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043-251-007
043-251-007 01-1499 LOWE, SHERRY n LANGEN, -George .5037B 721 OAK LAWN CHICO aV 3901Py' CONT: DANIEL 14EAL 4842E r4944E;4i; RELOCATE GAS METER 9i1 �/ 77743-25L7 ,` Oaklawn...Ave., -Chico 043-251-007 05-1679 CONTR: I LOWE liff"Watkins, 349 Oak -$t., •Chico - 'n•�fY/� (addition) 721 OAKLAWN, CHICo W Cont: DAN MULLINEX % nNGIN, George3275B ADDITION ( ,3. 777 Oak Lawn, Chico 3-251-7 CONTR: Krenek & Chandler, Rt. 2, Box 191B, (addition) Orland r if 4 e� NOTES IL ,t w r � . f RESIDENTIAL PERMIT NO. ' 043-251-007 - - -- 05-1679�� LOWE 721 OAKLAWN, CHICO 1 Cont: DAN MULLINEX ADDITION I , ! i I ` r SPECIAL CONDITIONS I- CHECKED T BY { SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY f USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 3TiV3 4 . �.t 1 i 1 JOB FINALED Signature J=OK 0= Not OK . = NotRy hle . =Not Ready MOBILE HOMES Date MOBILE MOME LMLMES (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) S. Electricity. Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft! P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements -Setbacks -Easements Date 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. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements -Setbacks -Easements 2. Footings; S¢e-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 -Stars -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 Vs 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GA 5. Elec.; Pool Lighting; 15 Vofts-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 Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Cavi B-1 Date Card B-1 Date Card B-1 Date Card B-1 = OK = Not OK = Not Appricable = Not Ready RESIDENTIAL, (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd. / /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ P' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date, Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17.er Htr.; Vent -Access -Combustion Air Baffle ater Pipe; Test & Anchor -Nail Protection W 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 Date Cana B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECT CAL (Permit) OK except #'s 24. F' ure & Transformer Clearance Ins. Protection �VE*6 Receptacles Spacing -Lights & Switches at Doors ze B xes & No. of Conductors Stapled PpfKe'x Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 9. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI 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 tight -Spa Light 35. Smoke Detector Date Q , /Card B-1 'IZ-Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform If Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAOG (Permit) OK except #'s Is Proper Materials & Anchors Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44, Draft Stop in Walls (rat proof) 45. ire Stops, Furred Ceilings -Stairs -Chasers -Tubs V. Headers & Beams -Size & Bearing Date FRAMING (Continued) " 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 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 X -Check Garage 3rd Story, 2 Exits 55. Stairs; Width=Headroom-Rise-Run-Landing-Fire Protection 56. Plywoo on Roof Overhang -Attic Vents -Rafter Outriggers 57. Sid' -Nailing Veneer 58.,2rfucco Mesh -Drip Screed -Fd. Vents-Underflr. Access Glazing Area -Glass Protection -Skylights -Plastic 0. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls- dows Date and B-1 Date Card B-1 Date Card B-1 ° Date Card B-1 Date F (PI OK except #'s Steps -Door & Sidelight Protection -Landings 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 & Suboanel. Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. EI . utlets at Wood Panel, Int. & Ext. xt. & Appliance; Ground -Air -Gap -Cooking Clearance lec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud 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 InsUdJDrive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No jic(��LZ�r, Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle- Underground 89. VeD'hdlon Throughout House Gla rotection Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 9 W r ewer Connected -C/O to Grade -HD Approval E y Compliance Certificate -Other Certificates Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Dat O,a -a6 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: I 411 BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT BPO51679 24 HOUR INSPECTION 4: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/30/2005 APN: 043-251-007-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 721 OAK LAWN AVE CHI License Class : License Number: Map Index: Date: Contractor: Description: remodel (250) addition (74) 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 Business and Professions Code: Any city or county which requires a Owner: LOWE SHERRI L permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 721 OAKLAWN AVE signed statement that he or she is licensed pursuant to the provisions of CHICO, CA the Contractor's Stale License Law (Chapter 9 commencing with Section 95926 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: LOWE SHERRI L Code: The Contractors' State License Law does not apply to an 721 OAKLAWN AVE owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, CHICO, CA provided that such improvements are not intended or offered for 95926 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and. Professions Code. The Contractors' State License Law does Contractor: MULLANIX CONSTRUCTION 1 not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed MULLANIX, GARY & DAN pursuant to the Contractors' State License Law.). 