HomeMy WebLinkAbout047-520-0030
47-52-03
ROBER!' MORTON
137 Landmark Dr, Chico
I Permit#806-88B,P,E,M(new single-family)
03
��7-52--
8B,E(new private garage)
Pe 1
I
03-3088
BRANDT, JEROME & ROSE
04
BR7-5'
AN 03-3088
13 7 LANDMARK DR, C
D L
C HICO
Cont: CHRISTIANSON ROOFING IN E
0(
RE ROOF W/ COMp
0
047-520-003
F 06:0370"-"�-'
BR-ADT,LJERRY
137 LANDMARK DRCHICO
Cont: GALLAGHER'S HEATING
HVAC C/o
I
Butte County Department of Development Services 4:A11F]'A
IN OTES 7 County Center Drive. Oroville, CA 95965
(530).538-7601 -.bqt!4ELco�tnty neV40s
I R E S I D E N T I A L
APN: Permit No.
t
n
Owner. 047-520-003 06-0370
BRADT, JERRY
Site Address: 137 LANDMARK DR, CHICO
Cont: GALLAGHER'S HEATFNG
Contractor. HVAC C/O
TypeofPermit:
SPECIAL CONDITIONS
CHECKED BY
SRA
FLOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
6 � � Kfft:-OR
og H %&S- -
DATE JOB FINALED: calOU-7
SIGNATURE:
OK
0 Not dK
MAN�UFACTURED HOMES
M I S C E L L A N E 0 U S
DATE, FOUNDATION " SOFT -SET
1 Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Loctn-Test; Fa[UC/0-Concrete
4 Wtr; Loctn-Test-Easement Needed-Re§ulator
5 Elec Loctn-Clrncs-Grnd Amp -Concrete
6 Yard Gas; Loctn-Tbst-Wrap Nat Lj or LPE D
Inch Sz Ft Lngth
7 BIckng; Sz-Spacing-Marriage Line
8 Gas; MH Test-Demand-Valve-Cnnctr
9 Elec MH Cntnty Test-Crossovers-Breakers-Cirncs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -C/O to Grade
12 Gas and Electricity Tagged
13 Tie Downs F1 Foundation
14 Exits
15 Cert of Occupancy
16 HUD Label/insignia Numbers Serial Numbers
DATE ID ECKS*COVERS*CARPORTS� GARAGES
I Zoning-Setbacks-Easernents
2 Ftgs; Soils-Sz-Opth-Spacing-Cnnctrs-SteeI
3 Decks, GirdersiJoists-Dcking-Brcing
Stairs-Guard/Handrails
4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg
Frmg-Brcng
5 Alum Awn; Columns-Cnnctns-Splice-Decal-Enclsrs
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 pnis
DATE IPOOLS
1 Setbacks -Easements
2 Soils: CompactionZtructure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15volts-GFI
6 Elec Enclsrs; Conduit Entries -Terminals -Listed
7 Elec Bonding', Metal w15'-CrcItng Eqp-Htr
8 Elec Grndng; Eqp w15' Crcitng Eqp-Pool Ightg
Bdxes-Enclsrs-pniboards-insultn to Main Conduit
9 Health Dept ApprvI
10 PImb; Cir Test-Wtr Supply Test
I I Lt Niche
12 Enclsr; Fencing -Alarms
13 Bonding, Diving board or Slide
041
Pool Drawing
OK
Not OK
RESIDENTIAL (Single
& Duplex)
DATE JUNDERFLOOR
DATE
IPLUMBING
I Zoning-Setbacks-Eas ements-Flood-S lope
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
2 Ftg Main Soils-Elec Grnd Ftg Dpth
54 Wtr Pipe; Test& Anchr-Nail Prtctn
3 Ftg Garage; Soils -Stee I -E lec: Grnd Ftg Dpth..
55 DWV; Test Fittings & Anchr Nail Pr.tctn
4 Ftg Porches/Decks; Soils -Steel Ftg Opth
56 Shwr Pan; Test First flr-Tub Acc
5 Sternwalls Main; Steel-Blockouts-Wrapped
57 Test Tub & Shwr, 2nd fir - Tub-Acc
6 Sternwalls Garage; Steel-Biockouts-Wrapped
- 58 Gas Pipe-, Sz & Anchrs
61 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 C/0 -Sewer Test
10 UF. Gas Pipe; Sz Anchrs-Sz Test
0
1j Wtr Pipe; Test-Anchrs-Rgitr-Service Test
12 Elec, Undrgrnd
DATE
IM E NICAL
13 Plenums & Ducts; CIrric-Material-Support-Insultri
14 Girders-Sills-Anchr BolttJoists-Vnts-Cripples
WrAC Ducts Insultn & Support C_�
62 Vent Fan. Exhaust abv Insultn
15 Acc & VntItn
on�sate Drain & OvrfIw, Sz & Grade
16. Insulation
r
&4*T ce-Vent Acc-Comb Air Rtrn[Vent 115 Outlet
Attic Acc & Pltfrm if Furnace in attic
DATE IFRAMING
17 Sills Proper Materials & Anchrs
DATE
IFINAL
18 Walls Studs -Nailing Spacing & Braces -Plates -Sound
66 Ext Steps -Door & SideLt Prtctn-Landings
19 Bearing Walls over Girders & fir Nailing
m
67 Sm Detector
20 Draft Stop in Walls (rat proof)
__;;;-Urn�ace Vnts-Cirnc-Comb, Air-Cnnctr
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
In Garage; abv-fir-Ducts-Mech Prtctn
22 Headers & Beams-Sz & Bearing
69 Bedroom Exiting
23 Hangers -Post Caps -An chrs-Cnn ctns
70 GF1 & Bath Fxtrs & Tub Acc-Spa
24 Ceili ng Joist-Rftr Ties -Purlin-Roof Brac-Truss-Shthg
71 GFI Arc Fault
25 Frplc Ties or Type A Flue-Frplc Throat CImc
72 Elec: Trim & Subpnl, Breaker S2.s & Labels
26 Attic Arc; Sz & Rmx: Prtctn-Draft Stop -Ins Baffles
73 Stairs, GuardlHandrails
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
74 Frplc or Stove, Clmc-Hearth
28 Garage Fire Prtctn Framing -RC Cliannel
75 Elec Outlets at Wood Pril, Int & Ext
29 Prprty Line Firewall & Opngs
76 Ktchn, Fxtr & AppInc; Grnd-Air-Gap-Cooking Clrnc
30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits
T7 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-CImc-Com Air Cnnctr-PRV; abv fir
34 Stucco Lath -Weep Screed-Fridbi Vnts-Undrfir 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-BolLs
.82 Elec Rcptcls in Garage (GFI) Romex Ortctn
37 Brace Int/Ext Wall pnls
83 lnsultn-Foam-Looked in Attic
38 Ins ultn-Wa Its -Ceilings
84 Guard Rails & Deck Cnstrctn-Post Caps
39 Infiltration-Walls-Wndws
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Clrnc Drnge Planters F-1 Yes [:j 14.
15�
0
87 S u rown-Finish
Unit Dscrinct, Elec-PImb
89 Wits aby Roof, PImb-AppInc-Frp1c-CIrnc to Opngs
90 Wtr Well, Dscnnct, Elec, Plmb
91 Ext Elec Trim, GFI RcptcIUndrgrnd
DATE JELECTRICAL
40 Fxtr & Trnsfrmr CImc4ns Prtctn
41 Elec Rcptcls Spacing-Lts & SVitches 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-C10 to grade -HD Apprv]
46 2 Appiric Circs in Ktchn & Cndctr Sz GF]
UF- �ergy CmpInc: Cert -Other Certs
47 Subfeed Wire Sz 9a CU or El AL
98 Address Posted
AC Wire Sz ga CU or El AL
99 Fire Sprinkler
48 Range Circ ga EICU orF] AL
Oven Circ g. El CU or El AL
Insu lated Neutral EjYes ONo
49 Service -Riser Cndctrs & Grnd Main Dsr-nnct
50 Eqp CIrncs pnis-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 -
PERMIT NO.
BP060370
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 penalty of perjury that I am licensed under
Issued Date: 02/16/2006 APN: 047-520-003-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class License Numbe,.D J � 3 4 -
Site Address: 137 LANDMARK DR CHI
Date: -� I Ob ContractorG fAt 104!rr .
in
Map Index:
C -J&E,
I
Description: CHANGE OUT HVAC
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: BRANDT JERRY & ROSEMARIE FAMILY
permit to construct, alter, improve, demolish, or repair any structure, prior
TRUST
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
BRANDT JEROME C & ROSEMARIE
the Contractor's State License Law (Chapter 9 commenting with. Section
TRUSTEES
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom -and the basis for the alleged exemption. Any
137 LANDMARK DR
violation of Section 7031.5 by any applicant for a permit subjects the
CHICO, CA 95973-9765
applicant to a civil penalty of not more than five hundred dollars ($500).):
1, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (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: GALLAGHER'S HEATING & AIR
provided that such improvements are not intended or offered for
PO BOX 35
sale. If however. the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
LOS MOLINAS, CA 96055
sale.).
