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043=700,0 01-2397
GREEN FAMILY TRUST.
13 KINGSBURY CT, CHICO
CONT: BAIRD ROOFING
REROOF
„.-»�.-•x+-ir . w •F:m } r ��, . .-. � : ..-•. �,r. � i fx. _ wr«..v+^v-r:'+S:+wY .✓�.slIGA'FiVI`'ii�';i' "-c+r: "xF`]+�..,w•aK>yc,,�” y��,: ���1�•�.eAt.�l
COUNTY OF BUTTE -DEPARTMENT OF'DEx'✓ELOPMENT SERVICES -BUILDING DIVISION
7County'Center Drive Oroville, California""95965 • Telephone (530) 53$-7541- PERMIT No.
(Rev. 12/96) APPLICATION°AND PERMIT `7
ASSESSOR PARCEL NUMBERC) ,
i( j
ZONING
BUILDINGPERMIT
OWNER
C, AFr AJ
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAIUNO ADDRE88�IRS
/ l -fi_
_
CONTRALTO '.
_ //I/
TELEPHONE
r�
'
.
coNTRAomA,ff UAsuwAbDRE j {/� J1
%i'1 ! l 1, b
CONS CTION LENDER ° '+
i
Fireplace
a
LENDER'S MAIUNO ADDRESS _
Total Valuation $
ARCHITECT OR ENGINEER i
I
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
V
ARCHITECT OR ENGINEERS MAIUNG ADDRESS -
ti.
Plan Checking Fee $
BUILDINGADDRESS
' w '
/V
Energy Plan Checking Fee $
$
" f
i`�f I
PERMIT FEE $
LOT NO.
AM
SUBDIVISIONS NE
PARCELi
PLUMBING PERMIT
Fling Fee •20.00
USEOFSTRUCTURE
fSolar
SF ❑ Duplex 13Mobilehome ❑ Other I
SPECIFY r.
Each Trap
7.00
or heat um water heater
23.00
Water piping
1-5.,00
Each as water heater or vent
15.00
TYPE OF WORK r"
I..
New O .Addition ❑ Remodel Ublities ❑ initallation ❑ Older ❑,
Describe Work: • — ry ((�
Gas piping system 1 - 5 outie
15.00
Building sewer
15.00
Mobile Home': "'S W
020.00
, r
PERMIT FEE t
ELE&RICAL PERMIT
Fling fee , 20.00
1
Win -23:00
Win- Service =OR mss
l
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 vforce and effect: /r ' // a
'License Class ��% Lic. No. /,' I ��"Y/
`'`OWNER' -BUILDER
t
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:I
❑ 1, 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 l
Main Service pw TO IOWA
46A0
NEW CONST DWELLING OCCUP
OR ADDNs. ( i ACC. BLD..
s0
3.50
NON RESID. CONST.EW MULTFOUTLET CIRCUITS
��� .
PowER APPARAruS
a swGLE OvnEr c.
F!PErf .DECLARATION Ex; OCCU OUTLET
20 ®I'0°OR
BAL 0 .so
FlXED . OR
Ex. Occup - o RESID. EA
5.00
Tem orar S ce
23.00
Mobile H e Facilities
20.00
Misc firing
23.00
PERMIT FEE $
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of thIe following declarations:
❑ I have and will maintain a certificate of Iconsent 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.
49 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 UA %-f %I'llAll-7 I
Policy Number 64. 177,1-`+f��
(rhe above sections need not -be if the permit is for work of a valuation
of one hundred dollars ($100) or less.)TiST.
❑ 1 certify that in the performance of the work1for 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
/ 31- Dateq1,00()11_J1
Sig nafure f App icant - ❑ Owner 10,Contractor ❑ Agent ".
An OSHA permit is required for excavItlons over 60" deep and demolition or construction
of structures over 3 stories in height. I
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEI: $
Mobile Home Installation Fee $
Energy Inspection Fee $
TYPE
TOTAL FEE $
"AZ.
o. PEES IMP
FLOOD
CDP
PARCEL
PD
HD
UE i
This permit is hereby Issued, under the applicable
ofthe Butte County Code and/or Resolutions
indicated above for which fees have been
By Date
PERMIT EXPIRES ON 0,2-0,022
provisions
to do workX
paid.
to
Receipt No.'
WHITE-D.D.S.-B.D. NAR -ASSESS R I PtNK"-INSPECTOR .,GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELO�MIENT SERVICES -
7 County Center Drive 9 Oroville, California 5965 • Telephone
(Rev. 12/96) APPLICATION AND PERMIT
BUILDING DIVISION
(530) 538-754161PERMIT NO.
