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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (630) 638-7636 (OROVILLE) (630) 891-2834 (CHICO)
OFFICE #: (630) 638-7641
PERMIT NO.
BPO53252
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 12/12/2005 APN: 047-430-046-000
the Business and pPfessions Code, and my license is in full force and
effect.
Class: License Number: /
Licen1/74/2-;O�Cfontractor:
Site Address: 14076 HWY 99 CHI
Date: _/f1C0 -�� �
Map Index:
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the
Description: ELECTRICAL SERVICE UPGRADE
Contractors' Stale 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: SAID A KARIM & MARIA L REV LIVING
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
SAID ABDUL K & MARIA L TRUSTEES
7000) of Division 3 of the Business and Professions Code) or that he or
DBA KARIMS CAFE
she is exempt therefrom and the basis for the alleged exemption.. Any
violation of Section 7031.5 by any applicant for a permit subjects the
14066 HWY 99 95973
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
Applicant: CHICO ELECTRIC
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
36 WEST EATON ROAD
year of completion, the owner -builder will have the burden of
CHICO, CA 95973
proving that he or she did not build or improve for the purpose of
sale.).
(530) 891-1933
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
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: CHICO ELECTRIC
❑ I am Exempt under Article 3 of the Business and Professions Code
36 WEST EATON ROAD
Date: Owner:
CHICO, CA 95973
(530) 891-1933
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
License #: 454345
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
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are: ,Q
Carrier:_l2w,�5, N7
00 7 Z(21
/-7—Z—U
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
Census Code:
become subject to the 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
��. 0,0forthwith
corn with )hose provisions.
Dale:
TNY7
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutio s to do work indicated bove for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By:ii Date:
PERMIT XPIRES ON: IL- 12— 0 �n
(Date
Address:
❑ 1 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 he owner. 1 agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any officia o r c nl of Butte County. I hereby
authorize represe ves of Butte County to enter upon the above mentioned property for inspection purpose
Print Name: Signature:
Date:
❑'Owner ❑ Contractor ❑ Agent for OwnerAgent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY**
CONTRACTOR
Name �
OWNER INFORMATION
Last NameFirst
1
City GIC O
Name
Address
O
/
l�
City
elo
State
Zip Z?
Phone
3
37
Fax
E-mail
CONTRACTOR
Name �
�l
Address
Address
City GIC O
City
State C,�
Zip
Phone ,q�3 2
/ ( J
Phone
Fax
E-mail
E-mail
Lic. # 5y2 c/
lass,
I
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
Cityn `L,
(.Stat�j
Address
Phone 5�.—%� q ax
U l
City
I No
State
Zip
Phone
Book
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name
Address
Cityn `L,
(.Stat�j
Cross Street
Phone 5�.—%� q ax
U l
E-mail
j j YV�
����
For office use only:
Zoning
Property Address
to
Flood Zone
Cross Street
SRA
I Yes
I No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BP
BIN #
.PROJECT LOCATION
AP#
Property Address
to
City
Cross Street
WORKER'S COMPENSATION
Policy NumberO Z?9 �0
Carrier - S cC )
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
Lk
Sq FT- Living Garage Open Cov
❑ 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
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: . Amount: '� 55 a) Bldg
SRA
Receipt #:4q S r'7 ( Sheriff
SMIP
Date: IL- 12- 015 $5S. OU Other
Total i I
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit., INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL -PLANS MUST BE LEGIBLE AND IN INK
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets.of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.),
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
—- REQUEST FOR FEE REFUNDS
Refunds can only be madeaupon written request by the person who paid the fee. The request must be made v4thin two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
047-430-046
05-3252
VUSAID,"'K'ARIMmnt'.t De.
N ® T E S 14076 HWYt99,
CHT -'3ars
a Cont: iCHICO ELEC''
ELEC SERV
RESIDENTIAL
APN: Permit No.
Owner.
Site Address:
Contractor: .
