HomeMy WebLinkAbout043-253-012043-253-012 PERMIT#98-0944
GODINEZ, Felipe R. Isabella
630 Bidwell Dr. , hico 3IIII��
Cont: Mike Ross
Add Bathrm & Remodel Closet/SF
043.253.012 03-027
GODINEZ, ISABELLA �NAIED -
630 BIDWELL DR, CHICO
CONT: BAKER ELECTRIC x-3-03
NEW ELEC SERVICE, MISC WIRI
043-253-012
GODINEZ, ISABELIA
630 BIDWELL'DR. CHICO
BAKER ELEC.
NEW SER. & NIC. "WIRE CONY.
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OFFICE COPY,
Address 6 3 6pq t --LZ[ A
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GAS
Meter By Date
ELECTRIC
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Meter By Date 60
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(Rev. 12/96)
COUNTY OF, BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
APPLICATION AND PERMIT C
PERMIT NO..,
A
ASSESSORPARCELNUJ0 �� _0 I
` J 3 rGJvp� � CEJ],
ZONINk- I
BUILDING PERMIT
OWNER
TELEPHONE
9y- SS
SO. FT. OCC. BUILDING VALUATION
OWNERS lu RE �
A. sya
E " / TELEPHONE
CONTRACTOR' /
CONTRACTOPS MAI(UANO•,/ADORE
CONSTRUCTION` LENDER
Fire lace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Flin Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS O d` A .
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO.
SUBDNISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
Each Trap -7.00
USEOFSTRUCTURE
SF,X Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater 23.00'
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ /RReemoodel E3 Utilities ❑ Installation 13 Other ❑
04 44
DescribeWork:"- �-.
•
t
Gas piping system 1 - 5 outlets 15.00
Buildingsewer 15.00
Mobile Home S G W 920.00
PERMIT FEE S
w" ztu a,�Ub ,
ELECTRICAL PERMIT Fling Fee 220.000
LE
Main Service A600V OR LESS 23.00 Jf/
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 full force and effect.
License'Class Lic. No.
OWNER -BUILDER DECLARATION
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.
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
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' compensation insurance carrier and policy number are:
Carrier
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'
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. ;
X Date //30/
Signa ure 'of Applicant - Owner ❑ Contractor XAgent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service TO tSCU000A 46.00
NEW CONST. DWEWNG OCCUP. SO
W
OR ADONS. ( s ACC, BLOS. 3.5QFT:
►N,OONN-RESD ' MULTI.OU CUTUITS @7.50
POWER APPARATUS
8 SINGLE OUTLET CIA.
Zap ,.00
Ex. Occup. OUTLET OR FIXTURES BAL p .50
Ex. Occup. ourLFrs p IFS )ERP 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00 40
PERMIT FEE S
'
MECHANICAL PERMIT (ling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $ t^ tA 00
cc
.3
ICGH9fi
VIDE
T TAL FEE $
HIZ.70.
IMP
I FLOOD
COF PARCEL I PD
HD
I ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do. work
indicat above for which fees have been paid.
By &uw Date/ _
PERMIT EXPIRES ON �' 3b -u T
Date
ReceiptNo. .30'b �14?b
WHITE-D.D.S.- .D. CANAR -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
y
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7" County Center Drive Oroville, California 95965 • Telephone (530) 538-7541®2 _022
(Rev. 12/96) APPLICATION AND PERMIT C J� G
ASSESSOR PARCEL NUZONI"
BUILDING PERMIT
OWNER ,
TELEPHONE
4y- S5
SO. FT. OCC. BUILDING VALUATION
.OWNERS IU RE ( Sys
CONTRACTOR' ME i. TELEPHONE
3 /3
CONTRAC ORS MAILING 'ADDRE
a
Al1
CONSTRUCTION LENDER '
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS . 90 �^
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDNIS IONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
Each Trap 7.00
USEOFSTRUCTURE
SFA Duplex ❑ Mobilehome ❑ Other
SPECIFY
-
Solar or heat um water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
�tionn�❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
New ❑ Addi01
j
Describe Work:
•
tz
Gas piping system 1 - 5 outlets 15.00
Buildin sewer 15.00
Mobile Home S G W @20.00
PERMIT FEE $
I
Z.ii�Q
ELECTRICAL PERMIT Fling Fee 20.00
60
Main Service ..A OR LESS 23.00 Q3,66
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 full force and effect.PSING
License Class Lic. No.
