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056-090-054
t I ----------- 56-09-54 561-0 54 f-41-90 H KARYL K H' KARYL CLARK FN IS pr E/ NIS ' pri a E/ ' S Cohasset Rd. �4 mi above church, Co S Cohas "I ' n CLARK, Kenneth 85 Bull Creek Ln, Cohasset Permit#3550 '3550- 86 -86,,E(add living area)SF Ag Exemption Permit' Chorses & goats) 56-09-56� Per �;� #3952-87B(Ist renewal/3550-86) 056-090-'054 PERMIT#94Z,2531 CLARK, KEN & KARYL .85 BULL CREEK LN., COHASSE'T NEW PRI 'DET GARAGE & CARPORT 06-090,7054 R .-.-.-PERMIT#96-10!"41? CLARK, Ken & Karyl 85,Bull Creek Ln., Cohasset 4", V a "Ist Ren 'l BP#94-2 , 531/G , rage�;�� fo�'����� I �'f.0+S" R SIDENTIAL 5fat 056-090-054 PERMIT#- CLARK, KEN & KARYL 85 BULL CREEK LN., COHASSET / NEW; P I DAFT GARAGE �CARPORT a- r OFFICE COPY Address 17x''1/ GAS Meter By V I Date ELECTRIC � Meter By Date J08 FINALED Signature \.. ,T V= OK O = Not OK - = Not Applicable Not Ready .MOBILE HOMES ' = Date/Initials MOBILE HOME UTILITIES (Plans) OK except #'a ' 1. Zoning Requlrements-Setbacks-Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) S. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L" ft. / /"Net. or/ /" L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date/Initials MOBILE HOME INSTALLATION (Plana) OK except q's 1. Zoning Requirements -Setbacks Easements 2 Footings; Size -Spacing -Marriage Line 3.. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy MISCE Decks; Griders and/or Joists-Decking-Bracir Wood Awn.; Posts-Beams-Rftrs: Connectors 51 Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6.1 Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Truases 9. iding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date/Initials POOLS (Plans) OK except #'a 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 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-Enclosures-Panelboa rds-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single .& Duplex) Date/Initials UNOJi LOOK Plans OK except #'s . Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -teat 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date/Initials PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors _Date/initials ELECTRICAL (Permit) OK except #'a 22. Fixture & Transformer Clearance -Ina. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mach. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral O Yes 0 No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels -Motors -Meth. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date/Initials MECHANICAL (Permit) OK except #'a 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date/Initials FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Wells (ret proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Bmc-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. 1 nsulation-Walls-Celli nos 60. Infiltration -Wells -Windows Date/Initials FINAL (Plans) OK except #'a 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. • Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door, Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection 75. Plb., Elec. & Mach. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic O Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door-Drainagge & Wood -Earth Clearance Looked under Floor O Yes 80. Following Instld.; Drive 0 Yes 0 No; Walks 0 Yea 0 No; Planters 0 Yes 0 No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg: Appliance -Fireplace: Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Cornnwnts at Final: COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERW NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDINGPERMIT OWNER rLyZ SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING KESS 1Z CoW CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAIUNG ADDRESS Permit Fee $ ARCHITECT OR ENGINEER UCENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINES S MAILING ADDRESS Penalty $ BUILDING ADDRESS e PERMITFEE $ •Sr PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome O Other A–i. SP IF1' Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New O Addition ❑ Remodel ❑ Utilities ❑ Installation O Other O Describe Work: ��/`/i1 �G Mobile Home S G W @20.00 PERMITFEE 1 $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service000V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A To 1000A ) 46.00 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law the following reason: Law owner of the property, or my employees with wages as their sole compensation, // will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NEW CONST. DWELLING OCCUR OR ADDNS. ( a ACC. BLDS. ) SO. 3.50 FT. NEW CONST. / MULTI -OUTLET NON-RESID. \ BRANCH CIRCUITS ) @7.50 / P SINGLCWER APPARATUS ) 8 NGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES ) .00 BAL @ I.50 50 Ex. Occup. FIXEDAPPLN . ea ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I 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 comp with os provisions. _ a X Date �� / Signa ure of p li n - er ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES �_ IMP FLOOD cDF PARCEL PD HO ISSUE — _. This permit is hereby issued under the applicable provisions of the Butte County Code an /or Resolutions to do work indicated ve for which fes have been paid. By Date PERMITEXPIRESON ate) q Receipt No. [j71 / WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT O.B.