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Home My WebLink About047-200-06654 047-20-0-066 x 91'-3879' BRADLEY, LINDA CONTR:' OWNER .4,587,W06KEY RD. CHICO SERV &.M!ISC ELEC/SF -"N,/RACOUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, 6a.1 fornia 95965 -'Telephone: 916%538-7541', + w., ,7 APPLICATION AND PERMIT -' ASSESSOR PARCEL NUMBER 47--204-066 ort. ZONIING A BUILDING PERMIT OWNER I Linda Bradlev TELEPHONE 342-2956 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 4587 tdooke Rd.. Qdco 95926 CONTRACTOR'S NAME Owner TELEPHONE 4. CO.NTRACTOR'S MAILING ADDRESS 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 r Permit fee $ PLUMBING PERMIT Filing Fee 15.00 4587 14nn ov Rd., MIan Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME ✓^j PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other i - SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S TGTW @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other FA Describe work: Replace Hemi Service $ Misc Electrid f /1 j � Q '$ al i rj i� /'! I" r a7 r T _/ �1 ry t..., T� u.• r b. .a'� / E:� N Permit Fee $ Contractor ELECTRICAL•PERMIT Filing Fee 15.00 -lira /n nr •.rcck- n fir✓ a`" E v r �4 600 V OR LESS �n Main service 18.50 200AORLESS 3 38,50 Main service 200A TO IOOOA) CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I 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 _37.50 NEW CONST. DWELLING OCCUP.& 3.64 sq.ft. OR ADDNS. ( ACC. NEW CONSTR. ULTLOULET I OUT NO N."ESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES AL 8 20 @ 76 FIXED APLNS. Ex. Occup. OUTLETS PIRESID IREA.) 3.001. Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 1 -15.00 15.00 Pre -Inspection 3 t :W00 Permit Fee $68.54 — „ WORKMEN'S COMPENSATION, INSURANCE I declare under penal ty,gtperjury (check one):'' ❑ The permit is for $100.00 (valuation) or less. E]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-Insurer I shall notemploy any person in any manner so as to become subject LP to the W. C. laws of California.' ,;:" v 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 MECHANICAL PERMIT FiIingFee 15.00 Heating t Cooling Hood 6.50 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(liabili6es, judgments, costs, 'and expenses which may in any way accrue against-s�a%id County in consequence of the granting} of this permit.; '��1` 1 Date $Cgnaty� of Applicant — Owner til Cenrraara�f❑ Agent ❑ An OSHA ' I permit is required for excavations over 5'0" deep and demolition or construct-/ ion of structures over 3 stories in height. j Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $66.54 HAI DFEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do j work indicated above for Wh'Trch fees have been paid. +` % DIRECTOR OF�PUBLIC WORKS By '/. ��y' Date //-f-9/ PERMIT EXPIRES Date % /r' /. -'! r._,.. 303036 - 68. Receipt No50 . r WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE J. . 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 :=1 CORRECTION NOTICE , V— ` IWNER- PERMIT NO: A routine inspection indicates that the following violations of County.Ordinance exist 10t1g,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 eed additional explanation, please contact this- office immediately. '/ A.,4O '5rL`n—n.LA/P_I L9 / 'iLr,,CLi.l 4 f c /�% "l r` �/ Q. I "�. / N I t 1 4 0 A jy Q Al n r D )�� ry C n ✓1/� �D - xE 4 Date `I�— 1 Inspector Date Inspector s COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS r 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541' 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER ' PERMIT NO. p, r, t A routine "inspection indicates that the following violations of County Ordinance r± 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, oeed additional explanation, please contact this office immediately. Date Inspector s r � COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville; California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 47-200-066(port.) ZONING', A-40 BUILDING PERMIT OWNER LindaBra le TELEPHONE SO. FT. OCC. BUILDING VALUATI ' i' OWNER'S MAILING ADD ESS 4587 W keRd., Chico 95926 CONTRACTOR'SNA E TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15,00 LENDER'S MAILING ADDRESS - 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 okey Rd Chico Each Trap 5.00 , Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent - 7.