800-892-3556
0 1, 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: GALLAGHER'S HEATING & AIR
PO BOX 35
0 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
LOS MOLINAS, CA 96055
800-892-3556
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
0 1 have and will maintain a certificate of consent to self -insure for
License #: 777334
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
P--1 have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier:
Policy#:_
Total Square Ft: 0 S. F.
0 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
forthwith comply with those provisions.
S -
Date:
Applicant 111�
WARNIN— U cure w orkers' '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.
5-�
t4 4 )-a
CONSTRUCTION LENDING AGENCY
issued
This permiti? hereb ssu under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (See 3097 Civ.)
,y
Resolutions -d ork in icated above for which fees have been paid.
By:_ Date:
Name:
oj
Address:
PERMIT EXPIRE
(Date)
0 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 of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any officialform or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection pLLr poses.
Print Name: —Te-rk Signature(,&
Date: -74 11� o
C3 Owner 0 Contractor 0 Agent for Owner O/A"gent for Contractor
B. C. Building Permit 01-16-04 pg 1
L
INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R
Site Address (�of\a JB I -a nCA T- Permit Number
13*7 i'c-r\amcLf�� 4.
INSTALLEd6dM"PLMANCE STATEMENT FOR DUCT LEAKAGE
Copies to: Builder, HERS Rater, Building Owner at Occupancy and Building Department
INSTALLER COMPLIANCE STATEMENT
The building was: V OTested at Final v1 0 Tested at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: '
0 Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior
finishing wall are properly sealed.
0 If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
0 Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used
V 11 DUCT LEAKAGE REDUCTION
Procedures for field verification and dia-enostic testinv- of air distribution systems are availahle in RArM- Annond;Y Rrd- 7
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Valu es
I
Enter Tested Leakage Flow in CFM:
4W
2
Fan Flow: Calculated (Nominal: VPrIcooling Y' 0 Heating) or V 0 Measured
If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfnV(kBtu/hr) x Heating
Capacity n Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here:
C3 CJ
V/ V/
3
Pass if Leakage Percentage:!� 6% for Final or:5 4% at Rough -in:
[100 x f_(Line # 1) /_(Line# 2)11
0 Pass 0 Fail
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out
4
Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct
System Altdation and/or Equipment Change -Out.
5
Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct
S stem for Duct System Alteration and/or Equipment Change -Out.
6
Enter Reduction in Leakage for Altered Duct System
(Line # 4) Minus _(Line # 5)] - (Only if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
V/ V/
8
Entire New Duct System - Pass if Leakage Percentage:5 6% for Final or:5 4% at Rough -in
rloo X.r — (Line # 5) / Line # 2)11
0 Pass 0 Fail
'TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out
Use one of the -following four Test or Verification Standards for compliance:
V/ V/
- 9
Pass if Leakage Percentage:!�, 15% [100 x [ _(Line # 5) (Line # 2)]]
X -P ass 0 Fail
10
Pass if Leakage to Outside Percentage 10% [ 100 x [—(Line # 7) / _ (Line # 2A]
0 Pass 0 Fail
11
Pass if Leakage Reduction Percentage 60% [100 x (Line # 6) / — (Line # 4)]]
and Verification by Smoke Test and Visual Inspection
0 Pass 0 Fail
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
0 Pass 0 Fail
Pass if One of Lines # 9 through # 12 pass
0Pass 0
V L] 1, the undersigned, verify that the above diagnostic test results
were performed in conformance with the requirements for compliance credit. 1, the- undersigned, also certify that the newly
installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in
Section 150 (m) of the 2005 Building Energy Efficiency Standards.
Signat Date Installing Subcontractor (Co. Name) OR
&J� t . J 1-"" C-/- I Z - Q G General Contractor (Co. Name)
Residential Compliance Forms March 2005
CERTIFICATE (IF FIELD VERIFICATION & DIAGNOSTIC TESTTNG (Page I of 8) CF4R
Pr6dect Address Builder Name
. 11 - (�-� n I Ir, ri
Builder Contact Telephone Plan Number �Ij
UER "'Lter
I\ �� -'I— 'k _Telephone Sami)lc GrOUD Number
—zw�' —�' — Hmate Zone
Signature Date Sample House i47u—mber
FIERSProvider
1 ' KK - �&� ) 1\
01iles tO: BUILDER, IRS PROVERER ArM BUILDING DEpARTM[ENT
HERS RATER C01 i CE STATEAIM
The house was: --' Teste� "" E], APProved as Part Of samPle testing, but was ot t
As the HERS ter ov os c n ested
the diagnostic col . I and field verification, I certify that the house identified on this form complies with
ce ents as checked -' on this form. Ile FIERS rater must check and verify that the new
distribution s is fu duc and correct tape is used before a:CF-4R may be released on every ested b ding. e RS
t!—_ uil 71 HE
rater must not I th until a properl completed and signed CF -6K has been received for the sample and tested
buildings. y
The installer has 1 rovi a copy of CF -6R (installation Certificate).
New Distribution is fully ducted (i.e., does not use budding cavities as plenurns or platfbrm returns in lieu of ducts).
New systems wl ere ch ith backed, rubber adhesive duct tape is installed, mastic and draw bands are used in
combination wit i cloth backed, rubber adhesive duct tape to sea] leaks at duct connections-
NMEVIUM R
REQ FOR DUCT LEAKAGE REDEMON �COMP�LLANC`ECRE�Dff���
Procedureiforfieldv ' all"on anddiagnmfic teWing0fairdjg&jb1W0n syslems are avalablen RACM
AP
Duct Diagnostic Pendjr RC4 3
T e Ted.ting Results
NEW CONSTRUCTiln - I
Duct Pressurization T!�st
Is (CFM @ B Pa)
M
I Enter Tested Leakage
Flow
alues ........ ..... ..
Fan Flow: Calculated W
, omi3ial:,ve
2 Enter Total Fan Flow CFWi: COOling'kr 0 Heating) or ve 0 Masred
.7.
3 Pass if Leakage per,
ee, tage:!g,16% 100 x L -(Line #: 1) / 2).0
.74000
-
ALTERATIONS: Duct S
-(Line
ir IEIVAC Equip
rstern Ind/o ment Change
0 Pass 0 Fail
4 Enter Tested Leakage
-Out
"low iA CFM from CF -6R Pre
Duct System Alteratio,
--Test of Existing Duct System Prior to
i and/oll
r Equipment Change _OuL
. ..........
Enter Tested
5 Leakage
"low CFM: F%al Test of New Duct System
for D RLaqnAp�E
or Altered Duct System
tion
tiOn Or uipment Cbange-out
Cl
Enter Reduction in Le.,
6
kage f
6r Altered Duct System L_(Lne 0 4) V
mus
(Only if Applicable)
—(Line # 5)]
7 Enter Tested Leakage i
,low injCFM to outside (Only if Applicable)
Entire New Duct
8 SY
77--7-
- if Leakage Percentage:!�- 60/.
VIK
100 X ine 5 / —Line # ]]
TEST OR VIE ST N"AMIJS: For Altered Duct 0 Pass 0 Fail
Use one of the followin r i or Verification Standards
Tesi uillment-Change-o�
9 Pass if Leakage Percc
ro - lia
e:5 1[l 51% " COMP Dee:
('00 x [--(Line # 5Y'l
10 Pass if ge to Out
- (Line # 2)]]
1
Me Percentage:5 1 0o/. (100 x
I L_(Line # 7) /
ass 13 Fail
(Line # 2)j]
Pass ifLeakage Reduc ion - 1
Percentage 2t 600% [100 X r L(Line # 6) /
0 Pass 0 Fail
and Verification by Sn
(Line # 4)]]
oke I st and Visual InVmtion
11 Pass 13 Fail
12 Pass if Sealin of all A
Xessi e Leaks and Verificatio by Smoke Test and Visual 1impetion
-------
... .... . 0 Pass 0 ]F�afll
Residential Compliance Fo
PM if One of Lines # 9 #—:2 pass
�ss-"
.
W 0 F H
?005
CERTIEFICATE
i
FILELD
VERIFICATION & DIAGNOSTIC TESTING (Page 3 of 8) CF4R
Project Address
3?74-�
Builder Name
Atan
BuffiderContait
umber'!q'
FIERS Rater
�Corn
TS;leVh?nc
\C\ C)
Sample Group Number
I ce Method
scriptiir6
Climate Zone
.
g Signawre
,,�Date
Sample House Number
Ft'r.m
der
HCOVF�
Stri�pqt Address:
City/StatcZip:
t )Y, n
_0ni twiftymn1w X"Xffvo�po
L 0
HERS RATER CO
The house was: I" T
As . the BERS rate, �ppvii
with the diagnostic testa
11'/Q The installer has,
F(oceduresforfield
r____T -----------
A -
in 010,01
13 IREFIUGERANt LC , A ... AJR
Verification for Required Zeftio
Valves
Ftdoor Unit Serial #
Location
Outdoor Unit !Make
0 oor it Mo I
utdoor Unit Model '
Date ofVerification
Date of Reffigerant i
Date of Thermni-nur
W 10-114L ANIP BUMUMG DEPAWPAEM
kNCE STATEMENT
10" 11 Approved as part of sample testing, but was not tested
Postic testing and field verification, I cer* that the house identified on this form complies
ance requirements as checked on this form.
a copy of CF_6R (rustaljation Certificate).
