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042-310-015
Ste-' - ,;`" T f- 'R. ,._�. ..'t '�i. .p,.. _a - '7 v � - 4 : _ .......�. �.s.'� s..+.....t�.��..+r1+ ... .. ..a... _ - - ... 042-310-015 98-2967 RITCHIE, Scott & DaRm _ 2890 Rodeo Avenue, Chico Addition walk-in closset and bath windows relocate new main service 042-310-015 05-2453 JONES, JERRY 2890 RODEO AVE., CHICO Cont: OWNER REPAIRS(FO LINDA -CION) 042-310-015 JONES GERALD 1, DEBORA14 OS -3134 2890 RODEO AVE, CHICO Cont: OWNER REPAIR -GAS LINE 1� t � x>�`�•°-�.z'i�L� , dn, .Y>� ^tt? �.�'�aks.+i ����'1�t��ti'� I�==••�,w, � ��"I � e „r r , �� , 1 042-310-015 98-2967 RESIDENTIAL RITCHIE, Scott & Dawn , 2890 Rodeo Avenue, Chico Addition walk-in closset and bath PERMIT NO.. windows relocate new main service PERMIT EXPIRES �� V OWNER CONTR. ASSESSOR PARCEL LOCATION i k i { CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS ' VERIFY Temp. Power. Pole l Called PG&E t Temp. Elec. Service'4,///A0 Called PG&E Temp. Gas Service Called PG&E ( JOB FINALED (Date) Signature �:.r-..r*�=�^h..7rr-r.3.+'h+.:2*ri��h �..�,� i-�%' a"�'•.,felSCt..�`n',`��'�+i. r�'� J COUNTY OF BUTTE f - 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 --K= i= 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. - i Date— 7 Inspector REV 10/92 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 - _ OWNER �t 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 cont this office immediately. yL i 4Ivaef D✓N� �. A 4 c C-,1A.L "V t A.'-7 r' + Date 3 7 Inspector REV 10/92 V- x I i, y j i3 Date 3 7 Inspector REV 10/92 V- x ��_ ..---.-�: �,.`.�-•,..n.-o.� X44"",. sem- .'''^i:- �r+r-. ivr .-'stir a..� �FXi-s`�.�i��.. COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES S 411 Main Street - Chico, CA - (530) 891-2751 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE a 2a[4 ► it T6 -Z-70 OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address an ould be corrected. Please notice this office when correction of work is completed. _Vy,6u have any questions pertaining to this matter, or need additional explanation, Please c act this office immediately. C(, .PtArocT AT took �=t ri. �f. h' -y �1 • y rc!S Date :!� — �` 7 Inspector -_&2iJ REV 10/92 COUNTY OF BUTTE r=r. 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 C; IEI-A►- y? -a2 zz OWNER PERMIT NO. t 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. i Date Inspector ' �T=/ 1 42 REV Building Owner- -Building Location ENERG :' INS , ALLATIO�N CER•: I = IC,�TE rol Building Permit # 9100-9 1:W;167- DESCR=I0N OF INSUL 71ON ROOF Mate -=al Thickness(:,aches) Bar..RIOR WALL Material - iJ Thickness (inches) _Z z CEILING Batt,or Blanket Type r Thickness (:aches-) Loose Fill Type Li ni: m: m Thicknes f (Inches)_ Area covered(ft. ) FLOOR, ELEVATED Material Thickness (inches) S?_ FLOOR, SLAB - Material Thickness(inches) Width(inchet) FOUIMA=QN WALL Material Thickness(iaches) Brand Name Thema? Resistance (R Value) Brand Name The -mal Resistance(R Value)= Brand Name Thermal Resistance(R Value) Brand Name . Number of Bags Wt. per bag _Ib. Thermal Resistaace(R Value)__ Brand Name Thermal Resistance(R Value)_ Brand Name Thermal Resistance(R Value)_ Brand Name Thermal Resistance(R Value) I hereby certify that the above insu]a tion was installed in the above building, - 'is consistent with- approved building department -plans--and attachments •sad• con- forms with requirements of Chapter 2-53 of State of California Energy Requiremen FIRM NAME/GWNER STATE COWZRACTOR'S LICENSE NO. SIGNATURE OF Terre I- e'rTON APPLICATOR - - I hereby certify the required features, devices, and equipment, au shown on the approved Building Department plans and attachments have been installed and .conform to the appli- ance standards and Chapter 2-53 of the State of California Energy .equirements. "L V / ! J P� 1 G7 )C� BUILDING CONTRACTOR/OWNER (Please Print) ( FIRM NALME) SIGNATURE OF BUILDING CONTRACTOR/OWNER HVAC FIRM NAME/OWNER (Please Print) STATE CONTRACTOR'S LICENSE NO. ��-/ __r�- ,� DATE STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF HVAC CONTRACTOR/OWNER DATE THIS CERTIFICATE KL'ST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL, AND A COPY SHALL BE POSTED WITHIN THE BUILDING. SEPTEMBER 1988 V - OK 0 - Not OK - - Not Applicable *-NotRimady ' --MOBILE HOMES Date MOBILE HOME VnLITIES Fdris) OK wwW Fa I. ZbnkV PAqukwnorft -!Sodmft - Easements '_.ZSods; SpscmdMH&WWSbwIch 1& sower, Lo=dcn-lWzFWW.A)C4X=ft "&Gas; LomvCrj.TlsjVVmXj -I.LIL 1 /Nat or/ XW -APG 7. Wei Ckamnce & Db meet f - UtiOly Ckwance 22.18 ............. . . Card 8-1 ab a CAM B-1 Date ---Card B-1 Date MOBILE HOME IINISTALLATION Onartal OK except /'s -1. Zor*V Roqdmrwd*. Selbecits Easwiwft 2. Foo*vg _qmNmckV-MaffI@ge Llne -`& Gas; MM TessDamardVOve-Corowcoor & Water MH `Ied4tegL&XpCovwcWr 7. Water and Sw&wC==cvxW.40 to Gtade40 Approval 8. Gad and Eke*4lQged TL, -10. Uts;lnsp.-Skekh 11. CeftofOcm4wlcy 12. Pomanert Foundadon only- Lkwm Decal Date Card B-1 Date - Card B-1 Date Card B-1 IDato Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARpOFITS, OK apt Ey 1. * F;oo*vs: Sails-Sb&oepmpidnpcawjsjt_—bd * Deeks; Girders and/or U*94Uh 4. Wood Awn.: Postsesams-11ft4mockwu S. Mm Awn.; 6. Carporwwr4owt000ry 7. Ekcbic % & Fmv.: Sh4Vctwr*-3ludw4IJ'bv-Vums 9. SidirV: Nm&ngAAenew6SwowQevh 10. Root. Sh*VAwFdV '_ - -411 it. Ext.:St8p&4Door94ArodiwW 12. Braced Wag Panels Dale Card 8-1 Cali7 Card 84 Dale Card B-1 Dale - Card B -I ab r POOLS F" OK except Fe 1. Setbacks-EamneriAs 2. Sok Cwnp&cdm3ftcIm;%b* 3. Pool SvucUig Dead M&iAJr*ig '."4. j -"j" 4. El&--; Raceptodes and U&ft gmbiw;eCA S. Elec.: Pool U*Oa 15 %tb4%9 - - .�v� - * E6-- &ckwirm Condit EselowTunihalAided 7. Elw-:Bard ng; Meld wX-CkvA*vEW%L4inier Ek,--; GmwxkV EqujpL v4V Ckcda*q Eq*4'W Lgh%;. - Bcw*Endouxe*Pandboatd*bmloMain iriCaii*A 9. FleafthDepaMwvtAppmAd 10. Pwft.: Cir. Ter %ter S6pov Ted 11. Ughl Niche Dale Card B-1 Date Card B -I Date Card 8-1 Dab Card B-1 6KRESIDENTIAL Not OK Not Applicable s Not Ready NC ERF LID OR (Plana) OK except ft a:s etbecks Easments-Floo"lope Ftg., Main; Sats -Flee. Gmd. / 1 r Ftg. Depth 3 Ftg. Garage. SoilsSttrd-Elec. Gmd/ t Ftg. 11I 4.Ftp. Patties b Decks: Sr>asSted / Ftp. Depth SterrrwaQs, Marro; Soeei-8loekoute-Wrapped - 6 Stemwaus, Garage; Ste"lockouts-Wrapped 6a. Mok1 Downs and Special Anchors ` 7. Stab, Steet-Wrapped a. Piers -Fireplace Ftg.