6820 PENTZ ROAD ❑ I am Exempt under Article Business and Professions Code 95969 :��L ( k<wner: (530)877-7892 Date: License #: 851890 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: PIETZ, GREGORY A. is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as I required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Total Square Ft: 74 S.F. Policy#: Valuation: $4,810.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' (J lP compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: -{�y 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.3.706_of.the. Labor, -- code, interest, and attorney's fees. - CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the Resoluf n do worki d" ated ve r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) B Date: Name: 2 3O PE MIT EXPIRES ON:- Address:Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and 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 I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any offi ialltlSm or document of Butte County. I hereby authorize representatives of Butte County to enter. upon the above mentioned property for inspection purposes. , �. i � Print Name: � Lr If Iy`-- Signature: Date: (7 d <_— Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor 11 B. C. Building Permit 01-16-04 pg 1 INSULATION CERTIFICATE 0 Number and Street ty Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Energy E//!ci cy Standards for residential buildings (Title 24, Part 6, California Code.of Regulations) as indicated o the Certificate of C pliance, where applicable. Item #s ignature, atensta ing Subcontractor(Co.Name) General Contractor (Co. Name) OR Owner Item #s Item ds Revised July 1995 Signature, Date Signature, Date Installing Subcontractor(Co. ame General Contractor (Co. Name) OR Owner Installing Subcontractor(Co.Name) General Contractor (Co. Name) OR Owner County ""` " Subdivision Lot Num a—r— Description of Installation 1. ROOF Material Brand Name Thickness (inches) Thermal Resistance (R -Value) 2. CEILING 22 Batt or Blanket Type 60* Brand Name Maky� z . Thickness (inches) Thermal Resistance (R -Value) i2 '3U Loose Fill Type Brand Name Contractor/s min installed weight/ft= Ib Minimum thickness.' inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value) 3. EXTERIOR WALL Frame Type 2 Y6( A. Cavity Insulation Material Brand Name i'? Thickness (inches) iW Thermal Resistance (R -Value) l B . Exterior Foam Sheathing Material Brand Name Thickness (inches) Thermal Resistance (R -Value) 4: RAISED FLOOR. Material Brand Name Thickness (inches) Thermal Resistance (R -Value) 5. SLAB FLOOR/PERIMETER Material Brand Name Thickness (inches) Thermal Resistance (R -Value) Perimeter Insulation Depth (inches) 6. FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Energy E//!ci cy Standards for residential buildings (Title 24, Part 6, California Code.of Regulations) as indicated o the Certificate of C pliance, where applicable. Item #s ignature, atensta ing Subcontractor(Co.Name) General Contractor (Co. Name) OR Owner Item #s Item ds Revised July 1995 Signature, Date Signature, Date Installing Subcontractor(Co. ame General Contractor (Co. Name) OR Owner Installing Subcontractor(Co.Name) General Contractor (Co. Name) OR Owner :i�':."� ��>�.-3,�,.. s:tit<r4�t;-�:-�G`r�*��-'--s.�r►t.—�.7s.�r •T-�-..t+vi:�►�.c- ' COUNTY OF BUTTE ` BUILDING DIVISION F: DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER `ice PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should"be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contaotthe Building InspW* as indicated below. Yc- k't cy�e !P . r" rz. x Date Inspector REV 4/05 Phone # � J r; FOR RE -INSPECTION CALL:; 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE 615 -16 7 �lj OWNER . PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions Pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. Date /" - 010. Inspector � L�7 /T- 573 REV 4/05 Phone # 1 / O FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 .COUNTY OF BUTTE .......... r BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. G < ,a/.r, lel_/_°i/' � ri✓t/lf.� �7'-i � �/ � I Date/ � l Inspector / C/ -M /% REV 4/05 Phone # S� � I ;-3 ' r FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 a ._�-"y.bl^y..�,v s ,. i'.71''�+-.r..%-�T" -..:1.-\x;..a4♦t—�.:�rNrf�ytrr...'�..^. 4#..�,..r.iur.-.