I VALVE (1XV)
Y"afte `Va?wOn V-1ves 4-e —lable w R,4CM Anvendix R1
;s'is70r6vided for inspection. The procedure shall consist of
verif ication that the, TXV is" n . sialled-on t7he'
-systern ind
n— shall Vi_`vehhed.;' ; ' i, I
Yes is a Pass Pass Fail
ME"URFNENT
Charge for Split System Space Cooling Systems without Thermostatic Expansion
Bhj/br
(must be checked monthly)
(must be checked monthly)
------- --- _� valulauuvey
Note: The system should b � ifinistalled and charged in accordance with the manufacturer,s specifi
verification shall be docuizreiited"' _C'F - cations and installer
on -6R b,1bre itar6g this Procedure- lf outdoor air drY-bulb is below 55 OF 'rater shall
use th6 Alternative Charge M ew'%iie ftbeedure,
Procedures fbr_Det6rminin� r R� t:Charge jisinj 1 e-, 8ij��')�jth
frigeran od are'ivjil�ble in RACM, A�pendix RD2.
es, A 6, ..of I Chftllation- Certifi6ate) W been' Pr� ded'with'rcpiger�nt charge i
Y 13 W' CF
measuement documented-,
Apni ZUUJ
I
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP060370
PERMITS BECOME NULL A I NO 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 penalty of perjury that I am licensed under
Issued Date: 02/16/2006 APN: 047-520-003-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class(�� �-_39 License Numbe7,7_17'33 4
Site Address: 137 LANDMARK DR CHI
Map Index:
Date: Contractor
Description: CHANGE OUT HVAC
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: BRANDT JERRY & ROSEMARIE FAMILY
permit to construct, alter, improve, demolish, or repair any structure, prior
TRUST
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
BRANDT JEROME C & ROSEMARIE
the Contractor's State License Law (Chapter 9 commenting with. Section
TRUSTEES
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
137 LANDMARK DR
violation of Section 7031.5 by any applicant for a permit subjects the
CHICO, CA 95973-9765
applicant to a civil penalty of not more than five hundred dollars ($500).):
C3 1, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (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: GALLAGHER'S HEATING & AIR
provided that such improvements are not intended or offered for
PO BOX 35
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
LOS MOLINAS, CA 96055
sale.).
800-892-3556
1, 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: GALLAGHER'S HEATING & AIR
1 am Exempt under Article 3 of the Business and Professions Code
PO BOX 35
Date: Owner:
LOS MOLINAS, CA 96055
800-892-3556
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
0 1 have and will maintain a certificate of consent to self -insure for
License #: 777334
workers' compensation, as provided for by Section 3700 of the
Labor Code. for the performance of the work for which this permit
is issued.
P__'I have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier: S4_C4 4-e-1 f_y�
115 00
Policy #:_ 1
Total Square Ft: 0 S. F.
0 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
forthwith comply w th those provisions.
2- f I S- 0(o
Date:
Applicant.4Q&ft YLJJA�A ko-p�
U -
U
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.
q44o-ON
CONSTRUCTION LENDING AGENCY
This permit ip 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
performance of the work for which this permit is issued (Sec 3097 Civ.)
Resolution rk in cated above for which fees have been paid.
`5
Name:
By: Date:
PERMIT EXPIREU: 6 3.
Address:
(Date) I
0 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.
0 Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
0 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 it is unlawful to alter the substance of any officialform or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection pgu�pose
/ iol
Print Name: c::a rujp_(_� Signatur.����A
Date: 7*1�16)10 0, 1
0 Owner El Contractor 0 Agent for Owner O/Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
0
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATfON
AND. SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 991-2934
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED A T TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY*
OWNER INFORMATION
as ame
rs arne
r
_
Address 1'�5-1 LayiJrnaV'_K r)y-j
City Ch 1'W
State GA
"1+A-7
Phone gq ('0 0 (4 D
Fax'
E-mail
0
CONTRACTOR
Name Gail
Flood zone
Address
Address P0
*3G
lilqj2e
State
State
Zip
q6A�'rz,_
Phone
E-mail
Fax
E-mail
Lic. 1,Class
N-Tn4 -
C_)o
0
APPLICANT SIGNATURE
For'6ffice use only:
ARCHITECTIENGINEER
Name
Flood zone
Address
M)L o)
City
No
State
zip
Phone
4
Fax
E-mail
Planner
Stale Lirense Number
APPLICANT SIGNATURE
For'6ffice use only:
APPLICANT INFORMATION
Name aA
Flood zone
Address pe)
M)L o)
City
No
State r a
ziqb
Phone
V�44
4
Fax
E-mail
Planner
APPLICANT SIGNATURE
For'6ffice use only:
Zoning
Property ddress
I � 1 Lanj rnOr
Flood zone
Cross Street
SRA
Yes
No
Occ.
Type Const.
Subdivision Name Map
Book
I Page
Lot#,
Planner
Date Approved:
nNIK=D C:r)D Q1 MR11ITTAll Pi=r)l 1lP1=MF:NTR
PERMIT
BP: -
BIN 9
PROJECTLOCATION
Property ddress
I � 1 Lanj rnOr
C'
th i- Cc
Cross Street
WORKER'S COMPENSATION
Policy Number -Tr�)
Camer
If hiring anyone other than license contractors, a certificate of wor er s
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
__"KtWZ cjv,+ 11yac.2
0
Sq FT- Living Garage Open Cov
0 Structure Built without Permits
El 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 departinent costs are not
refundable.
I k��ivqdbr. Amount: � 6 Bldg I I
Receipt #:
44L�4 >9 -
Date�_ It, �&�
SRA
Sheriff
IP
Other
Total
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBIWITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
0 1 . Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
0 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 or! plans AND 2 sets.of stamped and signed calculations.
0 3. Engineered truss details and layouts in duplicate (if required). No faxes!
0 4. Energy compliance design and supporting documentation in'duplicate.
0 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
0 6. Manufactured homes' (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
0 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.
0 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
0 9. Site plan and business license approval from the City of Biggs.
0 10. Letter of intent for non-residential buildings.
0 11. Building Permit Application Without Required Clearances Form
El 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.)
0
1 .
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
0
2.
Impact Fees.
0
3.
California Department of Forestry plan approval (if required).
0
4.
NPDES Form.
11
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
0
6.
Contractor's license information. (Number, Name Style, Classification).
O�
7.
Worker's Compensation Carrier and Policy Number.
0
8.
Owner -Builder Verification (if required).
0
9.
Letter of Signature authorization (if required).
0
10.
Recorded copy of Agricultural Acknowledgment Statement.
0
11.
0 Legal description from current recorded grant deed, 0 Copy of M.H. Title, Title transfer, or MCO.
El
.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 made upon written request by the person who paid the fee. The request must be made within 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
KVORMSSUILDING F0RMS\B1daADD1SubRamts.doc Paoe � of 2 RFV 8-12-05
w
BRANDT, JEROME'& ROSE
.137 LANDMARK DR,CHICO
Cont:'CHRISTIANSON ROOFING
RE ROOF W/ COMP
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 * Telephone (530) 538-754 PE MIT NO.
(Rev. 12/96) 13 � _J W
APPLICATION AND PERMIT - ( - 3014 le
ASSESSOR PARCEL NUMBER
tVA7_S?Q-0n1
ZONING
I
BUILDINGPERMIT
OWNER
JF.Rr*4F & ROSEMARIE BRANM
TELEPHONE
SO. FT. Occ. BUILDING VALUATION
30420a
OWNER'S MAILING ADDRESS
117 LANDMARK DR., CNIM, CA 9597.1
CON'rRACTOR'S NAME
(TRI,MANSON R01711FING,
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 6 3 00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS TAWW4W M r"TM
Energy Plan Checking Fee
$
$
PERMIT FEE
$ All (W)
LOT NO.
SUBDIIJISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 1DK Duplex 0 Mobilehome 0 Other X GZARAGE
SPECIFY
Each Trap
J 7.00
—
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New 0 Addition 0 Remodel 0 Utilities 0 Installation 0 Other)p,
Describe Work: R E S7 W CKWR
Gas piping system I - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service *.OoAv OoR' 's's'
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed undtir. provisions of Chapter
9 (commencing with Section 7000) of Division 3, of the Business ar7d Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from th6 Contractors Licen'se
Law for the following reason:
0 1, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
0 1 have and will maintain a certificatejof consent to self -insure for workers'
compensation, as provided for by section 3700 of. the Labor Code, for the
erformance of the work for which,this permit is issued.
01-11phave and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, forthe performance of workforwhich this permitis issued.