-Steel W.V.; Fall -Fitting -Test -2 Way CIO -Sewer Test 10. OFas Pipe: Sore Anchors - Yard Gas Pip[I Sore Test AWWater Pipe; Test Anctars•RegtdatorSen+ice Test 12. Electric Underground 13. Plenums b Ducts; Clearance -Mate i"uppor6lns. -Li8s-Anchor Access b ventilation 16_ Insulation u ata Card 8-1 Dab' ' " cr Card B-1" `ate Card B-1 rDab • �..; ICard B-1 )ata pWMBihlG fornrillo OKmceptth'1s . 17. Water f 9t; Ai Bdb ta. Water Pipe; Test a Andw-HO Ptobcl)ort Single & Duplex). M .. , Dam FRAMING (Continued) 4e. Hangers -Post Caps -Anchors -Connectors 47. Cling. JoistI Ties-Pur6rrroff Brac.-Tha"htinp..Rtnp. 48. Fireplace Ties or Tipe A Floe-Freptace Throat clearance 49. Attic Access: Sine b Romex Prote don•Oraft Stop -Ina. Baffin So. Bdrm. Windows or Exiting Doors -SM Mgt. li Dimensions St. Garage Fre Protection Framing 52. Property tine Firewall 3 Openings _ 53. Ext Doors -one Y -Check Garage 3rd Sorry, 2 Exits S4. Stairs: widt 4ieadroom-Rose-Run-IAncfin Fro Protection on - 56. Skiing -Nailing Veneer - 57. Stucco Mesh -Drip Screed -Fd. Vents-Undertk Access 58. Glazing Area -Glass ProtectionSky%hts-Plastic 59. Shear Walls: NaMiing-Bolts W. BrIce-I'nterior / ederior Wall Panels 62. hifiltration•WallsWindows Dab Card B-1 _ i :'Date Card 6-1 Date Card 8-1 • Date, a Card B-1 Date FINAL (Plans) OK except ft - r 63. s rtgke Detector _ tm�� ]des>�cteaa-ranee c«t1e Ak4onector ge; Above Floor-Duets•M�'eefi: Ptoticfion 9 - - J. 3 Bath Fortunes 3 Tub Aecesi%Spa Flee. Thm 3 SubpaneL Breaker sixes S Labels nce-Hearth _ ljeElec. Outlets at Wood Panel, Int b ExL 7r-XL-rm"rrpWMvcriMounI Gap•Cooldng Clearance Outlets & K les at IGL Counter ndrmg-Closure ' ara- Damper b. Air Connector-P.R.V. to G,a6g-: Above Floor -tech. Protection ;7 ib Elec. b Mech. Equip. Listed for location F.I.-Rornex Protection . nsulaWn-Foam-looked in Attic Es struction•Post Caps dn. VBents S Crawl Mole Door Drainage b Wood -Earth Clearance looked under Floor 0 Yes owirmg Inse : rive o Yes o NoM/aks Q Yes a NQPianters 0 Yes Q No ish r isconnect. Electrical -Plumbing _ encs Above Root, Plbg-Appiiance-Firedace-Clearan a to Openings ect, Electrical. Plumbing t lec. Trim, G.F.I. Receptacle -Underground e ' 6on Throught House Protection onecfions from Previous Inspections gged, Gas -Electric W S Sewer Connected -C/O to Grade -HD Approval nergy Compliance Certificate -Other Certificates Date /�. Card B-1 Date Card 8-1 Date �3 Card 8-1 Date Card B-1 Date Card B -I Date Card B-1 Comments at Final: . 19. p. ). Test Fittings &Andros{ W Ptobc4al ' Shower Pan; Test First FkbrTub Access 21.' Ted 16 & ShOweC Stud Root --Tub Access 22. Gas P*w. Sae & Andrors Date Card B-1 -^ ,'Date Card B-1 Date Card B-1 Dale Card 8-1 ELECTRICAL prem } OKwwept P* 23. Fomtae S Transformer CiearanceI Protection 24. Elm Receptacles Spate b Swldmes at Doss 2S. Sore Boxes 3 No. of Conduclom stapled 26. Ran« talled Cfbee to Edge of Stunts & C.L - 27. Equip. Girard made op iWach Fas4ws8ond Gas & Water 28. 2 Appliance Cirarb in 13cherm b Camdretor Sime GR subfeed wee sore! /ga Cu ora ac vlfiie size / /ga Am air a 30. Range Giro. ! / Ila Cu oraaven Cre. l 1 ga Cu or a Inwtated Neutral Yen GII 31. Service -Riser Conductors a Ground -Main Disconect 32. Equip. Clearances Pane"olo"ech. Epuip. 33. Clothes Closet LighWa wr UghlI Light 34. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except M's 35. A.C. Duets Insulation 8 Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain S Overflow, Size S Grade 38. Fumarce-Vent Access -Comb. Air -Return Air Vent I IS outlet 39. Attic Access b Platform if Furnace in Attic Date Card 8-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except A's 40. Sits Proper Materials b Anchors 41. Walls Studs -Nailing Spacing b Braces -Plates -Sound 42. Bearing Walls over Girders b Floor Nailing C-7 43. Draft Stop in Wags (rat prool) 44. Fire -Stops. Furred CeifingsSta'us-Chasers-Tubs '45. Headers S 8eamsSi.-e d Bearing - Dam FRAMING (Continued) 4e. Hangers -Post Caps -Anchors -Connectors 47. Cling. JoistI Ties-Pur6rrroff Brac.-Tha"htinp..Rtnp. 48. Fireplace Ties or Tipe A Floe-Freptace Throat clearance 49. Attic Access: Sine b Romex Prote don•Oraft Stop -Ina. Baffin So. Bdrm. Windows or Exiting Doors -SM Mgt. li Dimensions St. Garage Fre Protection Framing 52. Property tine Firewall 3 Openings _ 53. Ext Doors -one Y -Check Garage 3rd Sorry, 2 Exits S4. Stairs: widt 4ieadroom-Rose-Run-IAncfin Fro Protection on - 56. Skiing -Nailing Veneer - 57. Stucco Mesh -Drip Screed -Fd. Vents-Undertk Access 58. Glazing Area -Glass ProtectionSky%hts-Plastic 59. Shear Walls: NaMiing-Bolts W. BrIce-I'nterior / ederior Wall Panels 62. hifiltration•WallsWindows Dab Card B-1 _ i :'Date Card 6-1 Date Card 8-1 • Date, a Card B-1 Date FINAL (Plans) OK except ft - r 63. s rtgke Detector _ tm�� ]des>�cteaa-ranee c«t1e Ak4onector ge; Above Floor-Duets•M�'eefi: Ptoticfion 9 - - J. 3 Bath Fortunes 3 Tub Aecesi%Spa Flee. Thm 3 SubpaneL Breaker sixes S Labels nce-Hearth _ ljeElec. Outlets at Wood Panel, Int b ExL 7r-XL-rm"rrpWMvcriMounI Gap•Cooldng Clearance Outlets & K les at IGL Counter ndrmg-Closure ' ara- Damper b. Air Connector-P.R.V. to G,a6g-: Above Floor -tech. Protection ;7 ib Elec. b Mech. Equip. Listed for location F.I.-Rornex Protection . nsulaWn-Foam-looked in Attic Es struction•Post Caps dn. VBents S Crawl Mole Door Drainage b Wood -Earth Clearance looked under Floor 0 Yes owirmg Inse : rive o Yes o NoM/aks Q Yes a NQPianters 0 Yes Q No ish r isconnect. Electrical -Plumbing _ encs Above Root, Plbg-Appiiance-Firedace-Clearan a to Openings ect, Electrical. Plumbing t lec. Trim, G.F.I. Receptacle -Underground e ' 6on Throught House Protection onecfions from Previous Inspections gged, Gas -Electric W S Sewer Connected -C/O to Grade -HD Approval nergy Compliance Certificate -Other Certificates Date /�. Card B-1 Date Card 8-1 Date �3 Card 8-1 Date Card B-1 Date Card B -I Date Card B-1 Comments at Final: . COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES -_BU ING DIVISION ° 7 County Center Drive • Oroville, California 9965 • Telephonea38-75 P RMITY. (Rev. 12/96) APPLICATION ANDPERMIT az ASSES6Op�gR31 u0 015 [� ZONING BUILDING PERMIT OWNS SCOTT AND DAWN RITCHIE TELEPHONE SQ. FT. OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS 2890 RODEO AVENUE CHICO CA 95926 CONTR CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation rn ARCHITECT OR ENGINEER LICENSE NO. Fills Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2890 RODEO AVENUE Energy Plan Checking Fee $ 23.00 $ PERMIT FEE S IDT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing ee .00 USEOFSTRUCTURE SF K] Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 21.