBER DDNNG BUILDING PERMIT
OWNER n TELEPHONE
lSl(ce g_ SO. FT. OCC. BUILDING VALUATION
OWNER? MAUNG AD t
SS Mo r A r
NEW CONST. OWELLM OCCUP.
OR ADDNS. i ACC. OLDS.
NEW NON- REBID. MULTFOUTLET
COMRACTOR'S
TILEP/ONE
Ex. Occup. OVTLEr OR nmJNES
I
EX. OCCU FOEDAPPLNB• OR
OUTLETS ESID. EA
1
Temporary Service
i
Mobile Home Facilities
CONTRACTOR'S MAAJNG ADDRESS
PERMIT FEE S
CONSTRUCTION LOWER
MECHANICAL PERMIT
Heating
LENDER'S MAILING ADDRESS
Fireplace
ARCNTTECT OR ENOINEER
LICENSE No.
Total Valuation $
Filing Fee
S
20.00
ARCWTECT OR OXWEER'S MAUNG ADDRESS
Permit Fee
$
OUILONOADORESS
Plan Checkin Fee
S
Sr,
Energy Plan Checking Fee
$
F-
$
LOT NO. SUODNBIONENAME
PARCEL MAP
PERMIT FEE
$
PLUMBING PERMIT
Rling Fee 20.00
USEOFSTRUCTURE
Each Trap
7.00
SF ❑ Duplex O Mobllehome O Other
Solar or heat um water heater
23.00
Water piping
15.00 -
FM fY
TYPE OF WORK
Each gas water heater or vent
15.00
New ❑ Addition O Remodel ❑ LfdKes O InsiaOation ❑ Other ❑
Cas I in stem 1 - 5 outleffi
15.00
J
Buildingsewer
15.00
Describe Work: 1/a.//o //(` i� ],� rJ'�/-)CI r�
Mobile Home 11 C W
Q20.00
PERMIT FEE
S
ELECTRICAL PERMIT
'—'—• --- Main Service OOOV OR LESS
TOOA OR 1E88
Main Service 300A TO HOOOA
*PERMIT FEE PAID
SRA
SHERIFF
OTHER
AA 6VNT RECEIVEC
*RECEIPT NVMSER �-5 ;Pi c) a' LJ
* TO BE PVr INTO COMPUTER
Feel 20.00
48.00
3.52Fr.
97.50
23.00
20.00
23.00
6.50
20.00
PERMIT FES S
Mobile Home Installation Fee $
Energy Inspection Fee $
k7TH-7AZ--
TYPE TOTAL FEES . cG�
-ES -MP FLOOD COP PARCEL I PD I NO I ISSUE
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.
By
PERMIT EXPIRES ON
Date
NEW CONST. OWELLM OCCUP.
OR ADDNS. i ACC. OLDS.
NEW NON- REBID. MULTFOUTLET
POWER APPARATUS
i SWOLE OUTLET MR.
Ex. Occup. OVTLEr OR nmJNES
I
EX. OCCU FOEDAPPLNB• OR
OUTLETS ESID. EA
I
Temporary Service
i
Mobile Home Facilities
Misc. Wiring
PERMIT FEE S
MECHANICAL PERMIT
Heating
Coolina
Feel 20.00
48.00
3.52Fr.
97.50
23.00
20.00
23.00
6.50
20.00
PERMIT FES S
Mobile Home Installation Fee $
Energy Inspection Fee $
k7TH-7AZ--
TYPE TOTAL FEES . cG�
-ES -MP FLOOD COP PARCEL I PD I NO I ISSUE
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.
By
PERMIT EXPIRES ON
Date
r� COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 1 P RMIT No.
(Rev. 12/96) APPLICATIONAND PERMIT���`�$
ASSESSOR PARCEL NUMBER 0J 0
L
20NIN0
BUILDING PERMIT
OWNER
TELEPH NE
SO. FTC. OCC. BUILDING VALUATION
5 0
.OWNERS MAILING ADD SS
5-�7 C U
CONTRACTOR'S NAME /
Ov %
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ Z.
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF.Er'**'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 f
New ❑ Addition ❑ Remodel ❑ Ubl'Ities ❑ Installation ❑ Othw--EJ
Describe Work: . <96L.okm Qrnn�o F/,J AIAto^v
/l. �!l�rtA�[� Ln1l.� % ,OD-n.���✓
Gas piping stem 1 - 5 outlets
15.00
Buildingsewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 2IIA 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.
