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HomeMy WebLinkAbout042-600-0460'. 42c=' 514-91B,P,E, `DONALSON;Crag 1122 Str:eamside Ct , lot:' 10-A, ' nut Manor; Chico.' , (new single family)-qZ MMI �Vw an Q171 f p al _ , „111111 RU I NIIAL 42-60-46 514''91B,P,E,M DONALSON, Craig 1122 Streamside Ct,.lot 10-A,,Walnut Manor, Chico + (new single family) J OFF �Py Address—/O A GAS---- Meter By, Date ELECTRIC. Datehgf M—er..By — -- ;2292, s -K - �. log e 7 d- T_ I OFFICE COPY 1 Address // ??' 1 GAS Meter By Date Met y Date JOB FINALED (Date) i Signature 1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phond: 538-7141 747 Elliott Road, Paradise — Phone: 872-6307 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, or need additional explanation. olease contact this office immediately .4--1 1 rS _ v t v„ Date`� ` / Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 r 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE �bn ► A L 614 t.v r - ( O R -t B 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, or need additional explanation, please contact this office immediately. `h0 revT '�R11UvNlC Date 6-(-7- 9 Inspector lei^ r� ��.:" y;.�� •'LT. r. _(V.-' ,F.1,. •:...1C-`-aj.ith 3,__v-L.1..-�y:�ii..C'•�. yr y ..-..-.?at���'+.•'7 ., -}CTOUNTY.OF BUTTE.'.. . DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico -.Phone: 891-2751 7 County Center Drive, Oroville _Phorie: 538--75471 ` 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE LOT R P 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, or need additional explanation, please contact this office immediately. a Date 6 "1 z — -1I Inspector A ;UA, - -41 _ Owner �� Permit N6'.- ENERGY o'.ENERGY CERTIFICATION LOCATION A.P. NO. ROOF MATERIAL THICKNESS DESCRIPTION OF INSULATION BRAND NAME THERMAL RES. EXTERIOR WALL MATERIAL FIBERGLASS BRAND NAME. CERTAINTEED THICKNESS THERMAL RES. 3 CEILING " BATT OR BLANKET TYPE �RAND NAME CERTAINTEED • THICKNESS l Q p THERMAL RES. IP -fl LOOSE FILLTYPE INSUL-SAFE IIIBRAND NAME, CERTAINTEED THICKNESS 1--j- -THERMAL RES. 3p FLOOR,ELEVATED MATERIAL FIBERGLASS BRAND NAME CERTAINTEED- THICKNESS THERMAL RES.. FLOOR, SLAB MATERIAL BRAND NAME THICKNESS THERMAL RES. DTH .�... S WALL MATERIAL BRAND NAME . THICKNESS •�. �� THERMAL RES. �J I HEREBY,CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE ABOVE BUILDING IN CONFORMANCE WITH.THE STATE.OF CALIF. ENERGY REQUIREMENTS'. SHASTA INSULATION INC. #530235 _AI Rht NA ERSTATE CONTR. LICENSE NO. ereby cern y the above insulation and all required items as shown on the Building Depart. approved plans and attachments have been installed as required by the State of California Energy Requirements.. All equipment, devices and materials are of the.quality prescribed or a specifically approved by the State of Calif. _ d 1AL-5--z�-----------------=-------=------------- FIRM NAME/OWNER (PLEASE PRINT) STATE CONTRACTOR'S LICENSE NO. ATURE OF GENERAL CO-9-TRACTOR/OWNER I V . DATE -This certificate -must' -be on file with the BUILDING DEPARTMENT prior to final inspection approval and a copy shall be posted within the building. _ JANUARY 1984 .Y'T".+-cR• *,e J=dK 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-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L" ft. / /"Nat. or/ /" 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 \ v A 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.-Bracing 5. Alum. Awn.; Columns -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-Panelboards-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 d=OK O=Not OK - = Not Applicable Not Ready RESIDENTIAL (; ' = Date UND FLOOR (Plans) OIC except #'s ing-Setbacks-Easements-Flood-Slope Main; Soils-Elec. Grnd.