- I ))...:........ .. .. .....::.::.>.; ..: ;:.... w ... ...... ....... n � i!.: ;..«.. � : �.:..:..: ; ;.. ,::.'fit•}` 4• •iapM Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bewing your signature. Please complete and rev= this information at your earliest opportunity to avoid urmecessary delay in processing and issuing your building permit. No building perrait be issued until this verification is received. 1. I personally plan to provide the major labor and materials'for construction of the proposed property improvement: YEStA NOj ]. 2. I DA,VE(� SAVE NOT[ ] signed an application for a building permit for the proposed work: 3. I have contracted with the following person (firm) to provide the proposed construction: NA112E> ADDRESS: ' PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate; supervise, and provide the major work- ADDRESS: orkADDRESS: CITY• PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SOCIAL SECITR= NUMBER: DATE: C - 6-n NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and. returned to our office before we are permitted to issue the permit. O VE R Dear Property Owner. An application for a building permit has been submitted in your name listing yourself as the builder of property improvements seed. For your protection. you should be aware that as "owner -builder you are the responsible parry of record on such a permit. Building permits are not required to be signed by property owners unless they are personajtly performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following itiformation for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is S300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Intr--nal Revenue Service (and. if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale. property owners who are not licensed contractors are allowed to perform their work personally or through their own employe, without a lice:sed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors -is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about Iicarised contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento. CA. 95814. Plcnse complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware or these manors. The building permit will not be issued until the verification is returned. Sincer%e'r , / Michael C. veira. C.B.O. Manager. Building Inspection NOTE: This Owncr-Builder Infor-=Lion is required by Section 19830 of the California Health and Safety Code. 0�'-rR DATE: /Z s--%5' 62 PERMIT #: ASSESSOR PARCEL #: ©$� OWNER'S NAME: C 1140L- K FEES (Amount=d Purpose): BALANCE OF FEES: $ ADDITIONAL FEES: $ REINSPECTION FEE: $ SEMRIFF FEE: $ CUA FEE: $ TUA FEE: $ CSA 87 TRAFFIC FEE: $ WATER TENDER FEE: $ BATTALION # THERM DRAINAGE FEE $ IF BALANCE OF FEES OR ADDITIONAL VALUATION: VALUATION: $ ADDITIONAL VAL: $ (Check One) COUNTY CITY OF BIGGS (Check One) RESIDENTIAL COMMERCIAL RECEIPT NUMBER:' f i - I0 ' d Tf '3ZS899 T6 lddES : z0 966 T -Std -t 0 Certificate o ,0897 THE UNDERSIGNED MANUFACTURER HERCBY CERTIFIES that the structural wood products identified below and marked with a collective ,mark of American Wood Systems (AWS) were manufactured in acoordance with the specificatirins indicated below. XK7 ANSI Standard A190.1-1992, for Structural Glued Lai ninated Timber Ii ❑ QuF_ L Job Name C z A 4 /`. �. �� 3 - (.i Job Location 915, n .. �. �' ' ��,��1 [ - i0 f 1S 5 E�Vp Custtoomers 0edor No. WE 23296/ A r ��i6 Dwed_?,��/ 3 U31-95 %Mfg'sorderNo 09-03539 /�� I I C '7;n l,.f � � 7 J 0/9 6 - - - ------ C""' "`' `fit'QUALITY CONTROL SUPERVISOR Slonature 1. _ Title BOISE CASCADE CORP. P-1 U. BOX 50 - Company Addross--1 Date .BOISE, IDA110 83728 IT IS HEREBY CERTIFIED that the structural glued laminated timber production of the above- named manufacturer which carries a collective mark of American Wood Systems (AWS) is subject to regular audit by American Wood Systms, such audit consisting of the Inspection with reasonable frequency of the manufacturing p+oeess, with adequate sampling to verity the quatlty of glulam construction and the adequacy of glu:t., bond. 4009 1440 00 �op4QRq�, J�>P� tSa, 4 aZ NIH�"f�'•� . by Thomas G. Williamsc- Executive Vice President AMERICAN W4UP SY3- A RELATED C,0HPOHAIION OFF APA T©'d T28?_S899T6 :jc sm-),na NH3153'11 8S:t7T 966L-so-�1!II-t AONTUEWED THU FRI SAT DE--J.)ING COPY' •� ' ❑ ❑ ❑ ❑ ❑ DESCRIPTIOr4 AM DELIVER Store No. PM PICKUP p� LOADED ` 1 14X36 GARAGE: ?r: 32$ S IOi CASH 11321 11:21 483663 53896 CHECKED BY -'g 1100 E. 201h ST. P.O. BOX 689 is —HELP JOD CHICO, CA. 95928 CHICO, CA. 95927 I' 0 YES NO ( ) 3:2-1886 SALESMAN: DELYER Co NO. C- X313 2 2 2 9 '' 388 - LNFT. 2X4 STO & BTR GRh YF. S4S a r, — B C COD APPROVED BY: I` SO T CASH A T i I 91566 i is i' I i 1 I•� i is ALEJ'q%��-EKS,',THE BUILDER' G° 1. I. CHO !' ELKS CHICO t SA SOLD TO UNLESS NOTED BELOW) KEN CLARK 343-8194 C.O.D.Amlount 85 ROLL -CREEK LN ;. C011ASSET waxen term 'Date' Wanted' � Date Deli•beted: ' B No. t I 13 18 8S/38/96. 