«-r*+;,.ry COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine insp tion indicates that the following violations of Butte County Ordinances exist at the above dress and should be corrected. Please call for re -inspection when correction of work is mpleted. If you have any questions pertaining to this matter, or need additional explan ion, pleas—}e/ contact the Building Inspector as indicated b low. \ �l � Cc 2 I ✓� � rt V ,L, -��z- Date I (�)' I % , Z Inspector REV 4/05 Phone # �1 J J FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION 9: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP051679 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under' penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/30/2005 APN: 043-251-007-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 721 OAK LAWN AVE CHI License Class : License Number: Map Index: Date: Contractor: Description: remodel (250) addition (74) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: LOWE SHERRI L permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 721 OAKLAWN AVE signed statement that he or she is licensed pursuant to the provisions of CHICO, CA the Contractor's State License Law (Chapter 9 commencing with Section 95926 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended 'or offered for sale (Sec. 7044, Business and Professions Applicant: LOWE SHERRI L Code: The Contractors' State License Law does not apply to an 721 OAKLAWN AVE owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, CHICO, CA provided that such improvements are not intended or offered for 95926 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: MULLANIX CONSTRUCTION not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed MULLANIX, GARY & DAN pursuant to the Contractors' State License Law.). 6820 PENTZ ROAD ❑ 1 am Exempt under Article 3 of Oe Business and Professions Code 95969 _�1/� (530)877-7892 Date: � Owner: to License #: 851890 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: PIETZ, GREGORY A. is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 74 S.F. Policy#: Valuation: $4,810.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, / and agree that if I should become subject to the workers' �O (P compensation provisions of Section 3700 of the Labor Code, I shallra forthwith comply with those eprovisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is L/ r unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of V -compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolut' n dQ work i ve r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) 7ated Name: B Date: w PE MIT EXPIRES ON: 4'—solooAddress:Date ❑ I 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 I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any off" ianm or document of Butte County. I hereby authorize representatives of Butte County to enter, upon the above mentioned property for inspection purposes. Print Name: � \(—v- " Signature: oLOwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor L B. C. Building Permit 01-16-04 pg 1 Department C n it n i Michael Crump, Director of Public Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroviiie. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase el Construction Storm Water Permit and Storm Water CREtion Prevention Plan (SWPPP) Acknowledgement [LESS T4A l � ' `Project Description: r V) and/or Parcel Number: Project Location an nn b CA By suing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit fron the State of California. Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project. that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. i i Signed: Title: bwnelr Date: q -,5c) 14 BUTTE COUNTY 4 DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE`. (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 q A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION 3i�C9� l Website: www.buttecounty.net/dds ""PLEASE PRINT CLEARLY'" OWNER Last Name '� �1 irst Name JI" {moi ri Address 0 L V G� City / n„ State A Zip � 7 -To Phone 530 (p3 qbs I 77 <� Fax E-mail APPLICANT NAME CONTRACTOR Name t 0 (AV) MU � �) ri Address Zip City Fax State Zip Phone Typb Const. Fax E-mail Map Book Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City - Address Zip City Fax State Zip Phone Typb Const. Fax E-mail Map Book State License Number APPLICANT NAME Name Dvjini Address City - State Zip Phone Fax E-mail AP LICANT SIGNATURE X For office use only: AP#007 Zoning L Flood Zone ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): SRA I Yes No Occ. Typb Const. Subdivision Name Address Map Book Page Lot # Planner Date Approved: PERMIT NO. BP BIN # c-� LOCATION AP#007 Propert Address ®'-"� V L Cross Street ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): WORKER'S COMPENSATION Policy Number 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 Description Scope of Work: ft -IDD I`ll (Cr" Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): OVER FOR SUBMITTAL REQUIREMENTS II K:IFORMS\BUILDING FORMS1BldgApplSubRgmts.doc Page 1 of 2 EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by:a Receipt �j #P � i ` 0 