OWNER -BUILDER DECLARATION
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.
el, 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
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' compensation insurance carrier and policy number are:
Carrier
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'
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.
X Date ho /a -2
Signature of Applicant 75 Owner ❑ Contractor KAgent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO lOooA 46.00
NEW CONST. DW EWNG OCCUP. s0
OR ADDNS. ( 6 ACC. S.3.5¢FT.
T.
NON-ROESID. muLTI.OUTLET @7,50
8 OCR. OWELER APUTLErPARATUS
Ex. OCCu OUTLET OR FIXTURES BAL p .50
FIXED APPLtiS. OR
Ex. Occup. S.00
ounErs RESID. EA
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00 40
D PERMIT FEE *,finTgg
MECHANICAL PERMIT ee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $ 00
c
coND rrPE
VAL TAL FEE $
HAZ D IMP
FLOOD
CDF PARCEL PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicat above for which fees have been paid.
By Date 1-315,65
PERMIT EXPIRES ON 3a •O
Date
Receipt No.�vb 3iVb
WHITE-D.D.S.-R.D. CANARY -ASSESSOR PINK -INSPECTOR f GOLDENROD -APPLICANT
i
• Butte HH Nursing
Fax:5308959623 Jan 30 2003 15:11
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_LS
JAN
""""" CVVNIS'IYON
BU�DIN
P. 01
wrb�
Dec 17 02 11:3aa
p.2
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the 'or labor and materials for construction of the proposed
r e
property impment : YES NO C32. I HAVE HAVE NOT ❑ signed an application for a building permit for the proposed work
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTYOWNER:_,/.
SOCIAL SECURITY NUMBER:
DATE: 11,2,11)-1
NOTE:
1,2nlD-
NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to issue the permit.
OVER
Dec 17 02 11:37a
p.I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as
Property improvements specified the builder of
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit. Building permits are not required to be signed by property Owners unless they are
y protea
you performing their own work. If your work is being performed by someone other than ourself, may personally
yourself from possible liability if that person applies for the proper permit in his or her name, - y
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their lic
for which they apply. ense number on all permits
If you plan 'to do your own work, with the exception of various trades that you `plan to subcontract, you
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials 'and other costs) , is $300 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer. you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be.financial risks for you if you do not carry out these obligations, and these risks are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your
obligations under State Law, contact , the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale,, property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees, without a licensed contractor or subcontractor, only
under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
building permit, erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing their own
work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in vour community or at 1020 N Street, Sacramento, CA- 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned.
Sin&:re-I
Micha t C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
RESIDENTIAL
043-253-012 PERMIT#98-0944
f GODINEZ, Felipe R. Isabella
!PERMIT No. _. 630 Bidwell Dr., Chico
Cont: Mike Ross
rPERMIT EXPIRE, Add Bathrm & Remodel Closet/SF
i
OWNER
CONTR.
,ASSESSOR PARCEL
LOCATION
C f"
11 7
y
n
i
rte•
r '
x CHECKED
SRA BY
FLOOD CERTIFICATE REQ. ,
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
Temp. Power Pole
i
Called PGF
Temp. Elec. Se
Y
Called PGE
•5
Temp. Gas Ser
' Called PGE
JOB FINALED
Signature .
s
In
RESIDENTIAL
043-253-012 PERMIT#98-0944
f GODINEZ, Felipe R. Isabella
!PERMIT No. _. 630 Bidwell Dr., Chico
Cont: Mike Ross
rPERMIT EXPIRE, Add Bathrm & Remodel Closet/SF
i
OWNER
CONTR.
