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2464, Strea�slde Ct, Chico042-666-542-6T C RIS 05-0146TO HERC CHLICOSl D =ERE TRE &SO 00CARTW 05-01.46RIGHT, CJHRISTOPHER'
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NOTES RESIDENTIAL
1OS-0146
PERMIT NO,i , 042 600-03– 7
CARTWRIGHT, CHRISTOPHER
2464 STREAMSIDE CT, CHICO
Cont: GREE C O Oj OOFING
REROOF W —,
i
� c -
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
t
JOB FINALED (D
Signature
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5.
Stemwalls, Main; Steel-Blockouts-Wrapped
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
6a.
Hold Downs and Special Anchors
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftg.-Steel
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10.
UF, Gas Pipe; 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
L
Date
FRAMING (Continued)
Date
Hangers -Post Caps -Anchors -Connectors
Card B-1 Date Card B-1
Date
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17.
Water Htr.; Vent -Access -Combustion Air Baffle
18.
Water Pipe; Test & Anchor -Nail Protection
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
23.
Fire Sprinkler; Test
57.
Siding -Nailing Veneer
Date
58.
Card B-1 Date Card B-1
Date
59.
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Shear Walls; Nailing -Bolts
24.
Fixture & Transformer Clearance -Ins. Protection
Brace Interior/Exterior Wall Panels
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
Insulation -Walls -Ceilings
26.
Size Boxes & No. of Conductors Stapled
Infiltration -Walls -Windows
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
Card B-1 Date Card B-1
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral 0 Yes 0 No
32.
Service -Riser Conductors & Ground Main Disconnect
33.
Equip. Clearances Panels-Motors-Mech. Equip.
34.
Clothes Closet Light -Shower Light -Spa Light
69.
35.
Smoke Detector
70. Stairs & Rails
71.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
74.
36.
A.C. Ducts Insulation & Support
75. Garage Fire Door; Swing -Landing -Closure
37.
Vent Fan, Exhaust above insulation
A.C. Duct in Garage -Damper
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
80.
Card B-1 Date Card B-1
Date
81.
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
41.
Sills Proper Materials & Anchors
Clearance Looked under Floor 0 Yes
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
Following Instld./Drive 0 Yes 0 NoMalks 0 Yes 0 No/Planters 0 Yes 0 No
43.
Bearing Walls over Girders & Floor Nailing
Stucco Brown -Finish
44.
Draft Stop in Walls (rat proof)
A.C. Unit Disconnect, Electrical -Plumbing
45.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
46.
Headers & Beams -Size & Bearing
L
Date
FRAMING (Continued)
47.
Hangers -Post Caps -Anchors -Connectors
48.
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57.
Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59.
Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64.
Ext. Steps -Door & Sidelight Protection -Landings
65.
Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72.
Elec. Outlets at Wood Panel, Int. & Ext.
73.
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74.
Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door; Swing -Landing -Closure
76.
A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
83.
Following Instld./Drive 0 Yes 0 NoMalks 0 Yes 0 No/Planters 0 Yes 0 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:
J=OK
0 = Not OK
. = NotReadyable
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
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
3.
Sewer; Location -Test -Fall -C/0 -Concrete
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
4.
Water; Location -Test -Easement Needed (Sketch)
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Carports; Windows -Doors
6.
Gas; Location -Test -Wrap;-/ P' L 'ft.
/ P Nat. or / P' L "ft./ P LPG
Electric
7.
Well Clearance & Disconnect
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
8.
Utility Clearance
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
POOLS (Plans) OK except #'s
3. Gas; MH Test -Demand -Valve -Connector
1.
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
2.
5.
Drain; MH Test -Fall -Flex Connector
3.
6.
Water; MH Test -Regulator -Connector
4.
7.
Water and Sewer Connected -C/O to Grade -HD Approval
5.
8.
Gas and Electricity Tagged
6.
9.
