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HomeMy WebLinkAbout047-320-032i i p ' v 47-32-32 f If 1 t I ! f Cont: Western Sierra Const. 6rh u M 47-32-32 7ARIN- &-KIM-'JERGENS -- -- - - - AJ . 14021 Greenberry Ln., Chico Cont: Western Sierra Const. Permit #3512-85B P,E,M(new SF) 047-320-032 04-2029 DEMASI, JOSEPH i4021 GREENBERRY LN, CHICO Cont: FOUR COUNTIES ROOF REROOF/SF u M M � � � ,;0� I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds PERMIT NO. BP042029 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 07/12/2004 APN: 047-320-032-000 the Business and Professions Code, and my license is in full force and effect. License Class 63 % License Number:' � :—R— Site Address: 14021 GREENBERRY LN CHI Date:% Contractor:G}�_ COii iS /, Map, Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: RE -ROOF (28SQ) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: DEMASI JOSEPH A & JUANITA M REV LIV to its issuance, also requires the applicant for such permit to file a TRUST signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section DEMASI JOSEPH A 8r JUANITA M 7000) of Division 3 of the Business and Professions Code) or that he or TRUSTEES she is exempt therefrom and the basis for the alleged exemption. Any 2412 HARDING AVENUE violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): REDWOOD CITY, CA 94062 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, Applicant: FOUR COUNTIES ROOFING provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 3 CRUSADER COURT proving that he or she did not build or improve for the purpose of sale.). CHICO, CA 95973 ❑ I, as owner of the property, am exclusively contracting with (530) 343-1416 licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: FOUR COUNTIES ROOFING 131 am Exempt under Article 3 of the Business and Professions Code 3 CRUSADER COURT Date: Owner: CHICO, CA 95973 (530) 343-1416 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 774554 workers' compensation, as provided for by Section 3700 of the License #: 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation rr. Engineer: 9 insurance carrier and policy number are:: Policy #: Total Square Ft: 0 S. F. ❑ 1 certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: 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 provi ions. 0 Date: 1 Applicant: WARNING:Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of�}— 1 compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Cods ?nrvor I hereby affirm that there is a construction lending agency for the Resolutions do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) 7. 1-? • 04 Name: By: Date: PERMI XPIRES ON: 7' 1 � ' p5 Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge itis unlawful to alter the subst fficial form^or document of Butte County. I hereby ^ authorize representatives of Butttee C�o/u`nty tL enter upon til above mentioned property for inspectio urp!Iny al l ZZIA�i Print Name: / % l Signature: /V 2 Date: / ❑ Owner Contractor ❑ Agent for Owner 0 Agent for Contractor i► . BUTTE COUNTY - DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION .AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF A PPLICA TION LOCATION Property Address 1 LA 02I G{eev) bC rn C f+ t Cross Street WORKER'S COMPENSATION Policy Number 00053-oZ Carrier at -e Corn P avis . 'rueld If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit Issuance. LENDING AGENCY Name Address PERMIT NO. BP c BIN # OWNER Name Rdele Oe Mas' Address I,� p2 I Gre City Chi C() State C(4. Zip QS°I Zlo Phone � y s _ 5 Z � Fax r . E-mail CONTRACTOR Name C Address�-- City C// l 0 State. Zip _5' Phone Faxes _s—� E-mail Lic. #s- lass APPLICANT NAME ARCHITECT/ENGINEER Name City i Co -- Address 11 5Q -73- City Fax 3q3"—':5R -74 State Zip Phone Type Const. Fax E-mail Map Book State License Number APPLICANT NAME Name .