,ASSESSOR PARCEL
LOCATION
C f"
11 7
y
n
i
rte•
r '
x CHECKED
SRA BY
FLOOD CERTIFICATE REQ. ,
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
Temp. Power Pole
i
Called PGF
Temp. Elec. Se
Y
Called PGE
•5
Temp. Gas Ser
' Called PGE
JOB FINALED
Signature .
s
V=OK
0 = Not OK
Not Ap
•=Not Readyble MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
1. Zoning Requirements - Setbacks - Easements
2. Footings; Soils-Size-Dep"pacing-Connectors-Steel
2. Soils; Special MH Support Sketch
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
3. Sewer, Location-Test-Fall-CY"oncrete
4. Wood Awn.; Posts-Beams-Rttrs.-Connectors
Shthg.-Rfg.-Bracing
4. Water, Location-Test-Easement Needed (Sketch)
5. Alum. Awn.; Columns-ConnectionsSplice-Decal-Enclosures
5. Electricity; Location-Clearances-Gmd-/ /Amp-Concrete
6. Carports; Windows -Doors
6. Gas; Location-Test-Wrap; / fVft.
/ /Nat. or/ / L tt./ /LPG
7. Electric
7. Well Clearance & Disconnect -
8. Fnng.; Sils-AnchorsStuds-Rttrs-Trusses
8. Utility Clearance
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Card B-1 Date Card B-1
1. Zoning Requirements- Setbacks Easements
Card B-1 Date Card B-1
2. Footings; Size-Spacing-Marriage Line
POOLS (Plans) OK except #'s
3. Gas; MH Test-Demand Valve-Connector
1. Setbacks -Easements
4. Electricity; MH Test-Crossovers-Breakers-Clearances
2. Soils; Compaction -Structure Stability
5. Drain; MH Test-Fall-Flex Connector
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
6. Water; MH Test-Regulator-Connector
4. Elec.; Receptacles and Lighting, Distance-GFI
7. Water and Sewer Connected-C/0 to Grade-HD Approval
5. Elec.; Pool Lighting; 15 Volts-GFI
8. Gas and Electricity Tagged
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
9. Tie Downs-Type-Installation Cert.
7. Elec.; Bonding; Metal w/5 -Circulating Equip. -Heater
10. Exits; Insp.-Sketch
8. Elec.; Grounding; Equip. w/3 Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards4ns. to Main in Conduit
11. Cert of Occupancy
9. Health Department Approval
12. Permanent Foundation Only: License Decal -
10. Plumb.; Cir Test -Water Supply Test
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-Dep"pacing-Connectors-Steel
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rttrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns-ConnectionsSplice-Decal-Enclosures
6. Carports; Windows -Doors
7. Electric
8. Fnng.; Sils-AnchorsStuds-Rttrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/3 Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards4ns. to Main in Conduit
9. Health Department Approval
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
✓= OK-''
O= Not OK RESIDENTIAL
- = Not Applicable,
* = Not Ready
Date UNDERFLOOR (Plans) OK except #'s
oni gSetbacks-Easments-FloodSlope
Ftg.,- Main; Soils-Elec. Gmd.-/ p Ftg. Depth
3. Ftg. Garage; Soils-Steel-Elec. Gmd/ i Ftg. Depth
4. Ftg. Porches & Decks; Soils -Steel-/ N 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. Pier replace Ftg.-Steel
:W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test
10. UF. ipe; Size Anchors - Yard Gas Piping; Size Test
ater Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Pie & Ducts; Clearance -Material -Support -Ins.
irders-Sills-Anchor Bolts -Joists Vents-Crippies
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date;/a--91K Card B-1 Date Card B-1
Date PLU NG (Permit) OK except #'s
17. W Htr.; Vent -A ess-Combustion AirAAe
r Pipe; &
W. ail P o
20: Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
Date "Q-- pr(q ' Card B-1 ARO, Date - Card B-1
Date 0-.3��_qg Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
23. Fbdu Transformer Clearance -Ins. Protection
eceptacles Spacing -Lights & Switches at Doors
A5Aip-go-Ves & No. of Conductors Stapled
ex I stalled Close to Edge of Studs & C.J.
. Equip. Ground made up w/Mech Fastners-Bond Gas & Water
28. 2 Appliance Circuts in Kitchen & Conductor Size GFI
29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
30. Range Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or Al
(Si
Date SQ Card B-1 Date Card B-1
Date Car =1 r Date Card B-1
Date ING (Plans) OK except #'s
S' roper Materials & Anchors
linw-ft-uds-Nailing Spacing & Brac -PI - ound
420"Bearing Walls over Girders & Floor Nailing
43. Dr Stop in Walls (rat proof)
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
eaders & Beams -Size & Bearing
ngle & Duplex)
Date FRAMING (Continued)
s -Post Caps -Anchors -Connectors
7 ing. Joist-RfV. Ties-Purlin-roff Brac.-Truss- ng: Rfng:--
Flue-Fireplace Throat clearance
49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
U-4afttgerIri'rotection Framing
ne rewall & Openings
53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits
54. fairs; Width -Headroom -Rise -Run -landing -Fire Protection
*. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56. Siding -Nailing Veneer
57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58. Glazing Area -Glass Protection -Skylights -Plastic
59. Shear Walls; Nailing -Bolts
60. Br a Interior / Exterior W Panels
IVY QY'!2ulation-'vVA0<eiluvsf
62'lnfiltration-Walls- Windows
Date Card B-1 Date Card B-1 n
Date Car 1 Date Card B-1
Date INAL (Plans) OK except #'s
Steps -Door & Sidelight Protection -landings
2, moke Detector
rs Fi rnnry Vcnfc Claara_n1 , Air-Conector-
In Garage; Above Floor -Ducts -Meth. Protection --
roomng
G.RD& Bath Fixtures & Tub Access -Spa
ec. Trim & Subpanel, Breaker Sizes & Labels
, e nce-Hearth
7• , n . Ext.
p iance; Ground. -Air Gap -Cooking Clearance
e s & Recepticales at Kit. Counter
74?ire oor; Swing -Landing -Closure
7 . uct -n-G-, -ra-ge-- amper
omb. Air Connector-P.R.V.
In Garage; Above Floor -Meth. Protection
Elec. & Mech. Equip. Listed for Location
7 . ec. a a Protection
sulation-Foam-Looked in Attic
ec onstruction-Post Caps
dn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor f1 Yes
0 Yes 0 NoA'Valks 0 Yes 0 No/Planters 0 Yes 0 No
8&.-2tQtTUfhVW-Finisn
64. iscon , lectrical-Plumbing
stri ents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
nett, Electrical, Plumbing
. eceptacle Underground
en • ' n Throught House
lass Protection
orrections from Previous Inspections
g as -Electric
ewer onnected-C/0 to Grade -HD Approval
nergy Compliance Certificate -Other Certificates
Date L;? Card B-1 jW Date Card B-1
Date, Card B-1 (LnDate Card B-1
Date I Card B-1 Date Card B-1
Comments at Final:
Insulated Neutral 0 Yes 0 No
31.
Service -Riser Conductors & Ground -Main Disconect
32.
Equip. Clearances Panels-Motors-Mech. Epuip.
33.
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
Date
Card B-1 Date Card B-1
Date
Card B- Date Card B-1
Date
ANICAL (Permit) OK except #'s
to�ent
A . Ducts Insulation & Support
Fan, Exhaust above insulation
37.
Condensate Drain & Overflow, Size & Grade
38.
Fumance-Vent Access -Comb. Air -Return Air Vent 115 outlet
39.
Attic Access & Platform if Furnace in Attic
Date SQ Card B-1 Date Card B-1
Date Car =1 r Date Card B-1
Date ING (Plans) OK except #'s
S' roper Materials & Anchors
linw-ft-uds-Nailing Spacing & Brac -PI - ound
420"Bearing Walls over Girders & Floor Nailing
43. Dr Stop in Walls (rat proof)
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
eaders & Beams -Size & Bearing
ngle & Duplex)
Date FRAMING (Continued)
s -Post Caps -Anchors -Connectors
7 ing. Joist-RfV. Ties-Purlin-roff Brac.-Truss- ng: Rfng:--
Flue-Fireplace Throat clearance
49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
U-4afttgerIri'rotection Framing
ne rewall & Openings
53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits
54. fairs; Width -Headroom -Rise -Run -landing -Fire Protection
*. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56. Siding -Nailing Veneer
57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58. Glazing Area -Glass Protection -Skylights -Plastic
59. Shear Walls; Nailing -Bolts
60. Br a Interior / Exterior W Panels
IVY QY'!2ulation-'vVA0<eiluvsf
62'lnfiltration-Walls- Windows
Date Card B-1 Date Card B-1 n
Date Car 1 Date Card B-1
Date INAL (Plans) OK except #'s
Steps -Door & Sidelight Protection -landings
2, moke Detector
rs Fi rnnry Vcnfc Claara_n1 , Air-Conector-
In Garage; Above Floor -Ducts -Meth. Protection --
roomng
G.RD& Bath Fixtures & Tub Access -Spa
ec. Trim & Subpanel, Breaker Sizes & Labels
, e nce-Hearth
7• , n . Ext.
p iance; Ground. -Air Gap -Cooking Clearance
e s & Recepticales at Kit. Counter
74?ire oor; Swing -Landing -Closure
7 . uct -n-G-, -ra-ge-- amper
omb. Air Connector-P.R.V.