Tie Downs -Type -Installation Cert.
7.
10.
Exits; Insp.-Sketch
8.
11.
Cert. of Occupancy
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
Date
Light Niche
Card B-1 Date Card B-1
Date
Enclosure; Fencing -Alarms
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Date
1.
Zoning Requirements -Setbacks -Easements
Date
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
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO)
OFFICE M (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.netldds
PERMIT NO.
BPO50146
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am licensed under Issued Date: 01/20/2005 APN: 042-600-037-000
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.(� r Site Address: 2464 STREAMSIDE CT CHI
License Class: _3 / License Number: 27�r!7
Map Index:
Date: -/:z.2 V� as Contractor. 1eP-F_&42 /&a40 Aiw„q�
DeSCrlptlOn: REROOF W/COMP(10)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' Stale License Law for the following reason (Sec. 7031.5 CHRISTOPHER CARTWRIGHT
Business and Professions Code: Any city or county which requires a Owner:
permit to construct, alter, Improve, demolish; or repair any structure, prior
to its Issuance, also requires the applicant for such permit to file a 2464 STREAMSIDE CT
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's Slate License Law (Chapter 9. commencing with Section CHICO' CA
7000) of Division 3 of the Business and Professions Code) or that he or 95928
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicaril for a permit subjects the 530-899-9517
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure Is not
Intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: GREENE & SON ROOFING
owner of property who builds or Improves thereon, and who does
Contractor: GREENE & SON ROOFING
such work himself or herself or through his or her own employees,
PO BOX 2467
provided that such Improvements are not Intended or offered for
PO BOX 2467
sale. If however, the building or Improvements are sold within one
PARADISE, CA 95967-2467
year of completion, the owner -builder will have the burden of
530-873-3940
proving that he or she did not build or improve for the purpose of
sale.).
License M 275057
❑ I, as owner of the properly, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Profdaslons Code. The Contractors' State License Law does
not apply to an owner of property who builds or Improves thereon,
Contractor: GREENE & SON ROOFING
and who contracts for such projects with a contractor(s) licensed
Pursuant to the Contractors' State License Law.).
PO BOX 2467
❑ '1 am Exempt under Article 3 of the Business and Professions Code
PARADISE, CA 95967-2467
530-873-3940
Date: Owner:
WORKERS' COMPENSATION DECLARATION
License M 275057
I hereby affirm under penally of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
Architect:
is issued.
t have and will maintain workers' compensation Insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit Is Issued. My workers' compensation
insurance carrier and number are:
`policy
d
Carrier. 4��t1?�rT2n►
Total Square Ft: 0 S. F.
Policy #: 17 S 3 % 9
:I, Valuation: $0.00
Census Code:
O 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 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:
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 heNeby iss ed under the applicable provisions of the Bulle County Codn enruor u
I hereby affirm that there Is a construction lending agency for the Resolutions t dlcated above for which fees have been paid.
performance of the work for which this permit Is Issued (Sec 3097 CIv.)
Name: BY Data
PERMIT EXPIRES O i)42
Address: rnerei
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above Information Is correct, and that l 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 toenterupon the above mentioned properly for Inspection purposes.
Print Name: i 1 i G.J /�yef�li�� 'Signature:
Dale:
El Owner
Contractor
❑ Agent for Owner
❑ Agent for Contractor
O
BUTTE COUNTY
O DEPARTMENT OF DEVELOPMENT SERVICES
O BUILDING PERMIT APPLICATION
O AND SUBMITTAL REQUIREMENTS
O 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
p OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER
Last e r Y
irst Jia i
► ��,,5 d�� ►��
Address , f /14
City 0, ed
ps
Stat
�
N �— L
Phone _ 9�% ?
