HomeMy WebLinkAbout043-720-034X72.::0'='034'
`HODGMS'j--, J. t* i
186
Bidwell, Chico
cont,r: Jessee H&AC
gas.heaters/sf
043-720-034 Q�,V, 00-2581
MR. & NIRS RADERkW,//-.5�-
1866 BIDWELL AVE. CHICO
CONTR: FOUR COUNTIES ROOFING
RE ROOF EXISTING ROOF W/CONM
0
0
HILL, A. 0. 779.
I L
0 72� -off. i
Bidwell Avenue aprox. 1/2, mi past Oak
Chico AN
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j A % 043-720-034 00-2581
MR. & MRS RADER
1866 BIDWELL AVE. CHICO
CONTR: FOUR COUNTIES ROOFING
RE ROOF EXISTING ROOF W/COMP
• 1
\\\ t COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, Calilbrnia 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER s,}�,/j� /{.►yr
ZONING
BUILDINGPERMIT
OWNER
•
TELEPHONE A
4— , 711
SO. FT, OCC. BUILDING VALUATION
p
Rereoi ei-i—sting roof w com osit
OWNERS MAILING ADDRESS -
1866 Bidwell Avenue Chico CA 95926
shingles
cOMRAVourNAME
Counties Rootin T43H-1416 ONE
38 squares $50.00 $10980.00
CONTRACTORS MAILING ADDRESS
3 Crusader Court Chico CA 95978
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 1.980. 00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $ 45.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
1866 Bidwell Avenue
Energy Plan Checking Fee $
PERMIT FEE S65.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ 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 ❑ Installation ❑ Other ❑
Describe Work: rAr00f existing rOOiN w1eomeoaition
ahin�lAl�
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home Is I GI W @20.00
PERMIT FEE $
ELECTRICAL PERMIT Fling Fee 20.00
'ORMain Service 200A OR 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.P
License Class C-99 Lic. No. 774554
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.
❑ 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
reason4.
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( s ACC. BLDS. 3.5QFT:
Nq=REENDT' MULTI.OUTLET @7.50
I OWEAPPARATUS
B SINOOUTLET CIR.
Ex. Occu • oUTLErORFDRURES 20@''00
BAL @ .50
Ex. Occup. ofluXTlEtOrsA NS OR.
5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
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.
Myworkers' com ensation insurance carrier and policy number are:
Carrier Vil�anova
Policy Number WC4-09836705
(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 _ ii t tCl_t '"Ag -,ate 10/1!100 _
SignatuPe of Applicant - ❑ Owner ❑Contractor 16 Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Fling Fee 20,00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 65.00
HA2.
D. FEFS IMP
FLOOD
CDF
PARCELPD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By ' `/�� ! ,f,/ Date
PERMIT EXPIRES ON
11
(Da te
ReceiptNo. q �� -
WHITE-D.D.S.-B.D. CANARY-ASSESSOR'r PINK-fNSPECTOR GOLDENROD -APPLICANT 1
.on
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
•' 7 County Center Drive Oroville, California' 95965 • Telephone (530) 538-7541 PERMIT N0.
(Rev.1V96) APPLICATION AND PERMIT
ASSESSOR PARCELNUMBER
ZONING
BUILDING PERMIT
OWNERpO--
Mrs. Rader
TELEPHONE
-
SO. FT. OCC. BUILDING VALUATION
Reroof exisl;ing roof
w com osit
.3290
OWNERS MAILING ADDRESS SS
1866 Bidwell Avenue Chico CA 95926
shingles
cDMRAFourECounties Roofin
3431416
33 s u res 60.00 =
$1,980.00
CONTRACTORS MAILING ADDRESS
3 Crusader Court Chico CA 95973
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $ 1 980 00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
45.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
1866 Bidwell Avenue
Energy Plan Checking Fee $
$
PERMIT FEE $
65.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ 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 ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: re=of existing roof w/com? nsiti on
shingles
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 200, OR 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.8
License Class C-39 Lic. No. 774554
OWN WILDER DECLARATION
1 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
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 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 `lillanova
Policy Number WU4-09836tb
(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.
i
X ___ QAte 10.118.100
SignatA f' ofof Appli�ner ❑Contractor 411 Agent
An OSWAW permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWEWNG OCCUP. SO
OR ADDNS. & ACC. S.3.50FT.
RESID. MULTI•oUTLET @7.50
WELER APUTLETPARATUCIR.S
SPOINGO
20@'.00
Ex. Occup. OUTLET OR FIXTURES BAL_ o .50
Ex. Occup. .LINED p'.Ip,OFRA, 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring '(' 23.00
<TCR FEE $
MECHANI ERMIT (ling Fee 20.00
Heating
CoolingO ZS
Hood 6.50
Ventilation L
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 65.00
D SEs IMP
FLOOD
CDF
PARCEL
PD
I HD
I ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By 67PO4- ate 5 Q�
PERMIT EXPIRES ON �� �✓�
Date
ReceiptNo.
WHITE-D.D.S.-B.D. CANARY -AS ESSOR PINK-IFNSPECTOR GOLDENROD -APPLICANT
on
+ • 1. 1
" - 043-72-0-034
HODGES, Jackie 92-3613P,E,M
C 1866 Bidwe11�' Chico
contr: Jessee H&AC
gas heaters/sf
S
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t
i
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• � �� ,2i a S� ` �,�� 62' J Geo -'`�"�
OFFICE COPY
Address 'cTD
GAS
Meter By Date)
ELECTRIC
Meter By a e
/0
�r1 1
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS . PERMIT NO. ,
-4I 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
043-720-034
ZONING
ASR `
BUILDING PERMIT
OWNER ,.
Jacki Hodges
TELEPHONE
345-4811
SO. FT.
OCC.1 BUILDING VALUATION
OWNER'S MAILING ADDRESS
1866 Bidwell Ave. Chico 95926
CONTRACTOR'S NAME
Jessee Heating & Air Conditioning, in
TELEPHONE
. 891-4926
CONTRACTOR'S MAILING ADDRESS
3025 South ate lane Chico 95928
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation
is
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
1866 Bidwell Ave.. Chico
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 1 7.00 7.00
Each qas water heater or vent 2 7.00 14.00
USE OF STRUCTURE
SF ® Duplex❑ Mobilehome❑ Other
SPECIFY ,7,
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G W I @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ '.ther [
Describe work: Replace Heat Pump with Gas ater
&.2 Water Heaters,
Permit Fee $ 36' 00
•
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service ZOOAORLESS 18.50
CONTRACTORS LICENSE LAW l
I declare under penalty of perjury (Check One):
I am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$
and Professions Code and my license is in full force and effect.
License No. 405411 Classification (1-21 4$
ElI, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or, offered
for sale. (Sec. 7044) j
❑ I, as the owner, am exclusively contracting with licensed contract -
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service 200ATO1000AI 37.50
NEW CONST. ( DWELLING OCCUP.&) 3.6Qsq.ft.
OR ADDNS. ACC. SLOGS.
NEW CONSTR MULTI -OUTLET
NON-RESID BRANCH CIRC ITS @ 5.00
(POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20 76o
M
Ex. Occup. OUTLETS FIXED APP(RESID IREA.) 1I 3.00 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 18.1)0
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
LP a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Feel 15.00
Heating 1 V.00
Split
Cooling `On 1 • .5
9
Hood
t6*50
Ventilation
Permit Fee
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all, liabilities, judgments, costs, and expenses which may in any way accrue
aga,Lnst said County in conse uence of the granting of this permit.
�X at,_� �l--r! �"p', � Date /ii—/�'�7
r*21❑
Signature of Applicant — Owner❑ Contractor Agent
�A0SHA permit is required for excavations over 5'0" deep and demolition or construct-.
•on of structures over 3 stories in height.,
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE$94.50
HAz
DFEES
IMP
FLOOD
CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the applicable provi- I
sions of the Butte County Co°de and/or resolutions to do
�
work indicatet�bove for which fees have been paid.