-, hug umi es Ro�fi'n Address 3 &A S a d er C-7 City i Co -- State CA -- 11 5Q -73- Phone Fax 3q3"—':5R -74 E-mail APPLICANT SIGNATURE' X For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Description or Scope of Work: e roar- ' cl -I, rx C4 T 00� ci It2 C S Sq. Foota a ag D ❑ Structure Built without Permits ❑. Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be --tcr.wl•,�-a-rvtc-acr.r•�r�ai�--------------------•----- -- Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not r refundable. Page 1 of 2 Received by: Amount: S' Bldg SRA Receipt M 46 toga $ Sheriff SMTP Date:Other • 7/f,z�o4 Total REV 4-30-04 I. y PERMIT NO. 3512-85B,P,E;; PERMIT EXPIRES ' �7— 0 TJ OWNER AR•IN & KIM JERGENS CONTR. WESTERN SIERRA CONST. r' ASSESSOR PARCEL 47-32-32 LOCATION 14021 Greenberry Ln„ Chico 1 OFFICE COPY -� Address GAS Meter By a e ELECTRIC Meter By S i2 Date i .OFFICE COPY 4 Address GAS Meter By Date �- � ELECTRIC' Meter By,� Date ; ' t Temp. Power Pole I { Called PG&E i Temp. Elea Service i Called PG&E f , Temp. Gas Service Called PG&E JOB FINALEI Signature V OK ' " O = Not OK Not Applicable MOBILEHOMES = Not Ready • t MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -.Easements 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rfirs. -Con nec.-Shthg.-Rig.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas;.Location-Test-Wrap:/ /"L"ft./ /"Nat.or/ ./"L',ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/0 to Grade -HD Approval 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged B. Elec.; Grounding; Equip.w/5'-Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy - 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test f + Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date C"J.= OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL JSjngle and Duplex) Date U RFLOOR Plans OK exce i+Y's Date FRAMLNG Continued oning requirements -Setbacks -E- meets Property Line Firewall & Openings Ftg., Main; Soils-Steel-Ele - /T2„/" Ftg. Depth 491 Ext. Doors -One 3' -Check Garage -3rd story, 2 exits Ftg., Garage; Soils -Steel- /.. /'r Ftg. Depth s; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5 . lywood on Roof Overhang -Attic Vents -Rafter Outriggers Stemwalls, Main; Steel-Blockouts-Wrapped-Slab Siding -Na' .ing-Veneer temwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stuc esh-Dri eed-F ents-Un fir. Access Piers -Fireplace Ftg.-Steel Glazing Area -Glass PzFot#ction-Sk lights -Plastic D. .V.: F -F'" ngs- st way C/0 -Sewer a 6*_-4hear.W IIs; Nailing Bolts . Gas Pipe; Size -Anchors. 1 Water ; Tem Anc s -Regulator vice Te 1.1. Electric; Underground 1 . Plenums & Ducts; Clearance -Material -Support -Ins. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI 6Z, Date ' Card -BI Date Card -BI S Date 11JUM Card -BI Date Card -BI Date f I Card -BI Date Card -BI Sie. Date I ajg4g Card -BI Date Date FIN (Plans) OK except q's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except k's 5V' Ext. Steps -Door & Sidelight Protection -Landings 87,�moke Detector .IV. 14. Water Ht.; Vent -Access -Combustion Air 5 urnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 1 ter Pipe; Test & Anchors -Nail Protection 1 D.W.V.; Test-Fttngs & Anchors -Nail Protection Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 6 .F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 6 lec. Trim & Subpanel; Breaker Sizes -Labels 10r Gas Pipe; Size & Anchors 62.Staisa•& Rails 6 F' eplace or Stove; Clearances -Hearth 6 �Ejec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date Card -Bi Date Card -BI Date 6 Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 6 lec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK exce t p's' Garage Fire Door; Swing -Landing -Closer � 68�C:Duct in Garage -Damper 2 tura &Transformer Clearance -Ins. Protection 6 r. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In arage; Above Floor-Mech. Protection 2 c. Receptacles Spacing -Lights & Switches at Doors 2 S' Boxes & No. of Conductors -Stapled 7 Elec. &Mech. Equip. Listed for Location 2 ex Installed Close to Edge of Studs & C.J. 7f✓Elec. Receptacles in Garage; (G.F.I.)