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑X Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ADDITION WALKIN CLOSET AND BATH WINDOWS, RELOCATE NEW MAIN SER PANEL Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ 7 1.00 ELECTRICAL PERMIT Fling Fee 20.00 600VOR LESS Main Service zaOA OR LESS 23.00 3,00 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.P 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: ... f� 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 r Main Service TO 46.00 NEW coNsr. DWEwNG oCCUcuP. EL BBLDS. OR �G 3.52sFTo. NON REBID.NST MULACC. @7.50 ' 62 OWER APPARATUS a SINGLE OUTLET CIR. EX. OCCU . OUTLET OR FO(TURES @'.50 BL p .50 Ex. Occup. ounces Ao .OR,) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 68.69 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy nuMber-are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ 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. X Date Signature of Applicant - Owner ❑ Contractor [3Agent An OSHA permit is require for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ . CONST. TY Pf TOTAL FEE $ .1PV4 . o D. �� IMP FLOOD CDF I Pb I HD ISSU This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work in indicated above for which fees have been paid. 1 By D to PERMIT EXPIRES ON Data Receipt No. 251278 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT G (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California j95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING _ 5. BUILDING PERMIT OWNERTELEPNONE SG® +f_ SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS � 9 v d e v 4ve, G c o 45 92 - D COW CONTRACTOR'S NAME rp tt% ivy/ TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADORERS Fireplace Total Valuation L .X $ v ARCHITECT OR ENGINEER LICENSE NO. Filing Fee 20.00 Permit Fee $ ) ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee BUILDING ADDRESS c- e D A o -e_ Energy Plan Checking Fee S o7 S PERMIT FEE LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SFW.,Duplex ❑ Mobilehome ❑ Other sPEc�r Each Tr 31 7.00 ro Solar or heat pump water heater 23.00 Water piping 15.00 / D Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition M Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work:��(; G aL W & + S jam,/ Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE A/c / G I iV 'Q C 7 'Q— G , ..✓ 5 ELECTRICAL PERMIT Filing Fee 20.00 = LEss Main Service zooA DO,',LEss 23.00 3 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 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. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is Issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed If the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is Issued, I shall not employ any person In any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction of structures over 3 stories In height. Main SST. TO 1000A 46,0 NEW CONST. OWEiEL lLNO OCCUP. 30 OR ADONS. a ACC. BIDS. `3.5QFr. NO"ESID. BRANCH urLEr @7.50 POWER APPARATUS a SINGLE OUTLET CIR Ex. Occup. OUTLET OR FIXTURES �O@'•00 RAI_ .so APPI Ex. Occu . o °. , E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEi= 50 Mobile Home Installation Fee S Energy Inspection Fee S OCC CONST. TYPE TOTAL FEES , ,,� o FEES .0CDF PARCEL Po HD ISSUE This permit is hereby Issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. ro Receipt No. �_71 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT t 7-• •,y�, ,`�Y £ :�f��'+-' „�PT'ni�'S'��f'�4d���{' "'��'r•.J""'�Sn"��"''�`r{�+c�y�'',�'n^"•'�7,1�^��r,�f`,t�YSj2�:+�Ay:�Y�`�-tYe,:• �"r.�;�-% ""v� - COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALI'FORNM 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: Sc o � i- 4 Dowd ASSESSOR PARCEL NUMBER: /7Z— -3 /-- O / 5 Proposed Building Use: Building Inspector: 1&5 Date: Il- - x 9 - s At time of permit applition, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All iiems have been submitted .------------------------------------------------------------------------------------- ❑2. Plot plans, 3/4 sets, signed by the preparer of plans. ---------------------------------------------------- 113. Complete plans, 3/4 sets, signed by the preparer of plans. --------------------------------------------- 114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. 1:15. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- 06. Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------ ❑ 8. Hazardous Material Form. --------------------------------------------------------------------------------- ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ---------- 0 10 ees of $ ---------------------------- Impact fees as shown on the attached schedule. ------- ❑ 1 . California Department of Forestry plan approval/fees. ❑ 13. Flood elevation certificate. ---------------------------------------------------------------------------------------- 7rV5 4. Sanitation and plot plan approvalce.,N Health- Department. -------------------------------------------- 0 15. Ci hof Chico plumbing permit ----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- 1117. --------------------------------------------- ❑17. Planning approval for (A) Use: (B) Parking: -----••-------------------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). -------••-------------------- 020. Pre -inspection for required. Request to Building Inspector on - (Date) ❑21. Contractor's license information. (Number, Name Style, Classification). ---------------------- ------------- El 22. Workers' Compensation carrier and policy number. ----------------------------------------- ------------------ ❑23.Owner-Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- ❑ 24? Letter of signature authorization. ------------------------------------------------------------•-------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ------------------------------------------------- - ❑26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance. ------------------------------------------------------- --------------------- ❑28. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ _.--------------- ❑30.Other: -------- 7ou issue the ermit, process as follows El Mail to owner, ❑ ail to contractor. hone 8W - ,FyQ'3 and hold for pickup at C- % J office. ❑ Deliver with inspector. Applicant- fir/ Date: 1/7 Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Departure t Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: " Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. t r : "WS+Q it-wylr' '�` "�5 : `'"_ "" . ��w ,4 .