ASSESSOR PARCEL NUMBER _
ZOMNG
BUILDING PERMIT
OWNER
ILI
TELEPHONE
SQ. FT. OCC. BUILDING VALUATIO
�� 1
. OWNERS MAIUNG ADDRESS /
C/5!06
CONTRA '8 E - � �
T N /
.
CO MAILING TODRE
CONSTRUCTION LENDER
Fireplace 0 0
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $ V .
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
'v v'
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECS
Each Trap 1 7.00
Solar or heat pump water heater 23.00
Water pipinI
Each as water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel UdUti7es ❑ Installation Other ❑
Describe Work: N ► Qp d rb
Gas piping system 1 - 5 outie 15.00
Buildingsewer 15.00
Mobile Home W Q20.00
PERMIT FEE $
E TRICAL PERMIT Fling Fee 20.00
Main Service 2�0. oa Lss 23.00
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 Jpll f0 ce and effect/ �lQ/
License Class Lic. No. �Q�31 �
OWN ER -BUILDER 3DECLARATION
I 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.
❑ I, as owner of the property, am exclusively contracting with licensed contractorsisc
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.
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' colTipprisation insuran a carrier and policy number are:
Carrier J'✓
Policy Number
(The above sections need no be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
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 section 3700 of the Labor Code, I shall
fo with comply with those r isio s.
X Date
Signa ur � pplicant - ❑ Owner ontractor ❑ Agent
An OSHA permit is required for excava ns over SO" deep and demolition or construction
of structures over 3 stories In height.
Main Service 200A TO 1000A 46.00NEW
CONST. DWa ACC. aLDsELLING OCCUP. sO
OR ADDNS. ( . 3.5QFr:
NOIEREW 6D. MULTI -OUTLET
PS0 APPARATUS
a sINGLE oLITLEr aR
zo ®1 .00
Ex. Occup. OUTLET OR SAL .50
Ex. Occup., °° R�,o•° 5.00
Temporary S Ice 23.00
Mobile a Faces 20.00
irin 23.00
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
41171111ST. TYPE O
$
IIAZ.
D SEs IMP
PLOOD
cDF
PARCEL
PD
HD
uE
This permit is hereby Issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
ey Date W� V
PERMIT EXPIRES ON 4 C--01 02-:-.-
2WHITReceipt
to
No.
E-D.D.S.-B.D. NAR -AS ES R - NSPECTOR GOLDENROD -APPLICANT
WHITE-D.D.S.-B.D.
rl A 1i';i tl) JI !u. llclfl ri "! 9 .
--Date- -MOBIL•EHOME-UTILITIES-(Plans);OK qrs j
-;'
: ' 111111 ::•Gli
except -
-•Date-- '-DECKS •COVERS, -CARPORTS -ETC (P.tans)-OK'-except�/rs-•-r -
-------1-2o
--' ---1-Zonin Re; uirements Setbacks ;Easements? "- ' —'
-
'= 1,-Zonin , e ulrements-Setbacks ,Easements
Solis,;Spec,lal'.;MHISupport=SkeCch ., 1:1_.Iu);v .,: l2 hfi j'
2 Footings-.:Size,Depth-Spacing-Connectors ,e n
3.,iSewer; Locauo'nr Test,,,Fall G/O-Concrete; n Ln.�+,rt;,,.fc -�
„ „Decks Girders and/or Joists-Deckln Bracm Stairs. Rails
, ..3+ _ -_, l !_ 9 9- , ,-
4 Water;'Locatton-Test-Easement-Neededi(Sket F,, ,i"
4; Wood Awn ;:Posts=Beams RLfrsf Connec Shthg:.Rig'-Bracing
5. tLocahon
_Electricity Clearance"s: Grnd_ /I_ @ /?bAmp Concret_et�
_ _ _-i Y5 :Alum Awn7Col'umirs_Co'rineclions Splice_ Decal=Enclosu es
P. -Y" plat "or7 r iL L ft /• / LPG'•
_6 : GasLocatlori-Test_ Wrap:'/t3 / L`'ft /
6.. Carports;rW,indows-Door's
7,- Utility Clearance
7 Elec
- --- -
7-, -
---Card-B I. .-Date `- . • -Card B1-'- -_Date
Card -Bl... Date._tTorcu2 l,.i,es>_Card 81;,1 _,- r: ;,Date q _^,t.