E-mail
E-mail
CONTRACTOR
Name
6�a, Sve w v W
Address r�
City `S�
Sta�_
Z*59,67
Phone ?13 _3
Fax
E-mail
Lic. ,7,,., 71
'?�_-79
APP CANT SIGNATURE
X ,
For office use only:
ARCHITECT/ENGINEER
Name
Flood Zone
Address
SRA
City
tate
State
Zip
Phone
E-mail
Fax
E-mail
Planner
State License Number
APP CANT SIGNATURE
X ,
For office use only:
APPLICANT NAME
Name
Flood Zone
Address
SRA
City
tate
Zip
Phone
Fax
E-mail
Page
APP CANT SIGNATURE
X ,
For office use only:
Zoning
Property Address �1
Flood Zone
Cross Street
6/A7/�3-vP.
SRA
Yes
No
.Occ._Type
Const..
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
6
PERMIT
NO
—61 1lf�
BP
BIN #
LOCATION
Property Address �1
Cit
1
Cross Street
6/A7/�3-vP.
WORKER'S COMPENSATION
Policy Number
3 97,
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\B1dgApp1SubRgmts.doc Page 1 0
Description or Scope of Work:
Sq. Footage 4 C aT J
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by:
Receipt #:
f7 n
Amount: �� Bldg
SRA
Sheriff
SMIP
Other
Date: a p
, Total
RF\/ 7_97_04
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. (Note: Not required for additions to
mobile or modular homes.)
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down
or fnd plans, all in duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
❑ 13. Sanitation and site plan approval from the Environmental Health Department.
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and site pian approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑• 4. NPDES Form.
❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7. Worker's Compensation Carrier and Policy Number.
❑ 8. Owner -Builder Verification (if required).
❑ 9. Letter of Signature authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530)538.7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
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
KAFORMSOUILDING F0RMS\61dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04
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RESIDENTIAL � �J
X42-60-37 376-91B,P-,E,M
DONALSON, Craig
2464 Stream side Ct, Chico Q
( new sf )
L
OFFICE COPY
Address oiy�[� V7�lCa�wil��
LJdy � e✓ � n. l.�
GAS
Meter By f- Date
ELECTRIC
Meter By Date
L5 OFFICE COPY
Addres Y(o 5l leatif Si d 'e
GAS `p�
lr
Meter By R/ Date 7
ELECTRIC
Meter By Date
JOB FINALED (Date)
Signature
COUNTY OF BUTTE V
w DEPARTMENT OF PUBLIC WORKS e
' 196 Memorial Way, Chi6o — Phone: 891-2751
°y 7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
• ' Y
-CORRECTION NOTICE
OWNER - PERMIT NO:
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office -
when correction of work is completed. If you have any question pertaining to this
matter, r need additional explanation, please contact this office immediately.
a&l ,,//'oc a i0 1L"
A i Al
d . C 'e
Oe 617/
Date /n 2�--9�- Inspector /l //
t
0wner�Permit. No.
f
ENERGY CEfiTI FI CAI'l ON
CU4.Q__ roSw d e
LOCATION A.P. No.
DESCRIPTION O1' ]NSU LAT] ON t
ROOF
MATERIAL BRAND NAME
THICKNESS I'HERMAL RES.
EXTERIOR WALL
MATERIAL FIBE GLASS BRAND NAME CE`RTA IN'1'1•E1)
THICKNESS I I Z.r•t THERMAL RES.
CEILING
BATT OR BLANKET TYPEI SSBRAND NAME CERTAINTEED
THICKNESS 1 O � THERMAL RES. 3 0
LOOSE.FILLTYPE INSUL-SAFE.IIIBRAND NAME CERTAINTEFD
THICKNESS L THERMAL RES. e _ 3 a
FLOOR,ELEVATED
MATERIAL, FIBERGLASS BRAND NAME CERTAINTEED
THICKNESS THERMAL RES.
FLOOR, SLAB
PIATERIAL BRAND NAME
THICKNESS THERMAL RES.
