HomeMy WebLinkAbout042-590-079w
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RESIDENTIAL
PERMIT NO. 0qZ-510 "ol9 6!�'3ZZ(o
15Z-30 37 " 40-.r.1(fA Ce
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SPECIAL CONDITIONS
I CHECKED
r BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
} SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
OFFICE COPY
Address
GAS
Meter ByDate
ELECTR
Meter By IC Dat
JOB FINALED (&a -
Signat
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RESIDENTIAL
PERMIT NO. 0qZ-510 "ol9 6!�'3ZZ(o
15Z-30 37 " 40-.r.1(fA Ce
%A,,�i,o-was f
SPECIAL CONDITIONS
I CHECKED
r BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
} SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
OFFICE COPY
Address
GAS
Meter ByDate
ELECTR
Meter By IC Dat
JOB FINALED (&a -
Signat
ure
r
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netldds
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license Is In full force and
effect.
License Class: License Number:
Date: Contractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish; or repair any structure, prior
to its Issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's Slate License Law (Chapter 9, commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
Intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or Improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such Improvements are not Intended or offered for
sale. If however, the building or Improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Profdssions Code. The Contractors' Stale 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.). �n
❑ 'I am Exempt under Article 3 of the BusI9 sa-s d P/bfejiblons Code
s
Date: /` Owner,
WORKEfiS' COMPE7.;-
ON�O CLARATION
affirm I hereby arm under penally of pe of the following declarations:
ElI have and will maintain a certiicate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
Is issued.
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit Is Issued. My workers' compensation
Insurance carrier and policy number are:
PERMIT NO.
BP043226
Issued Date: 01/14/2005 APN: 042-590-079-000
Site Address: 3230 BAY AVE CHI
Map Index:
Description: NEW POLE AND PANEL BOX
Owner: THOMAS AND SUSAN PROVOST
3230 BAY AVE
CHICO, CA
95973
530-828-3173
Applicant: THOMAS AND SUSAN PROVOST
Contractor: DURHAM ELECTRIC
#11 COMMERCE COURT
#8 95928
530-842-1884
License #: 427565
Architect:
Engineer:
I,,
Carrier.
Policy #: Total Square Ft: 0 S. F.
1 certify that in the performance of the work for which this permit is Valuation: $0.00
issued, I shall not employ any person in any manner so as to Census Code:
become subject to the workers' compensation laws of California, t'
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WA ING: Failure to secure workers' compensation coverage Is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), In addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.`'
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for the
performance of the work for which this permit Is Issued (Sec 3097 Clv.)
Name:
PERMIT
Address:
sued under the applicable provisions of the Butte Cnunly Codes am1/Or
Indicated above for which fees have been paid.
L'o .j_�) i Date: l
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
Cl 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-Iam the owner or the duly authorized agent of the owner. I agree to comply with
all county and stale laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official,n ent of Its County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes.
Print Name:
Date
❑ Owner
❑ Contractor
Agent for Owner
❑ Agent for Contractor
J=OK
0 = Not OK
. = No ReadyApplicable
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1.
Zoning Requirements-Setbacks-Easements
2.
Soils; Special MH Support Sketch
3.
Sewer; Location-Test-Fall-C/0-Concrete
4.
Water; Location-Test-Easement Needed (Sketch)
5.
Electricity; Location-Clearances-Grnd-/ /Amp-Concrete
6.
Gas; Location -Test-Wrap;-/ /" L 'ft.
/ P Nat. or/ /" L "ft./ P LPG
7.
Well Clearance & Disconnect
8.
Utility Clearance
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
Date
12.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Card B-1 Date Card B-1
1.
Zoning Requirements-Setbacks-Easements
Card B-1 Date Card B-1
2.
Footings; Size-Spacing-Marriage Line
3.
Gas; MH Test-Demand-Valve-Connector
4.
Electricity; MH Test-Crossovers-Breakers-Clearances
5.
Drain; MH Test-Fall-Flex Connector
6.
Water; MH Test-Regulator-Connector
7.
Water and Sewer Connected-C/0 to Grade-HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs-Type-Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
ate
12.
Card B-1 Date Card B-1
)ate
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
F
1.
Zoning Requirements-Setbacks-Easements
Card B-1 Date Card B-1
2.
'Footings; Size-Spacing-Marriage Line
3.
Blocking
4.
Gas; MH Test-Demand-Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes -Enclosures- Panel boards- Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5. Stemwalls, Main; Steel -Blockouts-Wrapped
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
6a.
Hold Downs and Special Anchors
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftg.-Steel
9.
D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test
10.
UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11.
Water Pipe; Test -Anchors -Regulator -Service Test
12.
Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date
5U.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
52.
17.
Water Htr.; Vent -Access -Combustion Air Baffle
18.
Water Pipe; Test & Anchor -Nail Protection
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
20.
Shower Pan; Test, First Floor -Tub Access
55.
21.
Test Tub & Shower, Second Floor -Tub Access
56.
22.
Gas Pipe; Sixe & Anchors
23.