Card -BI Date aFFCI Card BI Date lsr�'. Id br'. i!
.- -
.Card'' -BI Date:+, t.;%-clr eliCard;B_ b+3'rcr!it "DaSe�z ou,iFJ „r
- s ".
Dat -e_.__ MOB IL_EHOME�INSTAL-LA_T.IW(Pfans);.OK except tl_su�-_____.._!� 4 F'jj
Date' POOLS (Plans) OK except N's
_.-� _�1.._ZoningRequirements Setbacks=Easements....._"_��__- i;.-_
.__ _1._.Setbacks,-Easements--__�_. _._.__• ._,'
.2: Footings;Size-Spacing-Marriage Line !i
_. 2.._Soils;_Cornp96tlon'-Structure`'Stability,.__:_.
' f^•.:'4 '1J 'r I 7) ,jH117 -i J V (I
-.. .3: -Gas -MH-Test-Demand-Va+ve-Connector-- -
. .. •u _.
-P_ooI.Sirucfu'r`e;.Stee l-Connectiong�T.hickness=Dead-Men-.Lining- --
- ----4.-Eleciriclty�MH'.Tesf-Cr6soyeis-Bieakers-Clearances ----j
`4. Elec.; Receptacles and Lighting, Distances-GFI
- 5: Drain;:MH Test-Fall�iFlex Connector _ R;.' - -�
-Elec.; 51 volts-GFf -
6. Water;;NIHJTesERegulator Connector121,, e Srll ';,jj
- --6"Elect Enclosures CondurGEnirles Terminalsl,Listed
7, Water and Sewer Connected -C/0 uo Grade-HDlApproval., �.
- -
-7; Elec. Bonding yMetal w/5, C rc---ting-Equfpment,;Heatee;'
__ _ _ __8,_Gas,and.Eleciricltj Taggedf + zw'. lx t r 6P ,! R ;I
- -
8 Elec.; Grounding,/Equip w/5'=Circulating Equip:;=Podt.L'gh(g
Boxes Enclosures ;P.anelboard_s Ins7,4tdfMain in:Conduit•t'
_- - -
-
-�- -- - 10; Cert.,of Occupan.
-•,9 _:Health..De_ p.a_rtm.. ent:A_p_ proval._`'-l.ull
- 10.-uPllirnb; Cir. Test -Water Supply. Test .
Card,B71 Date Tc,ir,lin ri'i; Card,Bl J , ;,q,� x Date(,r) .;>7=Fa .�� i1,
-Card -BI Date - - Card,Bl _ -Date a_.
'Card:e-I• Dete i�ai+t, ;inCard BI,.I�,,a> >.,,r,Date�'Jt.r>t>;=? .C8-_' -� ;
.Card=Bl' `-"'-'Date "Card=Bt' �"'--Date -' -- -'
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qS ! OSI lOi JIJ Y tr dJ +Q $ f+[ Gt 1+- •bC
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1
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V = OK
0 = Not OK
- = Not Applicable
* = No3.Read,y ,
14
RESIDENTIAL (Single and Duplex)
Date
UN L00 Plans OK exce t#'.s '
Date FftAMG Continued
Zo requirements -Se tbac asements
Aperty Line Firewall & Openings
Main; Soils -Steel -E1 nd.- / ! /" Ftg. Depth
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
t Garage; Soils -Steel- / /" Ftg. Depth
r6? -'Stairs;
Width -Headroom -Rise -Run -Landing -Fire Protection
4eTtg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
Plywood on Roof Overhang='Attid Vents -Rafter Outriggers
mwalls, Main: Steel-Blockouts=Wrapped-Slab
52.
Siding -Nailing -Veneer
Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
.
S c esh-Dr Screed -Fd - ss
to/iers-F'
-feel
!
bD.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test
.
_
Glazing Area -Glass Protection -Skylights -Plastic
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10. Water Pipe: Test-Anchors-Regulator-Seryice Test
11. Electric; Underground
12. Plenums &_Ducts; Clearance -Material -Support - Ins.
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
!,/, r/, �N
Y
(--fi�l3
Card -BI
Date Card -BI Date
Card -BI
Date Card -Bl Date
Card -BI
Date Card -BI Date
Card -BI
DateCard-BI Date
Date FINA ans) PK except #'s
Card -BI Date Card -BI Date
Date
PLUMBING (P' OK except #'s
5
. St -Door & Sidelight Protection -Landings
.