-/ /" Fig. Depth . F ., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth g., Porches & Decks; Soils -Steel-/ /Ftg. Depth Stte nwalls, Main; Steel -Bloc kouts-Wrapped temwalls, G rage; Steel -Bloc kouts-Wrapped 6a. I Downs nd Special Anchors S ; Stse -Wrapped 8.Kers-Fireplace Ftg.-Steel D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. 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 DateG %q/ Card B-1 Date Card B-1 Date J_ -J7-91' Card B-1 .rn Date Card B-1 Date PLUMBING (Permit) OK except #'s 1ijtater Htr.; Vent -Access -Combustion Air -Baffle 1 Water Pipe; T t & Anchor -Nail Protection W.V. T Fittings & Anchor -Nail Protection 19-501hower Pan; Test, First Floor -Tub Access 2Q ---est Tub & Shower, Second Floor -Tub Access Gas Pipe; Size & Anchors Date Q -Q,4. � Card B-1 C.I.Q Date Card B-1 Date i-Jq,,0 Card B-1 GG Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection Uo'Elec. Receptacles Spacing -Lights & Switches at Doors Size Boxes & No. of Conductors -Stapled 2 omex Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 2 2 Appliance Circuts in Kitchen & Conductor Size/GFI Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size /t0/ ga. © or Al 23' Range Circ. /!2/ ga. Cu of Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No ,36!Service-Riser Conductors & Ground -Main Disconnect 34!Equip. Clearances Panels-Motors-Mech. Equip. lothes Closet Light -Shower Light -Spa Light . Smoke Detector Date [o./2,C ( Card B-1 &r, Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s P^A.C. Ducts Insulation & Support aVent Fan; Exhaust above insulation 3iw.Gondensate Drain & Overflow; Size & Grade 3ZFlirnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38.-A"ic Access & Platform if Furnance in Attic Date Card B-1 [.,CS Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 30-Sils, Proper Material & Anchors Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) �Furred Ceilings -Stairs -Chase 44 Headers & Beam -Size & Bearinq (NOTE: An entry must be mad jingle & Duplex) Date FRAMING (Continued) 45. ers-Post Caps -Anchors -Connectors Cing. Joist-Rftr. ties-Purlin-roof erac s- hthng.-Ring. 4 Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. -Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49!Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing qy. Property Line Firewall & Openings Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 39-6tairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54., pl ood on Roof Overhang -Attic Vents -Rafter Outriggers &6 -Nailing Veneer Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access S<Glazing Area -Glass Protection -Skylights -Plastic. 58p. l ear Walls; Nailing -Bolts g5 Infilt ntiosuWtion-Ways-CeiVrrgs . n -W s-Wi ows is-ZO-til Ir -144 -NX, r 1LWr. COKe M - GG _ 6-4-1 AI - LtfFM f1IQtWALJ 1,44- plk Date ( ,V- P,07� Card B-1 Cram.,. Date Card B-1 Date Gard B-1 (.,4 Date Card B-1 t L (Plans) OK except #'s cfxt. Steps -Door & Sidelight Protection -Landings X2oke Detector F rnace; Vents -Clearance -Comb. Air -Connector - Garage; Above Floor-Ducts-Mech. Protection T room Exiting .F.I. & Bath Fixtures & Tub Access -Spa EIiy"Trim & Subpanel; Breaker Sizes & Labels 69iA & Rails ML F/ ep ace or Stove; Clearances -Hearth c. utlets at Wood Panel; Int. & Ext. K' . i . & Appliance; Grnd.-Air Gap -Cooking Clearance I . Outlets & Receptacles at Kit. Counter l5araq± Fire Door; Swing -Landing -Closer uct in Garage -Damper Wtr tr.; Vents -Clearance -Comb. Air-Connector-P.R.V. G age; Above Floor-Mech. Protection P ,Elec. & Mech. Equip. Listed for Location Ofec. Receptacles in Garage; (G.F.I.)