Fire Sprinkler; Test
59.
Date
Card B-1 Date Card B-1
Date
Shear Walls; Nailing -Bolts
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Brace Interior/Exterior Wall Panels
24.
Fixture & Transformer Clearance -Ins. Protection
62.
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
26.
Size Boxes & No. of Conductors Stapled
27.
Romex Installed Close to Edge of Studs & C.J.
Card B-1 Date Card B-1
28.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
Date FINAL (Plans) OK except #'s
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
65. Smoke Detector
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral U Yes O No
66.
32.
Service -Riser Conductors & Ground Main Disconnect
33.
Equip. Clearances Panels-Motors-Mech. Equip.
Bedroom Exiting
34.
Clothes Closet Light -Shower Light -Spa Light
68.
35.
Smoke Detector
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36.
A.C. Ducts Insulation & Support
Elec. Outlets at Wood Panel, Int. & Ext.
37.
Vent Fan, Exhaust above insulation
73.
38.
Condensate Drain & Overflow, Size & Grade
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40.
Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
A.C. Duct in Garage -Damper
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
41.
Sills Proper Materials & Anchors
78.
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
43.
Bearing Walls over Girders & Floor Nailing
44.
Draft Stop in Walls (rat proof)
Insulation -Foam -Looked in Attic
45.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
81.
46.
Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
5U.
Attic Access; Size & Iiomex Protection-urart Jtop-Ins. battles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59.
Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68.
G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70.
Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72.
Elec. Outlets at Wood Panel, Int. & Ext.
73.
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74.
Elec. Outlets & Receptacles at Kit. Counter
75.
Garage Fire Door; Swing -Landing -Closure
76.
A.C. Duct in Garage -Damper
77.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.FI.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83.
Following Instld./Drive 0 Yes O No/Walks 0 Yes O No/Planters O Yes Q No
84.
Stucco Brown -Finish
85.
A.C. Unit Disconnect, Electrical -Plumbing
86.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87.
Water Well, Disconnect, Electrical, Plumbing
88.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
89.
Ventilation Throughout House
90.
Glass Protection
91.
Corrections from Previous Inspections
92.
Gas Test -Meters Tagged, Gas -Electric
93.
Water & Sewer Connected -C/O to Grade -HD Approval
94.
Energy Compliance Certificate -Other Certificates
95.
Address Posted
96.
Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.netldds
PERMIT NO.
BP043226
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 01/14/2005 APN•' 042-590-079-000
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.
Site Address: 3230 BAY AVE CHI
License Class : License Number:
•
Map Index:
Date: Contractor.
OWNER -BUILDER DECLARATION
Description: NEW POLE AND PANEL BOX
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Owner: THOMAS AND SUSAN PROVOST
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish; or repair any structure, prior
to its Issuance, also requires the applicant for such permit to file a
3230 BAY AVE
signed statement that he or she Is licensed pursuant to the provisions of
the Contractor's Stale License Law (Chapter 9. commencing with Section
CHICO CA
7000) of Division 3 of the Business and Professions Code) or that he or
95973
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
530-828-3173
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
does to
Applicant: THOMAS AND SUSAN PROVOST
Code: The Contractors' State License Law not apply an
owner of property who builds or Improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or Improvements are sold within one
year of completion, the owner-bullder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Profdssions 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
Contractor: DURHAM ELECTRIC
pursuant to the Contractors' State License Law.).
❑ '1 am Exempt under Article 3 of tha Bust d P ofe Ions Code
#11 COMMERCE COURT
#8 95928
Date: Own r
530-842-1884
WOR S' COMPEN ON CLARATION
I hereby affirm under penalty of p u e of the following declarations:
License #: 427565
❑ 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
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit Is Issued. My workers' compensation
insurance carrier and policy number are:
Carrier.
Policy#:
Total Square Ft: 0 S. F.
Valuation: $0.00
1 certify that in the performance of the work for which this permit Is
Census Code:
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date: l%
Applicant:
WA 1NG: 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 i here issued under the applicable provisions of the Butte Cnunly CodA anrt/or
I hereby affirm that there Is a construction lending agency for the
Re 0, work Indicated above for which fees have been paid.
performance of the work for which this permit Is Issued (Sec 3097 Clv.)
BY Date: I
Name:
- O
PERMIT EXPIR S
Address:
Dafe
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information
is correct, and thall 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 ent of Its County. I hereby
authorize repred@ntalives of Butte County to enter upon the above mentioned
property for Inspection purposes.
Print Name: ,v\
Signatur : A
Date: �L
❑ Owner ❑ Contractor
gent for Owner 0 Agent for Contractor
,.1
TONT PROVOS4T- COWS-,4TRUCTION
3230 BAY AVENUE • CHICO CA 95973 • (530) 343-4391' • LICENSE # 634638
January 7, 2005
Dear Sir or Madam:
I authorize Jaime Snachez to act as my agent for the purposes of obtaining permits necessary for an
electrical service change at my residence at 3230 Bay Avenue, Chico, CA 95973.
f ,
Sincerely,,
Tom Provos
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