'Gl Date: L e— V-6 Amount: l.v Bldg SRA Sheriff SMIP Other Total REV 2-24-05 -SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications. must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT 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 6r.4 sets, signed by the pre -parer 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 trus''s details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ : " 5. Statement of Intent for Non -Heated and A/C for Non -Residential Buildings. �;.. ❑ 6. Manufactured homes: (A) installation 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 AccessoryBuilding Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) 0 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). - 0 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 liceris(�information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded'copy of Agricultural Acknowledgment Statement. , ❑ 11 ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12 Sanitation and site plan approval from the Environmental Health Department. , If you have questions or -would like additional information regarding this process, please contact a Permit Assistant at (530)538=7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request, by the person who paid the fee. The request must be made within two years from the date .of fee payment on permits not issued, and two_years from the date of permit issuance for, permits issued; however, on issued permits refunds can only be made if no` construction work has,been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMBUILDING F0RMS0dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05' rn r*%ft cfl Butte County Departrnent ofDevelopment Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538.7785 Facsimile TO: FROM: WILLDAN Scott Rutherford (530) 538-7160 �OT orFO 0 \ O 0 0 o o 0 UN srutherford(cDbuttecountv.ne10 t SUBJECT: Plans Transmittal For Review Per Contract O DATE: 7/1/2005 Applicant: Lowe, Sherri Permit No: 05-1679 Project Type: Add 043-251-007 100% 70% Plan Check Fees $ 340.94 $ 238.66 $ 340.94 $ 238.66 WILLDAN Fee $ 238.66 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other 67, w COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: L C ASSESSOR PARCEL NUMBER U Cf ^D � 7 ayy Al cr/�c� 6 Propose -Building Use: Permit Technician: Date: Ite required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 16J if ,.-' 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. f o e 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. IfN� 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl r _/ ❑/' 5. Letter from Engineer or Architect for truss design review. 1" 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. O 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ f 12. Hazardous Material Form j14 � 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Reining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ 0 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation' required ........................................... ❑/ 19: Erosion Control Plan Required........................................................................ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 1. City of Chico Plumbing permit........................................................................ ,. ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ / 23. California Department of Forestry plan approval ❑ paid. Sent by: 24. lanning approval for (A) Use: G1' (B)Parking: (C) Parcel Check:..... ❑ Contact Land Developm . nt abou _ Improvements( _Drainage ........................ rr,i �17.Encroachment PDES Form...{! �`.o.......?4�.e �!.. ................... ❑ Permit for driveway from the Public Works Dept ........................... �0 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization......................`............................................ ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone and hold for pickup. I have been informed of th ae bove it ms and requireme . for obtaining a building permit. r. (� Applicant: r Date: 1. Index permit application for the above i em numbered: �`� Plan Check Letter 2. Additional items re i ed Contractor, designe ; owne , was advised of the above data by phone, ❑ mail, ❑ counter, by Date:!15 Contractor, designe , was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: 100 I -c Structural reviewed b : Date: Structural approved by: I Date: IV Note transfer by: -Date: Yellow: Building Division is J \3h410TWU xl.