•r `� max. pl�ftibS::.' • S1EF ":ti Mrl Y3.v� l fth� FnM"ii���'w1r'lw;rm t COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION r 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541 SCHEDULE OF FEES DUE. OWNER 4- T)A..JA2 1 '� �� t '�- A.P. # yZ 1 �O/s PROPOSED BUILDING USE o / ��� ��� ,�-� DATE f y f G ' 6 REC # DATE REC 1. BUILDING PERMIT FEES -- Balance Due ................ $ -- Additional Fees Due ........... $ -` Additional Fees Due ........... $ -- Revised Plan Checking Fee ....... $ 2. SCHOOL DISTRICT FEES (paid at District Office) 3. SHERIFF FEES (paid at Building Division) Residential ........ x $360.00 = $_ Units Commercial (sq.ft.)... x $0.03 = $_ Sq.Ft. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit) . x = $ #Units Amt. Commercial (sq.ft.) .. x =$ Sq. Ft. Amt. 5. RECREATION DISTRICT FEES (paid at District Office) , 6. THERMALITO DRAINAGE DISTRICT FEES $425.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT _ DATE Original -Owner Copy -Building Div. (Rev. 12/96) 1 r• : OWNER -BUILDER VERIFICATION :] Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your s1WWMM, Please complete and return this information at your earliest opportunity to avoid �ry in processing and issuing your building permit. No building permit will be issued until Ws verification is received. 1. I personally plan to provide the major labor and materials for construction- of the proposed property improvement: YES % NO 0 2. I HAVE l.. HAVE NOTO signed an applicgdon for a building permit for" pr+opased w6& 3. I have cont racted.w.ith the following person (firm) to provide the proposed -NAME:- ADDRESS. NAME: =0% • :/~7?�i , ADDRESS TD.� ; . /�yJ •F{�!f .:; . V«�1;/'1©i n,;�. •�L•tr+ �l.Jv.� .{wLrj�`l._i - ti. y.... •PHONE.•\'J � •�.,/ ..� +� •.. l 'R•�. -.. ..:, .. ,. i. •.� :'.- f� �:. �� ~ �• �.:t.Nt ..r'..iStf; I.'R v!.•Y�r,�,l[ . . �'.. CONTItAGTOR'S 4. I plaii to. provide portions of this' work, but I have hired the following to • an�. t / T••., .:•.. olt . �. . .b!. WO NAME: ADD CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to psc�ONide the work indicatod: NAME ADDRESS PHONE TYPE.- OF Wilk' ' SIGNED: PRO SOCIAL SECURITY NUMBER: DATE: �E'C- NOTE: This Owner -Builder Yerykation Is required by Section 198.31 and 198.32 of* Caliyvrnla Health and Safety Code. This ver (cation must be completed gird returned to our office before we are permitted to issue the permit OVER 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 aro the responsible parry ofrecord 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 Brom 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. Ifyou plan to do your own work. with the exception of various trades that you plan to subcontract, you sbottid be aware of the following Anformadon for your benefit and protection: ♦ if you employ or otherwise engage any persons other than your immediate Brmily. and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as eontraaoors or subcontractom then you may be an employer. ♦ If you are an employer, you must register with the State and Fideral Governments as an employer and you are subject to several obligations including state and federal income tax withholding; federal social. secttrityr Heroes. ra. workers compensation insurance, disability insurance costs, and unemployment compensation coons. There may be financial risks for you if you do not carry out these obligations, and these risks are espeaw serious with respect to worker's compensation. insurance. ' ♦ . For more specific information 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 tinder 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 woik pai sonally or.through their own employees, without a licensed contractor or subcobttactor, only under limited '000didons. t ,,Afir-equent practice of unlicensed persons professing to be contractors,.is to secure an "owner builds" building pm& �neously implying that the property owner is providing his or her own labor and material personally. Building _= itsaareirot required to be signed'by property owners unless they are perfori iiig their ownwort peisonalV. ifotmation about licensed contractors may be obtained by contracting the Contractors State License Bond in your -- - - community or at 1020 N Strict, Sacramento', CA. 95814. - - Pkase compietathe"Owner Builder Verification" on the reverse side of this fora so that we can confirm that you are aware of these matters. The building permit 'wid not be issued until the verification is returned.. , edy. /6 Mi c el C.�Vi Ara, C.B.O. ' Man ger, Building Inspection NOTE: This Owner-Bullder.Info rmadon is required by Section 19830 of the Calljonrla Health and Safety Code OVER BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) i 'School District 6 ,I c D Building Department No. A.P. Number y, — 3 (— c� r S Jurisdiction: f� City County Property Owner ��D '•t1-�- �-- L'. �/�! /C. / /� / Property Location/Address tT Q /C, ®(,! p O AV � Subdivision Lot No. Building Department revieweo uy School Uistnct Personnel) District Identification No. Date School District certifies that tApplicant) (Street Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. by payment of. $ representing square feet. AB 2926 S FULL MITIGATION = School District Representative Date Paid by Check # Remarks: Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental.nuality Act ICEGAL this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis (10/98)dmm ................................................................................................ Residential Development 50 Sq. Footage 75 No of Living Mobile Home dditioN 'Supplemental to (Group R) Units Installation Conversion Permit # '(No foundation inspection): Commercial/Industrial Sq. Footage New addition (Including Exterior Roofed Areas) Building Department revieweo uy School Uistnct Personnel) District Identification No. Date School District certifies that tApplicant) (Street Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. by payment of. $ representing square feet. AB 2926 S FULL MITIGATION = School District Representative Date Paid by Check # Remarks: Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental.nuality Act ICEGAL this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis (10/98)dmm r��^p3,ry�,;�.�',�:,•�;i*�V'r'tnfi..'Siw'�q�''+`"�;FSo;,,�, �•+-r*±r�.:si*ra.