My workers' COMMpirisation insurance carrier anaipolicy number are:
Carrier ST.?7r
Policy Number 74C�E- <2a /3 d5dr 6
(The above sections need not be completed if the pbrmit is for work of a valuation
of one hundred dollars ($100) or less.)
0 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X Date
Signature of Applicant - 0 Owner 2"'Contractor 0 Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUP. 0.
OR ADONS. BLDS. 3.5,s
& ACC. FT.
NEW CONST. =TI-OUT1_,ET
NON-RESID. _. ,.. I.
g7.50
0 E.RAP= U
. 0
&TW C SIR.
ourLEr OR FIXTURES 2* 0
Ex. Occup. BAL @ .50
O.FVED A - OR"
Occup. PIPFI=.1 E 5.00
—Ex.
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wiring
PERMIT FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
—
Hood 6.50--
Ventilation
PERMIT FEIE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTALFEE$ 811.00
IMP
I FLOOD
CDF
PARCEL
PID
I HD
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
Bv/W,,/ tk A4"Cate
PERMIT EXPIRES ON #1017
/
the applicable provisions
Resolutions to do work
been paid.
I/ A/0
/
ReceiptNo.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION +11
7 County Center Drive * Oroville, California 95965 e Telephone (530) 538-754 PERf NO.
(Rev. 12/96) APPLICATION ANDPERMIT 015- W9 I
ASSESSOR PARCEL NUMBER
04.7-920-003
ZONING
BUILDINGPERMIT
OWNER
JEROME & ROSEMARTE. BRANDT
TELEPHONE
SQ. FT. Occ. BUILDING VALUATION
3,420
. OWNERS MAILING ADDRESS
117 LANDMARK D_R_ 04TC0, CA 9597�
CONTRACTORS NAME
CHRISTIANSON RonFING
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDERS MAJUNG ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ �_3.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
J_ 37 1-AmMARK, DR CHICO
Energy Plan Checking Fee
$
$
PERMIT FEE.
$ 00
LOT NO.
SUBDIVISIONS NAME
II
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 14X Duplex 0 Mobilehome 0 Other & C7ARACF.
SPECIFY
Each Trap
1 7.0
-
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK -
New 0 Addition 0 Remodel 13 Utilities 0 Installation 0 Other)(R
Describe Work: R-FROOF 5� S�l COMP
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I GI W I
(-W20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20-00
"OV OR LE:.S
Main Service OA OR LE
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.
_/
License Class Lic. No. '�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
0 1, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCC
OR AODNS. & ACC. BILDSUP
so
3.50FT.
N CONS T'_O_
MUESIDT =. CIRCUITS
97.50
OWER AP=US
&PSINGLE 0 CIR.
Ex. Occup. ( OUTLET OR FIXTURES
20 @ 1..5000
BAL @
Ex. Occup. ( ..ED A '(g=-.)0ERA,
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.001
I
PERMIT FEE
$
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
0 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
erformance of the work for which this permit is issued.
911"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' cgirnaensation insurance carrier and policy number are:
,e. .1-&o -
Carrier S7"k7ic C-2!
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEIE
$
Policy Number =),4V /34=5,1
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
0 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X Date
Signature of AppEcant - 0 Owner ER'117-ontractor 0 Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
I $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTALFEE$ IR CY)
IMP
I FLOOD
I CDF
PARCEL
PD
HO
SSUE
This permit is hereby issued under
of the Butte County Code and/or
indicateo above for which fees have
J J_4&&4&/Date
PERMIT EXPIRES ON
I
the applicable provisions
Resolutions to do work
been paid.
?
li
-7
)
ReceiptNo.
WHITE-D.D.S.-B.D. 'CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
-Ley 01V
/W Wr PERMIT NO. RQ�-B�LP�E,M
own"IT ovoince
6
a
OWNER-- RQRFRT MbRION TNC
CdNTR. Rol�r,�t, kort-on
ASSE68OR PARCEL 47—s?—ni
LOCATION 137 T-,q]3rjmqi-k Dr, Chirn
OFF*ICE COPY
Address
GAS
Meter By Date
ELECTRIC
ate
Meter By D
FAOFFICE COPY
Address
GAS
Meter By—
ELECTRIC Date
Meter BY
Temp. Pow
Called
Temp.-Elec
Called
Temp. Gas
Called
JOB FINAL
Signatu
= OK
'0 = Not OK
= NotApolicable
= Not Ready
MOBILE HOMES
MISCELLANEOUS
Date"
MOBILE HOME UTILITIES (Plans) OK except #'s
Dite
DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
1. Zoning Req u 1 rements-Setbacks- Easements
2. Soils; Special MH Support -Sketch
2. Footings; So i I s -Si ze-Depth-Spaci ng -Con nectors-Steel
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-Rftrs.-Connec.-
Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ P'Nat. or/ /"L"ft./ /"LPG
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
Card -B1 Date Card -1311 Date
Card -131
Date Card -1311 Date
11. Ext.; Steps -Doors- Land in gs
Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Req u i rements-Setbac ks- Easements
Card -131
Date Card -131 Date
2.'Footings; Size-Spaci n g-Marri age Line
Card -131
Date Card -1311 Date
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
Date
POOLS (Plans) OK except #'s
5. Drain; MH Test -Fall -Flex Connector
1. Setbacks -Easements
6. Water; MH Test- Reg u I ator-Con nector
2. Soils; Compaction -Structure Stability
7. Water and Sewer Connected -C/0 to Grade -HD Approval
3. Pool Structure; Steel -Connections -Thickness -
Dead Men -Lining
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
4. Elec.; Receptacles and Lighting, Distances-GFI
10. Cart. of Occupancy
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg.
Boxes- Enc I osu res- Panel boards- Ins. to Main in Conduit
Card -131 Date Card -131 Date
Card -131
Date Card -B1 Date
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Card -B1
Date Card -B1 Date
Card -1311
Date Card -B1 Date
0 = Not OK
- = Not Applicable RESIDENTIAL (Single and Duplex)
= Not Ready J I
Date , 4PERFLOOR (Plans) OK except #'s Date, . FFIMW AG (Continued)
VZoninq requirements -Setbacks -Easements, -&""",,TY-- '-A V H[knaers-Post CanrAnchnrq-rnnnPrtnr_Q
-P/,Ftg., Main; Soils -Steel -El rnd.-/ 14-/" Ftg. Depth J
2aQ
C40 Ong. Joi �t-Rf tf'.Xi`es--Au ri i n- Roof Brac.-Truss-Shthng.-Rfng.
$JFtg., Garage; Soils -Steel /JZ�/" Ftg. Depth
46. �Veplace fies*r-N`pe A Flue -Fireplace Throat
4.,F1q., Porches & Decks; Soils -Steel-/ /"Ftg. Depth
VAOC-Access; Size & Romex Protection- Draft Stop -Ins. Baff les
Y,Vemwalls, Main; Steel-Blockouts-Wrapped
Windows or Exiting Doors -Sill Hgt. & Dimensions
4"Stemwalls, Garage; Steel- Bloc ko uts-Wrap ped
4Vgarra_ge Fire Protection Framing
7. Slab; Steel -Wrapped
%rY'pKperty Line Firewall & Openings
8. Piers -Fireplace Ftg.-Steel
W. Ext. Doors -One T -Check Garage -3rd story, 2 exits
9f D.W.V.; Fall -Fittings -Test -2 way C/0 -Sewer Test
-52-5,tdhi-Wm4b4AeadiDDLm&Rise-Run-Landing-Fire Protection
10. Gas Pipe; Size -Anchors
58,."Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
11. Water Pipe; Test -Anchors -Regulator -Service Test
SidinQ-Nailing Veneer
12. Electric; Underground
%ucco'Mosh-Drip Screed -Fd. Vents-UnderfIr. Ac
13. PI-enums & Ducts; Clearance-Material-Supprt-Ins.
zing Area -Glass Protection -Skylights -Plastic
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
-47" 6ar Walls; Nailing -Bolts
15. Insulation
VAsulation-Walls-Cig.
Card -131 SIR Dat@4114A) Card -B1 Date
Card -131 Date Card -131 Date
Date PLJJMBING (Permit) OK except #'s
WAter Ht. Ver�-Access-Combustion Air
ater Pinieest & �nchors-Nail Protection
DA34.,4�[P-FUU6 & Anchors -Nail Protection
ower Pan; Test, First Floor -Tub Access
<��5st Tub & Shower, 2nd Floor -Tub Access
2VGas Pipe; Size & Anchors
I nf i Itration-YVal Is-Wnaws
Card -131 'ZZ< DateS�// Card -1311 Date
Card -BI CZZO DateV249C Card -Bi Date
Date FINAL (Plans) OK
& Sideliaht Protection -Land
S'moke Detector
Fujnace; Vents -Clearance -Comb. Air-Connector-
VGarage; Above Floor-Ducts-Mech. Protection
p6droom Exiting
G.F.I. &,BaWFixtures & Tub Access -Spa
Elec. Wmft Subpanel; Breaker Sizes -Labels
Card -131
Z,34- DateS�f/' ard-B1 Date
Card -B1
K:k D t 2512d "Card -131 Date
6t/F Clearances -Hearth
4place or Stove
f,
Outlets at Wood Panel; Int. & Ext.
it. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance
Date EL RICAL ermit) OK except #'s
2"Ixture & Transformer Clearance -Ins. Protection
3. Jii�c. Receptacles Spacing -Lights & Switches at Doors
ec. --..-is & Receptacles at Kit. Counter
V.X;e Boxes & No. of Conductors -Stapled
114arage Fire Door; Swing -Landing -Closer
./A.C. Duct in Garage -Damper I —I/-
Installed Close to Edge of Studs & C.J.