8S/38J96 Estimate No.... .Initial. . Salesman JIM i4ANLEY -- ;_ UNITS Customer Coda Segwnce No. DESCRIPTIOr4 Transaction Date Store No. S man'mm 1 ` 1 14X36 GARAGE: ?r: 32$ S IOi CASH 11321 11:21 483663 53896 1 -'g ":492FZ ITEM NUMBER DESCRIPTIOr4 2436G 1 ` 1 14X36 GARAGE: ?r: 32$ S IOi t, ad �►,�� � ►+aa , � � 241 ,.' ; 1.18` :...;118' - .2X4 STD&BTR, PRESSURE TRLATE�J . -'g ":492FZ 185 185 - 12Xd 91-1/4' STDbBTR OF 5TUOS' 1411F1 39.2 388 - LNFT. 2X4 STO & BTR GRh YF. S4S Z+ - 2624F2 3 a IXF 24 b2 ,4 ATR 01✓ ►+ ►� 2614F2, I 61� 68 ?X6 16 12 It. U's 1, I!E _ a 4IOF 1 1 ABOVE TO k 11 OF <� 1828F1 ,. 1. .2 '2X° 2e '42 1k BTR OF: �,�� all :fir 258F2 9 :9 - 2X6 8 12 & BTR OF 4128F2 . 2 2 = 4X12 8 112. & BTR OF 4116F2 1 1 4X11. F t2 & 8TR OF - 313G: '.18. '-is:=;3-1/8°X13-1/2 GLU LAM BEAN'74F 2614E 2 I 1 1- 2 X 6 14 12 & BTR OF . 116OS6 34 - 34 -.'1/16" 4X8 ORIENTED STRAND BRO 588FS8 32 32 19/3211 8"OC SELECT OF SID[ 14HFSS 288 188 - 1X4 HEM FIR SELECT STRU KO SIS 12cC 56 56 - 1X2 CLEAR WR CEDAR CSDT 34 34 = '0/C COMP DESERT TAN FOB YARD' DELL 341 3l CROUND DELIVERY 1SF364 3.1 3 - 158 36" 'ASTM FE4.T t4 SQUARE' Q0 16160.1 I 1 1 16X1 SEC GARAGE DOOR W/TORSII(0 c 6050 . 6831MS 2 2 - 6/8 X 3/9 SINGLE HILL VIKING " 1 16ce 4S 48 - 1X6 CLEAR r:'R CEDAR S1Sk R/I 458EPH i 1 - 4 5/8" FJ EXT PH WICASIN.6 '2PCS34 1 1 - "IC 1-3/4° SC PRIME CDA! DOOR ►,P. ►,� 628 2 2 - i4 X 1(I GABLE VENT 721 I 1 ' III.I:' 482 E i12 6;i i' 368aG 8 ? 'GAL `�PREO HOUSE WHITE' 'Y'' Z�' !•588G I 1 'SAL FDREn HOUSF: WHITE' " ►. MPORTANT., ALL MERCHANDISE REl'UnNED SUBJECT TO A RE- ;TOCKING CHAn rE. SFE REVERSE SIDE FOR 7FnMS A CONDITIONS. I tFr'D. RN, . .. _.. PAIF SUR -TOTAL TAX W _ �1n19UNL d COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT x-_531 ASSESSOR PARCEL NUMBER 56-09-54 ZONING tm-5 BUILDING PERMIT OWNER KEN & KARYL CLARK T343N0794 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESSOWNER 864 M 15,552.00 976 C 7,488.00 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 23.040.00 LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 941 ARCHITECT OR ENGINEER ucENSE NO. Plan Checking Fee $ -no 7 95 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS PERMIT FEE $ ZL90 Q5 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 IC D Ste— Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME' PAR LMAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome O Other PRI DET GARAGE & CARPORT SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New P Addition O Remodel O Utilities ❑ Installation O Other ❑ Describe Work: PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main ServiceIII OR LESS ( 200A OR LESS ) 2.3.00 Main Service ( 200A TO 1000A 46.00 1)Q NEW OR ADDNS.T ( DW & ACCLLINGBLDS. IS 4 3.501 F°. 30.2f CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one) O I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification lff I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑.I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POW ER APPARATUS ) a SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. .50 Ex. Occup.UTEDAPPWS.0E (OUTLETS IRESID.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a ertificate of Consent to Self -insure. VIshall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 50.25 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that 1 have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California 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 said County in con .que a of the grantin of is permit. X Date — ^' Signature of App? -,Cant - O Owner ❑ Contractor ❑Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONST. TYPE TOTAL FEE $ NAZ. D. FEES IMP FLOOjy� CDF ARCEL PD — H I E This permit is hereby issued under the of the Butte County Code and/or Resolutions indicated abov for which fees ave been BY PERMIT EXPIRES ON fDa to applicable provisions to do work paid. Date.C%`3� Receipt No.� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT i 4 E.H. USE ONLY Plot Plea Attached Floor Plea Attached Scat to B.D. Z4 / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance h/7, A ?//Va t, / 641e, -e �l/ L'/re�' ,Lr�, C'ail�sse� nG - 6 9 - S'Y Owner Location AP# PlanApproved for: Sewage Disposal Water Supply: Public Private Well Clearance for bedroom mobile home. Other .2,91 *X 36' rga9e' aT}�elcd 22 "x.29 � i Hold final for: Final clearance O.K. for: NOTE: A>o ✓Mi mho v,,a 8/92 Date (,�� .i(�y ,''+'�.>�,.�'ww✓��gtT++i:��:i.t}e�7�.•Y�.Q1+IF•fpr'9��'`�ti���...:.wicMH�x•i:i�'Y�i"�''s�i,.Y`�'V�'^ya� "fir:-:y,..yy [�. a ,��(.i`•r �rY qW r •�-rrnjy.< � K•1rWwr r r1' «r•yt;r y, P. ,rr•. M1 V COUNTYOF BUTTE -DEPARTMENT OF DEVELOPMENTSERVICES -BUILDING DIVISION t'.7 COUNTY CENTER DRIVE - OROVILLE, CALIFORMA-9 5965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SAEET OWNER t A. P. No.O — 'Se/ Proposed Building Use ('n fPit,+ Building Inspector JZV Date 9 117-1 ilail� At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . .............. .../. ............... r.4..... f Plot plans,0/4 sets, signed by preparer of plans. .......................... Complete plans,Q/4 sets, signed by preparer of plans . ...................... Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 1 Impact fees as shown on attached sche 1 ... {i 12 California Department of Forestry plan prov ....IR Flood elevation letter 100 year flood b ifornia En ineer. 4Kt 14 anitation and plot plana proval yc.scv, Health Department . ............� y City P of Chico lumbin9permit .......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. . Pre -Inspection request 20. Pre -inspection for required. . to Building Inspector. (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... . X24. Recorded copy of Agricultural Acknowledgement Statement . ................. f- 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... -� 27. Letter of intent on building use. 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access. ............ ......... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ..................:............ ...... 32. Plan check list . .............................................. `#..... . 33. 34. Whe you issue the_pprmit, process as follows: Mail to owner. Mail to contractor. Telephon .3-' and hold for pickup at i% office. Deliver with inspector. Other Parcel Creation O Acreage Applicant Date / x12 �fX__ Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. �_— Fire Dept. Other Date By The following data must be submitted p 1. Index permit for above items No. _ 2. Additional items required: it issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE Department of Development Se -vices Building Division. Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 OWNER -BUILDER VERIFICATION Attention Properry Owner: An "owner -builder" building permit has been applied for in your name and bearing your, signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan pto�provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) -e_ signed an application for a building permit for the proposed work. 3. 1 -have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractor's License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractor's License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner Social Security Number Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. t�;c COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916),538-754 PERMIT NO. APPLICATION AND PERMIT - 25 �! ASSESSOR PARCEL NUMBER — O ^ _ ZONING ! r `��✓ BUILDING PERMIT OWNER ^ r[_Jl I 1 T�IPHONE L� E•, SQ. FT. OCC. BUILDING VALUATION (, O(_ _ .� t OWNER'S ftr ADD V l ►y+- Y 1y't�l�v J bR 1 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Freplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ • LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE $ y. Q.q PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping I 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF O Duplex Cl Mobilehome O Other clFr Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S I G I W @20.00 TYPE OF WORK New KAddition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other O Describe Work: PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service BOOV OR LESS _ ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A )_ 46.00 NEW -"WELLING OCCUP OR ADONS. ( 8 ACC. RLOS. S0. 3•SC FT. .d CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O I, as the owner, 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) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O I am exempt under Sec. Business and Professions Code forthis reason NEW CONST.MUL rI.OUTLET NON-nESID ( BRANCH CIRCUITS ) @7.50 ( POW[ n APPARAruS ) S SINGLE OU FLET CIR. EX. Occup. ( ) oU1LET on rIX1UREs ZO @ 1.00 BAL. � .so Ex. Occu FIXED AP"S' on P' ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service_23.00 Mobile Home Facilities --r 20.00 Misc. Wiring 23.0 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Sp, a Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 _ Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California 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 a ainst aid County in consequence of the granting of this permit. X _Date Z Signature of Applicant - ❑ Owner O Contractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep a d demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ _ CUN1l. rrlE TOTAL FEESt4'-71 IIAZ. D. FEEs IMP FLOOD 1: PARCEL PD MD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON lOetel Receipt P /D-7 VVZ1 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Ex, *-Aaj� f, c., a y/ a g tn`• Ll tu l Ly(ri ,. HEALTH ENVIRONA��EN7A1. y f �1en� _ i r 1' F s • � 1J-- - B rn C SEP 1 2 1994 a �,,; CHICO, CALIFORNIA t :{• )JI C SEK NJSLl Ap �al�/C�Lee C� C�o�iz5Se7� 1 1 F � - ' j /046 Level � • e �. '�. ante ����.�r O 70 •.. .y,L� it .; �l �•f ,' -ter., ,� !fi f�. ' _ ,.' .