In Garage; Above Floor -Meth. Protection
Elec. & Mech. Equip. Listed for Location
7 . ec. a a Protection
sulation-Foam-Looked in Attic
ec onstruction-Post Caps
dn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor f1 Yes
0 Yes 0 NoA'Valks 0 Yes 0 No/Planters 0 Yes 0 No
8&.-2tQtTUfhVW-Finisn
64. iscon , lectrical-Plumbing
stri ents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
nett, Electrical, Plumbing
. eceptacle Underground
en • ' n Throught House
lass Protection
orrections from Previous Inspections
g as -Electric
ewer onnected-C/0 to Grade -HD Approval
nergy Compliance Certificate -Other Certificates
Date L;? Card B-1 jW Date Card B-1
Date, Card B-1 (LnDate Card B-1
Date I Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE
- BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
Go
OWNER
PERMIT
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
Date---'-/ 77 Inspector
REV 10/92
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
`7"G/G
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 notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
Date — — Inspectors /`tel l 61,
REV 10/92
,k" :f„`RR•av-iGel+-w.rrr:"n}.rr-'-�,--'_•.�-r--,.--+..f-,.-anrr.-..•- ��2-�w:CaY:�:r;.�:,r,,;,g-•`. ':i-i'��"+j
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES,
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
t� D d; n. e z / 1f y z/'/
OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address an should be corrected. Please notice this office when correction of work is
completed. If yo have any questions pertaining to this matter; or need additional explanation,
please Contac.t4his office immediately.
-kms a a cf-P
Date %2 2-t> -Inspector e,4
REV 10/92
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES'
411 Main Street • Chico, CA • (530) 891-2751
` 7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
I 9yy
OWNER If PERMIT NO.
A r/ntact
indicates that the following violations of butte county Ordinances exist at the
abshould be corrected. Please notice this office when correction of work is
coave any questions pertaining to this matter, or need additional explanation,
pleffice immediately.
".✓ i �a�� � o � /�a � c S
I la,`o or .v ' C �O
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/ a ,dg 11el
' l ®tee. Do� X17 CfJC�
IF V
Date J 0/ a Inspector
REV 10/9
E.H. USE ONLY
Plot Plan Attached
Floor Plan Attached
Sent to B.D. I
TO.: Building Department O
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for dwelling. Other
Hold final for:
Final clearance O.K. for:
NOT '
L�
•u Env' onmental Health Specialist Date
8/96
ENERGY INS:AUATION CEZI'_= ICATE
Building Owner�D��tfL2� Building Permic # -I
Building Location
DESCRIP'T'ION OF INSULA.ION
ROOF
Mate :al Brand Name
Thi=kness(:L=hes) The=al Resistance (R Value)
F':: z..RIOR WALL
Material
Thickness (inches)
CEILING
Batt or Blanket Type 6&Zr
Thickaess(inches) L
Loose Fill Type
Xinimz *+ Thicknesl (Inches)
Area covered(ft. )
FLOOR, ELEVATED
Material
Thiclmess(inches)
FLOOR, SLAB -
Material
Thickness(inches)
Width(inches)
FOUNDATION WALL
Material
Thickness (inches)
Brand Name;ff�}°,�/�
The_ -mal Resistance(R Value)
Brand Name �S
. Thermal, Resistance(R Value)
Brand Name .
Number of Bags_ Wt. per bag _Ib.
The=al Resistance(R Value)_
Brand Name�/I Thermal Resistance(R Value)__,_
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)_
I hereby certi.27 that the above insula tion was installed in the above building,
- zs consistent with. approved building department -plans--and attachments. •and• con-
forms th requirements of pter 2-53 of Stat of California Energy Requiremen
%iyi+/fza
e
FIFmM NAME/OWNM STATE -COX?-ACTOR'S LICENSE NO.
. SIGNA= OF ON APPLICATOR IDATE
I hereby certify the required features, devices, and equipment, aw shown on the approved
Building Department plans and attachments have been installed and .conform to the appli-
ance standards and Chapter 2-53 of the State of California Energy requirements.