WIDTH
FOUNDATION WALL/,!!ql /2 % WAIT
MATERIALy BRAND NAME
THICKNESS THERMAL RES.
I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS. INSTALLED IN THE ABOVE
BUILDING IN CONFORMANCE WITH THE STATE OF CALIF. ENERGY REQUIREMENTS.
SHASTA INSULATION IA'C. #530235
FIRM NAME OlJ E STATE CONTR. LICENSE NO.
I hereby certify the above insulation and all required items as shown
on the Building.De.part. approved plans and attachments have (leen installed.
as required by the State of California Energy Requirements.
All equipment, devices and materials are of the quality hrescribe'd, or
are specifically approved by the State of Calif.
FARM NAPIE/ OWNI.R ( PLEASE PRINT) . STATE CONTI;AC OR' S I.I CLN"
SIGNAT11RI: OF (,I NERAL (CONTRACTOR/OWNER 1)ATI'
This certif.,icat.e must on file with thc. BUILDING DEPARTMENT prior to
final inspection approva; and a copy shall be posted within thy• hui1ding.
.IANIIARY 1984-
.V OK
O = Not OK
Not Applicable
Not Ready MOBILE HOMES
' =
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / P L" ft.
/ P'Nat. or/ P L" ft./ /"LPG
7. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
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; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors
Shthg.-Rfg.-gracing
5. Alum. Awn.; Columna -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
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, Distances-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- Pane Iboa rds-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
=OK
O=N&tOK
- = Not Applicable
' Not Ready
RESIDENTIAL (Single & Duplex)
=
Date UNDERFLOOR (Plans) OK except #'s
Zoni in
. Ftg., Main; Soils-Elec.iBFf+d.-/JZC' Ftg. Depth
3 ., Garage; Soils-Steel-Elec. Cures/Z' Ftg. Depth
tg., Porches & Decks; Soils -Steel-/ 2Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel -Block outs -Wrapped
6a. H Downs and Special Anchors
Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
WID-W.V. II -Fitt ing-T -2 Way C/O -Sewer Test
1o. G ipe; Size -Anchors
14/'Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Insulation
Date c��Ct�e�t Card B-1 C,C-r Date V/ Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING Permit OK except #'s
aWater Htr. 52Access-Combustion Air -Baffle
j.YWater Pipe; Test & Anchor -Nail Protection
.W.V.; Test -Fittings & Anchor -Nail Protection
19-9hower Pan; Test, First Floor -Tub Access
20: -Test Tub & Shower, Second Floor -Tub Access
F1!Gas Pipe; Size & Anchors
Date( Card B.1 Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
2?!Fixture & Transformer Clearance -Ins. Protection
2 Elec. Receptacles Spacing -Lights & Switches at Doors
2 _Size Boxes & No. of Conductors -Stapled
Romex Installed Close to Edge of Studs & C.J.
ui ade up w/Mech. Fastners as & W
2 Appliance Circuts in Kitchen & Conductor Size/GFI
ubfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / toga.
for AI
,147 Range Circ. /arga. Cu o Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes XRNo
3 . Service -Riser Conductors & Ground -Main Disconnect
3ilrEquip. Clearances Panels-Motors-Mech. Equip.
64othes Closet Light -Shower Light -Spa Light
smoke Detector
Date ���p �� { Card B-1 (;� G Date Card B-1
Date j-$ t -if Card B-1 GG Date Card B-1
Date MECHANICAL (Permit) OK except #'s
4. .C. Ducts Insulation & Support
Vent Fan; Exhaust above insulation
46-C4adensate Drain & Overflow; Size & Grade
37 Furnance-Vent; Access -Comb. Air -Return Air Ve -115 outlet
38-Aitm-Access & Platform if Furnance in Attic
Date S Zp-ti Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except #'s
Sts, Proper Materiala
Walls Studs -Nailing, Spacing fates -Sound
6orBearing Walls over Girders & Floor Nailing
raft Stop in Walls (rat proof)
FirA Stops; Furred Ceilings -Stairs -Chases
Headers & Beam -Size & Bearing
Date FRAMING (Continued)
,4_5 --Hangers- Post Caps -Anchors -Connectors
Cing. Joist-Rftr. ties -Pu rlin -roof BracTr
JP6Shthng.-Rfng.