� ... .. IT t 8v i�Cst:Ef4G• � �1 te— _ T,..:+• f r � ' i > l Leoe .,Yr' N 11 tri•: - • t 2, i A 1 4T.i r•' Im c I •,1. ..r Y 17 i w i l r 8v i�Cst:Ef4G• � �1 'tr. . r .d . .q <. . . COUNTY OF BUTTE - DARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE - OROVJ.Lf-E, CALIFORNIA 95965 - TELEPHONE: (916) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT / PERMIT NO. - [ !iU' rn Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. / ZONING ,l J OWNER 62 oar PHONE N0. F %G - �h •e ✓ � OWNER'S ADDRESS / Coli l —9 _73 — 0 7 r3� � he O� PQ SS e_ LOCATION OF BUILDING SGlyl a v USE OF BUILDING SIZE OF STRUCTURE 30 X - SQ. FT. TYPE OF CONSTRUCTION: / Ake ,,[ WOOD FRAME STEEL CONCRETE OTHER (Specify) S;/"C&4Q_ TYPE OF SIDING ROOFCOVERINg FLOOR TYPE c e!a /jai ve ESTIMATED COST OF CONSTRUCTION l�aa- $ AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows - '�^ �� FRONT ,�� _ SIDES REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date / - Signature of Owner Permit Fee - $25.00 Receipt No. The above described AG Building is exempt from a building permit. White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant Director of Public Works BY Date F-'"`���' 4<. r e. FLOOD/ PARCEL P.D. ROOFING/ ISSUE ✓ � I V Director of Public Works BY Date F-'"`���' 4<. r e. COUNTY OF BUTTE - DEPARTMENT:OF-'PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OR01WLEYrCAL,IEGANIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION'DATA SHEET -Permit No. / OWNER IeA ��_" CL�i�/�x,. P. (� Proposed Building UseBuilding Inspector Date At time of p (nit 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/triplicate, signed by preparer of plans ....... . 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered planslind calcs, with wet signature on plans .. 5. Hazardous Material Form .......................... ............. . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid ................................................ 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector 'J (Date) f 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. sf 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .:.. . 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... ` 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No.) 2. Additional items required: s� Contractor, designer, owner, was advised of above required data by_phone_-nail counter by ..date Contractor, designer, owner, was advised of above required data by—phone _mail—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW Temp. Power Pole Called PG&E Temp. Elec. Service_ Call Temp. Ga Calle JOB FIN, Sign; PERMIT NO. PERMIT EXPIRES OWNER KENN;4 CLARK CONTR. owner ASSESSOR PARCEL 56-09-54 LOCATION N/S pri dr, E/S Cohasset Rd 4 mi above church, Cohasset &"-Ik p-,/, �W — ()n' 191A,t'X, Temp. Power Pole Called PG&E Temp. Elec. Service_ Call Temp. Ga Calle JOB FIN, Sign; JOK 0 = Not OK - = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except H's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's '1. Zoning Requirements -Setbacks -Easements _ 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L" ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI ` Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1, Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability �V 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5'-CirculatingEquipment-Heater 8. Gas and Electricity Tagged B. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes- Enc losures- Pane Iboards- Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date V = OK 0 = Not OK YY - = Not ApAicable = No, Ready ,/ RESIDENTIAt'(Single and Duplex) Date UND FLOOR Plans OK except #'s Date FRAJVfiNG (Continued) - -oning requirements -Setbacks -Easements V �tg., Property Line Firewall & Openings Main; Soils -St eel-�!�� rr�d._ / 2/ Ftg. Depth Ext. Doors -One 3' -Check Garage -3rd story, 2 exits — 3. FIg., Garage; Soils -Steel- / /" Fig. Depth 5 . [ - eadroom-Rise-Run-Landing-Fire Protection__ - 4. F tg., Porches & Decks; Soi Is -Step Fig. Depth _ ./Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Stemwalls,Mn; Steel-Blockouts-WrappeSlab M. Siding -Nailing -Veneer $._ Stem -walls, Garage; Steel -Blackouts- tel53e - rip Screed-Fdn. Vents-Underflr. Access 7. Piers_ Fireplace Ftg.-Steel _ .,,Rlazing Area -Glass Protection -Skylights -Plastic - 8. D.W.V.: Fall -F' - 2 way C/O -Sewer Test Shear Walls; ailing -Bolts - 9. Gas Pipe; Siz hors _-_ 10. Water Pipe: T -Anchors-Regulator-Service Test 11. Electric: Un erground 12. Plenums & Ducts; Clearance -Material -Support -Ins. LD - 13. Girders_Sills-Anchor Bolts -Joists -Vents -Cripples Card -BI Date d Card -BI Date _ Card -BI Card -BI Date C4jqYX, Card -BI Date Date Card -BI Date Card -81 Card -BI S Date Card -BI Date Date Card -BI Date Date FIN (Plans) OK except it's Date PLU NG (Permit) OK a ept p's t. Steps -Door & Sidelight Protection -Landings §3,/Smoke Detector Card -BI Card -BI 14. Water .: Vent- ess-Combustion Air 15. Water Pipe. & Anchors -Nail Protection 16. D.W.V.: Te - gs & Anchors -Nail Protection 17. Shower P n: Test, t Floor -Tub Access 18. Test b & Shower, 2nd -Tub Access 19. Ga ipe Size & Anchors J1rs Date _ Card -BI Date Date Card -BI Date - earance-Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection r a Ix ures & Tub Access Elec. Trim & So4aae4-Breaker Sizes -Labels Rat s Stove' Clearances -Hearth 6,r Elec. Outlets at Wood Panel; Int. & Ext. _ p Grnd.