%.n0:) I.UAa TO: Building Department 5001E 9Ad FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location E.H. USE ON Plot Plan Attached Mat Plan Attacft Sent to B.D. SSt 3_c/�S�f �- On,F /rte? AP# Plan Approved for: Sewage Disposal Water Supply: nPublic^ Private Well Clearance for dwelling. Other �{� C �.vl� �X Hold final for: Final clearance O.K. for: NOTE: 0 Environmental Health Specialist '712-4 Date -4�4 / 8/96 11 tr.t.a. F tor ell. r COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER 6&�v A.P. # G c► /� /'�� PROPROSED BUILDING USE BUILDING PERMIT FEES --- Balance Due ..................... DATE &—R -7-0'J— —R -7"'J RECEIPT ## L DATE REC. --- FEMA Flood elevation review ... $ --- dditional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES Glri'1 C 0 (paid at School District Office) (form available after Plan Check) a 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. *'4. RECREATION DISTRICT FEES , L� (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning $ 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 a' at B i1dii Division) 8. SMIP a 9. OTHER 10. OTHER 11. OTHER At time of permit application, I was adv' ed the may be changed during the plan the ing proce APPLICANT % �,39�97 t,3b1QY- I fees are required to be paid prior to issuance of the permit. These fees DATE (,�-1 I\) Pursuant to Government Code Section 66020, you are thereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) School District A.P. Number Property Owner Property Location BUTTE COUNTY SCHOOLS IMPACT -FEE CERTIFICATION FORM (One form per Building) TRA W Iq -7 nito lin if i d Sch�l D - i c Building Department No. nq S-2�� 1—(0, Jurisdiction: Q City '/Courdt Subdivision _ . - L6f No. Ta.......................................................................................� Residential Development Q Q Q Sq. Footage -74 No of Living Mobile Home Addition/ 'Supplemental to (Grou . R) Units InstallationConversion , Permit # '(No foundation inspection) i :......................................................................r ............... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) ? Commercialh ddstrial New Addition h Sq. Footage (Including Exterior Roofed Areas) o5 Date District Identification No. School District certifies that (Applicant) �{ 7idi (Street Address) (Phone Number))/ Ohl (City)�.; (State) x... i', (Zip ) Code has complied with the requirements of Resolution No. representing square feet. B 2926 III W by payment of $ . t $ LA5 TireT�9N $ Date Paid by Check # Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with Government Code Section 66020(a), within 90 days from the date fees aro paid. Failure to submit a timely wrltbn protest will prohibit you from challenging the Imposition of the fees In any court action. H, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quallty Act (CEQA), this project may be subject to additional school fees to fully fnMga% Its Impact on the school district's schools. White (school district), Yellow (building department), Pink (applicant). feeform.xis (3M5)drhm Butte County Department of Developinelit Se-vlces �urr�o0 7 County Center Drive o e Oroville, CA 95965 ~ O � 1G`�� O (530) 538-7601 Telephone ° ° cOUN'�y (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: 0 I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation: clearance to the Building Division as soon as clearance is obtained. • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not .limited to, verification the parcel was legally created, adherence.to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: Ibo We APN: ®-q 3- a� ) ` l� l� Building site address: 20 � L -o ujh Permit No.: �w I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the e -r ferenced building permit application and my signature below: SIGNATURE OF A DATE Copy to Applicant/EH/File K:Forms/BldgPermitwithoutClearances 020705 A v W I LLDAN ' Serving Public Agencies .�1 �T August 29, 2005 Scott Rutherford Butte County Building Department 7' County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com BUTTE COUNTY PLAN REVIEW REPORT Status: Approved Jurisdiction Job No: 05-1679 Assessor's Parcel No: 043-251-007 Description: Lowe Addition Willdan Project No: 14353-1757 Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: # Plans: Two (2) copies sheets 1 and 2 dated 06/14/05, by Greg Peitz A.I.A. *. Energy, Calculations: Two (2) copies dated 06/19/05, by Greg Peitz A.I.A. F ti i The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. 1! 1. W I LLDAN Serving Public Agencies APPLICABLE CODES Our review was based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code (CBC). • Part 6, known as the California Energy Code, and Energy Commission Standards (CECS). CODE ANALYSIS Our plan review revealed the following information regarding the occupancy designation, type of construction, and other pertinent features. This information is consistent with that shown on the plans. Type of Type of ist Floor 2" Floor Specific Use Occupancy Construction Stories Total Sq Ft Sq Ft Sq Ft Dwelling Addition R-3 V -N 2 74 NA 74 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. 