.9ornex
�qUip. Ground made up w/Mech. Fasteners -Bond Gas & Water
Wtr. Htr.; Vents -Clearance -Comb. Air4CorP(ecto-�11P.R.V.-
, A Garage; Above Floor-Mech. Protectidm--,---.J
i�'
2 . pliance Circuits in Kitchen & Conductor Size
t - Plb., Elec. & Mach. Equip. Listed for Location
Jlk.'�6bfeed Wire Size ga. Cu or A[-A.C. Wire Size / /ga.
A;u or Al
75.,Wc. Receptacles in Garage; (G.F.I.)-Romex Protec.'
- -
29' Range Circ. /(,/ ga. Cu or(61--bven Circ. ga. Cu or Al.
,Insulated NeuTral �A Yes No
-Asulation-Foam-Looked in Attic 0 Yes
71y;,Guard Rails & Deck Construction -Post Caps
LlIXervice-Riser Conductors & Ground -Main Disconnect
79' Fdn Vents & Crawl Hole Door. -Drainage & Wood -E rth
)blearance Looked unoer Fl?± 0 Yes
3'f. �quip. Clearances Panels-Motors-Mech. Equip.
32'.'r1nfhAQ Closet Light -Shower Light -Spa Light
16. Following instid.; Dr'v'e OUNes C3 No; Walks QVVes 0 No;
Planters 0 Yes No
Z§tucco; Brown -Finish
Card -131
'�_��Date '�/Z�UCard-131 Date
Vf.,A.Q,-Unit; Disconnect, Electrical, Plumbing
Card -131
Date I Card -131 Date
at Y4nts Above Roof; Plbg.-Appliy6e-Firepl.-Clearance to
lopenings.
Date
M EC . HANICAL (Permit) OK except #'s
(Water well; DlsconnecQKctrical� Plumbing
U'A,X. Ducts Insulation & Support
xterior Elec. Trim; G.F.I. -9—eceptacle- U n derg round
1L4/'y,6nt Fan; Exhaust above insulation
i"21
-entilation throughout House
4�4'ondensaZ24ain & Overflow; Size & Grade
(Wornace-gdi�l>ccess-Comb. Air -Return Air Vent -11 15 outlet
3q' Attic Access & Platform if Furnace in Attic
Card -131 '7�>g_ Date 15�- Card -B1 Date
Card -131 Date I Card -131 Date
Date WAMING (Plans) OK except #'s
Millis,, Proper Material & Anchors
'"W..,WAfIs Studs -Nailing, Spacing & Bracing -Plates -Sound
. earing Walls over Girders & Floor Nailing
gay',Ipraft Stop in Walls (rat proof)
4r,,f7ire Stops; Furred Ceilings -Stairs -Chases -Tub
4V HeRdAr R Ream -Size & Bearing
Glass Protection
$ions from Previous Inpections
est -Meters Tagged; Gas -Electric aAX
& Sewer Connected -C/O to Grade -HD
w. tnergy L;ompliance Uertilicate-Utner Uertiticates
I I ."
Card -B1 Date Card -B1 Date
Card -B1 Da4��/J(g Card -B1 Date
Card -131 �Dat .(/,/g Card -BI Date
Comments at Final: I /
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive. Oroville — Phone: 538-7641
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
"0
A routine Inspection Indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
whe
t�correction of work is completed. If you have any question pertaining to this
ma r, or need additional explanation, please contact this office Immediately.
A-114, / f ( CA4114,0�� e4---
wwlmll
( 2 D A r-
Inspector- Date—C
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way. Chico — Phone: 891-2751
7 County Center Drive. Orovi Ile — Phone: 536-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
klz�'
OWNER
IT 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
w�n correction of work is completed. If you have any question pertaining to this
m te r, or need additional explanation, please contact this office Immediately.
Zt
Inspector 1AA/f
9=p- Fe"71-'r
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive. Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
'4�
C
OWNER r'r-r111VIIT NO.
A routine/ inspection indicates that the following violations of County Ordinance
�exist al(the above address and should be corrected. Please notify this office
I
q rection of work Is completed. If you have any question pertaining to this
matt , or/ need additional explanation, please contact this office immediately.
41 -el
'? 'N -01
I nspector—htel� Date—
Owner': Permit No..
ENERGY CERTIF ICAT ION
1.37 LANDMARK nRTvF 47-52-103
LOCATION A.P.-No.
DESCRIPTION OF:INSULATION
ROOF
Material Brand, -Name
Thickness(inches) thermal Resistance (R Value)
EXTERIOR WALL
Material FIBERGLASS BATTS Brand Name MANVTI _I F
Thickness(inches) 5 3/811 Thermal Resistance(R Value) R13
CEILING
Batt or Blanket Type FIBERGLASS RATT(; Brand Name ' MANVII I E
Thickness (inches) 10,, Therrial Resistance(R Value" .-r-3n
Loose Fill Type' FTgFgf,-1 A c; c; Brand Name nj,jFNc,-_r0pKjTNC
Minimum Thicknes� (Inches) 141, Number of Bags -in Wt. per bag 71 lb.
Area covered(ft.z) 1561 - Thermal Resistance(R Value) g -in
FLOOR, ELEVATED
Material,
Thickness(inches)
FLOORP SLAB
Material
Thickness(inches)
Width(inches)
FOUNDATION WALL
Material
Thickness(inches)
Brand Name
Thermal
Resistance(R Value)
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.
I DERKE 1�1 1 TIQN, -0-
F I RE _10jE row- - -
APPLICATOR
4991 5n
STATE CONTRACTOR'S LICENSE NO.
I hereby certify the above insulation and 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. or
Robert R. Morton, Inc. 495430
FIRM NAME/OWNER (Please print) STATE CONTRACTOR'S LICENSE NO.
/� ij�* Qz Z�2 JLme 13, 1988
SIGIIATbRE OF (JENERAL CONTRACTOR/OWNER DATE
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL
INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING .
January 1984
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSESSOR , CE UMBER
ZONING
BUILDING PERMIT
OWN R
ahelo"-1
�4-
TELEPHONE
SQ.FT. OCC. BUILDING VALUATION
gm? —4--
::�y y
OWI'MR15-MAILING ADDRESS '
/ (ff - poa&�-
-�5_7i, #
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUC&TION LENIPER
4exe-1
NOWN
Total Valuation
Filing Fee
$ i cf. 00
—
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ AQ
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Fi I ing Fee '10.00
Each Trap
2.00 -�,In
Solar or heat pump water heater
20-00
LOT NO.
.2
SUBDIVISION NAME
CEL MAP
-7
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
S FA DuplexF� MobilehomeE] Other
SPECIFY
Gas piping system I - 5 outlets
5.00
A3
Building sewer
_T
5.nn .5. 1�27 10'
Mobile Home S FG W7
-
A=- - —
[10.00e���-
TYPE OF WORK
NevA AdditionO Remodel EJ Utilities[:] InstallationD OtherEJ
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
6OOV OR LESS
Main service 100 AM -P OR LESS
10.00 Z/ -)-
Main service EA. ADD -L 100 AMP
2.50 ' -
0 , 6;,�
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
$-I am licensed under provisions of Chapt. 9, Div. 3 S
of the Busines
and Professions Cooe and my license is in full force and effect.
License No. -4/ 4-3 . 4/10 -Classification
- f
1, 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)
1, as the owner, am exclusively contracting with licensed UUIILIt[GL-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NEW CONST. DWELLING OCC
OR ADDNS. ( ACC. SLOGS.
21/2tsqft
4TIZ�
NEW CONSTR. MULTI.DUTLET
NON*RESI., 9 RANCH CIRCUITSLL
2.50 ea
POWER APPARATUS.&
(SINGLE OUTLET CIR
Ex. Occup(OUTLETS OR FIXTURES
20@50C
BALO 300
FIXED APPLNS OR
Ex. Occup. OUTLETS (RESI*D.) EA.)
2.00
Temporary service
10.00 _4�)
Mobile I Home Facilities
15.00
Misc. Wiring
15.00
—
Pemit Fee
$ 4)11451
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.
r] 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
Fi I ing Fee 10.00
Heating
4 6V
Cooling
Hood
3.00
Venti lation
19
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
against s id Coun y in consequence of the ranting of this permit.
J4,q,1, ��Date Ve
Signature of Applicant - Owner.a2-Contractor 0- Agent
An OSHA permit is required for exca ations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee 01�
TOTAL PERMIT FEE $
occup.1
C Pyl
ISC7?rA71
21
_,Su E
;�f
This permit is hereby issued under
of the Butte County Code and/or
work indicated above for which
I IM��F PUBLIC
By
PERMITEXPIRES Date q-.(5-KC1
the applicable provi-
resolutions to do
fees have been paid.