-Ro x Protec. 2 quip. Ground made up w/Mech. Fasteners -Bond Gas & Water o 7 a, -Foam -Looked in Attic Yes 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails Deck Construction -Post Caps 7�Qtr. Vents & Crawl Hole or -Drainage & Wood -Earth Clearance Looked under Floor Yes 7 F in instld.: Drive s No; Walks Yes o; �w g ❑ ❑ Planters 2yes 6s4•P10-- 26 ed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 2 Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No -*e-28. Service -Riser Conductors & Ground -Main Disconnect 2, S Stucco; Br n -Finish C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _Venis Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn s. 2 Equip. Clearances; Panels-Motors-Mech. Equip. -911_4 "hes Closet Light -Shower Light Wa)er Well; Disconnect, Electrical, Plumbing 8G/� erior Elec. Trim; G.F.I. Receptacle -Underground Card B I Date Card BI Date a tilation throughout House 8"1 s Protection Card B -I Date Card -BI Date Date MEC LAICAL (Permit) OK except q's 8 C rrec ions from Previous Inspections est -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval 24- . Ducts; Insulation & Support Vent Fan; Exhaust above Insulation Energy Compliance Certificate -Other Certificates U-6ortdensate Drain & Overflow; Size & Grade 4. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet ?5__AUic Access & Platform if Furnace in Attic Card -BI Date 2. Card -BI Date Card -BI Date Card -BI Date Card BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FR ING Plans OK except q's Is; Proper Material & Anchors alls; Studs -Nailing, Spacing & Bracing -Plates -Sound Arrftw 3 Varing Walls over Girders & Floor Nailing 3 I}caff Stop in Walls (rat proof) 4 re Stops; Furred Ceilings -Stairs -Chases -Tub ead r & Beam -Size & Bearing 4e njers-Post Caps -Anchors -Connectors 4 Ing. Joist-Rftr. Ties-Purlin-_Roof Brac.-Truss-Shlhn_g.-Rfn_g_._ _ 4 .Fireplace Ties or Type A Flue -Fireplace Throat ttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4 Odrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 4W Garage Fire Protection Framing COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS f 196 Memorial Way, Chico — Phone 891-2761 y 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE jc,.r 2.,:, ?<12- FS" OWNER 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. r- �I.1 ./'�iA �.� f� /�/IC ✓�`T I"`7 �J �O 3.11 (rA/_QRP Q'�:'0e' _�0 ✓SQ_ 5159 /9 l (r> 5i l Inspecto�Date ,)__ z-<-- Sf(- _ COUNTY OF BUTTE i DEPARTMENT OF PUBLIC WORKS A 196 Memorial Way, Chico — Phone: 891-2151- 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE S /2 -25' 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 Inspector_ AG8� Date_1 G -S Owner: Permit No. ENERGY C :RVIF LCAT I0N _ Greenberry Lane LOCATION A.P. No. DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material_ Fiberglass Batts Thickness(inches) 614" CEILING Brand Name Thermal Resistance (R Value) Brand. Name Owens-Corning Thermal Resistance(R Value) R 1 9 Batt or Blanket Type Brand Name Thickness(inches) Thermal Resistance(R Value) Loose Fill Type Fiberglass Brand Name Owens-Corning Minimum Thickness(Inches) 14" Number of Bags 31 Wt. per bag 35 lb. Area covered(ft.`) 115.36 Thermal Resistance(R Value) FLOOR, ELEVATED Material Fiberglass Batts Thickness(inches) 614 " FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) Brand Name Owens-Corning Thermal Resistance(R Value) R19 Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify that -the above insulation was installed in the above building in conformance with the State of California Energy Requirements. LOERKE INSULATION CO. #432518 FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. AT a -V,74 February 4, 1986 SIGNATURE'OF INSTALLATION APPLICATOR DATE I hereby certify the above insulation acrd all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. FIRM NAME/0 R (Please print) STATE CONTRACTOR'S LICENSE