Fireplace Ties or Type A Flue-Fireplac r ra
Attic Access; Size & Romex Protection -Draft Stop-Ins!Baffles
490Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
. Garage Fire Protection Framing
. Property Line Firewall & Openings
52 -Ext Doors -One T -Check Garage -3rd Story, 2 Exits
&3 -Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
ie plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Nailing Veneer
tucco Mesh -Drip Screed -Fd. Vents-Underflr. Access (n�f
Glazing Area -Glass Protection -Skylights -Plastic
58.-94ear Walls; Nailing -Bolts
58'l su ion-Wa11s`-Carlin s
Infiltr'on-W Is -W dows
' -3a'gt F0KewALt, - I VT'mtoR-- /3.:.l..,A
3-13-c/ rt •( C-ZI
Date gip Lj ( Card B-1 Q4 ;� Date �i_c� / Card B-1
Date Card B-1 Date '7,5,ql Card B-1
Date FINA tans) OK except #'s
Ext teps-Door & Sidelight Protection -Landings
oke Detector
urnace; Vents -Clearance -Comb. Air-Connector-
��� In arage; Above Floor-Ducts-Mech. Protection
edroom Exiting
.I. & Bath Fixtures & Tub Access -Spa
6 ec. Trim & Subpanel; Breaker Sizes & Labels
irep ace or Stove; Clearances -Hearth
b9 -E s at Wood Panel; Int. & Ext.
Kit ixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
7 . lec. Outlets & Receptacles at Kit. Counter
Garage Fire Door; Swing -Landing -Closer
arage-Damper
7 tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor-Mech. Protection
Ib., Elec. & Mech. Equip. Listed for Location
lec Receptacles in Garage; (G. F.I.) -Rome x Protection
7 nsulation-Foam-Looked in Attic es
u rd Rails & Deck Construction -Post Caps
ag-fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Flo ❑ Yes
8 ol!owing instld.; Drive es 0 No; Walks Yes ❑ No;
PV,wrs 0 Yes 2No
S cco; Brown -Finish
A.0 nit; Disconnect, Electrical, Plumbing
ents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
84-Vtlater-well- Disconnect, Electrical, Plumbing
xterior Elec. Trim; G.F.I. Receptacle -Underground
8 entilation Throughout House
8L,Zfa_ss Pr tection
8 orre ions Pre s Ins ctions
9_ Q (Test eter a e EI ri '1
( . W er &Sewer Connected -C/O to Grade -HD Approval
QYIE-nergy Compliance Certificate -Other Certificates
Date 9-q-91 Card B-1 may! Date -(09Z Card B-1
DateCard B-1 /0 Date Card B-1
Date „73-QI Card B-1 #Sfp Date Card B-1
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 SE
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
42-60-37
ZONING
S
BUILDING PERMIT
°CZAt( .J
&L
�
S0. FT. BUILDING VALUATION
jO�CC.
1 300 +` 52f000.00
OWNER'S MAILING ADDRESS
P.O. Box 4055, Chico 95927
420 M 5,880.00
CONTRACTOR'S NAME
Owner
TELEPHONE
153 C 1,530.00
•
CONTRACTOR'S MAILING ADDRESS
Fireplace I A 1,000.00
CONSTRUCTION LENDER
OWN-
Total Valuation $60,410.00
Filing Fee
$
10,00
LENDER'S MAILING ADDRESS
Permit Fee
$316.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 15,00
Energy Plan Checking Fee
$ 15,00
ARCHITECT OR ENGINEER'S MAILING ADDRESS -
Penalty
$
BUILDING ADDRESS
Permit fee
$356.00
- PLUMBING PERMIT
Filing Fee
10.00
2464 Streamside Ct . . Chico
Each Trap
2.00
18.00
Solar or heat pump water heater
20.00
LOT NO.