�,nr-•�+*�""��,-•Y�1y,+-+�t�*-----�,f'-•- ;y� BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) ►School District 1 . Building Department No. A.P. Number y,Z 3 t 6 is Jurisdiction: p� City /I County Property Owner 5t^_. D +4- G WAJ Property Location/Address 8 Q X?O d is o AV Subdivision Lot No. ................................................................................................ Residential Development : Sq. Footage 75 No of Living Mobile Home dddion/ 'Supplemental to (Group Rj Units Installation Conversion Permit # '(No foundation inspection): ................................................................................................................... Commercial/Industrial New Addition Building Department District Identification No. Irioor mans reviewed Dv scnooi uistnct School District certifies that Sq. Footage (Including Exterior Roofed Areas) Date (Applicant) (Street Address) (Phone Number) (City) has complied with the requirements of Resolution No. representing (State) ►Zip Code) by payment oft $ square feet. AB 2926 $ FULL MITIGATION $ School District Representative Date Paid by Check # Remarks: Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act ICEQAI, this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls 110/981dmm s ,`p���'` ♦yi- M. ' CS�'XJ'S'1q„A 4—A'A'e BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORV (One form per Building) t O'School District C i� 1 ( ja Building Department No. A.P. Number%,Zj j' (� �S Jurisdiction: Q� City County Property Owner sC D f 4 I G w•,� lE- //' i `{ G Property Location/Address go RQG%p C) /4V Subdivision Lot No. Building Department imoor rians reviewea Dv scnooi uistnct versonnel District Identification No. School District certifies that (Street Address) Date (Applicant) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. representing School District Representative Paid by Check # by payment of. $ square feet. AB 292fi $ FULL MITIGATION $ Remarks: Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act ICEQAI, this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis 110/98)dmm ........................................ .........�............................................ Residential Development :. Sq. Footage No of Living Mobile Home ddition/ Supplemental to (Group R) Units Installation Conversion Permit # •(No foundation inspection)' ......................................................................................................... Commercial/Industrial Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department imoor rians reviewea Dv scnooi uistnct versonnel District Identification No. School District certifies that (Street Address) Date (Applicant) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. representing School District Representative Paid by Check # by payment of. $ square feet. AB 292fi $ FULL MITIGATION $ Remarks: Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act ICEQAI, this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis 110/98)dmm taY\�loc.0110 � —} ;� set of plans and speci$caatia�is'Itoo _ o ke' t n p o tl e%Job at all times and it is unlavn%d to make Fny, changes or alterwtionsc on same without w*ritteh permission f7coni thb Department of Publics Woks. Co=4 & Butte. ` ; IN _ 1 - NOTE: All lNiAUEjala AR Vy^r � Q - Accordance with Recognized Good Practices and Of a tlu.aaity Prescribed :dor the Specified use �y'rr in the Uniform Building, Plumbing & lulechanic Q Codes and the l SUOnsl 131e0trloal Code. M ,h5 44 1ILDiNci P ARTS — �? 107' �Oj7Gc� LS II de ,l Bps ens e. and 3a�P,oi4c�� .� �y� �16tijje' tY o �� S`o O� — x,6 Tr � Per 00d& Q �da vvitt, ffi ,3°aions2g� (;, a0 0 eu,:c. AcR c91 'T' I o �n 13+�c�+ P-oo►�n �n i.,,, F o; c�vovacie bedroom 3 WiI?.( 57 Jpen din.ens!Ms of 04" h - vldr height BUTTE C®UNT Rul'L NG DEQ R - .i. de ,l Bps ens e. and 3a�P,oi4c�� .� �y� �16tijje' tY o �� S`o O� — x,6 Tr � Per 00d& Q �da vvitt, ffi ,3°aions2g� (;, a0 0 eu,:c. AcR c91 'T' I o �n 13+�c�+ P-oo►�n �n i.,,, F o; c�vovacie bedroom 3 WiI?.( 57 Jpen din.ens!Ms of 04" h - vldr height BUTTE C®UNT Rul'L NG DEQ R - 12'' LADD IT7Op1 For Sc6ir <- OA-Wol ME I I j�� M1IIr 0 ^ off+` o �2 4 ❑O �XV ..NxH I F-(0012 a�C>w _ C V j JOi'5 4�eM aL)TTE COON WILDING ®EPAR- N, P P .R 0 V �Z•�g�W�y�pOW . � I If �XV ..NxH I F-(0012 a�C>w _ C V j JOi'5 4�eM aL)TTE COON WILDING ®EPAR- N, P P .R 0 V o- U9 ►-� � x� 8 eTw�c v d r CLI wRr�lat� 3 yy �✓I -A los M �'n Q 0OpL( "x r t Qo a Q Thdi�y _ 2 l„J �Ylt�atNS! g_ � I -,i . .... ,.,.........., ...•.ra r-..ck r-'�,'. r.^-- ."r^r sr-ar w�-r er�rw: ^'+.-� =a+� E I I I I I T c � O� 2 � i V v • e -DWI,g' t �+C gyp"' �►-+ I PLU�,Na :LEC, RICA/,, A �'v r T t 'vA, �`' Egli IaN SAND UP%, OF NF-! r USC I o I � 10 A C+ 15 Atdo access and ventilation per oh. t*, UM CWV y. N4eLk o� sD cII w LIS J3 NAlUa b-12 ui —Es w" 51 0 ,::,O)< .NTL" .uv'- �i t a.--�-- t- ° � It I VI -1 f G. lv f TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance ' E.*jiUSE ONLY Plot Plan Attached Y'%s Floor Plan Aac ad CJ" Sent to B.D. I Ave, -.316-015' Owner Location AP# Plan Approved for: Sewage Disposal X Water Supply: Public Private Well N - Clearance for -d . Other r-k5ne-/ ��l✓fa„ Hold final for: Final clearance O.K. for: NOTE: C - �o! LT - 111 ,s-_�/ Environmental Health Specialist Date PLAN REVISION Please complete the following information in order to process your submittal. If this form is not complete, correc and legible, it may cause a -delay in processing. Owner's Name: . ( i (� Received B . Date: A.P. Contact Phone Number: Purpose of submittal: % --- ❑ Permit Application Data ItA_rnIVI RE CE e, ❑ Engineering OCT 1, 0 20 ,0 Ian Revision BUTTE COUN " f BUILDING DIVISION P-equested by B or Correction Notice - Inspector's ` p s Nam.,. ❑ Requested By Plan's Examiner - Exam per's Name: ❑ Other: -- If you are revising a plan which has already been issued, submit two(2) drawings reflecting th revisions for plan review. If engineering is involved in this revision, the engineer must put his requirements on tpese drawings and stamp and sign the drawings. Include two (2) sets of wet signed engineering. Revised drawingilpust clearly show ,zhangesed and --1 AdQhim_v_QJved, When Approved, Process as Follows: ❑ Mail to Owner at Lhis address: ❑ Mail to Contractor at this address: Call _ 0 1 it ® and hold for pickup at the Chico .Office Oroville Office Deliver with next inspection. Revised Plan Check Fee:6-01;97.00 Receipt #: 0 -Additional Fees Not Required Additional fees may be due based upon complexity and time involved to process this submittal. Additional Fees: Receipt #: ���Y/5� �7 ZX(. _ 1(." C C - w/ ►+ L)S z( HAyl(tIas izC3r;� exier tic, usF. LI x8 T� (r" �(y S U5 CC"K Na�`-�� ,gyp prod max, 9 W, 4 3 D taew Douro. Re p� I � €pOK; C-4 `I�t-o vs G '10 77 - ,vim NOTES Butte County Department of Development Services. •eurrf°• ^RE^ 7 County Center Drive, Oroville, CA 95965 ° (530) 538-7601 www.buttecounty neydds °Ouety