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ® Describe work: Replace Main Service & Misc Electrim ++I' f/ P_DeL_. r-- i'� 7. f /� r'� / 4 r r'TKy LZTiO , Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 n...ic S C+Q. 600V OR LESS Main service 200AORLESS O C 1 18.50 18.50 Main service 200A TO IOOOAI 1 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 Business and Professions Code and my license is in full force and effect. License No. Classification -Ex. IEA.) , as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.& OR ACDNS. (ACC. BLDGS. 3.64sq.ft. NEW CONSTRESID, RANCH TLET NO N.R ESID BRANCH CIRC ITS CIRCUITS) @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 20 76 JAL_ 8 ARA Occup. OUTLETS ED PLNS (RESID IR 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 9 1 -15.00 15.00 Pre—Inspection 1 .00 Permit Fee $ 6s- Cin — 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 subjectHood to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling g 6.50 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I also agre to save, indemnify and keep harmless the County of Butte against all liabil' s, judgments, corp, and expenses which may in any way accrue ag Id County in cons q ence of the granting of this perm X Q Date 11711A;71 Signat a of Applicant — Owner Cantracta Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height.By.v Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 68.50 HAz 1) FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indic above for h fees R UBLIC 4ffiot� PER IT EXPI • ES Date applicable provi- resolutions to do have been paid. WORKS Date __Z/ — �q Receipt No. , 103036 — 68.50 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT i • ry COUNTY OF BUTTE - DEPARTMEsNt';-00PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLIMION DATA SHEET / ' Permit No. 1, N1_2A 9r,AD1e_j 1-17' 200 _666 OWNER /' A. P. No. Proposed Building Use P(J�/iIZ %IJ (%tLSuilding Inspector 2LI Date — At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 1.�All DATE RECEIVED APPROVED items have been 2.• submitted . .............................. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form....................•�.................. 6. Energy Design Compliance'and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... _ 3 School District fees paid .............. .14. Sanitation approval from Health Department 15. City of Chico plumbing permit........... 16. Plot plan and business license approval froom City of (see City for other requirements) - 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) .' 20. Pre -Inspection for rEo Uir j k4 U+I I f4fe5veq u i red,/.".Pre-Inspec. request to " 21. Building Inspector (Date) Contractor's license information (No., Name Style; Classifications ... 22. Certificate of Workmans Compensation Insurance ..... 23. ... .... . Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: _(Mail to owner. Mail to contractor. ' Telephone and hold for pickup at office'. Deliver w/inspector. Other ApP'ic Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new 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_lnail—co Contractor, designer, owner, was advised of above required data by—phone—mall—co Plans checked Copy—DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder by ..date by date Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Califoroia 95965 - Telephone: 916.'538-7541 APP�IC�TION AND PERMIT ASSESSOR PARCEL NUMBER 01,11 Q 7 '�0W - 7U BUILDING PERMIT OWNER �^TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S ADDRESS /sgG 9552 CONTRACTOR'S NAME 0W'NCe_ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 41_5—e 1/U o o k _ Permit fee $ PLUMBING PERMIT Filing Fee 15.00 C Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF(�- Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 1 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition � Remodel ❑ Uti lities � Instal lation C Other ❑ �Describe work: ` r— a in/ e'er%ik e /Vjf S L �"ILrC-t Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 200A OR LESS 18.50 ,SO Main service 200A TO 1000A) 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 Business and Professions Code and my license is in full force and effect. License No. Classification 17t, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors, (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.