S Detector
Card -BI
Card -Bl
14. r Ve Access -Combustion Air
ft
r Pipe: Test & Anchors -Nail Protection
.W.V.: Test=Fttngs-& Anchors -Nail Prot ection
1 ower Pan: Test, First Floor -Tub Access
Tub &I Shower, 2nd Floor=Tub Access
Gas Pipe: Size & Anchors
Sn�
Date / �/v Card -BI _ Date
Date Card -B1 Date
urnace; Vents -Clearance -Comb. Air -Connector -
arage; Ab'ove.Floor-Ducts-Meeh. Protection
•
�oom Exiting
G.E."—Bath Fixtures & Tub Access
lec. Trim & Subpanel; Breaker Sizes -Labels
r
eplace or Stove; Clearances -Hearth
Ele utlets at Wood Panel; Int. &•Ext.
ixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
6 .
EIe tlets & Receptacles at Kit. Counter
Date
L . AL Permit OK except #'s
6
arae r; SwIng-Land ing-Closer
.C. Duct in Garage -Damper
Card B -I
Card B -I
_
ture & Transformer Clearance -Ins. Protection
eceptacles Spacing- Lights& Switches at Doors
Si oxes & No. of Conductors -Stapled
R Installed Close to Edge of Studs &[C.J.
p. Ground made up w/Meth. Fasteners -Bond Gas & Water
ppliance Circuits in Kitchen &Conductor Size
Su ed Wire Size / _ / ga. Cu or AI-A.C!. Wire Size / / ga. Cu or AI
ange Circ. / ga: Cu or AI-O,ven Circ. / / ga. Cu or At,
In +eted Neutral Yes No _
Riser Conductors &Ground Main' Disconnect
E c?, Panels Motors Mech 1 Equip.
3 I Closet' t -Shower Light
- --- - - ----- - .--.------
-- ------
Date Card -BI Date -_
Date Card -BI Date
tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In e; Above Floor -Meeh. Protection
•
Plb ec. &.Meth. Equip. Listed for Location
7
eceptacles in Garage; (G.F.L)-Rome �otec.
7
Ins -Foam-Looked In Attic es
7
uard Rails '& Deck Construction -Post Caps
zd
Fa -n Crawl Hole Door -Drainage &.Wood -Earth Clearance
Looked der Floor ❑Yes Zj
75
owing instld.: Drive s E] No; Walks. E -�es�❑ No;
P ers ❑Yes o
S o' Brown -Finish
7t;.
Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
"Vents Above -Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
8for
+ Disconnect, Electrical, Plumbing
Elec. Trim; G.F.I. Receptacle -Underground
g
e ti throughout House
aa-161.-c
n
Date
ME NICAL (Permit) OK except # s
8
rrecti Previous Inspections
t -Meters Tagged; Gas -Electric
Card -BI
Card -Bi
vDucts. Insulation &'Support -
t'Fan: Exhaust above Insulation
ondensate Drain & Overflow: Size & Grade _
rnace-Vent: Access -Comb. Air-Retu4Air Vent -115V outletttic Access & Platform if Furnace in Attic
OA
-
Date Card -BI Date -
Date Card -BI Date
er &Sewer Connected -C/O to Grade -HD Approval
nergy Compliance Certificate -Other Certificates
—
Card -BI
Date Card -BI Date
Card -BI
Date ICard BI Date
Card -BI
Date Card -BI, Date
Date
FRAMING(Plans) OK except #'s I
Com lents at Final:
&__811 Is, Proper Material & Anchors I
O7. Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound
3 earing Walls over Girders & Floor Nailing
aft Stop in Walls (rat proof) -- _-
I' tops :_Furred Ceili_n s- Stairs-Chases-Tub
& Beam -size & earn
4. Hangers_< --Anchors- nectorsl
4 Cing. Joist-Rftr. Ties -Pur lii� -Truss-Shthnq.-Rfng.
44. F eplace Ties or Type A Flue -Fireplace Throat
tic Access: Size & Romex Protection -Draft Stop -Ins. Baffles
B m. Windows or Exiting Doors -Sill Hgt.!& Dimensions
. Garage Fire Protection Framing
--
—
_
--
- --
(NOTE Anentry must be made each time you visit jobsite)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
_ 196 Memorial Way, Chico — Phone: 891-2751 1
'{ 7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
WN -�
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.
f
�sL
Inspector Date
COUNTY. OF BUTTE
DEPARTMENT OF'PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7.County Center Drive, Oroville — Phone: 53.4-4541 _
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PEERMI T -NON/O' .