RESIDENTIAL APN:y I Z---310 - 015- T Yl / Permit No. (0S J 1> Owner. �I V�'% Site Address: Z� cl iZ O�l^'O / A L Contractor. +' ✓ N u ✓t'�i (,o'j/ �- v� I p/� Type of Permit: (~-4 a k 1(-" C' OFFICE COPY Address G S f Meter By ` D ELECTRIC Meter By I Date SPECIAL CONDITIONS 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: l v) O J SIGNATURE: CHECKED BY +=OK 0 = Not OK ,MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET DATE ID E C K S`C O V E R S -C A R P O R T S GARAGES 1 Zoning -Setbacks -Easements 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 2 Ftgs; Soils-Sz-Dpth-Spacing-CnnctrsSteel 3 Sewer; Loctn-Test; Fall/C/O-Concrete 3 Decks, Girders/Joists-Dcking-Brcing 4 Wtr; Loctn-Test-Easement Needed -Regulator Stairs-Guard/Handrails 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 4 Wood Awn; Posts -Beams -Rftrs-Cnnctrs-Shthg 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LPO Frmg-Brcng Inch Sz Ft Lngth 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 7 Blckng; Sz-Spacing-Marriage Line 6 Carports; Wndws-Doors 8 Gas; MH Test-Demand-Valve-Cnnctr 7 Electric 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 8 Frmg; Sills -An chrs-Studs -Rftrs-Trusses 10 Drain; MH Test -Fall -Flex Cnnctr 9 Siding; Nailing -Veneer -Stucco -Lath 11 Wtr & Sewer Connected -C/O to Grade 10 Roof; Shthg-Roofing 12 Gas and Electricity Tagged 11 Ext; Steps -Doors -Landings 13 Tie Downs ❑ Foundation ❑ 12 Braced Wall pnis 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers °'� mac`. or of Pool Drawing 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'-Crcitng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcitng Eqp-Pool Ightg Bdxes-Enclsrs-pniboards-Insultn 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 mac` mac`. or of Pool Drawing 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'-Crcitng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcitng Eqp-Pool Ightg Bdxes-Enclsrs-pniboards-Insultn 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 =OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE JPLUMBING 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 Ftg 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 -6lockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub,Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a 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 C/0 -Sewer Test .� ' 1.0 UF, Gas Pipe; Sz Anchrs-Sz Test o' 0`oms`s` 1 i Wtr Pipe; Test-Anchrs-Rgltr-Service Test DATE IMECHANICAL 12 Elec Undrgrnd 61 AC Ducts Insultn & Support 13 Plenums & Ducts; Cirnc-MaterialSupport-lnsuitn 14 Girders-Sills-Anchr BoltsJoists -Vnts -Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic 4. Oa 0` DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Cirnc-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 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Cirnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Cirnc-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 X -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn 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 Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnis 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Cirnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Cirnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn 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 ❑AL 98 Address Posted AC Wire Sz ga ❑ CU or ❑AL 99 Fire Sprinkler 48 Range Circ ga ❑ CU or ❑AL Oven Circ ga ❑ CU or rAL Insulated Neutral ❑Yes ONO 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnis-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 4 L�9' -y. 9-' \se � a I " 1 I 1 �(/ �• f/ Tt- !1 6i_V_ _ _ice—+.--=�� — f• _. �_ i.? , I_Y� s ' _ __ •- _ _ —_ __- -- -__ ' + _ T { — - ; , Do W 4C4L I Aerole 7710: Ir tie , �' ; rte!'Gv BUILDIN PM io- . .1 . v. :ep4mss- Z4S:3 ;1.:Y�2"a:i�ivo._:;tr:3�7.ki`.: C:: ,`.'f?' _`'LL•a`:. ^.:r:: x:,^t..C;� ,�. � .�' r__ �i, :'�;:; r`�.`.� is ,`t i;,'..ti: '✓„i �'.,ai �•k• � rF:..!�r �SY,.�:ix` .�r �i •6 .':. Attention Property Owner: An "owner -builder” building permit has been applied for in your name and bearing your signature. Please complete and return this infonnation 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 material for construction of this proposed property improvement: YES [] NO [ ]. 2. I HAVE] 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: -PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: 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 . t SIGNED: PROPERTY OWNER: 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 office before we are permitted to issue the permit. Rev'd 11/42004 Butte County Department of Development Services ADMINISTRATION t BUILDING `GIS t PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: .An application for a building permit has been submitted in your name listing yourself as the builder of the 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact 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 contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. 04�_ C. Vieir4 C.B.O. Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER A.P. # PROPROSED BUILDING USE H'17G , DATE y RECEIPT # DATE REC. 1. BUILDING PERMIT FEES q C' --- Balance Due ..................... $ 21301 %J --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.). Sq.Ftg. X $0.03 = $ 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 8. SMIP 9. OTHER 10. OTHER 11. OTHER $ At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed dar ng the plaq dh cking process. APPLICANT --I- DATE?—Z5—(g S Pursuant to MoverQef(t CoOSection 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISfbN 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax •(530)538-2140 PERMIT APPLICATION DATA SHEET r� OWNER: U e,S je� ASSESSOR PARCEL NUMBER f J Proposed Building Use: OA4A-IO i7 i- Ir -s Permit Technician: --pp Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 7 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. O 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ _ 0 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by-..._ ❑ 18. Soils Report and/or Engineered Foundation required ........................................... _ ❑ 19. Erosion Control Plan Required........................................................................ _ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit......................................................................... ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: .... ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 26. NPDES Form............................................................................................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................:................... �# r ❑ 34. Deed Restriction.......................................................................................... :0 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone 1/7,;�f-/L- 'PC and hold for pickup. I have been jnfoymed of the_,pboq items and requirements for obtaining a building permit. Applicant: �`� �� `/ .� Date: _7-13-05 1. Index 'it �pli oj�e a o numbered: Plan Check Iter 2. Additiona_ktems r Contractor, desigr, o was a he above data by p one, ❑ mail, ❑ counter, by Date: Contractor, designer, ner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: _Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2534 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLIC.4TION . Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** - APPLICANT NAME OWNER Name 5Q Last Name First Name Address Join e -, J Address Z 1` Zip City i Staters Zip 3 Phone 3c C@Z`i — W I F _ O 3 E-mail cim P'1-\ - APPLICANT NAME CONTRACTOR Name 5Q City Address Zip City Fax State Zip Phone Book Fax E-mail Planner Lic. # Class - APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number - APPLICANT NAME Name Address City State Zip Phone Fax E-mail For office use only: Zoning I 4_ Flood Zone SRA Yes o Occ. k3 I Type Const. Ij Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. 5- 2W, BIN # J� LOCATION -o. 41— 31L Property Address Cit Cross Street , WORKER'S COMPENSATION Policy Number O ( (' 8Z , 63 Carrier wo "rUwil 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: /= ll�✓,r�/) nz 6 el,/ 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. OVER FOR SUBMITTAL REQUIREMENTS L K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 0 Received by: Amount: q Bldg SRA Receipt #: �f j2 Sheriff SMIP Date: Other q 9 Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BEACCEPTED.. ALL PLANS MUST BE LEGIBLEAND 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 inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\13IdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 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 OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" - APPLICANT INFORMATION OWNER INFORMATION Last Name City First Name i � Address City City. State Stat Zip 3 Phone 2 J -o IRI Fax E-mail Lic. # 7 2 APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner Lic. # 7 2 Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X C . Uyw-Q For office use only: Zoning Property Address c�C,. �J Flood Zone Cross Street SRA Yes No Occ. Type Const. Subdivision Name Map Book Page • Lot # Planner Date Approved: n% 1r 1e r-r%M ell 1MVI11TTA1 nrr\1IlpertncKITC PERMIT NO. BPn•531M BIN h .PROJECT LOCATION AP# 0y2-310-015 Property Address c�C,. �J City Cross Street WORKER'S COMPENSATION Policy Number G Q 12 _ b 1 Carrier Q -6,� una 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 Descri tion or Scope of Work: C5-a� 1._' 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: �• Amount: Bldg SRA n Receipt #: Sheriff SMIP oOther Date:1 I "G3 ` 55.0'0 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 A/C 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\B1dgAppJSubRgmts.doc Page 2 of 2 REV 8-12-05 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. BP052453 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/16/2005 APN: 042-310-015-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number. Site Address: 2890 RODEO AVE CHI Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: FOUNDATION REPAIRS(500) 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: JONES GERALD J & DEBORAH 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 2890 RODEO AVE 7000) of Division 3 of the Business and Professions Code) or that he or is CHICO, CA she exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 95973-8963 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' Stale License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: JONES GERALD J & DEBORAH 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 2890 RODEO AVE 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 sale.). 95973-8963 ❑ 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: ❑ 1 am Exempt under Article�3 of the Business Code �and (�Professssi Ions Date: 1IL—L Owner: �L- -� " t -� •� ` y t!�� 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 License #: Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Engineer: Carrier: Policy #: ❑ I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, 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 comply with those provisions. n � ��-C 111 E). Date: Applicant: 9 �y2 WARNING: Failure to secure workers' compensation coverage is q- OS unlawful, and shall subject an employer to criminal penalties and one W— W hundred' thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol ti ns to do work indica_twe_i:l above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) (� %, "1 - � O5 Name: By: �1( YII���JI� Date: ly `1( Y1 IEXPIRES Address: PERMIT 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. 0 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 u on the above mentioned property for inspection purposes. 1p► �,, �n• Print Name: k 1(,Y a 1 �c ��P"� Signature: 1 N�KJ�;YCL.{� 1 C�.� 5 'A _Q___9 — ` t✓LJ Date: ( LD Owner ❑ Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SE=RVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP053134 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 11/23/2005 APN: 042-310-015-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 2890 RODEO AVE CHI Date: Contractor: Map Index: Description: REPAIR GAS LINE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: JONES GERALD J & DEBORAH 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 2890 RODEO AVE 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA 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 95973-8963 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: JONES CONSTRUCTION, JERRY 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 2890 RODEO AVENUE proving that he or she did not build or improve for the purpose of sale.). CHICO, CA 95973 W I, as owner of the property, am exclusively contracting with (530) 624-2018 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: JONES CONSTRUCTION, JERRY ❑ lam Exempt under Article 3 of the Business and Professions Code '�� O C �''�J !` Q� Date: Owner. 