BUILDING CONTRACTOR/OWNER (Please Print)
(FIRM NAME)
IVI�
SIGNATURE OF BUILDINGCONTRACTOR/OWNER
HVAC FIRM NAME/OWNER (Please Print)
STATE CONTRACTOR'S LICENSE NO.
.2/
DATE r
STATE CONTRACTOR'S LICENSE NO.
SIGNATURE OF HVAC CONTRACTOR/OWNER 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.
SEPTEMBER 1988
a4...��.
. � x'. v'R4'�.
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A
E
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
• 7 County Center Drive - Oroville, California, 95965 - Telephone (916) 538-75ERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 043-253-012
ZONING R-1
BUILDING PERMIT
OWNER GODII\TEZ, FELIPE R. & ISABELLA
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
4, 428.00
OWNERS MAILING ADDRESSR3
630 BIDWELL DRIVE, CHICO, CA 95926
CONTRACTOR'S NAME MIKE ROSS
414H07072
CONTRACTORS MAILING ADDRESS
2668 GUYNN AVENUE, CHICO, CA
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
'
Total Valuation $
4,428.00
ARCHITECT OR ENGINEER
LICENSE NO.
-Filing Fee
$ 20.00
Permit Fee
$ 72.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 46.80
BUILDING ADDRESS 630 BIDWELL DRIVE, CHICO
Energy Plan Checking Fee
$ 23.00
$
PERMIT FEE
S 161 .80
LOT NO.
SUBDNISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF U Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
3 7.00 21.00
Solar or heat pump water heater
23.00
Water piping
1 15.00 15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition M Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: ADD BATH, BEDROOM EXTENTION, ADD CLOSET
TO LIVING ROOM.
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
920.00
PERMIT FEE
$ JQ.UU
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service Zppgp.LESS
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 full force and effect.
y J
License Class ,,� Lic. No. � �
OWNER -BUILDER DECLARATION
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.
❑ 1, 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
performance of the work for which this permit is issued.
❑ 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
Main Service ( 200A TO IOOOA
46.00
NEW CONST. DWELLING OCCUP.
OR (
3,5Q so
2.85
EW coNsr. Mulri ounS.
NON-RESID. ANC
97.50
PONGLE UTLET CIWER APPARATUS
8 SIO R.
Ex. OCCUP. OUTLET OR FURORES
20 @ 1'00
SAL ,So
UNS
Ex. Occup. ourLEEDTSA RES D.OEA.
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$ 22.85
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
DUCT
4.50
PERMIT FEE
_L
$ 24-90
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
qj�we hundred dollars ($100) or less.)
certify that in the performance of the work for which this permit is issued, 1 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.
/7 7
X�___ __ Date �l /
Signat re of Ap licant - ❑ Owner ontractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ 46.00
Occ
R3
CONST. TYPE
VNTOTAL FEE $ 11
HAZ.
r
0.FEESIMP
FLOOD
"'
COF
PARCEL PD
---,
HD SUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
1
the applicable provisions
Resolutions to do work
been paid.
a
Date Jdo
D.
Receipt No. 236548
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
• � ,t, -
i .�
��
'.. _ .. - l _ .1 ..
i_ _ _ - _ _?',_ . . . _
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COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
" V 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 ERMIT NC
(Rev I2mm APPLICATIO14AND PERMIT
ASSESSOR PAACELNUnEti ,�^ X53 _ I�
zO'? I
BUILDING PERMIT
`Zo oi:4 'we -r_ Fen K� nG
I
�y�
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
"'�2
8 • )b
_
OWNERS MAILING ADDRESS -3 V A j a�p `lI l by. C t�i i s �� 1• �a(o
/ �2
TELEPHONE
CoftroAcrowf MA!jNO ADORE" G
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ L4, 41
a 00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
ARCHITECT OR ENOINEER9 MMNG ADDRESS
Plan Checking Fee
$
6ua.DwOADORESS �b r
Energy Plan Checking Fee
$ aA !j . Q 0
$
1p PERMIT FEE
$
LOT NO.