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.
i�
azalmmfim— ✓��i`
Inspector__ _ Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico- Phone: 891-2751
t 7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
OWNER
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 complete8. If you have any question pertaining to this
it r need ad lt onE=ease contact this ffice immediately.
. (kfwers Steve' Lane Construction
#13 Kingsbury. Ct.
ATION
Permit No.
CER,TIFIC,ATION
DESCRIPTION OF INSULATION
A.P..No.
ROOF
Material.
Brand:Name
Thickness(inches)
Thermal Resistance. (R: Value)
EXTERIOR WALL
Material Fiber lass
Brand Name Certainteed
Thickness(inches) 3P
Thermal Re.sistance(R Value)
R-13
CEILING
Batt or. Blanket 'type Fiberglass/BattBrand Name Certainteed
Thickness(inches) 1011
ThermaVResistance(R`Value)
R.-30 \ .
Fil1.:Type Insul-Safe III
Brand •Name,-Certainteed
Minimum ThicknesI(Inche9) 11."
Number of Bags Wt. per bag
lb.
Area covered(ft. ) 148
Thermal Resistance(R Value)
R- 0
FLOOR, ELEVATED
Material Fiberglass
Brand Name Certainteed
Thickness(inches)
Thermal Resistance(R Value)
FLOOR, SLAB
Material
Brand Name
Thickness(inches)
Thermal Resistance(R.Value)
Width(inches)
FOUNDATION WALL
Material
Brand Name
Thickness(i.nchcs)
Thermal Re'sistance(R Value)
I hereby certify that the above insulation
was installed in the above
building
in conformance with the State.of California
Energy Requirements.
Sha a.I sulation
# 272941
FIRM 11`tE 41r1iR
STATE CONTRACTOR'S LICENSE NO.
7-10-87
SIGNATURE OF INSTALLATION APPLICATOR
DATE
I hereby certify.tinsulation and all required items as shown on the
Building Department.approved.plans and attachments have been installed as.
required by the State of California'Ener Requirements.
All equipment, devices and'muterials'are of the quulity prescribed or -are'.
specifrae .11y approved by the State of California.
FI /OWNER (Pr ase print) STATE CONTRACTOR'S LICENSE NO.
S TURF OF GENERAL CONTRACTOR OWNER DATE
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL
INSPECTION APPROVAL AND A COPY. SHALL BE, POSTED WIT11IN,THE BUILDING.
January 1984
COUNTY OF BUTTE- DEPARTMENT OF PUBLIC WORKS
- 7 County Center Drive - Oroville;-Callfofnia 95965 - Telephone 916/534-4541'
APPLICATION AND PERMIT
PERIVIT 140
009 /—W'
AA
- - _
ASSESSOR PARCEL /L4/
414/ —3
Zo"'"G
.BUILDING PERMIT
.
OWNER -
TELEPHONE
��� /IO
SQ. FT. DCC. BUILDING V+ALUATION -
2
O`• 0.0
OWNER'S MAILING ADDRESS- _
o
, a
CONTRACTOR. S,NAME
w W
TELEPHONE
O . a C)
CONTR CTOR'S MAILING ADDRESS -
Fireplace
00
CONSTRUCTION LENDER
tiOr�-C
UNKNOWN..
Total Valuation $
440Q- 00
Filing Fee
$ -
10.00
LENDER'S MAILING ADDRESS - -
Permit Fee.
$ A/03,00
ARCHITECT OR ENGINEER -
ONr
LICENSE NO..
Plan Checking Fee
$
15,00
Energy Plan Checking Fee
$
r aD
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit' fee'
PLUMBING PERMIT
Filing Fee
10.00,
Each Trap,
2.00
kt"a
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION/ NAME PARCEL MAP
}.o �f✓
Water piping
5.00
, Qb
Each qas water heater or, vent 5.00
, uo
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 , 0J
Building sewer 5.00
Mobile Home IS I G I W 0.00 ea
TYPE OF WORK
Ne.X Addition ❑ ._,Remodel[:] Utilities ❑ Installation❑ Other ❑
nn
Describe work:
W
Permit Fee $
U0
Contractor
ELECTRICALPERMIT Filing Fee
10.00
e00V OR LESS
Main service 100 AMP OR LESS
10.00
J0. 0 O
Main service EA. ADD•L 100 AMP
2.50
CONTRACTORS LICENSE LAW
(.declare r penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Profession Code and my license is in full rce 'and effect.