2890 RODEO AVENUE WORKERS' COMPENSATION DECLARATION CHICO, CA 95973 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 (530) 624-2018 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit License #: 792726 is issued. l� 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: C' �L.W Engineer: Carrier: 0( o c 1 Z2 r V Policy #:713- 11 ❑ 1 certify that in the performance of the work for which this permit is otal Square Ft: 0 S. F. +,+, issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laves of California, Valuation: $0.00 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith those Census Code: j' "✓1 comply with provisions. Date: G00 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 issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) � 2 �O� I —23-0-5 Name: BY: n r 11 Q Date:.. `1 PERMIT EXPIRES ON: Address: (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official forth or document of Butte County. I hereby authorize re r entat, s�of�Bu�tt-ee County to ennter upon the above mentioned property for inspectiop- u ss. �/ "—' 0 S � A /lxJ Print Name:iCJrCJy' t IVU Signature: c� \ / a l: )1 lyl) V b Y Date: her ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16.04 pg 1 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 PROJECT INFORMATION Site Address: 2890 RODEO AVE Owner: permit No: B07-1039 APN: 042-310-015 JONES, GERALD Issued Date: 5/14/2007 By GLB Permit type: MISCELLANEOUS 2890 RODEO AVE Subtype: Re -Roof CHICO, CA 95973 Expiration Date: 5/13/2008 Description: REROOF 21 SQ Occupancy: Zoning: A5 Contractor Applicant: Square Footage: G & R ROOFING G & R ROOFING Building Garage Remdl/Addn 2587 NORD AVENUE 2587 NORD AVENUE CHICO, CA 95973. CHICO, CA 95973 Other Porch/Patio Total (530)894-6537 (530)894-6537 FEE INFORMATION DBMSC Re -Roofing $137.50 Total Charged: $137.50 Fees Paid: $137.50 Balance Due: $0.00 Receipt No: B3053 .LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License G & R ROOFING 877008 / C39 / 4/30/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that 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 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Secti 7000) of Division 3 of the Business and Professions Code, and my license Pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in f l rce and eff of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the 1 basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 5/14/2007 i the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Cont cos Signhwwd Date ❑ 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). rn I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: �/Q J Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: State Fund Policy Number:713-0004266 Exp. Date:10/1/2007 Contractors License Law.). (This section nee not a completed if the permit is for one hundred dollars ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑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 lifomia, and agree that if I should become subject to the workers' X 5/14/2007 compensation provisio f Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date pr ons. l X 5/14/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Sign Date WAR I :FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SH LL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNUD THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) injury, including death, property damage used t is arising out of, or in anyway connected with the issuance of this pe i . I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND us r occupancy of y dewa.k, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEYS FEES. C n to enter the ov entioned property for inspection purposes. I hereby certify that I am the Pr pe or a au rized to act on the property owners behalf. 5/14/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for N Pe mi ee GN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner 1:1 Contractor OR. Agent for Owner V/ Agent for Contractor FILE COPY Y' Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name First Name trrw Mailing Address City C State Zip !g�i,7 Phone Fax E-mail r APPLICANT INFORMATION ARCHITECT/ENGINEER Name State Zip =Addhass Fax City Occ. State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name inn Address � �.-- City State Zip Phone _ Fax E-mail APPLX4 iAT SIGNATURE a0 � S�— r I�3 PERMIT NO. BIN # PROJECT LOCATION API Property Address City WORKER'S COMPENSATION Policy Number. .71 Carder If hiring anyone other than Iicen cont ctors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: a15 T- Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): C,� For office use only: Zoning FloodZone SRA Yes No Occ. Type Const. I I License Detail California Home Page 1 of 2 License Detail CALIFORNIA CONTRACTORS STATE LICEN Contractor License # 877008 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: . CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the lin button to obtain complaint and/or legal action information. . Per B&P 7071.17, only construction related civil judgments reported to the CSLB are disclosed. . Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. . Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. Extract Date: 05/14/2007 * * * Business Information * * * G & R ROOFING INC 2587 NORD AVENUE CHICO, CA 95973 Business Phone Number: (530) 894-6537 Entity: Corporation Issue Date: 04/28/2006 Expire Date: 04/30/2008 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * Class Description C39 ROOFING * * * Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 291016 in the am, $12,500 with the bonding company http://www2.cslb.ca.gov/CSLB—LIBRARY/License+Detail.asp 5/14/2007 License Detail Page 2 of 2 -y AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 01/01/2007 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(1): The Responsible Managing Officer (RMO) DEI LEE RIOS certified that he/she owns 10 percent or more of the voting stock/equity of corporation. A bond of qualifying individual is not required. Effective Date: 04/28/2006 * * * Workers Compensation Information This.license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 713-0004266 Effective Date: 10/01/2005 Expire Date: 10/01/2007 Personnel listed on this license (current or disassociated) are listed on other licei Personnel List Other Licenses License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request © 2006 State of California. Conditions of Use Privacy Policy http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 5/14/2007 ._..! _;. �. IW w .. ... .. .... .. 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