W 1/
�DIRECTOAFOF PUBLIC WORKS
By ,�{r%y' / f,-, Date, e2. 139
PERMIT EXPIRES Date %CJ -7�„ 9g
Receipt No. 126013
WHITE•D.P. W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
--" COUNTY OF BUTTE
Y .
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt TRoad, Chico, CA - (916),891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
OWNER PERMIT NO -
A routine inspection indicates that the following violations of Butte County Ordinances existat
the above address and should be corrected. Please notify 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.
I
==wiifd Lrd way,fmif
iiiiiiiiiiiiiiiiij
Date Z Inspector
REV 11/91
- COUNTY OF BUTTE ;
' ' ' DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
OWNEW PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
rY\ � rl , 5 Ric,6 - r) 'r " V ° t) r,-�, , . - r- fzo A A Ti -,
Date � �'� �� Inspector
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
A
PERMIT NO.
01-3
All
ASSESSOR PARCEL NUMBER
043-720-034
ZO,tJING
' ASR
BUILDING PERMIT
OWNER
Jacki Hodges
TELEPHONE
345-4811
SO, FT, OCC, BUILDING VALUATION
'
OWNER'S MAILING ADDRESS
1866 Bidwell Ave. Chico 95926
CONTRACTOR'SNAME
TELEPHONE
Jessee Heating & Air Conditionin Ind.
891-4926
CONTRACTOR'S MAILING ADDRESS
3025 Southgate Lane Chico 95928
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
1866 Bidwell Ave., Chico
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
1 7.00 7,00
Each pas water heater or vent
2 7.00 14.00
USE OF STRUCTURE
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
SF® Duplex❑ Mobilehome❑ Other
Mobile Home S I G I W
@ 15.00
SPECIFY
TYPE OF WORK
New Addition ❑ Remodel❑ Utilities❑ Installation❑ Other®
PerrnitFee
$36.00
Describe work: Replace Heat Pump with Gas Heater
Contractor
& 2 Water Heaters
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18,50
Main service 200A TO t000A1
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the BUslnes$
and Professions Code and my license is in full force and effect.
License No. 405411 Classification cf-gn, 1-3
NEW CONST. DWELLING OCCUP.&`
OR ADONS. ( ACC. BLDGS. I
NEW CONSTR. MULTI -OUTLET
NON•RESID BRANCH CIRC ITS
POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. OCCup(OUTLETS OR FIXTURES
3.6dsq.ft.
@ 5.00
20 760
❑ I, as the owner, or my employees with wages as their sole compen-
Ex. OCCUp. OUTLETS FIXED P(RESID IREA.�
I 3.0O 3.00
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
Temporary service
Mobile Home Facilities
Misc. byirin g
1 15.00
15.00
'15.00
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Permit Fee
$18.00
WORKMEN'S COMPENSATION INSURANCE
Contractor
I declare under penalty of perjury (check one):
MECHANICAL PERMIT
Filing Fee 1 15.00
❑ The permit is for $100.00 (valuation) or less.
Heating
0.00 19.00
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
S lit
Cooling 32 Ton
1 6.50 16.50
❑ I shall not employ any person in any manner so as to become subject
Hood
6.50
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Ventilation
perrnit Fee
Contractor
$ 40.50
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also a ee to save, indemnify and keep harmless the County of Butte against
al Iiab i ies, judgments sts, and expenses which may in any way accrue
ag st id Cou in c nse ence of the g anting of this permit.
Mobile Home Installation Fee S
Energy Inspection Fee $
Occ CONST TYPE TOTAL FEE $ 94.50
HAz DFEES IMP FLOOD CDF PARCEL PD HD ISSUE
Date /�—%o� �%�%
This permit is hereby issued under the applicable provi- �
si nar re of A licant - owner
g pp ❑ Contractor � Agent ❑
An SHA permit is required for excavations over 5'0" deep and demolition or construct-
of structures over 3 stories in height.
