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Home My WebLink About042-310-011' Ae,'� Butte County Department of Development Services. evr7E �aea I N O TE S 7 County Center Drive, Oroville, CA 95965 (530) 538-7601 v.ww.buttEc%knty nevdds co°"ty I RESIDENTIAL APN: Permit No. Owner. 042-310-011 06-0438 WEBSTER, DANIEL Site Address: 2846 RODEO AVE, CHICO CONT: COMFORT AIR AND ELEC Contractor. ELEC SERV PANEL C/O — Type of Permit: OFFICE COPY Address •�• GAS Meter By Date ELECTRIC .Meter By Date i SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: — — SIGNATURE:C f0 =.OK - Not OK 'MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Li SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat Q or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers -Breakers -CIrncs 10 Drain; MH Test -Fall -Flex Cnnctr ' 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs 0 Foundation 0 14 Exits 15 Cert of Occupancy 16 HUD Labet/Insignia Numbers Serial Numbers DATE ID E C K S'C OV E R S'C A R P O RTS `G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils -Sz-DpthSpacing-CnnctrsSteeI 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; S ills -An chrs -Stu ds-Rftrs-Trusses 9 Siding; Nailing-VeneerStucco-Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls °tee DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pnlboards4nsultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing Alarms 13 Bonding, Diving board or Slide 4 s °'a 0 Ise - ' Pool Drawing OK Not OK KESIDENTIAL (Single & Dup(e)o DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Fig Dpth- 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth. ` 56 Shwr Pan; Test, First fir -Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub-Acc 6 Stem -malls Garage; Steel-Biockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 61 Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test a 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1l Wtr Pipe; Test-Anchrs-Rgitr-Service Test 12 Elec Undrgrnd DATE IM E C H A N I C A L 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 61 AC Ducts Insultn & Support 14 Girders-Sills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16.lnsulation 64 Furnace -Vent Acc-Comb Air Rtrn[Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic c` 01' 0S` oa `mac` O DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideLt Prtctn-landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-DIrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage- abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 71 GF1 Arc Fault 25 Frp1c Ties or Type A Flue-Frplc Throat Clmc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting DoorsSill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls atKtchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Lottn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insulin -Walls -Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters QYes [:]No s` 87 Stucco Brown -Finish 88 AC Unit Dscnnc% Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs DATE ELECTRICAL 90 Wtr Well, Dscnnct, Elec, Plmb 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntitn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97- Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or El AL 98 Address Posted AC Wire Sz ga CU or QAL 99 Fire Sprinkler 48 Range Circ ga CU or AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral DYes ❑No o` 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector u X042-310-011: 04-0220 WEBSTER, DANIEL ,r 2846 RODEO AVE, CHICO .. , l Cont: ANTHONY ROOFING RE ROOF 24 SQ COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Orovllle, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT &- — ocp;; c) ASSESSOR PARCEL NUMBER `6666" WO -110-011 -011 ZONING BUILDING PERMIT OWNER ANTM. WFR."rFR TELEPHONE SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS 994(l 994(l OPIM VF _ 04TM ra Q-%020 44 I - 1 _446- CONTRACTOR'S NAME I I A,WMNY ROOPMr, TELEPHONE CONTRACTORS MAIUNG ADDRESS - CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —FilingFee $ 20.00 Permit Fee $ q t'iii ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2846 RODEO AVE.. C.HICO Energy Plan Checking Fee $ $ PERMIT FEE $ 55 t1l1 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF .��' Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap7.00 Solar or heat um 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 OX I Describe Work: MOOF 24 SO *Xp } Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S i ELECTRICAL PERMITFiling f— Fee 20.00 Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I 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. 