-Air Gap -Cooking Clearance ceptacles at Kit. Counter Date EL CTRICAL Permit OK except q's 1871 Ge age Fire r; wing -Landing -Closer ara a-Daer Card B -I Card B -I 2Ffxture & Transformer Clearance -Ins. Protection �ec. Receptacles Spacing -Lights & Switches at Doors ize Boxes & No. of Conductors -Stapled �Romex Installed Close to Edge of Studs & C.J. �/ Equip. Ground made up w/Meth. Fasteners_-BvrltriGas-& rance Circuits in Kitchew& Conductor Size Wire Size / / ga. Cu or AI rre Size / g Cu or _ _C.Lpo 2 Rayge-GircrT a. C AI O Circ. / / ga. Cu or Al, Insulated Neuf 0 - --- ----- ice-Ri r Condu ors & Ground -Main Disconnect 25-EtTOTr.-CTearances: anels-Motors_Mech. Equip. _97(2. es Closet Light -Shower Light - ---- -- ,(] /� - -- - -- �,` Date I'/ Card -BI Date _- - Date Card -BI Date nc . Air-Connector-P.R.V.- Garage; o or -M . rotection Pfyl EIec. & MoGU-Equip. Listed for Location G rage; (G. F.I.)-Ramex Protec. Insulation -Foam -Looked in Attic E] Yes onstruction-Post Caps Fdn. Vet & ravel tole Door -Drainage &Wood -Earth Clearance k or ❑ Ye Followin mstld.: Dri 9 Yes [1 0: Walks G Yes o; Planters ❑Yes No -. VITIT. isconnect-Clrnces-Brkr. & Cond. Size -115V Outlet Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. _ _ P . ct, Electrical, Plumbing _ xterior Elec. Trim; G.F.I. Receptacle -Underground _ ilation throughout House ass Protection Date MECHARLCAL m•it) OK except 4's Corrections from Previous Inspections 154. est—Meters T ed; Gas -Electric Card -BI Card -BI 31. A.C. s.Insulation & Support .-._ 32. Vent a Exhaust above Insulation _ 33. Co ensat Drain & Overflow: Size -& Grade 3a. F arnace-Ve t: Access -Comb. Air -Return Air Vent -115V outlet _ 35. [tic Access Platform if Furnace in Attic Date Card -BI Date Date Card -BI Date _ ewer Connected -C/O to Grade -HD Approval nergy Compliance Certificate -Other Certificates a - ---- - -- _Card -BI +_gDate' _ Card -BI Date Card-BI/A, Da Card -BI Date Card -BI Date Card -BI Date Date FR MING(Plans) OK except q's Com rents at Final: Sills, Proper Material & Anchors AVAalls. Studs -Nailing, Spacing & Bracing -Plates -Sound 3i/Bearing Walls over Girders & Floor Nailing JB' raft Stop in Walls (rat proof) ---- ,�/D - -- 44. .Fire Stops: Furred Ceili_ggss-Stairs-Chases-Tub 'jH eder & Beam -Size & Bearing - _ _ - __--- 4V' H a2 angers -Post Caps -Anchors -Connectors 4k Cing. Joist-Rfir. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. p -y* evEu-eplace Throat Attic Access. Size & Romex Protection -Draft Stop -Ins. Baffles 40--STMM. endows or Exiting Doors -Sill Hgi. & Dimensions 47 -@nreoje-F+re-Protection Framing _ -- --- - -- - �- --- ---- - ----- -- - --- - - - - - ---_—_ - -_---- - - - - ---- - - - - --_ -- _ .- (NOTE Anentrymust be made each time youvisit jobsite) I�ca`Li�,�Ji'u"_nl•,� F _.. y'"�+'x^..="'v-'� :�r:..a 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 3 5'2 - P,2 PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction --of work'is completed. If you have any question pertaining to this ;ma�tte�r,,eed additional explanation, please contact this office immediately. i. i t - Inspector Date Owner: /���C/�� /lii C��/.l /L l� Permit No. LOCATION ENERGY C$ R T I F ICATION DESCRIPTION OF INSULATION ROOF Material Thickness(inches) X EXTERIOR WALL Material Thickness (inc es) A` CEILING Batt or Blanket Type �S Thickness(inches) /pf/ Loose Fill Type Minimum Thickness(Inches) Area covered(ft.2) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) A. P. No. Brand Name Thermal Resistance (R Value) Brand Name,0GfEicl S- /t'Q/� /k Thermal Resistance(R Value) /Z Brand Name Thermal Resistance(R Value) --,j Brand Name Number of Bags Wt. per bag lb. Thermal Resistance(R Value) 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 they State of California Energy Requirements. FIRM /OWNER STATE CONTRACTOR'S LICENSE NO. ?F SIGNATURE OF INSTALLATION APPLICATOR DATE 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. -- 11 C'all9 C 7L,'1 i^ FIRM NAME OWNER (Please pri t) STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF GENERAL 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 WORKSPERMIT NO/rr 7 County Center Drive - Oroville, Caaifornia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT (l ASSES OR PARCEL NUMBER ZONING BUILDING PERMIT OWN R I TELEPHONE O�L, SQ, FT. OCC. BUILDING VALUATION 7 1,00. U® OW R'S MAILING ADDRESS C ws >e !