Receipt NO. 126013
Bions of the Butte County, a and/or resolutions to do j
Work indica ab ve r hick fees have been paid.
R F PUBLIC WORKS
BY Date -O- -
PERMITEXPIRES Date
WHITE-D.P.W., •ELLOW-ASSESSOR, PINK•INSPECTOR, GOLDENROD -APPLICANT
�r{1+Y`�1v�'F;!'+9i'S7'q�/4�Tfhi'�'�' ' �i'l�~^��"_}�z. ''..T�/Y11�.�,�,''",.�.�Ld ^"�if'�F�f7cslv��vS 71"+q. 1frr��M1�i .��„y(••�•,a�'
COUNTY OF BUTTE i DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE,,;�ALIFORNIA 95955 , TELEPHONE (916) 538-7541 ,
PERMIT APPLICATION DATA SHEET
OWNER 1� D D CD S A. P. o. 4 3-72D
Proposed Building Use Building Inspector Date
At time of perm
i 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 submitted. .. ':.. .... ... ... .. .. ....... .. ... .. . ...
2. Plot plans, 3/4 sets, signed by preparer of plans . ...........................
3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... .
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form.........k..... ...............................
6. Energy Design Compliance and supporting documentation�r� ................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in'duplicate (required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of$ ..........................................
11. Impact fees as shown on attached schedule . ..............................
° 12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . .............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements , (B) Drainage. .......... .
' 19. Driveway permit (construction approval required prior to occupancy). . .
IS44Aspection request
20. Pre -inspection for required. . to Building Inspector (Dale)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner _)............
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ......................................... .
29. Documentation of legal access . ........................................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
• and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When you issue the permit, process as follows: Mail to owner. _ _ Mail to contractor.
Telephone and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation
Acreage ApV ficant Date
Copy of Haz-Mat form sent Health Dept. Fire d`ept_.,. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. r Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541
APPLICATION AND PERMIT
ASSESSOR P RCEL NUMBER
ZO„5-
BUILDING PERMIT
o NE wEL
v ro
PHo
SO. FT.
OCC. BUILDING VALUATION
O R'S IL NG ODRESS� �'
CON A 'S NAr• i�
TELEPHONE
CO ACTOR'S MAILI AOORESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee $ 15,00
LENDER'S MAILING AOORESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUIL 1 G 0RESS G
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
Each Trap I 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping 7.00 O
Each pas water heater or vent 7.00 UQ
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
FV
Gas piping system 1 - 5 outlets 5.0
'Building sewer 15.001SPECT
Mob le Home S G W 1 615.001
TYPE OF WORK
New ❑ Addition ❑ Remodel C Utilities ❑ Instal latio ❑ 0th r ❑
Describe work:
�.
Permit Fee $ r
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 600v OR LESS 18.50.
200A OR LESS
Main service 20CATO1000A1 37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. Business and Professions Code
for this reason
NEW conlsT.( DWELLING OCCUP.b+ 3.6dsq.ft.
OR AO NS. AGC. SLOGS. II
NEW CONSTR. ULTI.OUTLET la 5.00
NON-RESID BRANCH CIRCUITS)
POWER APPARATUS b
(SINGLE OUTLET CIR.
(
Ex, OCCUp\OUTLETS OR FIXTURES 20 76d
AL
Ex. Occup. OUTLETS IIFIXEO RESID 1REJ I 3.00 r
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring '15.00
Permit Fee $ e
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT Filing Fee 15.00
Heating r
Cooling
I Hood 6.50
I Ventilation
Permit Fee $
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in anyway crue
against said County in consequence of the granting of this permit
X Date 7/
Signature of Applicant — Owner L7 Contractor E] Agent ❑
An OSHA permit is required for excavations over 5'0" deep and de olition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEES r
HAz
0FEES
IMP
FLOOD
CDF
PARCEL
PO HD
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
Work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES Date
/1
Receipt No. I �D 32
.�
WNITC-O.P.W., TCLLOw-A9eC3lOR, PINK -INSPECTOR. GOLDENA00•APPLiCA04T