SUSONISION'SNAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00 _J.Do
USEOFSTRUCTURE
SF 9( Duplex ❑ Mobilehome ❑ Other
SPECIE
Solar or heat pump water heater
23.00
Water piping
1 15.00 /5;00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition A Remodel ❑ Utilities ❑ Installation ❑ Other ❑
DescribeWork: aXSC):a d,�(�
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home IS I G I W
Q20.00
PERMIT FEE
$
M
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service =00' LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
1 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 Contractors License
Law for the following reason:
❑ 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.
❑ I 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.
❑ 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.5-p
My workers' compensation insurance carrier and policy number are:
Carrier
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'HAz.
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.
X Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0' deep and demolition or construction
of structures over 3 stories In height.
Main Service YooA To I000A
46.00
NEw CONST. owEuu+o Occup. 3.5¢xsG;
OR ADDNS. ( a ACC. eLos. `�
UTLET Q7,50
NEW NON-RESI°. MULTI OCIRCUITS
aroSMaL. o QTc R.
EX. OCCU OUTLET OR PomJRES en20L O I.w
FIXED APPLIJS. OR
Ex. Occup. ouTLETs RESIo. EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
9-5D j
t_
PERMIT FES i 5
Mobile Home Installation Fee L
Energy Inspection Fee 1 S L4 (0 -ou
occ
__5
r
TOTAL FEES )j
o. FEES
�.
IMP
.�
I FLOOo
I COF
PARCEL
✓
I PD
.r
I HO
YISSUPol
✓
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date _
pato
Receipt No.
WHITE •O.O.S.•8.0. CAN RY•ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
N
.,CO'U1VTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: v ASSESSOR PARC 011 3 -a 53 - n I o�
Proposed Building Use: Building Inspector: Date: ` / S ' Y,9
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All items have been submi'tted --------------------------------------------------------------------------------------
E12. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------
03. Complete plans, 3/4 sets, signed by the preparer of plans. -----------------------------------------------------
❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.--------
115.
-------
❑5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
❑6. Energy Design Compliance and supporting documentation. ----------------------------------------------------
117. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------
❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications.------------------
❑ 10. Fees of $ -------------------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. ---- 7------------------------------------------------------------
❑ 12. California Department of Forestry plan approval/fees. ---------------------------------------------------------
0 13 -Flood elevation certificate. ------------= --------------------------------------------------------------------------
4. Sanitation and plot plan approval_ Health Department. -------------------------------------------
❑ 15. City of Chico plumbing permit. -----------------------------------------------------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------------------------------
❑ 17. Planning approval for (A) Use: (B) Parking: --------------------------
1118.
-------------------------
❑18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. -----------------------
❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). ----------------------------
❑20. Pre -inspection for required Request to Building Inspector on
021. Contractor's license information. (Number, Name Style, Classification). ---------------------- =-------------
❑22. Workers' Compensation carrier and policy number. -----------------------------------------------------------
❑23. -Owner-Builder Verification (Given to owner ❑, Mailed to owner 13) - --------------------------------------
❑ 24. Letter of signature authorization. --------------------------------------------------------------------------------
❑25. Recorded copy of Agricultural Acknowledgment Statement. --------------------------------------------------
❑26. Letter of intent on building use. -----------------------------------------------------------------------------------
❑27. Manufactured Home utility clearance. ---------------------------------------------------------------------------
❑28. Existing violations and/or expired permits. ----------------------------------------------------------------------
❑29. ❑433.A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .---------------
030.
--------------
❑30. Other: -------
(Date)
When you issue thepermit, Drocess as follows ❑ Mail to owner, ❑Mail�to contractor.
Telephone y � N and hold for pickup at office. ❑ Deliver with inspector.
4Applicant:0��%�' " � Date:
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Ari Pollution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: t
1. Index permit application for the above items numbered: ❑ Plan Check List '
2. Additional items required
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ B 4ding Di ' 'on counter, by Date:
Plans reviewed by: Date: Plans approved by: Date: (p •� 2.9
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
Y ,
T0.
FROM:
SUBJECT:
Building Department
Environmental Health
Sanitation Clearance
--Tin4-�
..., .
E.H. USE ONLY
Plot Plan Attache
Floor Plan Attached�-
Sent to B.D
7�5 -y--VkSa S - OR
Owner Location AP##
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for dwelling. Other
Hold -final -for: -
Final clearance O.K. for:
NOTE:
En
8/96
nmenfal Health SpecialistDate
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