S3
SUBDIVISION NAME
VIAL UT �L�b
PARCEL MAP
(�
�� d '%
Water piping
j 5.00
5.00
Each qas water heater or vent 1 5.00
5.00
USE OF STRUCTURE
SF 9 Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
1 1 5.00
5.00
Building sewer 1 5.00
5.00
Mobile Home I S G W 10.00e
TYPE OF WORK
New I Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work: 3 Bedroom _
So
Permit Fee $4&-@Q
00
Contractor
ELECTRICAL PERMIT Filing Fee
10.00
Main service BOOV OR LESS
100 AMP OR LESS
10.00
Main service EA. ADC'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Profess i S C de arm my license is in fu � force and effect.
5
License No. Classification
❑ I, as the owner, or. my employees with wages as their sole compen-
sation, will do the work,and the.structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCU
OR ACDNS, C ACC. BLOGS. )
2/z¢sgft
X 43.00
NEW CONSTR.MULTI-OUTLET 2,50 ea
NON.RESID BRANCH CIRC ITS
POWER APPARATUS e
SINGLE OUTLET CIR. )
Ex. OCcU OUTLETS OR FIXTURES 20@505
p 9AL@30
FIXED
Ex. Occup. OUT ETS PRESID IREA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee 3 Q
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or, a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT FiIingFee
10.00
Heating 1 6.00
6.00
Dlial
Cooling
g 1 6.00
6.00
Hood j 3.00
3.00
Ventilation2 3.00
6.00
Permit Fee $31.00
'Contractor
I certify that I have read this application and state that the above information
Js correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may 'n a way accrue
again said Cpunt in conse ence of the granting of this prmi
ate j C1
SI ture of p lic Int Owner Contractor Agent ❑
An OSHA perm., is required for excavations over 5'0" deep m li 'on or construct-
.ion of structures over 3 stories in height.I.
Mobile Home Installation Fee $
Energy Inspection Fee $30,00
Q4X
UN yyPE
UU�V
TOTAL FEE 3,00
HAZ
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SCHL
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PAR•
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V/
Th;s permit is Hereby issued under
sions of the Butte County Code and/or
work indicated abov for which fees
DI E R 0 PUBLIC
l
BY [J _
PERMIT EXPIRES ate Z
the applicable
resolutions
have
WORKS
L
Qate
provi-
to do
been paid.
V
Receipt No. 70.00 3�
WNITE-D.P.W., YELLO -A OR, TOR, GOLDE D -APPLICANT
R
A9RTT7�TMM'tY� _ .�'' `�/y�:(... `-. ,.'i_; ; i •IS''. 'J, (,y y� ``A� a7SVK..�i�
COUNTY OF BUTTE - DEPARTME T.,OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVIIitE, Cf9'NIPORNIA 95965 - TELEPHONE: 916/538-7541
* y .. ;,4 r �
PERMIT APPLIC-ATION DATA SHEET_(rD I
�' Permit No.
OWNER C 414 / (n Dy�t/.9 �— S�� A. P. No. Z G �%
Proposed Building Use �1%i �%(���� Building Inspector Date Z ��
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
r '° -VDATE"RECEIVED APPROVED
1. All items have been submitted . ....................................
2. Plot plans in duplicate/triplicate, signed by preparer of plans ........
3. Complete plans in duplicate/triplicate, signed by preparer of plans ..
4. Complete engineered plans and calcs, with wet signature on plans ..
` 5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
'' 9. Mobilehome installation data including manufacturer's installation
f instructions/ ...................................
10. Fees of $ q� ........................
i _111. Chico Urban Area fees paid .......................................