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:
EV 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 200ATO 1000A
46.00
NEW CONST. DWELLINGOCT
EL
BBLDS
( ACC.
ORNEW
3.5Qso
cors M&
NON•RESID.UT
@7.50
P60 APPARATUS
8 SINGLE OurLET CIR.
EX. OCCu OUTLET OR FIXTURES
.00
BA_ O I.50
LNS
Ex. Occup. ouT,EF°rs aEsIDOEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE S
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.
❑ 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.)
J� I 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
fo ith comply with those provisions.
��%% /
X q�C,(' ��� Date 3 � Z—O /
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.
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEP_ $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ CONST TYPE
TOTAL FEE $
HA2. D. FEES IMP FLOOD CDF PARCEL PD HD IS UE
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.
By ^Date 12- a /
PERMIT EXPIRES ON ✓ �y���
Date
ReceiptNo.J
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
OWNER -BUILDER ,VERIFICATION
Attention Property Owner:
An "owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit will be issued until this
verification is received.
i. I personally plan to provide the major labor and materials for construction of the proposed
property improvement , YES ji , . NO
1'1 HAVER HAVE NOT E3 signed an application for a building permit for the proposed work.
3. I have contracted with the following person.(firm) to.prayioe_tie,proposed construction:
NAME. - - «.i • ,,...
ADDRESS: CITY:_ .
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired -the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: CITY: -
PHONE: CONTRACTOR'S LICENSE NO. +
5. I will provide some of the workbut I have contracted (hired) the following persons to provide.
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED: /)
PROPERTYOWNER: /�,� / / K
SOCIAL SECURITY NUMBER:
DATE:
NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed and
returned to our offlee before we are permitted to Issue the permit.
OWNER BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your time listing yourself as the builder of propeity
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have'a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply... ;
uyod pled to (Wy,. r own'work„ with the exception of various trades that you plan to subcontrad, you should
be aware of the following information for your benefit and protection: '
♦ If you employ or odu wise engage any persons other than your immediate family, and the work (inchtdingniaterials
and other costs) is $300 or more for the entire.project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There maybe financial risks for you ifyou do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
+Mag2ee'r,%8uVti1diing
ra, C.B.O.
[nspection
NOTE. This Owner -Builder Information is required by Section 19830 of the Calybrnla Health and Safety Coda
OVER
NOTES
S 'Y
RESIDENTIAL
PERMIT NO.
09 - 28 (o
5.
r
i
�f
i
YI
1
0
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS ..
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date) �_ Z2 NQS
Signature�� - -
= OK
= Not OK
= NotReadyable 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/0 -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6. iGas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / /" L "ft./ P LPG
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.
7.
Well Clearance & Disconnect
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
8.
Utility Clearance
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
Date
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
Card B-1 Date Card B-1
Date
10.
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s -
12.
1.
Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
Card B-1 Date Card B-1
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/0 to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
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-GFI
5.
Elec.; 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 Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., (Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5.
Stemwalls, Main; Steel- Bloc kouts-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 -Fitting -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 Underg,ound
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15.
Access & Ventilation
16.
Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
Card B-1 Date Card B-1
Date
PLUMBING (Permit$ OK except #'s
17.
Water Htr.; Vent -Access -Combustion Air Baffle
18.
Water Pipe; Tes- & 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
72.
Elec. Outlets at Wood Panel, Int. & Ext.
Date
73.
Card B-1 Date Card B-1
Date
74.
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Garage Fire Door; Swing -Landing -Closure
24.
Fixture & Transformer Clearance -Ins. Protection
A.C. Duct in Garage -Damper
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
26.
Size Boxes & No. of Conductors Stapled
Plb.; Elec. & Mech. Equip. Listed for Location
27.
Romex Installed Close to Edge of Studs & C.J.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
28.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
Insulation -Foam -Looked in Attic
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
Guard Rails & Deck Construction -Post Caps
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral ❑ Yes ❑ No
Clearance Looked under Floor ❑ Yes
32.
Service -Riser Conductors & Ground Main Disconnect
Following Instld./Drive ❑ Yes ❑ No/Walks O Yes ❑ No/Planters O Yes ❑ No
33.
Equip. Clearances Panels-Motors-Mech. Equip.
Stucco Brown -Finish
34.
Clothes Closet Light -Shower Light -Spa Light
A.C. Unit Disconnect, Electrical -Plumbing
35.
Smoke Detector
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
90.
36.