License No. 4 CIdSSIflCatlOn
❑ 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
❑ I, as the owner, am exclusively contracting with licensed contract-
ontract-
ors.
ors.(Sec. 7044)
❑ I am exempt under Sec. 'Business and. Professions Code
for this reason
NEW CONST. DWELLING'OCCUP.& Flo
OR.ADDNS.- ACC. BLDGS. ) , h2Soft
NEW CONSTR. ULTI.OUT LET
NON.RESID BRANCH CIRC ITS 2.50 ea
/POWER APPARATUS e
(SINGLE OUTLET cIR. )
(
Ex. Occu SAL930
P\OUTLETS OR FIXTURES eAL030
Ex. Occup. OUTLETS P(RESID )FIXED APLNS. KEA.) 2.00
Temporary service 10.00 0, cro
Mobile Home Facilities 15.00
Misc. �Yiring 15.00
Permit Fee $ y' ,
WORKMEN'S COMPENSATION• INSURANCE
I declare under penalty of perjury (check one):
❑ he 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�K
"o �
Cooling .4{, 'T.
We 00,
Hood 3.00
1 3,rsa
'Ventilation
6,00
permit Fee $
36,00
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 buildin construction; and hereby authorize representatives of the Countyot
Butte to er pon th bove-mentioned property for inspection purposes.
I also ag save, demnify and keep harmless the County of Butte against
all liabil 'e , judg ts, costs, and expenses which may in any way accrue
against i unty conse uence of the granting of this per 't.
d—
X to
Sig re 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 $ vz+
TOTAL PERMIT FEE $ p
OccuP.
CONST.TYPEJ
PLp1��HD
C •
SSu
i
This permit is hereby issued under
sions of the Butte County Code and/or
work_. indicated above for which
DIRECT OF PUBLIC
By
PE EXPIRES. Date
the applicable
resolutions
fees have
WORKS
Date��
.:?= V_
provi-
to do
been paid.
—,P%
Receipt No. %% �o C7
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
a� ' yr •� �1 p. •:!•: _ .._.
_ ,: f.i � i .r _'tip. .a -
h
c. .
ter•
. t � ,`� L,
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rr � .. ...
�
17
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-
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it
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COUNTY OF BUTTE - DEPARTMENT OF -PUBLIC WORKS - BUILDING DIVISION.
7 COUNTY CENTER DRIVE - OROVILL&,iCACII ORNIA 95965 - TELEPHONE: 916/534-4541
-PERMIT APPLICATION DATA SHEET
Permit No.
OWNER. S1te .e. �o.r.e% A. P. No'. `4 3
Proposed Building Use Building Inspector Date /4
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 submiked.. . . . . . . .
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. Plans with Energy Design Compliance Statement. . . . .
6. "CUSD ''Fees Paid" Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
Letter of signature authorization.
Sanitation approval from Health Dept. y4_1
11. Planning approval for (A) Use: (B) Parking: d��'`
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner, Mail to owner ❑.),
_15. Improvements may be required. . . . . . . . . r
16. Mobilehome Installation Data. . . . . . . . �r
17. Pre -Inspection for
Pre -In spec. request to (Date)
Required. Building Inspector
_
13•: Recorded copy of Agricultural Acknowledgment Statement. 3
19. Driveway Permit.
20. Plot plan approval from city of
21.
22.
When you issue the permit, process as follows: ..Mail
Telephoneand hold for pickup a
Other A
Applicant
owner, .ai i to contractor. '
.�_office,,_Deliver w/inspector.
Date
Copy of plans sent - 'Health Dept., Fire Dept., Other Date
The following data must be submitted prior to pLermit issuance: (Circle new item not checked above).
1. Index permit for above items No. `
2. Additional items required: l
Contractor, designer, owner, was advised of above required data by_phone_—Mail counter by date
Contractor, designer, owner, was advised of above required data by—phone —ma ll_counter by date
Plans checked by ' Date Plans approved by -Date g
__L sets of plans on hold in--,ZFile cabinet AP folder
Flours: 10:00 a.m. - 3:00 p.m.
Copy -DPW
I t
- .
%
ww
TO: Building Department
FROM: Encroachment Permit Section
RE: Driveway Clearance
owner location AP #
Driveway permit 312- has been issued for the above property.
si nature date
QoIFLI,\NCE 1lli� t
=anN ffiAt:�E �463vool
pct certifia OutL
scl
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to