WORKS
W -,?V
_/3 610
natA
Receipt No. ZY23
WHITE-O.P.W., YELLOW-A389390M. PINK -INSPECTOR. GOLDENROD-APPL I CANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING'DIVIS]ON
7 COUNTY CENTER DR k IVE - OROVILLE, CA . LIFORNIA 95965 - TELEPHONE: 916/538-7541��
PER MIT APP LICA, T
V)JORDATA SHEET
Permit No.
OWNER A. P. N o. 6 :3
Proposed Building Use __�'Building Inspector Date -5,4 V_e
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 duplicate/iriplicate, 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 Plaps with,Energy Design Compliance Statement . . . . . . 4z
School District "Fees Paid'' Stamp on Floor Plan.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
__ZMA9. Letter of signature authorlization. 51 1
Sanitation approval fro H*ea*lth- Dept.
ZU10.
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-Bui Ider Verif ication (G iven to owner [1, Mai I to owner
Improvements may be required . . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . .. . . . . .
1-7,,. Pre -Inspection R uirel Pre-Inspec. request to 'Date.)
eq U. Building Inspector
fi� Recorded copy of Agricultural Acknowledgment Statement.
19. Driveway Permit.
__20. Pl.ot, plan approval from city of
21.
01 37 41�
T -J
When you issue the pp,(Ml* , -process as follows: —Mail W_owner, —Mail to contractor -
T
elephon e �and hold for pickup dl�_:�!�_ice, —Deliver w/inspectoii.
Other
A p p I i c a n t tz -), _*'a —te
k- — —
Copy of plans sent — Health Dept., —Fire Dept., — Other—Date
The following data must be submitted p
1. Index permit for above items No.
2. Additional items required: —
or -to permit issuance: (Circle new itern not checked above).
Contractor, designe <�Xas advised of above required data by —phone ____rna i I —counter by— date
Contractor, designer, owner, was advised c, above required data by —phone _rna i I —counter by— date
Plans checked by Date Plans approved by Date
_L_ Sets of plans on hold in I File cabinet _AP folder
Copy—DPW
TO Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Dispo sal Water Supply
Hold final for: Water Supply
Final'clearance O.K.'for: Water Supply
Clearance for Y bedroom mab;i&e home. other.
NOTE.
1-2-
sa"nitarian D . ate
Return to DPW AGRICULTURAL STA'rEM_I1-'NJ' OF ACKNOWLEDGEM`.NT
FOR RESIDENTTAL DEVL1,OPM1_-'NT
",�;)n 26-8.1. of the Butte County Code RECORDED BUTTE COUNTY
se.c_ti
C� 1; OFFICIAL RECORDS BY
requi.re, this acknowled geme[ I L be recorded -
prior to issuance of a building permit.
The property described herein is adjacent
On MArr-h 17, 1 9RR before me, the undersigned, a Notary Public in and for
Lo land or included within an area zone(]
1968 MAR 18 PM 12: 46
for agricultural purposes, and residents
C
M
L)
of" this property may be Subject to incon-
CANDACE- J. GRUBBS
veniences or discomfort arLsing front the
CLERK -RECORDER FEE_�_
use of agriculturat. chemicals, including,
E
but not. limiLed to herbicides, pesticides,
and ferLilizers; and from the pursuit
basis of satisfactory evidence) to be the persons who executed
of agricultural operations including,
88-
1) u t not limited to cul.Li.vaLion, plowing NOT COMPAREM WITH
XX
S& A, on behalf of
spray -i ng, pruning, and harvesting whiN ORIGINPA- t,,,1)rtJMENT
Rriht-rt- R-Mnrtnn, Tnr
occas.ionally generate dusL, smoke, noise, and odor. Butte CounLy
has esLablished iigrictll
Lural. zones which have as a priority use for productive agriCUlLurat purposes, and rusid(�tils
w-ii.hin said zones and on adjacent property should be prepared to
accepl- Such i.ii(-()iiveiiicn(-(,
or disconlorm from normal, necessary farm operations.
A1.] Lhat real. property Situate ill the County of Butte, State of Californki, described �is
fo t1ows:
Date: PROPERTY OWNERS:
" CA
SLat-0-of
SS.
County of e, tl e
Present A.P. NoY7
Oil this the Lz�__/day of
the undersigned Notary Public, personally appeared
E] Personally known to me. [:] Proved t:o me oil the basi.-;
of saLislacLory evidence.
to be the person(s) whose name(s)
SLIbscribed to the wi.L ' hi ' n instrument and acknowledged Llial
executed the same for the . purposes therein contaLned. IN W ITN F�S-)
WHEREOF, I.hereunto set my hand and official seal.
STATE OF CALIFORNIA )ss
COUNTY OF Ril t t- P I
otary Public
On MArr-h 17, 1 9RR before me, the undersigned, a Notary Public in and for
C
M
L)
said State, person3lly appeared Rc)bprt R_ Mcirton
and
personally known to me (or proved to me on the
E
basis of satisfactory evidence) to be the persons who executed
the within instrument as
M
C1.
i7i E
President and
XX
S& A, on behalf of
0
0 0
Rriht-rt- R-Mnrtnn, Tnr
..............................
,Z M
CO U
the corporation therein named, and acknowledged to me that
...........
CHICIAL SEAL
0
L) C
such corporation executed the within instrument pursuant to its
CALIFUMIA
I
by-laws or a resolution of its board of directors.
C 0 u N; T y
My 10, 1992
CD
WITNESS my hand and official seal.
....................... .............
(0
0
-------
Sig' lt�_ P�L
for
nature _ V,
_,
C Y , A . P F. R '; FT A L I
(This area official notarial seal)
ORDER NO. -BU -98110
cRiPTION
DES
PROPERTY SITUATE IN THE STATE OF
THAT CERTAIN REAL
L
AL
CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS:
PARCEL I:
CEL 2, AS SHOWN ON THAT CERTAIN PARCEL MAP ENTITLED, "BEING A
PAR
PORTION OF THE S.W. 1/4 OF SECTION 28, T.23N., R.lE., M.D.B. &
M. SAID PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER
ON FEBRUARY 5, 1981,
OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA,
IN BOOK 81 OF MAPS, AT PAGE(S) 72.
RESERVING THEREFROM A NON-EXCLUSIVE EASEMENT FOR INGRESS AND
EGRESS AND PUBLIC UTILITIES OVER LANDMARK DRIVE, AS SHOWN ON SAID
PARCEL MAP.
PARCEL II:
A NON-EXCLUSIVE PUBLIC EASEMENT FOR INGRESS AND EGRESS AND FOR
PUBLIC UTILITIES OVER LANDMARK DRIVE, AS SHOWN ON THAT CERTAIN
PARCEL MAP ENTITLED, "BEING A PORTION OF THE.S.W. 1/4 OF SECTION
28, T.23N., R.lE., M.D.B. & M-111 SAID PARCEL MAP WAS RECORDED IN
THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON FEBRUARY 5, 1981, IN BOOK 81 OF MAPS, AT PAGE(S)
72.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF
PARCEL I, DESCRIBED ABOVE.
PARCEL III:
A NON-EXCLUSIVE- RIGHT OF WAY FOR ROAD AND PUBLIC UTILITIES
PURPOSES OVER A STRIP OF LAND 60 FEET IN WIDTH, AS SHOWN ON THAT
CERTAIN BOUNDARY'LINE MODIFICATION PARCEL MAP ENTITLED, "BEING A
PORTION OF THE S.W. 1/4 OF SECTION 28, T.23N., R.lE., M.D.B. &
M.11, SAID PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER
OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MARCH 21, 1980,
IN BOOK 76 OF MAPS, AT PAGE(S) 27.
EXCEPTING THEREFROM - ALL THAT PORTION LYING WITHIN THE BOUNDS OF
PARCEL I, DESCRIBED ABOVE.
PARCEL IV:
A NON -EXCLUSIVE -RIGHT OF WAY FOR -ROAD AND PUBLIC UTILITY PURPOSES
OVER A STRIP OF LAND 60 FEET IN WIDTH, THE CENTERLINE OF WHICH IS
DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHEAST CORNER OF PARCEL 4, AS SHOWN ON THAT
CERTAIN PARCE U- MAP —OF -,A- PORTION OF THE- SOUTHWEST QUARTER OF
SECTION 281 TOWNSHIP 23' 'NORTH, RANGE 1 EAST, M.D.B. & M., WHICH
PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY OF -BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1976, IN
BOOK 59 OF MAPS, AT PAGE 56; THENCE SOUTH 89 DEG. 471 4911 WEST
ALONG' -THE NORTHERLY LINE OF SAID PARCEL 4, A DISTANCE OF 409.86
FEET;'THENCE SOUTH 03 DEG. 061 2911 WEST, A DISTANCE OF 30.05 FEET
TO THE L TRUE ]�OINT'OF BEGINNING FOR THE HEREIN DESCRIBED CENTER-
LINE; THENCE FROM SAID TRUE POINT OF BEGINNING, -NORTH 03 DEG. 061_
29%.EAST, A.DI9TANCE OF.,451.87 FEET; THENCE ON A TANGENT CURVE
CONCAVE -TO THE'SOUTHEAST, HAVING A RADIUS OF 295.00 FEET THROUGH
A CENTIE�f -ANGLE OF 90 DEG. 001 001' IT AN ARC DISTANCE OF 463.39
FEET;'..THENCE SOUTH 86 DEG. 531 31" EAST, A DISTANCE OF 114.17
FEET TO THE'EASTERLY LINE OF.PARCEL 1 OF SAID PARCEL MAP AND THE
END OF SAID CENTERLINE.
I
RESIDENTIAL PLAN CHECKING GUIDE
(S.F., DUPLEX,& MISC. ONLY)
7/85
/*,#,S mot Af -,rr
Bldg. P ermit #
OWNER 1?.004-4—r ekVA1bX---, A.P. # 40 -5,A- - 40:3
GENERAL
le***' Zoning requirements: (sideyards and number of permitted living units)'.
4Z41*�-Valuation.
4 -""Plans signed by designer.
4-,'�ergy Design and Compliance.
S-"' Existing violations on property.
PLOT PLAN
k. -I" -'Complete parcel size and dimensions.
tbacks, sideyards, easements, etc.
-t
.,,Other buildings or structures.
�.�Grading, fills, drainage.
. -Flood hazard.
;��'Special conditions on creation map or compliance document.
FLOOR PLAN
.�Complete to scale plan with dimensions.
Required windows for light and ventilation (Sec. 1205).
&I"'Required windows for second exit (Sec. 1204).
4e'*�Skylights (Chapter 34 & Sec. 5207).
��uman impact glass (Sec. 5406).
i�lequired room sizes, ceiling heights (Sec. 1207).
. F.C.I.s in baths, garage and exterior outlets (Article 210-8).
8. Light fixtures, switches, receptacles, and exterior receptacles for maintenance of
mechanical equipment.
Locations of water heater, heating and cooling equipment, other electrical or gas
equipment, and plumbing fixtures.
ua-� Garage firewall, do 0 r size, and closer (Sec. 503(d)(3)).
Y4'0"'l - 3'0" exterior ex it door (Sec. 3304(e)).
IQOO'*'- F irep lace and wood s tove location.
W0.00" Smoke detectors (Sec. 1210).
STRUCTURAL DETAILS
Y -'-Foundation plan complete enough-ito construct building.
L --'Floor construction details complete enough:to construct building.
&v -'Elevations and wall construction details complete enough to construct.building.
4woo�Roof construction details complete enough to construct building.
5. Fireplace construcfion details and calcs if necessary..
Rw-'S-ufficient data and details to satisfy energy requirements (State Law) (Form 1).
MISCELLANEOUS ITEMS TO LOOK OUT FOR
P""Exposure I plywood on exposed locations and overhangs.
*'---Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306).
-9---Gu,ardrail details (Sec. 1711 & 3306(j)).
,4-�.Brick or stone veneer (Chapter 30).
&-'Exterior plaster - weep screeds (Sec. 4706).
h,.��roper roof pitch for roof covering (Chapter 32).
4-v-�after ties or bearing ridge beam.
506 Momrox.-4 RESIDENTIAL PLAN CHECKING GUIDE (CONT'D) 7/85
MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONT'D)
9. -'Garage door or porch header sizes.
9.�— Adequate bracing.
1.0 Living area over garage - complete 1 -hour separation required on garage side
including supporting walls and posts, etc.
It— Two exits on three-story dwellings (Sec. 3303 & see Mezannines 1716).
I& -----Attic access and ventilation (Sec. 3205).
.+3. derfloor access and ventilation (Sec. 2516).
��W:od stoves,'clearances, alcoves & 1 -hour shafts.
164-"-C-o-mbustion air for fuel burning appliances.
+6. Noise requirements on duplexes.-
-t?,- Adobe soils - special -foundation design..
-1-8. Retaining walls requiring design.
1&#-�nusual shape, size or split level house requiring lateral design.
I r/1 WIMP i�' -,I -
wjouv
PERMIT NO.
PERMIT EXPIRES
OWNER
CONTR.
ASSESSOR PARCEL 47— 59-0 3
LOCATION 137, 1-2ndinagk Dr, Chico
Temp.Pow
Called
Temp. Eloc
Called
Temp. Gas
Called
JOB FINAL
Signatu
=01K
0 = Not OK
- = Not Applicable
= Not Ready MOBILE HOMES
MISCELLANEO1 10'
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
'DaW
DERWCOVERS,CARPORTS,GAF4fGES, (Plans)OK except #'s
1. Zoning Req u i reme nts-Setbac ks- Easements
VZoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
:Y Footings; Soils-Size-Depth-Spacing-Connectors-SteeI
3. Sewer; Locati on -Test- Fal I-C/0-Conc rete
3. Decks; Girders and/or Joists-Decki ng-Braci ng-Stai rs- Rai Is
4. Water; Locati o n -Test- Ease me nt Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-
Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ Amp -Concrete
6. Gas; Location -Test -Wrap: PV'ft.
/ P'Nat. or/ P'L"ft./ P'LPG
5. Alum. Awn.; Col u m ns -Con nections-Spi ice- Decal- Enclosures.
6. Cq�Fports; Windows -Doors
7. Utility Clearance
ie�-
".6g; Sills-Anchors-Studs-Rftrs-Trusses
VSiding; Nailing -Veneer -Stucco -Mesh
Card -131
Date Card -131 Date
10. Roof; Shthg-Roofing
Card -131
Date Card -131 Date
11. Ext.; Steps -Doors -Landings
Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Card -131
Card -131
,��g Date �L�,Card-131 Date
Date V I Card -Ell Date
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test- Demand -Valve -Con nector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
Date
POOLS (Plans) OK except #'s
5. Drain; MH Test-Fall-Flek Connector
1. Setbacks- Ease m ents
6. Water; MH Test -Regulator -Connector
2. Soils; Compaction -Structure Stability
7. Water and Sewer Connected -C/0 to Grade -HD Approval
3. Pool Structure; Steel -Connections -Thickness -
Dead Men -Lining
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
4. Elec.; Receptacles and Lighting, Distances-GFI
10. Cert. of Occupancy
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg.
Boxes-Enclosu res- Panel boards -Ins. to Main in Conduit
Card -131 Date Card; -131 Date
Card -131
Date Card -131 Date
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Card -Ell
Date Card -1311 Date
Card -131
Date Card -BI Date
= OK
= Not OK
= Not Applicable RESIDENTIAL (Single and Duplex)
= Not Ready �w -
Date
UNDEfIFLOOR (Plans) OK except #'s
Date
FRAMING (Continue )
-i_toqing requirements -Setbacks -Easements
44. Hangers -Post Caps -Anchors -Connectors
2. X., Main; Soils-Steel-Elo%�._/7�?_/" Ftg. Depth
45. CIng. Joist-Rf tr.'-Ties- Puri i n- Roof Brac.-Truss-Shthng.-Rfng.
19,/Ftg., Garage; Soils-Steel-/1�2_/" Ftg. Depth
46. Fireplace Ties or Type A Flue -Fireplace Throat
4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth
47. Attic Access; Size & Romex Protection- Draft Stop -ins. Baff les
S. �temwalls, Main; Steel-Blockouts-Wrapped
48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
'Vstemwalls, Garage; Steel- Bloc ko u ts-Wrapped
49. Garage Fire Protection Framing
7. Slab; Steel -Wrapped
50. Property Line Firewall & Openings
8. Piers -Fireplace Ftg.-Steel
51. Ext. Doors -One T -Check Garage -3rd story, 2 exits
9. D.W.V.; Fall -Fittings -Test -2 way C/0 -Sewer Test
52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
10. Gas Pipe; Size -Anchors
53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
11. Water Pipe; Test -Anchors -Regulator -Service Test
54. Siding -Nailing Veneer
12. Electric; Underground
'S% St_uc-"esh-Drip`-Sc-faed-Fd. Vents-Underfir. Acce
13. Plenums & Ducts; Clearance- Material-Supprt-Ins.
56. Glazing Area -Glass Protection -Skylights -Plastic
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
57. Shear Walls; Nailing -Bolts
15. Insulation
58. Insulation-Walls-Cig.
59. Infiltration-Walls-Wndws
Card -131
Dateq Card -131 Date
Card -131
Date Card -131 Date
Card -B1
Date Card -B1 Date
Card -B1
Date Card -B1 Date
Date
PLUMBING (Permit) OK except #'s
16. Water Ht. Vent -Access -Combustion Air
Date
FINAL (Plans) OK except #'s
17. Water Pipe; Test & Anchors -Nail ProteClion
i8. D.W.V.; Test-Fttngs & Anchors -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access_ a
,_63.