NO. - ��4?,� SIGNATURE -GENECONTRACTOR 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. January 1984 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 • - APPLICATION ANY PERMIT - PERMIT NO. - S ASSESSOR PARCEL NUMB Ai ZONI BUILDING PERMIT OWNE` �}.. ,/t, } - l I I TELEPHON SQ. FT. OCC. BUILDING VALUATION OWNER'S MAIL NG AD ESS /) t /�/ r CO TRACT R'S NAE n1 V, V I 14 Ir lteA TELEPHONE CON RACTO^^R'S MA NG ADDR SS _ a d v 2 0 0 l Fireplace it� k000 CON jijUCTIO LENDER UNKNOWN Total Valuation$ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCH ECT OR ENGINEER J///O ; LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ Z51 I ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ • BUILDING ADDRESS (91-oeq be re Permit fee $ 119. PLUMBING PERMIT Filing Fee 10.00 Each Trap St 2.00 Solar or heat pump water heater 20.00 CLOT N SUBDI I ION AME a• �G(� © Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF [A Duplex❑ Mobilehome❑ Other SPECI FY Gas piping system 1 - 5 outlets 5.00 19 n Building sewer 5.00 Mobile Home S G W 0.00 ea ,. TYPE OF WORK New Additiondel❑ Utilities ❑ Installation❑ Other ❑ 'Describe work: c a o Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 1 10.00 Main service 1 000V OR 0 AMP ORLESS10.00 4.00 Main service EA. ADD'L too AMP 2.50 CONTRACTORS LICENSE LAW I decVIunder penalty of perjury (check one): i am licensed under provisions of Chapt. 9, Div. 3 of the Business s and Professions Code and my license is in full force and effect. License No.%�� 3 Classification] d'-'' ❑ 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 CONST. (DWELLING OCC 1/zOsgft OR ACDNS. ACC. BLDGS. NEW CONSTR. ULTI-OUTLET 2,50 ea NON.RESIO BRANCH CIRC ITS POWER APPARATUS &) (SINGLE OUTLET CIR. EX. Occup(OUTLETS OR FIXTURES 20050t eALO 30 FIXED APPLNS. OR \ EX. Occup. OUTLETS (RESID,) EA./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ as— 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 10.00 Heating4,00 Cooling Cp. Q Hood 3.00 Ventilation3 r 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 Wd keep harmless the County of Butte against all liabilities, dgments, cost and expenses which may in any way accrue against sai ou ty in consequ ce of the granting of this permit. Xate 6y Signature of Applicant — Owner ❑ Contractor Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 height. Mobile Home Installation Fee $ Energy Inspection Fee $ 0 TOTAL PERMIT FEE $ o cu P. 3 co [ 1 oD PARCE PD ND IS F, I/'// This permit is hereby issued under sions of the Butte County Code and/or work indicated above for whi h DIR R OF P LIC a By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date /s�toriesinn Receipt No. __. Ja / WNITC-D.P.W., YELLOW-A88[930R, PINK -INSPECTOR, GOLDENROD -APPLICANT Md- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVI LLE, CALIF ktryORNIA 95965 - TELEPHONE: 916/534-4541 c:, 1 4 PERMIT APPLICATION DATA SHEET / Permit No. OWNER iY vl '1 1 l F ✓ e. N A. P. No. Proposed Building Use ,12 a 1,1) Permit Fee Based Upon: Complete Contract Price ` DPW Valuation Other/(Explain) Building Inspector //1 ��(%/ter/('.r Dates/���� 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.L 4 2., All items have been submitted. . . . . . . . . . . . Plot plans i n du.p.l.i•cate./-twi•pl+cate. . . . . . . . 3. Complete plans in d.up.l.i.ca.te./_t.ri.ptIcate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . Plans with Energy Design -Compliances Statement . . . State-Ene.rg-y-Forms-No.-. U q f) �,, S.. �C . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ , 9. Letter of signature authorization. W 10..Sanitation approval from 9�.� �.n . Health Dept. . . . ./-*:R'.;�! 7- 11. 