-AQP CONTRACTOR'S R QA - TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER N ON UNKNOWN Total Valuation $ [�00. o(> Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ Yr. SO ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,b' S Energy Plan Checking Fee $ is,00 ARCHITECT OREENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS P� `i tJ� IIS, - f Permit fee $ QI -75- PLUMBING PERMIT Filing Fee 110.00 Each Trap V 2,00 {- Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5,00 USE OF STRUCTURE SFU_ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G 10.00 ea TYPE OF WORK New ❑ AdditionA Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: L t u �nr� a 4'R Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMPORV OR 10.00 Main service EA. ADD'L too AMP 2.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): �❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 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 con ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.8d OR ACDNS. ACC. BLDGS. I�z¢sgft NEW CONSTR ULT' -OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS e SINGLE OUTLET CIR. I EX, QCCUp OUTLETS OR FIXTURES 1.20050c ALO 30 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID.) EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00tract- Misc. Wiring g 15.00 Permit Fee $ "21,00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): f The permit is for $100.00 (valuation) or less. O I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3,00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agains i u in co se a the granting of this pe mit. V Date Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit isrequired for excavations over 5'0" deep and demolition or construct- ion of structureess over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee 30,00 TOTAL PERMIT FEE _' $ �� occuP- 9-3 CONST�.Tp PE �A/S 1'�-'9 oD PARC This permit is hereby issued under the applicable provi- sions f the Butte C unty Code and/or resolutions to do wo i icated ab a for which fees have been paid. E TOR PUBLIC WORKS By to 9104rc`�6 PERMIT EXPIRES Date `��/ Receipt No. CD -1 d—q WHITE-D.P.W.. YELLOW-ASBC390R. PINK -INSPECTOR, GOLDENROD -APPLICANT h COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 , PERMIT APPLICATION DATA SHEET Permit No. OWNER 1-62 NNe Aln f 1- -1v A. P. No.S-6 _ 9 Proposed Building Use Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing andJor issuance: DATE RECEIVED APPROVED t 1. All items have been submitted: ": . . . . . . . . . . --(5 Plot plans in duplicake%tr-ipftcate, signed by preparer of plans. . /scA- G e246� Complete plans in duplicate./_1ri.p,I.Lcate., signed by preparer of plans. /5e 4. Complete engineered plans and calcs, with wet signature on plans. Plans with Energy Design Compliance Statement. . . . . . CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . f 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . , , , 9. Letter of signature authorization. .0. Sanitation approval from Ch' . . Health Dept. • . . 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner ❑ ), _15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . 17. Pre -Inspection for Pre-Inspec. request to (Date) Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of 21. Lige /ficA-T7o When yo .ssue the permit, process as follows: Mail to owner, Mail to contractor. /Telephone 3y3- 07'741 and hold for pickup aoffice, Deliver w/inspector. _ Other Applicant Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted pry tg�permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---nall—counter by date Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date Plans checked by Date Plans approved byto Z.a - I Sets of plans on hold in File cabinet AP folder — Flours: 10:00 a.m. - 3:00 P.M. Copy—DPW 5 5 v 61& TO: Building Department FROM: Environmental Health, Chico SUBJECT: Sanitation Clearance 4 ✓ Owner Locati.on AP# Plan anproved for: sewage disposal water supply Hold final for: water supply Final clearance O.K. for: water -supply Clearance for bedroom mobile home. Other �V,2 Note*** Sanitarian Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of ,the proposed property improvement (yes or no) �. 2. I (have/have not) RIiQ signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed nstruction: Nam Address City Phone Contractors License No. Cis I plan to prov ab" to coordinate, sup Name Address Phone rtions of this work, but I have hired the following person vise, and provide the major work Contractors License No. 5. I will provide some of the work persons to provide the work indic Name Address City t I have contracted (hired) the following 'fid: Signed: Property Owner Social Security Number � - Date - Phone Type of Work NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. INSTALLED ENERGY SHEET FOR ' ADDITIONS TO RESIDENTIAL BUILDINGS PERMIT N0. PACKAGE "A" (Additions) y JOB ADDRESS TYPE OF WOR EU FORM 7 SQUARE FOOTAGE Existing Residence New Addition�� New Total �d�v r The following information sheet, showing mandatory features and required features of Package "A" must be completed and attached to all plans for additions. to dwellings. Additions to dwellings include room additions, .converti'ng garages and patios to living" areas, house moves that add footage and attic conversions, and any space that is ex- r� isting non -conditioned space that is converted to conditioned.space. Remodeling of'.. existing conditioned space is not included. ZONE 11 ZONE 12 ZONE lE APPLIES TO NEW AREA CEILING v-300 0 - WALL . R-11 R 11 R 9 w - 1 -1 SI3---R -11 - 7 GLAZING >65 .65 .65 SHADING SOUTH -OPTIMUM OVERHANG or .36 S.C.. WEST - .36 S.C. LOOSE FILL INSULATION.