(DWELLING OCCUP OR ADONS. .� ACC. SLOGS. 3.60 sq.ft. NEW R SID. BRANCH NON •RESI D. BRANCH CIRC ITS .�la 5.00 (POWER APPARATUS s\ SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 20 761 FIXED Ex. Occup. OUTLETS (RESID )LNS.REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. �Virin g 15.00 15. O a r Permit Fee — 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. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Coolin g Hood 6.50 Ventilation penult Fee $ LContractor 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 against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner[] Contractor ❑ Agent ❑ An OSHA ion of structures f over 3gstoriesoinehe excavations over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Ener Inspection Fee $ Energy P OCC CONST TYPE TOTAL FEES-,--�'--- HAz 1 11 FEES IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. Q 343 lv� WHITE-D.P.W., YELLOW-ASSE330R, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive,,Oroville, CA 95965 Phone: 916-538-7541 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 major labor and m teria for construction of the proposed property improvement (yes or no). 2. I (have/have not) --J signed an appl`'cation 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 Contractors License No. 0 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 Contractors 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 Sign NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. a PRE -INSPECTION OWNER: DATE % / - � - ' 7 / LOCATION: (A)onP.t�l � V(`� A.P. #dy% - Zoe - - Q / CONTRACTOR: /J (J`i N� ZONING l �l 6 PRE -INSPECTION FOR: V �' r T h r k,e—> r) I Iq(�-eM Pjj+ oiP nn & 11 �o ",:Rqp C, I << P DATE TO INSPECTOR PERMIT HISTORY: NONE KI AS FOLLOWS: Z��-er ,A tt A C - h e d� ^� TYPE OF OCCUPANCY_I� FIELD - INFORMATION BUILDING USAGE: 2 e-�5 i l e -,j 4 o0m". 6 OCCUPIED D/ HAS ELECTRIC �f1AS GASAS SANITATION FACILITIES E-IHEATED-COOLED =✓PERSON CONTACTED OTHER COMMENTS: ACTION RECOMMENDED: ISSUE HOLD lAne-rD k/ AA PA lO 411-Pe1 IntaNio.A 1 OTHER: bii ,t � o «- 4r. Z/' I f t Al k;P;.-hP. BY DATE _,��—� vr� tis 6c�(glf66 �GSSutg` r[�Y ,. J _. .. i, C� ..-.__._�__.__1_ j�.. . J "r COUNTY OF - DE4AT'F NT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. d Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. ZONING- L� Q-% OWNER PHONE NO. ,/ VE- F 7�' �� OWNER'S ADDRESS FI LOCATION OF BUILDING USE OF BUILDING SIZE OF STRUCTURE L S X Z_ S` _ � SO. FT. TYPE OF CONSTRUCTION: ,/ WOOD FRAME STEEL � CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING FLOOR TYPE //'2.✓ C'or rc ESTIMATED COST OF CONSTRUCTION. 4 Q $ �p EGBings shall comply with th�uilding front, side., and rear yard requirements of the applicable County �/ es as follows. f%�� 30 ' `� l % �eZ� f O FRONT SIDESS REARS F AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above. and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. �L Date % 7 )(Signature of Owner "--Z' Permit Fee - $25.00 The above described AG Building is exempt from a building permit. Receipt No. '1 (o-49QA Director of Public Works By. Date 94-4? ' White - DPW, Yellow - Assessor, Pink- B. I., Goldenrod - Applicant N ,n COUNTY OF BUTTE - DEPARTMENl'�&F TJBLIC WORKS - BUILDING DIVISION , 7 COUNTY CENTER DRIVE - OROVIL"LE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 r % PERMIT APPLICATION DATA SHEET C Permit No. OWNER S f D 7`� ' tt A. P. No. y7 a \1 " % Proposed Building Use Ih Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector—r-","\ Date—ah 473, At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in dup,icate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intert for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . ... . 17. Pre -Inspection for Required. request to (Dote) P q Building Inspector 18. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant �' �z Date 2 Copy of plans sent Health Dept., Fire Dept., Other Date During the plan c-iecking process, the following data must be submitted prior to permit issuance. (Foi required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date Other: Copy—DPW