A.C. Ducts Insulation & Support
91.
37.
Vent Fan, Exhaust above insulation
92.
38.
Condensate Drain & Overflow, Size & Grade
93.
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
94.
40.
Attic Access & Platform if Furnace in Attic
Date
Address Posted
Card B-1 Date Card B-1
Date
Fire Sprinkler
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Date
41.
Sills Prooer Materials & Anchors
Date
42.
Walls Stds-Nailiig Spacing & Braces -Plates -Sound
Comments at Final:
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- Purl in -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.
Bdrm. 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
Card 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 ❑ Yes
_
83.
Following Instld./Drive ❑ Yes ❑ No/Walks O Yes ❑ No/Planters O Yes ❑ 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 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP042867
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: 09/30/2004 APN•- 042-300-009-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 3596 HWY 32 CHI
Date: Contractor.
Map Index:
Description: REROOF ROLL AND COMP 15 SQ
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
Owner: ANTHONY DOSSIE
permit to construct, alter, improve, demolish, or repair any structure, prior
to . its issuance, also requires the applicant for such permit to file a
3695 HWY 32
signed statement that he or she is licensed pursuant to the provisions of
CHICO CA
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
95973
she is exempt therefrom and the basis for the alleged exemption. Any
530-894-2285
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
Applicant: ANTHONY DOSSIE
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.).
O 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
Contractor'
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 a Business and Professions Code
3bo
Date: Own
License #:
WORKERS' COMPENSATION DECLARATION
1 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
Architect:
is issued.
Engineer:
❑ 1 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:
Total Square Ft: 0 S. F.
Policy a:
Valuation: $0.00
Census Code:
I 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.
9 /30/f y
Date:
Applican • Y
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 attomey's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereb ss ed under the applicable provisions of the ButteqCnty CodR anrUor
_
I hereby affirm that there is a construction lending agency for the
Resolutions to d� w ri dicated.above for which fees have been paid.v
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By Z-� Date:
X -
Address:L,,--Date
PERMIT EXPIRES ON:
❑ 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. 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 an official form or document of Butte County. I hereby
authorize rep/rese/natives of Butte County to enter upon the above mentioned property for inspection purposes
Print Na rp� v l 0� a e✓ 5 I -Q Signature:
Date: O
(Owner ❑ Contractor ❑ Agent for Owner ❑ Agent 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 REOULRED AT TIME OF APPLICA TION
"PLEASE PRINT CLEARLY"
OWNER
Last Name D< -S
ust Nam 1
Address SGq S_ w -L—
city C"h) (�O
Stately
l�
Zip
ST2
Phon 6 — 2 2��
Fax
E-mail
CONTRACTOR
Name
Address
City
State
Zip
Phone
Fax
E-mail
Uc. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name N -
A,
Address
Zip p
City
Fax
State
Zip
Phone
Page
Fax
E-mail
Date Approved:
State License Number
APPLICANT NAME
Name qyr&v, DU 557 1•�
Address 3F? (0 H,,,'Z-2-
city c _ \ CU/�
tattC
Zip p
Phon Z2F'jS�
Fax
E-mail
APPLICANT SIGNATURE
For office use nly:
Zoning
Propert ddress
Iq VV\
. Flood Zone
CS
ross Street
SRA I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERAUT
Vtt
1•' C''
BIN #
LOCATION
AP# OV
Z — 30v—oo9
Propert ddress
Iq VV\
City
CS
ross Street
SRA
WORKER'S COMPENSATION
Policy Number Ai _ /� `
Y�
Carrier
tf hiring anyone other than license contractors, a certiFcate of worker's
compensation must be shown at the time of permit issuance.
Dateg
I
LENDING AGENCY
Name
Address
n �9 pp Descript'on or Scope of Wor
1Z2 `Y�vcrtJ YYI
Sq. Footage
❑ 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
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.
�i.. �'.n••'.�r�i m n a+ J-- M--- A -[q
0CN/ 7 -17 AA
11Re ' ed b . Amount [
Bldg
W
SRA
Receipt #:
Sheriff
41
SMIP
Dateg
I
Other
Total
�i.. �'.n••'.�r�i m n a+ J-- M--- A -[q
0CN/ 7 -17 AA
N
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 faxesl
❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to
mobile or modular homes.)
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Data sheets and 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).
❑ 13. Sanitation and site plan approval from the Environmental Health Department.
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, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application 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
KeTunds can oniy 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
;heck fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
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