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042-320-004
AP 42-32-4 -MORRIS-GEORGE--- 7 -MORRIS GEORGE - 7 Arbor Dr., Chico contr: John Nystrom, Durham a Permit¢# 4598-74B,E (addition) 042-320-004 - ; 06-1408 HEYNNEMAN, RICHARD' 7 ARBOR DR, CHICO Cont: MCHATTON ELE04�4 . ELEC(C/O) . t - N o6 I �N M CN. Butte County Department of Development Services ur anFa N 07 E S 7 County Center Drive, Oroville, CA 95965 'moo (530) 538-7601 www,buttecounty.n@Vdjs ur RESIDENTIAL APN: 0 ! 2— 3 Zo — 00 4 Permit No. 06 --.1 Y08 Owner. Site Address: -7 AR3o R DP (V C Cf{ Ict� Contractor. Type of Permit: /ZV / C� C •l' ,441 ,6i E' 06k7 - OFFICE 6k /OFFICE COPY Address GAS Meter By Date ELECTRI Meter By S�tnM01�5 Date y ' 7 i SPECIAL CONDITIONS • CHECKED BY Q SRA Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED Q SPECIAL INSPECTION ITEMS Q VERIFY Q USE PERMIT CONDITIONS 0 SUB -STANDARD HOUSING LETTER Q ENCROACHMENT PERMIT Q REINSPECTION FEE PAID ❑ ENV HLTH CLEARANCE 0 r y 3 Or=% Nom AVE. ME/4(L- W, 1-I900 DATE JOB FINALED: r� C--%' — SIGNATURE: �� . o5i't(j 06 BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING, PERMIT BP061408 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/13/2006 APN: 042-320-004-000 the Business and Code, and my license is in full force and �Prfessions effect.L,� 7j 7�f LicenseClass ' l� Numrber: Site Address: 7 ARBOR DR CHI �L'jic�ense —�� Date: � ontractor:r "/�944�11-0 Map Index: Description: SERVICE CHANGE OUT 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: HEYNNEMAN, RICHARD to its issuance, also requires the applicant for such permit to file a 7 ARBOR DR 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 95926-3003 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: MCHATTON ELECTRIC 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, 9 ARBOR DRIVE provided that such improvements are not intended or offered for CHICO, CA 95926 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530)893-3616 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: MCHATTON ELECTRIC 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.). 9 ARBOR DRIVE ❑ 1 am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95926 (530)893-3616 Date: Owner: License #: 477674 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: Cl 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 Census Code: Policy : I certify that in the performance of the work for which this permit is s ed, I shall not employ any person in any manner so as to ome subject to the workers' compensation laws of California, 1.1 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwithcom ly with those provisions , I C(J Date:.LJ7�- K M^ �� 1 �r I r/L�'�"� Applicant: • WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby is ed under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) ' Resolutions to do ®< indicated•a ove for which fees have been pai . J----!--, ' t/ performance permit By: 1�Da 00 Name: 7 PERMIT EXPIRES ON: ' U 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 hereby authorize representatives of Butte County to enter upon the above me tioned property inspection pur oses. r%j r ' e� ` / V Signature: Print Name: Date: ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 +=OK MANUFACTURED HOMES DATE U PERMANENT FOUNDATION L___I SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Lorin -Test; FallIC/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-DImcs-Gmd 'Amp -Concrete 6 Yard Gas; Loctn-Test Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Une 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clmcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ -14 Exits MISCELLANEOUS - DATE IDECKS'C0VERS'CARP0RTS'GARAGES 1 ZoningSetbacks-Easements 2 Ftgs; SoilsSz4OpthSpacing-CnnctrsSteel 3 Decks, Girders/Jotsts-Dcking-Brcing Stairs-Guardniandrails 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Fang; Sills-AnchrsStuds4fts Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Fit; Steps -Doors -Landings 12 Braced Wall pnls 15 Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers 40 DATE POOLS M 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability _ 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men4Jning 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lung; 1S volts-GFI 6 Elec.Enclsrs; Conduit Entries Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcitng Egp-Htr 8 Elec Gmdng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pnlboirdsansultn to Main Conduit 9 Health Dept Apprvl . 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche , 12 Encisr; Fencing -Alarms 13 Bonding, Diving board or Slide Pool Drawing RESIDENTIAL (Single & Duplex), DATE UNDERFLOOR DATE IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Gmd Ftp DRth 3 Ftg Garage; Soils-Steel-Elec Gmd Ftg Dpth 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwalls Main; Steel-Blockouts Wrapped 6 Stemwalts Garage; Steel-Blockouts Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgWService Test 12. Elec Undrgrnd 13 Plenums & Ducts; Cirnc-MaterialSupport4nsultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Ace & Vntltn 16 Insulation DATE FRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders 8 fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops,"Furred CeilingsStairs-Chasers-Tubs 22 Headers & Beams -Si &' Bearing' 23 Hangers -Post Caps-Anchri-lCitnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frpic Ties or Type A Flue=Frpic Throat Clrnc 26 Attic A&c, Sz &Binz Prtctn -Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtcth Framing -RC Channel 29 Prprty Line Firewall .& Opngs' 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng Attic Vnts-Rftr Outrgrs _ 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Ace 35 Glazing Area -Glass PrtetnSkyLts-Plastic . 36 Shear Wails; Nailing -Bolts 37 Brace InUExt Wall pnls 38 insultn-Walls-Ceilings 39 I nfiltration-Walls-W ndws DATE JELECJL2ICAL M8'rxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcts Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eq rnd made up w/Mech Fstnrs 45,Smdng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ya D CU or D AL AC Wire Sz qa D CU or DAL 48 Range Circ , D CU or DAL Oven Circ ca D CU or D AL lnsuJated Neutral DY. 0 N ervice-Riser Cndctrs & Grnd Main Dscnnct qpClrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector Ole 41 53 Wtr Htr; Vent Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr.Nall Prtctn 56 Shwr Pan; Test, First fir -Tub Ace 57 Test Tuti & Shwr, 2nd fir - Tub Ace 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas.Piping DATE IMECHAWICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Ace & Pitfrm if Furnace In attic FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Ace -Spa 71 Gf1�Arc Fault lec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Cimc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd Air -Gap -Cooking Cimc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper. 80 Wtr Htr, Vnts-Cimc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3' drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcis in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86. Cimc Drnge Planters D Yes D No 8 tuccoBrown-Finish PRt.►EL, 88 AC Unit Dsennct, Elec-Pimb 89 Vnts abv Roof, PImb-Appinc-Frplc-Cimc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous lhspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler S . A BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 'LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr fessions Code, and my license is in full force and effect. Licensee Class - v �Lic/e�nse Number:_ Date::::�J - / ontractor: / V 1�t(f�i� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the 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 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed, contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: Cl 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 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: Policy I certify ythat in the performance of the work for which this permit is i s ed. I shall not employ any person in any manner so as to n I ome subject to the workers' compensation laws of California, 1 V and agree that if I should become subject to the workers' IU! compensation provisions of Section 3700 of the Labor Code, I shall forthwith com ly with those provisions Date:��— w Applica WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Name: Address: PERMIT NO. BP061408 Issued Date: 06/13/2006 APN: 042-320-004-000 Site Address: 7 ARBOR DR CHI Map Index: Description: SERVICE CHANGE OUT Owner: HEYNNEMAN, RICHARD 7 ARBOR DR CHICO, CA 95926-3003 Applicant: MCHATTON ELECTRIC 9 ARBOR DRIVE CHICO, CA 95926 (530)893-3616 Contractor: MCHATTON ELECTRIC 9 ARBOR DRIVE CHICO, CA 95926 (530)893-3616 License #: 477674 Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: is hereby is ed under the applicable provisions of the Butte County to d indicated-aj,ove for which fees have been pain. - PERMIT EXPIRES ONv (v _15 - U and/or ❑ 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 hereby authorize representatives of Butte County to enter upon the aboveme tinned property inspection pur oses. Print Name: S ' ` _ ' " " P,�O Signature: J I Date: v ❑ Owner VContactor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 oOT BUTTE BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. 0 o BUILDING PERMIT APPLICATION o o AND SUBMITTAL REQUIREMENTS o - O 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OO OFFICE #: (530) 538-7541 `1O A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION BIN # U N Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Ls taevl t , Ern 1 � Iv NA i ami, / n0 C.C't �1 " �J Address On- Cityc�(t � 0 StateC / Zip Z /p 1tz Phone Fax E-mail CONTRACTOR Name GHQ T -Or, -j Name . Address Af J5or Otn,_ City t co State Zip o� (_ �P Faxc'/n� Phone c APPLICANT INFORMATION ARCHITECT/ENGINEER Name . City Address Zip City Fax State Zip Phone Planner Fax E-mail Address State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE xG_"; -4 For office use only: Zoning Propy Aodress Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PROJECT LOCATION AP# �c? j,"� . 6 Propy Aodress Ct�yy tdlGv cross Stepat WORKER'S COMPENSATION Policy tta 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: �fLULC 4-J6)C Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date. of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. la� Received.by: Amount: Bldg �� 7 SRA Ke�cejlpI; Sheriff Y5 ✓ SMIP Date:(� % Other Total Page 1 of 3 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS . The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph papers ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits Issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees -for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 3 REV 8-12-05 u c. iPERMIT NO. 4598-74B,E P E s i M 3 iMH UTIL. r PERMIT NO. PERMIT EXPIRES OWNER Morris George ,iCONTR. John Nystrom, Durham ,,LOCATION (A.P. 42-32-4 ) 7 Arbor Dr., Chioo i� Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E 1 Temp. Gas Serv. Called PG&E JOBr FINALED (Da ) M �1 (Signature 3 1 7aA COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS - BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows - 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing —• Sewer Garage Fdn. VentsFixtures Footings Garage Vents Water Htr. StemwaII Slab •Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation .Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h Z — 2— — Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Z- — Z — Test Water Htr. Stucco — Final panels Mesh MECHANICAL -Sub Grd. Fault Prot. Scratch Heating Service Brown Z. Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS l,q NS f � � r Z re 0• v r vv s �%�% G/h LYLl�NC/Grr'cc� /�!C-dGL�l�S COUNTY OF BUTTE DEPARTMENT OF PUBLIC KS 7 County Center Drive — Oroville, California 95965 Al,Telephone: 534-4541 APPLICATIOWAND PERMIT � authorize representatives of the County of Butte to enter upon the above -men one property for inspection purposes. X Ila XDate t4l,6174 ignature of Permiteeor Agen / Receipt No. ` Zg White-D.P.W. — Yellow -Assessor — Pink -Inspector — Gol enrod-Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OVIOUBLIC WORKS By Date /(—/CC — ilding permit expires Date ................. ..... ........... ...�... BUILDING Owner E SQ. FT. OCC. BUILDING VALUATJW Mailing Address Telephone No. Fireplace Contractor ,Jo O Total Valuation Mailing Address PQ G Permit Fee Plan Checking Fee&/or Penalty Tele h �Lone No. Building Address Permit Fee $ $ PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 ao *Each Trap 1.50 /G Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. L/ 7 Z " Z� Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F Sa FireDept. FireZone Use Permit Building sewer 5.00 EQA I Parking Plans Parcel Declaration Parcel Ma P 60' R/W Imp provements Lawn sprinkler system 2.00 Bldg. Pla ec'd Parcel j4proval Plas Approval Permit Fee $ $ NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ,©Q EQ�Op Main service incl. 1 meter Additional meters, each 1.00 Single Family Ur Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bal(410 Re s., swShes & fix Olets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. di sp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No.0 S3Misc. Classification wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. Dave placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. r-1I certify that in the performance of the work for which this permitis issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL_ No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ �� authorize representatives of the County of Butte to enter upon the above -men one property for inspection purposes. X Ila XDate t4l,6174 ignature of Permiteeor Agen / Receipt No. ` Zg White-D.P.W. — Yellow -Assessor — Pink -Inspector — Gol enrod-Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OVIOUBLIC WORKS By Date /(—/CC — ilding permit expires Date ................. ..... ........... ...�...