3. All plan sheets shall be signed by designer or person responsible for the plans as required by California Health & Safety Code Section 5536.1. SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals. Sincerely, Tom Trueb Plans Examiner Thank you Cc: Alice Mefford, amefford@buttecounty.net Sherri Lowe, 721 Oaklawn, Chico, Ca. 95926 Page 2 of 2 Butte County 05-1679 Willdan 1.4353-1757-MITC2.F 043-251-007 LOWE, SHERRY 01-1499 721 OAK LAWN CHICO CONT: DANIEL HEAL RELOCATE GAS,METER i OFFICE COPY MssAS, GAS / (� r Meter ByDate � 1 V J ELECTRIC Meter By Date r 1. COUNTY OF BUTTE -DEPARTMENT O� DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530),538-7541 PERMIT NO. (Rev. 12/96) APPLICATION'AND PERMIT ASSESSOR PARCEL NUMBER w . �- ZONING BUILDING PERMIT OWNER % / TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS I z-, G co Nr CTO RIS NAME TELEPHONE �j �/J e -L/ Y C M/pA�CTO S MAILING ADD SJ$' / c••..� 07 lt'S,-A/i,i/�/WT�,at CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS _ Total Valuation $ ARC CT 0R•ENGINEEi}1� LICENSE NO. Flirt Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS / / /i"iI Ir 1 Energy Plan Checking Fee $ PERMIT FEE _ LOT NO. SUBDIVISIONS NAME PARCEL MAP , PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF I/Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK 4 New ❑ Addition ❑ Remodel 13 - Utilities p' Installation [3Other[3 I Describe Work: J'� /�-.�}_��-cJ c--�►hG tirti. + "b C I Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ 1j / j ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoOA OR LESS 23.00 1 LICENSED CONTRACTOR'S DECLARATION 1 I hereby affirm under penalty of. perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.,... License Class Lic. No. { OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contract is 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.l ❑ 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 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 of the work for which this permit is Issued. ®/ I have and will maintain workers' compensation Insurance, as required by Section /have 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' Kyo rper��sation insur ncrarrier ,nd ` olicy number are: Carrier /�. ? V �• �,;, �, - Policy Number C-111 S *9 y'" © (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any.,manner so as to, become subject to workers' compensation laws of California, and agree that if should become subject to the m w?fkers' compensation • provisions of -section 3700 of the Labor Code, I shall f rthw th comply.wfth those rovisions. t f� / — X Date ice,,,/// Sicfnature of Applicant - ❑ Owner I110Contractor ❑ Agent/' An OSHA permit is're uired for excavations over 5'0" dee and demolition or construction of structurs over 3 stories in height. P Main Service 200A TO 1000A 46.00 NEW CONST. OWEwNo OCCUP. SO OR ADDNS. ( a ACC. S. 3.50FT; NEW CONS MULTI.O TLET TC. @7.50 NON•RESID. BRANCH CYR POWER APPARATUS 8 SINGLE 0.CIR. 1 .00 Ex. Occup. o(mEr OR PocTUREs BAL p .w FLED APPLNS. OR Ex. Occup.. oLfTLETS RESID. Eo. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating —Cooling Hood 6.50 Ventilation PERMIT FES $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE,$ r HAZ. r D PEES , IMP FLOOD CDP sPARCEL..PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have r By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. C°// �A Date / ReceiptNo. 3 � ql) WHITE-D.D.S.-B.D. _, CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ®% ray 9`� ASSESSOR PARCEL NUMBER Q f� ] ^ Q J [_ / ZONING BUILDING PERMIT OWNER / TELEPHONE SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS Z5/0 n 1w (/ COM CTO S NAME TELEPHONE (� S _�T C g9 A�UUyp ADp S CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARC NGIt{E LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS:22-1 Qdi< Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF M/Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 12 Installation ❑ Other ❑ Describe Work: Gas piping stem 1 - 5 outlets 15.00 1 Building sewer 15.00 Mobile Home I S I G I W Q20.00 PERMIT FEE S r ELECTRICAL PERMIT Fling Fee 20.00 V LE Main Service . AOR LESS 23.00 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 fulljQrcS and effect. License Class Lic. No. 3 / q �3 / Y OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 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 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' mpensation, 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' oZery ion insurnc arrier ncT olicy number are: Carrier �-i,G 1 �v r:. _ Policy Number $ — (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' com ensation laws of California, and agree that if I should become subject to the w s' compensation provisions of section 3700 of the Labor Code, I shall f rth th comply with ose rovisio s. ` / `Q ®' 6 X Date / Si nature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46.00 200ALICENSED NEW CONST. DWEW WEE NG OCCUCUP. OR ADONS. ( & ACC. BLAS. SO 3.5¢FT. =R °�Ip. MULTI.OUTLET @7.50 POWER APPARATUS 8 SINGLE 0 T. CIR. Ex. Occup. OUTLET ORFOMAES 2O°''00 BAL O .SO LINSI Ex. Occup.pig Rp,pEk 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. p. PEES IMP PLOOD CDF HD IS E This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON Pate) provisions to do work paid. G x-L-� Receipt No. tl! I WHITE-D.D.S.-B.D. CANARY -AS SSOR PINK -INSPECTOR GOLDENROD -APPLICANT