(Density) INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) .pTarnn nnnDTL'��bA�ig 1.6,1-- v ni vtc �rra.:scx-n DUCTS PER UMC _. Ch, 10 MAXIMUM GLAZING16% OF AREA PLUS REMOVED GLAZING LY fit ..• OUILDI Fy DEPARTM94 7/83 HEATING, VENTIIATING. AIM CONDITIONING SYSTEM (A) Heating Central Gas Furnace % (brand and model number) SE Btu/hr (heating capacity) Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope Other (describe) (B) Cooling Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) Other (describe) DOMESTIC WATER SYSTEM ❑ (A) Gas Only Gallons (brand and model number) (tank size) ❑ Heat Pump w/Electric Backup (brand and model number) Gallons 2 (tank size) [3* Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load = maximum outlet capacity gas furnace BTU Cooling: Summer design temperature ', cooling load BTU *2 Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title 24, Part 2, Chapter 2-53 of the California Administration Code. S GNATURE OF UILDING D SIGNER OR PLICANT *113 HEATING, VENTIIATING. AIM CONDITIONING SYSTEM (A) Heating Central Gas Furnace % (brand and model number) SE Btu/hr (heating capacity) Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope Other (describe) (B) Cooling Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) Other (describe) DOMESTIC WATER SYSTEM ❑ (A) Gas Only Gallons (brand and model number) (tank size) ❑ Heat Pump w/Electric Backup (brand and model number) Gallons 2 (tank size) [3* Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load = maximum outlet capacity gas furnace BTU Cooling: Summer design temperature ', cooling load BTU *2 Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title 24, Part 2, Chapter 2-53 of the California Administration Code. S GNATURE OF UILDING D SIGNER OR PLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Calitornia 95965 - Telephone: 916/538-7541 G_:1_ APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT O ERTELEPHONE e�n�f r 33 o7y .SQ. FT. DCC. BUILDING VALUATION O DE R'SMAILING ADDSNS r�/7// A� CONTRAC OR•S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS F i rep I ace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee Qri iL $ �]J ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS / /= � � � )Permittee = PLUMBING PERMIT Filing Fee 10.00 Olde C� �" GjSS� Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTUREGas SF[Z Duplex❑ Mobilehome❑ Other TfUGY>1/ ., 6-7 SPECT FY piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ RelnodelD Utilities ❑ Installation ❑ Othe Describe work: /S r�/%%fig J S Q �� Permit Fee $ Contractor ELECTRICAL, PERMIT Filing Fee 10.00 Main service e00v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penally of perjury (check one P Y P J Yhk ( )• ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 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 contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.a , OR ACDNS. (ACC. BLDGS. /s¢sgft NEW U TLOUTLET 2,50 ea LNON."ES'ESI.. .BRA C CIRC ITS POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup( zAL@0 0 30 OUTLETS OR FIXTURES .200030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Yirin 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor 1 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 Iiabilitie jud ments, costs, and expenses which may in any way accrue a(ns a' Co in se a the granting of is permit. Signature of Applicant — Owner 00�Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ o�S OCCUP. CONST.TYP[ SCHOOL FLOOD PARCEL PD NO ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indi d above for which IR OF PU BY PE IT EXPIRES Date the applicable provi- resolutions to do f s have been paid. WORKS Date Receipt No. WNIT[-D.P.W., YELLOW-Aee[330R. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your, signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit: No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property /improvement (.yes or no)(_. 2. I (have/have not) �Gt1{'- signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name A/o, -e Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate supervise, and provide the major work: Name �.�/w Address City Phone Contractors License No. 5. I will provide some of the work. but I have contracted (hired) the following persons to provide the work indicated: Name y% Address Phone Type of Work Signed: Property Owner Social Security Number Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. 1,4 ,;r:,�.. IN ,:n _. ,. �_ r. � .. ., 1 ..,...:.. ).. k Ir.,I , � t,r. i, ,.r i.. I i., r-•.,:,... ,. ,.,.. . ..� �-,,,. ..,r�. ..,.I.V.,u., � ��- . r. i ♦� �. �., � � � f �.,., � - .. i...+:.t,.a +...a4 A iii IQ ":19'Ift 00 MIA P, mum A% 'to A'03W. I ft, It' 01, W101 9 'It to 00*11 lk", Alt WA, mit ot'P w ff --q TIN MAW, wl" . .... ...... mffflll&��