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. . . . . . . .,. Pre-Inspec. request to (Date) Pre -Inspection for Required. Building i specro ) � ��• Recorded copy of Agricultural Acknowledgment Statement. /o��/�pZ8s �9. Other DRIVI;IaAY PEP, MIT & OON57'RUCTION APPROVAL REQUIRED PRIOR TO OCCUPANCY 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 Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the fol lowing data must be submitted prior to permit issuance. (For required items not checked above at time of plication, 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 9S Plans checked by. Plans approved by Other: Copy—DPW Date Date TO: Building Department FROM: Environmental Health, Chico SUBJECT: Sanitation Clearance Owner Locatiort AP# Plan approved for: sewage disposal water supply Hold final for: water supply Final clearance O.K. for:. water supply I'Clearance for 3 bedroom. home. Other Note*** Sanitarian Date �"... _�, .,y.,e, _ ;.,".w..,�w...!.i-we.+rv.x.y�,A.�M,,e. w..a•w. u,a.;. da ;..r_." n.i ,_...xkfc,,,,,-,Y,L r.. ri.x.K.Mra•. Regurn to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT 95!"39752 Section 26-8.1 of the 'Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. F -DED ii -'OFFICIAL RECORDS OF BUTTE COUHTY. CALIFORNIA - 0 TI;E REQUEST OF The property described herein is adjacent to land or included ►935 DEC 16 PIA 4: 06 within an area zoned for agricultural purposes, and residents of this ELEAiort .ccCKER property may be subject to inconveniences or discomfort arising from fRK-R�C,ORFSE the use of agricultural chemicals, including, but not limited to her bicid. , pes QER icides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, / smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on [L adjacent property should be prepared to accept such inconvenience or disconform from normal, pagq necessary'farm operations. All that real property situate in the County of Butte, State of California, described as follows: Lot 4, as Shown on that certain Map entitled, "MTSON SUBOIVSICN UNIT NO. 2", which Map was filed in the Office of the Recorder of the County of Butte, State of California, on .Iuly 27, 1981, in Book 80 of Maps, at pages 92 and 93. I Subjer-t to Covenants, Conditions and Restrictions, recorded A+xjust 17, 1981, in Book 2649, IFage 509, Official Records. _ 4 Date: VMPERTY OWNERS: dr State of �� �� ) On this the day of �C . 19 "� before SS. me, the undersigned Notary Public, personally appeared County of 1�LM� ICL TL Personally known to me. / / Proved to me on the basis of satisfactory evidence. to be the person(s) whose aame(s) subscribed to the within instrument and acknowledged that executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No./�J ®���m®�se�se�3i�t �secaer�® X3 ARYPONX.ClsL, 130io 07unty ni ri i': v`c 6`i h ; BUTTE COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH 1516 MEMORIAL WAY SEWAGE DISPOSAL PERMIT 7 COUNTY CENTER DRIVE CHICO, CALIFORNIA 95926 747 ELLIOTT ROAD OROVILLE, CALIFORNIA 95965 PARADISE, CALIFORNIA 95969 Phone: 534-4281 Phone: 891-2727 Phone: 872-2961, Ext. 58 Date Issued %(a W.t_ 111 gj EXPIRES ONE YEAR FROM DATE OF ISSUANCE Permit Issued to U 1A p/.i� hn (P�a .A 2r z prix P2 2- CC i4 Jjr ori —. C A To construct a sewage disposal system for:Located at: at: o rQ t ,,. b+ A rr LCL2— �. SEPTIC TANK SYSTEM REQUIREMENTS Septic Tank (Inside Measurements) Length: . . . . . . . ft. Width: . . . . . . . ft. Liquid depth: . . . . ft. Liquid capacity: . I !) O gals. Special conditions: 0 Leaching Field Total Length: . . . ft. Trench width:inches Minimum No. of lines .Z . . . . Rock under tile . . . (o . inches - Additional leaching field will be required if experience shows it to be necessary. No part of the system may be located within 50 feet of the center line of any County Road. NOTE: Satisfactory inspection by the Health Department is required before backfilling or putting the system into use. Occupancy of a new building is not permitted until the system is approved. Permit Fee $ f? Oti Penalty Fee $ Total Fee $ 7 4 2 Building Sewer Fee $ Issued By: - Receipt No. ?� 1 3 (9���( A 1 C(2 h = ,a rI it 11, Sal �.. 1 3 n � '.� ' ,�i hJa. 1j �; L.�7 �� r� ;i"' �, � <f ��} � f; _ ��t^� � � �9 1 ., �l ��