E _�Z'l 2. Park fees paid .................................................
` — ---13. C ()4� School District fees paid .
t 14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
1 - Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-inspec.request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22-. Certificate of Workmans Compensation Insurance ..................
,3: Owner -Builder Verification (Given to owner 0, Mail to owner 0)�
24. Recorded copy of Agricultural Acknowledgment Statement O W.�``�W
25. Letter of signature authorization .................................
26.
27.
When yq.0 issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone nd hold for pickup at office. Deliver w/inspector.
Other
Applican(_11Z4Date
Copy of plans sent Health Dept., Fire Dept., Other Date
The following data must be submitted prior to permit issuance: (Circle new itefn�aot the ked b . e),
1. Index permit for above items No. ) 13,
o�
2. Additional items req:u'i`red:
r
S 5
...Contractor, designer, owner, was advised of above required data by—phone _—nail counter by ..date
Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date
Plans checked by, Date Plans approved by ��— Date o2 -�
Sets of plans on hold in . File cabinet AP folder
Copy—DPW
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER -
_ - 3-7
ZONI G
d0
BUILDING PERMIT
OWNER
TELEPHO E.
a �
3 �/ y6
SQ. FT. OCC. BUILDING VALUATION
o o
OWNER'S 1--, �ILING A-qO5�
vM /b C 1 C CJ Cil -7 q- lT'Z
CON CT
ME
TELEPHONE
J CJ 7
CONTRACTOR'S MAILING ADDRESS
IAifl i L
CONSTRUCTION LENDER
UNKNOWN
Total Valuation I $ 411
V
Filing Fee
$
10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
;O
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 15 ,
Energy Plan Checking Fee
$ /5, r
ARCHIT NEER'S MAILING ADDRESS
Penalty -
$
UILDING -D SS
CP--r--r'A YvIS C
Permit fee
$
,
PLUMBING PERMIT
Filing Fee
10.00
Zr!O
Each Trap
2.00
/ 00
Solar or heat pump water heater
20.00
LOT NO.
5p,Vt/
SUBDIVISION NAME h-^
,+ i- lV Ovl 0T -410)2 �J
PARCEL MAP
Water piping
5.00
,Od
Each qas water heater or vent 5.00
r 0 0
USE OF STRUCTURE
SFXDuplex❑ Mobilehome❑ Other
// `` SPECIFY
Gas piping system 1 - 5 outlets
5.00
Q
Building sewer 5.00
' 00
Mobile Home S G I W 0.00e
TYPE OF WORK
Newx Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑
Describe work: _
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee
10.00
Main service V OR LE
100 AMP ORSLESS
10.00
101 ,90
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUsinesS
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUP.&\
OR ADONS. ACC. BLDGS. I
,/ZQsgn v Q
NEW CONSTR. ULTI.OUTLET 2.50 ea
NON-RESID BRANCH CIRC ITS
POWER APPARATUS 6
(SINGLE OUTLET CIR. )
Ex. Occup( OR FIXTURES eAl®30¢
FIXED APPLN5. OR
EX. Occup- OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee ;
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee
10.00
Heating
6.00
flu
Cooling
Hood 3.00
3,d
Ventilation 3.00
/p.6 v
Permit Fee ; ��,
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $ d
occ
CONST TYPE
TOTA $
HAz
cuA
PARK
SCHL
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L
1 PAR
PD
HD issuE
Th's permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
the applicable
resolutions
have
WORKS
Date
provi-
to do
been paid.
Receiot N.`�i 7
'! COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916:'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
42-60-37
ZONING
A-20
BUILDING PERMIT
�N I� / -1
?Eil'�jP
}ej�
S0. FT. OCC. BUILDING VALUATION
17 [2,000.00
O WNER'S MAILING ADDRESS
P.O. Box 4055, Chico 95927
420 M 5,880,00
Cooling
CONTRACTOR'S NAME UK
Owner
TELEPHONE
153 C 1,530.00
of Consent to Self -Insure.
CONTRACTOR'S MAILING ADDRESS ,{�
J
Fireplace A 1,000.00
CONSTRUCTION LENDER/
s
UNKNOWN
Total Valuation $60,410.00
Filing Fee $ 10.0
'LENDER'S MAILING ADDRESS
Permit Fee $316.00
to the W. C. laws of California.
ARCHITECT OR ENGINEER tl(� LICENSE NO.
ARCHITECT OR ENGINEER'S MAILING ADDRESS �1-
Plan Checking Fee $ 15,00
Energy Plan Checking Fee $ 15.00
Penalty $
Notice to Applicant: If after making this statement, should you become subject
BUILDING ADDRESS
Permit fee $356.00
PLUMBING PERMIT Filing Fee 10.00
2464 Streamside Ct . Chico
Each Trap 2.00 18.00
Solar or heat pump water heater 20.00
LOT NO.
53
SUBDIVISION NAME
\A✓Q,-LiJ U T �-4 A j_Q
PARCEL MAP
Water piping 1 5.00 5,00
Each qas water heater or vent 1 5.00 1 5.00
x� USE OF STRUCTURE
I--3
�
SF LDuplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00 5,00
Building sewer 1 5.00 5.00
Mobile Home I S I G JW I 10.00ea
TYPE OF WORK
New Addition❑' Remodel[] Utilities[] Installation❑ Other❑
Describe work:
Permit Fee $48,00
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
Main service 6004 OR LESS 10.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 2.50
NEW CONST.(DWELLING oCCUP.& X 43.00
OR ADONS. ACC. BLOGS. I 2/vtsgft
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury (check one):
�NON.RESID
l� am licensed under provisions of Chapt. 9, Div. 3 Of the Business
and Professi s C de an my license is in fu � force and effect.
License No. Classification
License
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR. ULTI.OUTLET2,50 ea
BRANCH CIRC ITS
(POWER
"' /POWER APPARATUS e\
OUTLET CIR.
Ex. OCCUp(OUTLETS OR FIXTURES 1.20@50C
0¢
Ex. Occup. OUTLETS PIRESID IFIXED APLNS RE A.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $63.00
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
MECHANICAL PERMIT FiIingFee 10.00
❑ The permit is for $100.00 (valuation) or less.
Heating
116.00
6,00
I have placed on file with the County of Butte Building Department
Dilal
a Certificate of Workmen's Compensation Insurance or a Certificate
Cooling
1
6,00
6.00
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
Hood
1
3.00
3,00
to the W. C. laws of California.
Ventilation
2
3,00
6,00
Notice to Applicant: If after making this statement, should you become subject
Permit Fee
$31.00
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
I certify that I have read this application and state that the above information Mobile Home Installation Fee $
is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $30.00
to building construction, and hereby authorize representatives of the County of occ CONST TYPE
Butte to enter upon the above-mentioned property for inspection purposes. $528.0
FEE 0
I also agree to save, indemnify and keep harmless the County of Butte against HAz CUA PARK TOTAL ALSCHE PAR 0 o ISSUE
all liabilities, judgments, costs, and expenses which may 'n a way accrue
again said Count in conse ence of the granting of this p�rmi
-2- 11 Gl Th;s permit is nereby issued unser the applicable p
ate sions of the Butte County Code and/or resolutions t
S. tore of P lic nt Owner Contractor Agent ❑ work indicated above for which fees have been paid.
lAn OSHA permit is required For excavations over 5'0" deep and demolition or construct- DIRECTOR OF PUBLIC WORKS
I--n"2 structures over 3 stories in height.
\ Itipt No. 70.00// 3�j By Date
L -D. P.W„ TELLa -A OR, TOR, GOLDENROD -APPLICANT PERMIT EXPIRES Date
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