Ext,�Steps-Door & Sidelight Protection -Landings
05imoke Detector
62. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
Pedroom Exiting
64. _I. & Bath Fixtures & Tub Access -Spa
20. Test Tub & ShowqA 2rA qkoor-Tub *WsJ(C'
21. Gas Pipe; Size &1Ahc0jrdj j
16"3
Al
Elec. Trim & Subpanel; Breaker Sizes -Labels
Card -B1
Date Card -B1 Date
466.
Stairs & Rails
Card -131
Date Card -B1 Date / A
67 Fireplace or Stove; Clearances -Hearth
68. Elec. Outlets at Wood Panel; Int. & Ext.
Date ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -ins. Protectlohj
69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance
23. Elec. Receptacles Spacing -Lights & Switches at Doors
70. Elec. Outlets & Receptacles at Kit. Counter
24. Size Boxes & No. of Conductors -Stapled
71. Garage Fire Door; Swing -Landing -Closer
25. Romex Installed Close to Edge of Studs & C.J.
72. A.C. Duct in Garage -Damper
26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
27. 2 Appliance Circuits in Kitchen & Conductor Size
74. Plb., Elec. & Mach. Equip. Listed for Location
28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size / /ga.
Cu or Al
75. Elec. Receptacles in Garage; (G.F.I.)-Romax Protec.
29. Range Circ. ga. Cu or Al -Oven Circ. ga. Cu or Al.
Insulated Neutral Yes No
76. Insulation -Foam -Looked In Attic E3 Yes
77. Guard Rails & Deck Construction -Post Caps
30. Service -Riser Conductors & Ground -Main Disconnect
78. Fdn. Vents & Crawl Hole Door-DrainaTe & Wood -Earth
Clearance Looked under Floor 13 es
7
31. Equip. Clearances Panels-Motors-Mech. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
79. Following instid.; Drive C3 Yes 0 No; Walks 0 Yes 0 No;
Planters 0 Yes 13 No
-
80. Stucco; Brown -Finish
Card -131
Date Card -131 Date
81. A.C. Unit; Disconnect, Electrical, Plumbing
Card -B1
Date Card -B1 Date
82. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to
Openings.
Date
MECHANICAL (Permit) OK except #'s
83. Water Well; Disconnect, Electrical, Plumbing
33. A.C. Ducts Insulation & Support
84. Exterior Elec. Trim; G.F.I. Receptacle- U nderg round
34. Vent Fan; Exhaust above insulation
85. Ventilation throughout House
35. Condeosate Drain & Overflow; Size & Grade
86. Glass Protection
36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet
87. Corrections from Previous Inpections
37. Attic Access & Platform if Furnace in Attic
88. Gas Test -Meters Tagged; Gas -Electric
89. Water & Sewer Connected -C/O to Gracle-HD Approval
90. Energy Compliance Certificate -Other Certificates
Card -131
Date Card -131 Date
Card -131
Date Card -131 Date
Card -131
Date Card -B1 Date
Card -131
Date Card -B1 Date
Date FRAMING (Plans) OK except #'s
38. Sills, Proper Material & Anchors
Card -131
Date Card -B1 Date
39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
Comments at Final:
40. Bearing Walls over Girders & Floor Nailing
41. Draft Stop in Walls (rat proof)
42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
43. Header & Beam -Size & Bearing
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PER HT NO
7 County Center Drive - Oroville,ZaliforQla 95965 - Telephone: 916/538-754( /,�7 , %.-�
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
4/2- z5V - /Q-3
ZON I N.r.,
15/_ZZ
BUILDING PERMIT
OwNe'R
TELEPHONE
SQ.FT. OCC. BUILDING VALU�TION
40 ZV r)
_W,6V7J
OWNER'S MAILING ADDRESS
All 16
CONTRACTOR'S NAME
-5-
ELEPHONE
CONTRACTOR'S MAILING ADDRESS
-5r
Fireplace
CONSTRUCTION LENDER
Z2P "'9
UNKNOWN
tion
Total Value $
Filing Fee
$ 10.00
LENDER'l MAILING ADDRESS
Permit Fee
$ _17.17)
ARCHITECT OR ENGIN ER
LICEN9E NO.
Plan Checking Fee
-
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ A�a � -71
PLUMBING PERMIT
FilingFee 1 10.00
1.3 7 Z�00177,�ee_
Each Trap
J 2.00 1
Solar or heat pump water heater
20-00
LOT NO.
SUBDIVISION NAME
1
PARCEL MAP
1
Water piping
5.00
Each qas water heater or vent
5.00
110-00ea
USE OF STRUCTWE,
SFO DuplexR Mobilehome[] OtherM/ Z!2!�2 �-
SPECIFY /
Gas piping system 1 - 5 outlets
5.00
452 ilding sewer
5.00
Mobile Home S I G I W I
TYPE OF WORK
New Addition
A I Remodelo UtilitiesO InstallationEl Other F-1 ;
Describe work: zo X;ZK I
Permit Fee
$ I
Contractor
IT
ELECTRICAL PERMIT
FilingFee 10.00
600V OR LESS
Main service 100 AMP OR LESS
10.00
Main service EA. ADO -L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Busines S
and Professions C and my license is in full force and effect.
License No. 4 IZ-7 0 — Classification a
El 1, 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)
1, as the owner, am exclusively contracting with licensed UVIRIOUt-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NEW CONST DWELLING OCC
OR ADDNS. ACC.BLDGS. 21/20sqft
NEW CONSTR. MULTI*OUTLE:T 2.50 ea
N O..RESID, BR ANCH CIRCU ITS
(POWER APPARATUS &I
SINGLE OUTLET C -91R. 1)
Ex. Occup(OUTLETS OR FIXTURES 1.20050t
AUP 30t
FIXED APPLNS. OR
Ex. OCCUP- OUTLETS (RESIC.) EA.) 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
F� 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
to the W. C. provisions of the Labor Code, you must forthwith comply w i th """
such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Fi I ing Fee 10-00
Heating
Cooling
Hood
3.00
Venti I ation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above informa;jon___�oblle
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 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 County in consequence of the nt . ng of this permit.
", ) v A�v
X _Z Date
Signature ofNApplicant - Owner 0 --Contractor �- Agent El
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Home Installation Fee $
Energy Inspection Fee
TOTAL PERMIT FEE $
occ u P.
C. It
JSC1IOOLJFr�JPARCii;,j.4
iso
permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
1�
DiRE9TQWOF PUBLIC
By VhAa�
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
r)RtA 13
6L_
Receipt No.
WHITZ-O.P.W., YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD-APPLI CANT
OWNER
COUNTY OF BUTTE - DEPARTMENT- OF�,PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILtrE I _CKL:061RNIA 95965 - TELEPHONE: 9116/538-754(1,_�
PERM,IT APPLICAT110N DATA SHEET
r Permit No.
2'" A P No
Proposed Building Use
Building -Inspector 141 9�2�
Date
At time of permit application, I was advised the following data must be submitted prior to permit processing5,-e/
and:/orissuance: DATE RECEIVED APPROVED"
2.,
3.
4.
5.
6.
7
11.
12.
13.
14.
15.
16.
i �.
18.
19.
20.
21.
22.
All items have been submitted. . . / . . . . . . . .
Plot plans in duplicate./triplicate, signed by preparer of plans. . .
Complete plans in duplicate./triplicate, signed by preparer of plans.
Complete engineered plans and calc's, with wet signature on plans.
Plans with Energy Design Compliance Statement . . . . . .
School District "Fees Paid" Stamp on Floor Plan.
Statement of Intent for Non -Heated and AC Buildings.
Fees of $ . . . . . . . .
Letter of signature authorizat.ion . . . . .
Panitation approval from . t4��,' �� * , Heal'th Dept. .,e .
Planning approval for (A) Use: — (B) Parking:— .
Certificate of Workmen's Compensation Insurance . . . . . .
Contractor's License Information (no., name style, classif.) . .
Owner -Builder Verification (Given to owner[1, Mail to ownerEb
Improvements may be required . . . . . . . . . .
Mobilehome Installation Data. . . . . . . . . .
Pre -Inspection for 4 Pre-Inspec. request to
Required-� Building Inspector
Recorded copy of Agricultural Acknowledgment Statement.
Driveway Permit.
Plot plan approval from city of
Engineered trusses'in duplicate (required prior tolplan check).—
When you issue the permit, pr cess as follows: —Mail to owner, —Mail to contractor.
-Telephone 2 and hold for pickup at��_b�ice, —Deliver w/inspector.
Other
Applicant Date
Copy of plans sent — Health Dept., Fire Dept., — Other— Date
The following data must be submitted prior to permit issuance: (Circle new item not checked aboyp).
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 _rna I I —counter by— date
Plans checked by Date Plans approved by- —Date
Sets of plans on hold in 'File cabinet _AP folder
Copy—DPW
.0
Mete)
?i
TO Building Department
FIROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply
Hoild,final for: Water Supply
Final clearance O.K. for:. Water Supply
Clearance for bedroom mobile home. Other.
f
NOTE -
S Z-i—t -a r �iW�—
Date