-Romex Protection Insulation -Foam -Looked in Attic ❑ Yes GMrd Rails & Deck Construction -Post Caps 1•� nts & Crawl Hole Door -Drainage & Wood -Earth e ance Looked under Floor 11 Yes F lowing instld.; Drivein Yes 0 No; Walks V Yes 0 No; lanters V1 Yes VNo (K./.C. Unit; Disconnect, Electrical, Plumbing Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Op Ings , er Well; Disconnect, Electrical, Plumbing rior Elec. Trim; G.F.I. Receptacle -Underground entilation Throughout House i from Previous W ter & Sewer Connected -C/O to Grade -HD Approval 9 . Energy Compliance Certificate -Other Certificates 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: I e each time you visit job site) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Dr Iva - Orovllle, California 96966 • Telephone, 010/538.7549 514-9 APPLICATION AND PERMIT, 42-60-46 S OWNSR TE69PH Nr. Crai_ Donalson 3 OWNER'S MA161NG ADORES P 0 Box 4055 Chico 95927 BUILDING PERMIT SQ. FT. OCC. BUILDING VALUATION 420 M 5,880-00 CON Owner TELEPHONE 153 (21 1,530.00 CONTRACTOR'S MAILING ADDRESS Fireplace A 1,000.00 CONSTRUCTION LENDER UNKNOWN Total Valuation 1 $ 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 1122 Streamside Ct, Chico Permit fee $ 356.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 9 2.00 Solar or heat pump water heater 20.00 'LOT NO. SUBDIVISION NAME PARCEL MAP 10AIRM Walnut Manor Water piping 5.00 b.UU Each Qas water heater or vent 5.00 USE OF STRUCTURE SFU Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 1 5.00 Mobile Home S G W 10.00ea TYPE OF WORK NeQM Addition ❑ Remodel ❑ Uti Iities ❑ Installation ❑ Other ❑ Describe work: Master -60--88 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 10.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I de la under penalty of perjury (Check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions] de- and my license is 'in f force and effect. License License N• t 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.BI , OR AODNS. ACG. BLDGS. ) /20sgft 43 00 NEW CONSTFL MULTI -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS /POWER APPARATUS .&) (SINGLE OUTLET CIR. ) Ex. OCCU OUTLETS OR FIXTURES 2ALO3 t P 1.20050t FIXED ALNS. Ex. OCCUp. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 15.00 9 Permit Fee $ 73. WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ e permit is for $100.00 (valuation) or less. 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 Filing Fee 10.00 Heating Cooling g 1 6.00 6.00 Hood 1 31-M 3.00 Ventilation 2 3.06 6.00 _ Permit Fee $ 31.00 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby 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 againstHAz. all liabilities, judgments, costs, and expenses which may in any way accrue against said Geunt in consequ e.of the granting of this per it. -- L. Date - SIature of pp. ica t - Owner ❑ Contractors Agent An OSHA per is,Y quired for excavations Ov r S'0" deep and demolition or construct- ion of structures over 3 stories in height: Mobile Home Installation Fee $ Energy Inspection Fee $ 30.00 coN T P - TOTAL F $ 538.00 '000 cu PAR s H F CDF PAR P I r, Issu This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By 1�4Date PERM EXPIRES Date K •'� F '' //// Receipt No. ?J �- Z -Y rO(� WNITE-O.P.W., YELLOW -ASSESSOR, PINK -IN CTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET / Permit No. OWNER ��o Dal 1,4 A. P. No. Proposed Building Use Building Inspector Date �5 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE 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 %`makinstructions.... (•...o� ••••• �•1.7�v�•• •••••••• 0. Fees of $—T / V x 11. ' Chico Urban Area fees paid ............ .�j( � • ,� / cl% .Park fees paid ....................... ��.�. �.yr ......... . l/ S� School District fees pal 67 5_. Z / 14. Sanitation approval from Health ep x men )r 5. 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: ..... 18 Improvements may be required. Contact Land Development Section DPW /4 Driveway permit (construction approval required prior to occupancy) required . Pre-Inspec. request to Date) 20. Pre -Inspection for q Building Inspector 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner 0, Mail to owner o) ..... fl f x . Recorded copy of Agricultural Acknowledgment Statement ....... 25. Letter of signature authorization ................................... 26. 27. When you sue the permit, process as follows: Mail too owner. Mail to contractor. eIephone and hold for pickup at C�office. Deliver w/inspector. Other -a f Applicant i) ! (—'' - Date Copy of Haz-Mat form sent Health Dept. —Fire Dept. --Air Pollution Date Copy of plans sent Health Dept. —Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new I no c c . d bov 1'. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---jnaiI _counter by .date Contractor, designer, owner, was advised of above required data by—phone —mai l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder "nn 09 '34sg)ri "S DOD MoUr I uo uoW 9 Lwo+litn to V! fta P'W 'OL -14=V q+tA 19 1 . 41 ma" p AWW3 *"a^ p WOMAK'aa of moif umqwmd vow^ V"m mugs uo Suolpjolle jo Seametp, Auff oi*w al 1"ejun m tj pui Sawl 4 110 10 901 444 UO j" sq. Imw -w%mwads p —1�*- P. pf va- '?'al VN 1al r GATE OF APPLICATION COUNTY AP. No. CITY OF CHICO APPLICATION PERMIT. PERMIT NO PROJECT ADDRESS :, 441 MAIN STREET/P.O. BOX 3420 PHONE (916) 895-4891 pri 1 11 1991 11042-07-147 1137 L., '486, 2484, c480 2476 474 470, 466 LOT BLOCK SU (VISION ZONING OCCUPANCY REQ. UNITS 4, n t manor MASTER PLAN PLAN NO. _ -460 2458 Stream d al un OWNER: Crai Donal son UAT USE/VAR. NO. STORIES TYPE CONST. BLDG. USE PARKING SPACE AREA SO. Fr. OWNER'S ADDRESS: P.O. BOX 4055 342-8463 LESSEE: PHONE: BLDG. USE/DESCRIPTION OF WORK' LESSEE'S ADDRESS: Lots 2A 2B, U13A BB 4A 4B 5A 5B 6A °°"T""CT°R' Dona 1 s on CITYgust"E� LOC. BU 10A 10B 15A 15B A TRA MMAa. O°AD°DRESS; P O Box 40553421-8463— PHONE: lateral ohne 'o ARCHITECT ENGINEER OR DESIGNER STATE LICENSE: O CONNECTION ARCHITECTS ENGMEER'S OR DESIGNER'S ADDRESS PHONE: 'AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER Vin DEEP AND DEMOLITION OR CONSTRUCTION OF STRUCTURES OVER 3 STORIES IN HEIGHT. LICENSED CONTRACTORS DECLARATION PLUMBING PERMIT PROCESSING OTT. FEE SUMMARY OF FEES Acct. No*. 1 hereby affirm that I am licensed under Me provisions of Chapter 9 (commenting with Section 7000) of Division 3 of the Business Professions Code, and my license Is In FIXTURE TRAP BUILDING P/C. 16-476 full force and effect. BUILDING SEWER License Class Uc. Number, " WATER HEATER AND/OR VENT GRADING PLAN CHECK 10-476 Dates � lam— Contractor (��! ' GAS SYSTEM SS APPLICATION S 31-487 OWNER -B ER DECLARATION % INSTAL. ALTER REPAIR WATER PIPE OFFSITE (MPR. P/C 10474 I hereby affirm that I am exempt from the Contract es License Law for the following ANTI-SYPHON/BACKFLOW PREVENTOR reason [Sec. 7031.5• Business and Professions Code: Any city or county which requires permit to construct, atter, Improve, demolish, or repair any structure, prior to Its Issuance, SEWER MAIN EXTENSION ENERGY P/C (EST.) 10-476a also requires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 [commencing with Section 70001 of Division 3 of the Business and Professions Code) or that he 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 TOTAL PLUMBING FEES TOTAL FEES PAYABLE AT TIME OF APPLICATION hundred dollars (3500).]:PROCESSING ❑ 1• as owner of the property, or my employees with wages as their sole compensation, ELECTRICAL PERMIT OTT. FEE will do the work, and the structure Is riot Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of prop- SERVICE/SUBPANEL BUILDING PERMIT 10-425 erty who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are riot Intended or offered for sale. If, how- CIRCUITS PLUMBING PERMIT 10-425wn nn ever, the building or Ionprovement Is sold within one year of completion, the owner -builder RECEPT SWITCH OTHER OUTLET ELECTRICAL PERMIT 113-425 will have the burden of proving that he did riot build or Improve for the purpose of sale.) POWER APPARATUS APPLIANCE MECHANICAL PERMIT 10.425 O I, as owner of the property, am exdusivey corrtractirg with licensed contractors to construct the. project ISec. 7044, Business and Professions Code: The Contractors License Law does not appto an owner of property who builds or Improves thereon, and lbr contractor(s) [loomed to the Contractor's SIGNS GRADING PERMIT 10-425 who contracts such projects with a pursuant Lican9e Low')' NEW RESIDENTIAL .025X - TEMP POWER STREET FACILITY IMPROVEMENT FEE 29.485 816.00 0 1 am exempt under Sec. B. a P. C. for this reason SEWER TRUNK LINE 30.488 Date Owner TOTAL ELECTRICAL FEES SEWER WPCP 31-487 paid WORKERS' COMPENSATION DECLARATION SEWER MAIN 32.488 I hereby affirm that I have a certificate of consent to sell -Insure, or a certificate of PROCESSING Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.). MECHANICAL PERMIT OTT. FEE PARK FEES 41-478 MECHEXHAUST -HOOD/DUCT' PARK FEES 44478 PolicyNoO57674990 Cornto Fund Oy Certified copy Is hereby fumished. / CXCertt ied Copy Is flied with the dtybuil Inspedbn dMslori.` / VENT FAN SINGLE DUCT STORM DRAIN 26-493 none ,• ( / { �` COOLING Date'y7� �— Applicant t / - H TING IN -LIEU (STREET) 25-497 WOODSTOVE ALLEY IMPR. 25-498 CERTIFICATE OF EXEMPTION FROM ORKEAS' COMPENSATION INSURANCE (Tht is section need not be Completed the permit Is for one hundred dollars ($100) or ENG. INSP. FEES 1D-474 less.] le artly that In the performance of the work for which this permit Is Issued, 1 shall not PLAN MAINTENANCE FEE ' 10481 employ anype neon In any manner so as to become subject to the Workers' Compensation Laws of CelR�rtlla. TOTAL MECHANICAL FEES SUPP. PLAN CHECK FEE 10-476 Date Applicant OTHER: NOTICE TO APPLICANT: ff,after making this Certificate ofExem on, you should become DEPT. APPROVALS REQ.: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shelf be deemed revoked. ❑ HEALTH • ❑ PLANNING ❑ ARB ❑ ENG. ❑ SCHOOL ❑ FIRE CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending aggency for the performance of the work for which this permit Is Issued (Sec. 3097, CN. CI El OTHER Lenders NameTOTAL (.enders Address APPROVED BY THIS APPLJCATION BECOMES A PERMIT FE PAYABLE AT t i7=' ( '� ' I'- � V{WDATED. TIME OF ERMIT ISSUANCE p� ❑CASH _r CHECK', I 3,840.0 comity that I have read this application and state that the above Information Is correct. X : I agree to oomdy wlth a8 city end county ordinances and state laws relating to building SIGNATURE OF AP LICANf OR AGENT corhslnlcton, end herhby e e representatives of this city to enter upon the above- mentioned property for Inspection purposes. I VALIDATION OWNER ❑ CONTRACTOR , ] AGENT ❑ BY: k t ,'.W,. ` 9-. `_4111 DATE nwTC 44nitilra WORK NOT RF COMMENCED 9/89,1M Ingo rc M" V PERMITTEE COPY .o'"