1 , i / License Class (- , 1 Il Lic. No. ' ! f '� L OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages 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. I ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A To 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. a ACC. BLDS. SO 3.5Q�: NEW NONR61D. T. MULTI.OUTLET @7.50 POWER APPARATUS a SINGLE oIJRhT CIR. Ex. Occup. OUTLET OR FIXTURES zo p 1.00 BAL QFIX.50 Ex. Occup. OUTLETS PM.) E. 5.00 Temporary Service 2300 Mobile Home Facilities /'20.00 Misc. Wirin # 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following decarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the /,performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier -I', f,.: MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number Lv>- L (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 mannei so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation' provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions_. ( X" / l / _ Date (Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction{y of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 55.00 HAZ. , D. FEES IMP FLOOD COF PARCEL I PD I HD 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. 01 r d` ! i Date (, � 1 PERMIT EXPIRES ON i J �/ r Date Receipt No. " '� J� 0116'1 WHITE-D.D.S.-B.D. T CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP060438 RMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION ffhereby affirm under penalty of perjury that I am licensed under of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 02/24/2006 APN: 042-310-011-000 the Business and Professions Code, and my license is in full force and effect. / License Class: F b .0 ZU License Number: Site Address: 2846 RODEO AVE CHI Date: Contractor: 06 b 10x`2( )4-1 `(IvVap Index:. Description: NEW ELEC SERVICE PANEL p 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 WEBSTER DANIEL E LIVING TRUST permit to construct, alter, improve, demolish, or repair any structure, prior Owner: to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section C/O WEBSTER DANIEL E TRUSTEE 7000) of Division 3 of the Business and Professions Code) or that he or 2846 RODEO AVENUE she is exempt therefrom and the basis for the alleged exemption. Any CHICO, CA 95926-8963 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, avid the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: COMFORT AIR AND ELECTRIC 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 14286 HWY 99 year of completion, the owner -builder will have the burden of CHICO, CA. proving that he or she did not build or improve for the purpose of 95973 sale.). 530-892-2125 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: COMFORT AIR AND ELECTRIC ❑ I am Exempt under Article 3 of the Business and Professions Code 14286 HWY 99 Date: Owner: CHICO, CA. 95973 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 530-892-2125 ❑ 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 License #: 777975 is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are: ce-m Engineer: Carrier: I �l 3- Ohl �jSiOd Policy#: Square Ft: 0 S. F. ❑ 1 certify that in the performance of the work for which this permit.isTOtal issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comp y with th se provisions. Date:al,-acll I 0 Applicant: WARNING: Failure to secure workers' compensation coverage is G 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 hereby is " ed under t ppi c e provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) Resolu ns to do wor indicated a ve for - ch fees have been paid. 0�7 -- G V' o performance permit Name: By: f Date: Address: PERMIT EXPIRES ON: 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 a 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 o docume of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes � Print Name: . / �( i"` � Signature: Date: Z -Z /0 ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 Gv�s`7Z� 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 OFAPPLICATIOA' Website: www.buttecounty.netldds Qin/ �EASE PRINT CLEARLY" OWNER INFORMATION Last Rame First am Addre, s_ ( ,4 (, 4 City e L� (CO Slap n Zip l �d Phone Fax E-mail CONTRACTOR Name Co-yx �� ia- t' 2 d' Lac 7 (Z I (Z - Address Address 2 6 S'-� Iq rt✓ ci' Q % City t Cd Stat Zip Phone2 2 QS - Fax 0 �g5 O G E-mail OA.Lic. Zip s Wt7,j' 1 APPL/ NT SIGNATURE X For office use only:. ARCHITECT/ENGINEER Name l Address r City I No State Zip Phone Book Fax E-mail Planner State License Number APPL/ NT SIGNATURE X For office use only:. APPLICANT INFORMATION Name l Address SRA City I No State Zap Phone Book Fax E-mail Planner APPL/ NT SIGNATURE X For office use only:. Zoning Prc�Wd s /�o,�� C-) Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Tot # 7. Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP&O BIN # PROJECT LOCATION AP#0 L/2 — 3/0 _ 0// Prc�Wd s /�o,�� C-) Cityro C Q Cross Street 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: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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; . l (�7 Amount: Bldg Receipt#: jz� Sheriff .q v ` \1_SM1P Date Other Total SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5.. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Workers Compensation Carrier and Policy Number. ❑ 8: Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the.person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 P" COUNTY OF BUTTE a'DEPARTMENT O E ikoPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT - o02a n ASSESSOR PARCEL NUMBER \ _ v ZONING BUILDING PERMIT OWNER WANIM n STU TELEPHONE SO. FT, OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS - 2846 RQDFQ 414E JQHiw� QA O5 CONTRACTOR'S NAME TELEPHONE 1 7440 CONTRACTORS MAIUNG ADDRESS 1 CONSTRUCTION LENDER LFireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ 3500 Plan Checking Fee $ BUILDING ADDRESS , 221 Tco Energy Plan Checking Fee $ PERMIT FEE $ 171 171 00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing rCel 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um 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: F'-(1nF 94 SQ COMP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 V OR Main Service . '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. LO WNER-BUILDER DIARATION I herebyaffirm under penalty of perjury that I am exempt from the Contractors License P nY P 1 rY p Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will- do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I h e and will maintain a certificate of consent to self -insure for workers' mpensation, as provided for by section 3700 of the Labor Code, for the erformance of the work for which this permit is issued. /Phaveand 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' compp��ens tion insurance carrier and policy number are: Carrier S�j�"�� Main Service 200A TO 1000A 46.00 NEIN CONST. DWELLING OCCUR s0 OR ADDNS. ( a ACC. BLDS. 3.5¢Fr, NEIN CONST. MULTI. ' OUTU 07.50 NON RESID. POWER APPARATUS a sINOLE ovrLEr cw. Ex. OCCU . OLlTIET OR FDITUREs BAL 9 1.00 EX. OCCU FDLED APPLNS. OR O.RESID. EA 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 - CA7,0 05 (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 th p orm ce of th for which this permit is issued, I shall not employ a rson any so as to become subject to workers' compensati s of C ifornia, d ree that if I should become subject to the workers' nsatio , r sec Ion 37 - of the Labor Code, I shall f with ly with e r vi Date a ure App ican - ff Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 55.00 HAZ. D. FEES IMP FLOOD CDF PARCEL pp HD 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. ,Dpat d PERMIT EXPIRES ON ii 0 ate Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION PERMIT N0. 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-�54��aQ (Rev.12/96) APPLICATION AND PERMIT mwNG BUILDING PERMIT ' ASSESSORPARCELNUNBEA �MONE gp, FT per, BUILDING. ALUATION Ow •. s AD / �•�p liltO TELEPNONE CO..WA I*.'- iC1 COINSTAUCnON-UDOER LENDERS HAILING ADDRESS Fireplace Total Valuation $ LOT NO. ucENSE N0. Firma Fee $ ARCMiEGT OR ENGINEER USEOFSTRUCTURE Permit Fee ARCwfECr OR ENGWEERR'S MA NG ADDRESS - Plan ChecIdIng Fee $ Water piping Energy Plan Checking Fee $ eULMr. ADDRESS S PERMIT FEE $ PARCEL WPLUMBING sueonnsrous NAME PERMIT LOT NO. , Each Trap USEOFSTRUCTURE Solar or heat pump water heater Water piping SF Duplex ❑ Mobilehome ❑ Other SAF ch 9as water heater or vent TYPE OF WORK Gas i in 1 - 5 outlets New c3 Addition ❑ A odes ❑ Uri s ❑ Installation E3 Other Building sewer Mobile Home S G W Describe Work PERMIT FEE � ELECTRICAL PERMIT •••V OR LE55 Main Service 2.A OR LESS Main Service 200A To NEW CONST. OWEM OCW. ( _MDA OR ADONi ACC.BD PERMIT FEE PAID $ fR Ex. Occup. (ovnETORWIVRES SRA SHERIFF OTHER P i AMOUNT RECEIVED $ DATE RECEIVED 20.00 ring Fee 1 20.00 7.00 23.00 15.00 15.00 15.00 15.00 @20.00 jFeej 20.00 23.00 46.00 $0.1 1 3.50 a7.5o FD® APPU% ORKS- MECHWOCAL Ex- Occup.OLMETS ES . EA Temporary Service Mobile Home Facilities W= Wiring PERMIT FPERMIT I Firing Fee_L 20.00 6.50 PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ O'O coFW. 'rm TOTAL FEE $ NAL 0. FEES DIP FLOOD I COF PARCEL PD Iro 5SLA 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