Type of Permit:
i
r
i
,111iit000
4'
CHECKED BY
` DATE JOB FINALED'
SIGNATURE: ��U`i %Cx,—S!J! a h
. =OK
0 = Not OK
MANUFACTURED HOMES
MISCELLANEOUS
DATE PERMANENT FOUNDATION SOFT -SET
1 Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Loctn-Test; Fall/C/O-Concrete
4 Wtr, Loctn-Test-Easement Needed -Regulator
5 Elec Loctn-Clrncs-Grnd Amp -Concrete
6 Yard Gas; Loctn-Test-Wrap Nat Q or LPF
Inch Sz Ft Lngth
7. Blckng; Sz-Spacing-Marriage Line
8 Gas; MH Test-Demand-Valve-Cnnctr
9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -C/O to Grade
12 Gas and Electricity Tagged
13 Tie Downs 0 Foundation Q
14 Exits
15 Cert of Occupancy
16 HUD Label/Insignia Numbers Serial Numbers
DATE ID E C K S`C O V E R S'C A R P O R T S `G A R A G E S
1 Zoning -Setbacks -Easements
2 Ftgs; Soils-Sz-DpthSpacing-CrinctrsSteel
3 Decks, Girders/Joists-Dcking-Brcing
Stairs-Guard/Handrails
4 Wood Awn; Posts -Beams -Rftrs-Cnn ctrs -S hthg
Frmg-Brcng
5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs
6 Carports; Wndws-Doors
7 Electric
8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof; Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnls
DATE IPOOLS
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15 volts-GFI
6 Elec Enclsrs; Conduit Entries -Terminals -Listed
7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr
8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg
Bones-Enclsrs-pnlboards-Insultn to Main Conduit
9 Health Dept Apprvl
10 Plmb; Cir Test-Wtr Supply Test
11 Lt Niche
12 Enclsr, Fencing -Alarms
13 Bonding, Diving board or Slide
Pool Drawing
= OK
0 = Not OK
RESIDENTIAL (Single &
Duplex)
DATE JUNDERFLOOR
DATE
PLUMBING
1 Zoning -Setbacks -Easements -Flood -Slope
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
2 Fig Main; Soils-Elec Grnd Ftg Dpth
54 Wtr Pipe; Test & Anchr-Nail Prtctn
3 Fig Garage; Soils-Steel-Elec Gmd Fig Dpth•
55 DWV; Test Fittings & Anchr Nail Prtctn
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
56 Shwr Pan; Test, First fir -Tub Acc
5 Sternwalls Main; Steel -Blockouts-Wrapped
57 Test Tub & Shwr, 2nd fir - Tub•Acc
6 Stemwalls Garage; Steel -Blockouts-Wrapped
58 Gas Pipe; Sz & Anchrs
69 Hold Downs and Special Anchrs
59 Fire Sprinkler; Test
7 Slab, Steel Wrapped
60 Yard Gas Piping
8 Piers-Frplc Ftg-Steel
9 DWV, Fall -Fitting -Test -2 -way CIO -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
°� °'°
11 Wtr Pipe; Test-Anchrs-RgltrService Test
12 Elec Undrgrnd
DATE
IMECHANICAL
13 Plenums & Ducts; Cirnc-MaterialSupport-Insultn
61 AC Ducts Insultn & Support
14 Girders-Sills-Anchr BoltsJoists-Vnts-Cripples
62 Vent Fan, Exhaust abv Insulin
15 Acc & Vntltn
63 Condensate Drain & Ovrflw, Sz & Grade
16. Insulation
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
�c ,P
DATE IFRAMING
17 Sills Proper Materials & Anchrs
DATE
F I N A L
18 Wa"Is Studs -Nailing Spacing & Braces -Plates -Sound
66 Ext Steps -Door & SideLt Prtctn-Landings
19 Bearing Walls over Girders & fir Nailing
67 Smoke Detector
20 Draft Stop in Walls (rat proof)
68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
In Garage; abv-flr-Ducts-Mech Prtctn
22 Headers & Beams-Sz & Bearing
69 Bedroom Exiting
23 Hangers -Post Caps-Anchrs-Cnnctns
70 GFI & Bath Fxtrs & Tub Acc-Spa
24 Ceiling Joist-Rftr Tles-Purlin-Roof Brac TrussShthg
71 GFI Arc Fault
25 Frplc Ties or Type A Flue-Frplc Throat Cirnc
72 Elec Trim & Subpnl, Breaker Sis & Labels
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles
73 Stairs, Guard/Handrails
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
74 Frplc or Stove, Clrnc-Hearth
28 Garage Fire Prtctn Framing -RC Channel
75 Elec Outlets at Wood Pnl, Int & Ext
29 Pnprty Line Firewall & Opngs
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cirnc
30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits
77 Elec Outlets & Rcptcls at Ktchn Counter
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
78 Garage Fire Door; Swing -Landing -Closure
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
79 AC Duct in Garage -Damper
33 Siding -Nailing Veneer
80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc
Mech Prtctn; LPG Appince Undr House 3" drain
35 Glazing Area -Glass Prtctn-SkyLts-Plastic
81 Plmb; Elec & Mech Eqp Listed for Loctn
36 Shear Walls; Nailing -Bolts
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
37 Brace Int/Ext Wall pnls
83 Insultn-Foam-Looked in Attic
38 Insulin -Walls -Ceilings
84 Guard Rails & Deck Cnstrctn-Post Caps
39 Infiltration-Walls-Wndws
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Cirnc Drnge Planters ❑Yes ❑No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, Pimb-Appinc-Frplc-Cirnc to Opngs
DATE JELECTRICAL
90 Wtr Well, Dscnnct, Elec, Pimb
40 Fxtr & Trnsfrmr Cimc4ns Prtctn
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
41 Elec Rcptcls Spacing-Lts & Switches at Doors
92 Vntltn thru House
42 Sz Boxes & No Of Cndctrs Stapled
93 Glass Prtctn
43 Romex Installed Close to Edge of Studs & CJ
94 Corrections from previous Inspctns
44 Eqp Grnd made up w/Mech Fstnrs
95 Gas Test -Meters Tagged, Gas-Elec
45 Grndng Electrode Bond Gas & Wtr
96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
97 Energy Cmpinc Cert -Other Certs
47 Subfeed Wire Sz ee ❑ CU or DAL
98 Address Posted
AC Wire Sz ya ❑ CU or D AL
99 Fire Sprinkler
48 Range Circ ga ❑ CU or ❑AL
Oven Circ ya ❑ CU or ❑ AL
Insulated Neutral ❑ Yes D No
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp CImcs pnis-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector