HomeMy WebLinkAbout056-110-060i
A.P. 56-11-60
A ON LIBBY
app. MUO'off W/S Cohasset Rd. ,app
9001s. 6 �rch( just back of` Gtr
Hart house)Co asset a,►�`9�
Permit 23,46y 74, fa.m.ZA
5
6-11-60
Perm/tet #5822 75B (new private
g6-�rage )
56-11-60 1940-91B
LIBBEY, Byron'
145 Hollow Oak Ln, Cohasset
cont: Sierra Roofing
(reroof/sf) -
-7
056=110-060 PERMI-T#9�-..186
LIBBY,. Byron `�--0 J�>�
145 Hollow _Oak Ln.,, Co.hasself
Add to Dining & Fmlyr./SF
I
056=110-006. -j-.PERMIT#96LT8
LIBBY , BRYRON'v E ' ''
145'- HOLLOW OAK DR. ; COHASSE
CONT: JESSEE:: HTG'.& AIR/
LHTG�&:GAS=L_INE/SF
�.056�110,-060__,.___ _ _ 05-0805
LIBBY, BYRON. � }
145 HOLLOW OAK DR, CHICO
Cont: AIR ART HEATING & AI jVp
ADD A/C TO EXST'SYSTEM -I" .T-dS
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NOTES RESIDENTIAL
4 x056 -I 10-060 f OS -0805
PERMIT N0. LIBBY, BYRON
R CHICO
145 HOLLOW OAK D ,
Cont: AIR ART HEATING & Al
ADD A/C TO EXST SYSTEM
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SPECIAL CONDITIONS
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
'�.
*JOB FINALED (Date)
T
,4 �4
�I Signature
t�
CHECKED
BY
J=OK
0 = Not OK
. = NotReadyable
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Soils; Special MH Support Sketch
4.
3.
Sewer; Location -Test -Fall -C/O -Concrete
5.
4.
Water; Location -Test -Easement Needed (Sketch)
6.
5.
Electricity; Location -Clearances-Grnd-/ /Amp -Concrete
7.
6.
Gas; Location -Test -Wrap;-/ P' L 'ft.
/ P Nat. or / P' L "ft./ P LPG
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
7.
Well Clearance & Disconnect
Siding; Nailing -Veneer -Stucco -Mesh
8.
Utility Clearance
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Date
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
POOLS (Plans) OK except #'s
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.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
11.
Light Niche
12. Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-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- Panelboards-Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12. Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. 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 Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12.
Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15.
Access & Ventilation
16.
Insulation
Date
FRAMING (Continued)
Card B-1 Date Card B-1
Date
Hangers -Post Caps -Anchors -Connectors
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17.
Water Htr.; Vent -Access -Combustion Air Baffle
18.
Water Pipe; Test & Anchor -Nail Protection
51.
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
52.
20.
Shower Pan; Test, First Floor -Tub Access
53.
21.
Test Tub & Shower, Second Floor -Tub Access
54.
22.
Gas Pipe; Sixe & Anchors
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
23.
Fire Sprinkler; Test
57.
Siding -Nailing Veneer
Date
58.
Card B-1 Date Card B-1
Date
59.
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Shear Walls; Nailing -Bolts
24.
Fixture & Transformer Clearance -Ins. Protection
Brace Interior/Exterior Wall Panels
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
Insulation -Walls -Ceilings
26.
Size Boxes & No. of Conductors Stapled
Date
27.
Romex Installed Close to Edge of Studs & C.J.
Date
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
Card B-1 Date Card B-1
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral O Yes O No
66.
32. Service -Riser Conductors & Ground Main Disconnect
33.
Equip. Clearances Panels-Motors-Mech. Equip.
34.
Clothes Closet Light -Shower Light -Spa Light
35.
Smoke Detector
70. Stairs & Rails
Date
Fireplace or Stove, Clearance -Hearth
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
74. Elec. Outlets & Receptacles at Kit. Counter
36.
A.C. Ducts Insulation & Support
Garage Fire Door; Swing -Landing -Closure
37.
Vent Fan, Exhaust above insulation
A.C. Duct in Garage -Damper
38.
Condensate Drain & Overflow, Size & Grade
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
Plb.; Elec. & Mech. Equip. Listed for Location
40.
Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
82.
41.
Sills Proper Materials & Anchors
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
83.
43.
Bearing Walls over Girders & Floor Nailing
84. Stucco Brown -Finish
44.
Draft Stop in Walls (rat proof)
A.C. Unit Disconnect, Electrical -Plumbing
45.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
46.
Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
_
47.
Hangers -Post Caps -Anchors -Connectors
48.
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57.
Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59.
Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64.
Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68.
G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73.
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75.
Garage Fire Door; Swing -Landing -Closure
76.
A.C. Duct in Garage -Damper
77.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83.
Following Instld./Drive 0 Yes 0 No/Walks 0 Yes O No/Planters 0 Yes 0 No
84. Stucco Brown -Finish
85.
A.C. Unit Disconnect, Electrical -Plumbing
86.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90.
Glass Protection
91. Corrections from Previous Inspections
92.
Gas Test -Meters Tagged, Gas -Electric
93.
Water & Sewer Connected -C/O to Grade -HD Approval
94.
Energy Compliance Certificate -Other Certificates
95.
Address Posted
96.
Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
PERMIT NO.
DEPARTMENT OF DEVELOPMENT,SERVICES
BUILDING PERMIT BP050805
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (5 30) 891-2834 (CHICO)
OFFICE #: (630) 538-7541
B. C. Building Permit 01-16-04 pg 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 03/28/2005 APN: 056-110-060-000
the Business and Professions Code, and my license is in full force and
effect. e" 33530
License Class : License Number:
Site Address: 145 HOLLOW OAK DR COH
Date: ^��� �� Contractor. Aka -A& - .
Map Index: -
Description: add a/c to existing system
'OWNER -BUILDER DECLARATION
I hereby affirm under penally 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: LIBBY BYRON & SUE
permit to construct, alter, Improve, demolish, or repair any structure, prior
to its Issuance, also requires the applicant for such permit to file a
145 HOLLOW OAK DR
signed statement that he or she Is licensed pursuant to the provisions of
CHICO, CA
the Contractors Stale License Law (Chapter 9 commencing with Section
95926
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
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than rive hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure Is not
Intended or offered for sale (Sec. 7044, Business and Professions
Applicant: AIR -ART HEATING & AIR
Code: The Contractors' Slate License Law does not apply to an
owner of properly who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
1407 ALMOND STREET
provided that such Improvements are not Intended or offered for
CHICO, CA 95928
sale. If however, the building or Improvements are sold within one
year of completion, the owner -builder will have the burden of
530-895-1.420
proving that he or she did not build or Improve for the purpose of
airartco@msn.com
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Ptofessions Code. The Contractors' State License Law does
Contractor: AIR -ART HEATING & AIR
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.).
1407 ALMOND STREET
CHICO, CA 95928
C31 am Exempt under Article 3 of the Business and Professions Code
530-895-1420
Dale: Owner:
airartco@msn.com
License #: 335302
WORKERS' COMPENSATION DECLARATION
I reby affirm under penally of perjury one of the following declarations:
1 have and will maintain a certificate or 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
Architect:
Is Issued.
Engineer:
❑ I have and will maintain workers' compensation Insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit Is issued. My workers' compensation
Insurance carrier and policy number are: .
Carrier: S �- U N V2)
Total Square Ft: 0 S. F.
Valuation: $0.00
a - 000DT7- OLl
Policy ►f: a2
Census Code: C -P
❑ 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 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 thoseprovisions.
Date:
Applicant:---
pplicanPWARNING:
WARNING,Fallure to secure workers' compensation coverage Is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), In addition to the cost of
compensation, damages as provided for In Section 3706 of the Labor
code, Interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for the
of the work for which this Is Issued (Sec 3097 CIV.)
This pe Is hereb der a appll able provisions of the Butte County C de and/or
Resol on to do rk In caled a ova for fch fees have been paid.
Performance permit
BY ate:
Name:
D
PER EXPIRES ON:
Address:
(Dale
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification In accordance with Section 19627.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Atlached 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 slate laws relating to building construction. I acknowledge it Is unlawful to alter the substance of any official form or document of Butte County. I hereby
for inspection pur o
authorize representatives offButteCounty to enter upon the above mentioned property
om/(
Print Nam, CIN. C, U�Signature:
Date:
D Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
YYY• BUTTE COUNTY PERMIT
DEPARTMENT OF DEVELOPMENT SERVICES NO.
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS BPt�S-l��
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 a
OFFICE #: (530) 538-7541 BIN #
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
**PLEASE PRINT CLEARLY**
OWNER
Last Namel_ �� ;
irst Name o
Address i ` 15- ��,��vk/ � 4K bp,
City C,h l (0 _ C� s�
State C
Zip p'b—, 73
l
Phone 34� ,'112-7
Fax
E-mail
CONTRACTOR
Name \?, _ A ,R
Address IyOZ (A\,,_0 ck
City Q.)VN i ( O
State CA
Zip Q5l'a s
-Phon
-Fa
E-mail\,R�RTCoQwi60)
Lic.#'n'53ozClasLs'ap
Phone
APPLICANT SIGNATURE
X Ckk V't
For office use only.
ARCHITECT/ENGINEER
Name
C� UC,� 12
Address
j LLO Z �` w dZ�
City
Subdivision Name
State
Zip
Phone
Lot #
Fax
E-mail
Date Approved:
State License Number
APPLICANT SIGNATURE
X Ckk V't
For office use only.
APPLICANT NAME
Name
C� UC,� 12
Address
j LLO Z �` w dZ�
City
Subdivision Name
State
Zip
Phone
Lot #
Fax
E-mail
Date Approved:
APPLICANT SIGNATURE
X Ckk V't
For office use only.
Zoning
Flood Zone SRA Yes No
Occ.
WORKER'S COMPENSATION
Type Const.
Subdivision Name
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
Map Book
Page
Lot #
Planner
Date Approved:
LOCATION
Property Address �Vn
City
Cross Street
WORKER'S COMPENSATION
Policy Number 000c -I 7 ,
I
Off/Carrier
S� I �L Fop
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
—Name
Address
Description or Scope of Work:
/ A& Al2,
eXlSTln 1AtM in
Sq. Footage 15-0,-)
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
OVER FOR SUBMITTAL REQUIREMENTS L,
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Received byi.
�r� /5J
Receipt #:
Amount: Bldg
a�
Date:
VURN
Ktv /-L/-U4
VA
SUBMITTAL & PERMIT REQUIREMENTS
.,-,The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑
1.
Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑
2.
Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph papers) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑
3.
Engineered truss details and layouts in duplicate (if required). No faxes!
❑
4.
Energy, compliance design and supporting documentation in duplicate. (Note: Not required for additions to
mobile or modular homes.)
❑
5.
Statement of Intent for Non -heated and AIC for Non -Residential Buildings. f
❑
6.
Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down
or fnd plans, all in duplicate.
❑
7.
Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) -Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑
8.
Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑
9.
Site plan and business license -approval from the City of Biggs.
❑
10.
Letter of intent for non-residential buildings.
❑
11.
Detached Accessory Building Form filled out by the owner (if required).,.
❑
12.
Hazardous Material Form (for Commercial Buildings only).
—17 �.3-
SanitatiDn-aad-slte plan-apptoyat ftomihe-EnvironmentaLH.ealib-Depadment.
Remaining
items needed to issue the permit. Additional items may be required after Plan Check and :Planning.
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carries and Policy Number.
❑
8.
Owner -Builder Verification,(if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application 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 lie 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
KAFORMS\BUItDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04
/���
9s ��
ENCROACHMENT
1996
DESCRIPTION
OF WORK
CONCRETE APPROACH
REPLACE JOINT POLE
TREE TRIMMING,PRUNING
ASPHALT EXIST. D/W
VARIOUS EXTRALEGAL LOADS
SNOW CAT
DRAG TREES ACCROSS ROAD
LOCATION
OF WORK
OTIS CT., 13787 (AP66-07-14)
OLD OLIVE HWY 0 LOST HORIZON
DR.
ALL COUNTY ROADWAYS
OAKWOOD LN, 88
LIMITED COUNTY ROADS
CARMEN LN,WILSON LANDING
RD,HUMBOLT
WILSON LANDING RD.
23
1 � .
PERMIT NO. 2 46-74 IBPE
P
i
E
` f
M
FAH UTIL.
PERMIT NO.
PERMIT EXPIRES
OWNER Byron Libby
C:ONTR. onWer
LOCATION (A.P. 56-11-60
App.1200' off W/S Cohasset Rd.aBp.900' S.
of church ( just in back of Gary Hart housE
Oohasset
9
Urlo-lble L f7l
f
L
1
t
S
Temp. Power Pole
Called PG&E
• Temp. Elea Serv. ;Q-19
Called PG&E
i Temp. Gas Serv.
Called PG&E
JOB —c:.2 / — -2/
FINALED
(Date)
(Signature)
I FA
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Cont'd)
PLUMBING
Setback '12--
Firewall
Soil Piping
Forms ')-8 J—ZK
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwal I
Siding
To out -�
Slab
Roof Sheathing
Water Pi in
Piers - 3J -7,W
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwall
Slab
Prov. for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of ex.
structure
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing y/
ELECTRICAL
Masonry Walls
o
Throat ^'
Roucih
Reinf. Steel
Final "'
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors `
Framing %— o
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE REMARKS 9
R CORRECTIONS
TIV111"d)VA E40-1
i
COUNTY OF BUTTE OEPARTMENT OF PUBLIC WORK
7 County Center Drive — Orovi lie, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authwice iuPtez�ientniives or the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date
Sign ure of P'errmitee or Agent
Receipt No. z_�� �f
White-D.P.W. — Yellow- Assessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR OF PJ4BLIC WORKS
BY V Date
Bilding permit expires Date .........................................
BUILDIN
Owner 644�1�, '
SQ. FT. OCC. BUILDING VALUATION
Mailing Addre
el ho a No.
Fireplace
Contractor
Total Valuation
Mai I i ng Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
r
OL
ilding Address DQ [�
PLUMBING
No.
@
FEE
PERMIT FILING FEE $2.00
rOV
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
loor
17
Each gas water reater or vent 1.50
A. P. No. '�" Q
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fees
W.0 S on
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
I Park
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im ro ements
P
Lawn sprinkler system 2.00
Bldg. P c'd Parcel proval
or
s Approval
Permit Fee
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
l�
r
Main service incl. 1 meter
or
Additional meters, a ch
1.00
Sub -panel (12 or ess) (more than 12)
r
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space -Mater
1.00
i
+
Li ht fixture bal0d?0
R s., sw t hes & fix lets
Hood, x. Fan or F.A. Furn. Motor 1.00
r -7r
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
vap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pum
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
69 1 am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
s-,
$ S
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
Elhave placed on file with the County of Butte a certificate of
'workmen's Compensation Insurance.
I certify that in the performance of the work for which this
PJ permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
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/j
MECHANICAL
No.
@
FEE_
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$ S"
TOTAL PERMIT FEE
authwice iuPtez�ientniives or the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date
Sign ure of P'errmitee or Agent
Receipt No. z_�� �f
White-D.P.W. — Yellow- Assessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR OF PJ4BLIC WORKS
BY V Date
Bilding permit expires Date .........................................
ENERGY INSTALLATION CERTIFICATE
Building Owner ' " Building Permit r#
Building Location
ROOF
Material
Thickness(inche) /Z '
DESCRI-27ION OF INSULATION
Brand Name
En'=..KIOR WALL
Material L. ✓
Thickness(inches)
CEILING
Batt or Blanket Type
Thickness(inches.)
Loose Fill Type
Min- Thickness (Inches)
Area covered(ft.2)
FLOOR, E=A=
Material
Thickness(inches)
FLOOR, SLAB
Material
Thickness(inches)
Width(inches)
FOUNDATION WALL
Material
Thickness(inches)
I hereby
-
-is consis
f orms wit
The=al Resistance (R Value)
Brand Name
The --mal Resistance(R Valu°)
Brand Name
Thermal Resistance(R Value)__
Brand Name .
Number of Bags Wt. per bag Ib.
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
certify that the above insula tion was installed in the above
tent with. approved building department -plans --and attachments
h requirements of Chapter 2-53 of State of California Energy
FIRM NAME/OWNER
building,
snd• con-
Requiremen
STATE CONTRACTOR'S LICENSE NO.
SIGNATURE OF INSTe7.T-o't'TON APPLICATOR ---
�• r
I hereby certify the required features, devices, and equipment, au shown on the approved
Building Department plans and attachments have been installed and .conform to the appli-
ance standards and Chapter 2-53 of the State of California Energy .equirements.
W Ag:a� f-�MA _* - -
BUILDING NTRACTOR/OWNER (Pleaa Print) STATE CONTRACTOR'S LICENSE NO.
(FIRM -NAME)
SIGNATURE OF BUILDING CONTRACTOR/OWNER
HVAC FIRM NAME/OWNER (Please Print)
SIGNATURE OF HVAC CONTRACTOR/OWNER
DATE
STATE CONTRACTOR'S LICENSE NO.
DATE
THIS CERTIFICATE riUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION
APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING.
SEPTEMBER 1988
REMDENTIAL
056-110-060 PERMIT#96-1861
LIBBY, Byron -
145 Hollow Oak Ln., Cohasset
Add to Dining & Fmlyrm/SF
�cjlo.o-g , •.
1
Ao� 01A•
163/6
P,�
I OFFICE COPY
y i
Address
GAS DateL�� i
Meter By
ELECTRIC Date I "1
t Meter By y� "
JOB FINi m,6— (Date)
Y
V=OK
0 = Not OK
Not *=NotRepadyble MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
1. Zoning Requirements - Setbacks - Easements
2. Footings; Soils-Size-DepthSpacing-Connectors-Steel l
2. Soils; Special MH Support Sketch
3. Decks; Girders and/or Joists-Decking-BracingStairs-Rails
3. Sewer, Location -Test -Fall -C/0 -Concrete
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg: Rfg.-Bracing
4. Water, Location -Test -Easement Needed (Sketch)
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
5. Electricity; Location-Clearances-Gmd-/. /Amp -Concrete
6. Carports; Windows -Doors
6. Gas; Location -Test -Wrap; / /Vtt.
/ /Nat. or/ tt'ft./ /LPG
7. Electric
7. Well Clearance & Disconnect
8. Frmg.; Sils-Anchors-Studs-Rftrs-Trusses
8. Utility Clearance
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Card B-1 Date Card B-1
1. Zoning Requirements- Setbacks Easements
- -
2. Footings; Sine -Spacing -Marriage Line
•3. Gis; MH Test-DemandValve-Connector 4
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/0 to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert of Occupancy
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Cana B-1 Date Card B-1
Date
Card B-1 Date Card B-1
a
0
LA
r
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils-Size-DepthSpacing-Connectors-Steel l
3. Decks; Girders and/or Joists-Decking-BracingStairs-Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg: Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
o
4
✓ = OK
0 = Not OK
- = Not Applicable
= Not Ready
Date j UNDERFLOOR (Plans) OK except
RESIDENTIAL (Single & Duplex)
#'s I Date FRAMII
.,Ttg.l Main; Soils-Elec. Gmd.-/ N Ftg. Depth
al'Ftg. Garage; Soils-Steel-Elec. Grnd/ N Ftg. Depth
F Porches & Decks; Soils -Steel-/ /' Ftg. Depth
. Stemwalls, Main; Steel-Blockouts-Wrapped
temwalls, Garage; Steel-Blockoutsa/yrapped
6a. td Downs and Special Anchors
7-0b, Steel -Wrapped
Piers -Fireplace Ftg.-Steel
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
1 UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
0.O \
12.1 Electric Underqround
V I 13.1Pjenums & Ducts; Clearance -Material -Support -Ins.
IV Access & Ventilation
16. Insulation
Date
ELECTRICAL (Permit) OK except #'s
Card B-1 Date
Card B-1
Date
c. Receptacles Spacing -Lights & Switches at Doors
Card B-1 Date
Card B-1
Date
mex Installed Close to Edge of Studs & C.J.
PLU BING (Permit) OK except #'s
p. Ground made up w/Mech Fastners-Bond Gas & Water
17.
Water .; Vent -Access -Combustion Air Baffle
-
3 .
18.
Water ipe; Test & Anchor -Nail Protection
Service -Riser Conductors & Ground -Main Disconect
2
19.
D.W..; Test Fittings & Anchor -Nail Protection
Clothes Closet Light -Shower Light -Spa Light
34.
20.
Sh er Pan; Test, First Floor -Tub Access
jjjZ,Z 4
21.
T64 Tub & Shower, Second Floor -Tub Access
G Pipe; Sixe & Anchors
In Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
In e; Above Floor-Mech. Protection
Date
Date
Card B-1 Date
Card B-1
Date
nsul n -Foam -Looked in A
Card B-1 Date
Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Card B-1 Date Card B-1
.15ixture & Transformer Clearance -Ins. Protection
4.
c. Receptacles Spacing -Lights & Switches at Doors
96;ee
Boxes & No. of Conductors Stapled
MECHANICAL (Permit) OK except #'s
mex Installed Close to Edge of Studs & C.J.
35.
p. Ground made up w/Mech Fastners-Bond Gas & Water
2 Appliance Circuts in Kitchen & Conductor Size GFI
VqAt Fan, Exhaust above insulation
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
3 .
Range Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral 0 Yes 0 No
_ 311
Service -Riser Conductors & Ground -Main Disconect
2
Equip. Clearances Panels-Motors-Mech. Epuip.
33
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
Date
Card B-1 YJW Date a '' Card Bt1
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
moke Detector z
MECHANICAL (Permit) OK except #'s
. urnace; Vents -Clearance -Comb, Air-Conector- T
In Garage; Above Floor-Ducts-Mech. Protection
35.
A.g. Ducts Insulation & Support
36.
VqAt Fan, Exhaust above insulation
c S b reaker Sizes & Labels
37.
ondensate Drain & Overflow, Size & Grade
7
38.
Furnance Vent Access -Comb. Air -Return Air Vent 115 outlet
ec. Outlets at Woe�Partef'htt-R Etc
31.
Attic Access & Platform if Furnace in Attic
71.wFrec.
Outlets & Recep es at Kit. Counter
7.
7
in arage- am er
Date
In Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
In e; Above Floor-Mech. Protection
Card B-1 Date Card B-1
Date
787
Card B-1 Date Card B-1
Date
nsul n -Foam -Looked in A
FRAMING (Plans) OK except #'s
A.
Si oyer Materials & Anchors
alls uds-Nailing Spacing & Braces -Plates -Sound
B " g Vydlls over Girders & Floor Nailing
aft op in Walls (rat proof)
44
F' Stops, Furred Ceilings -Stairs -Chasers -Tubs
Headers & Beams -Size & Bearing
,- i
Cling. Joist-Rftr..Ties-Pullin-roff Brac.-Truss-Shting: Rfng.
V . - F' a fes or Type A Flue -Fireplace Throat clearance
ttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
fin. Windows or Exiting Doors -Sill Hgt. & Dimensions
arage Fire Protection Framing
.Property Line Firewall & Openings
V. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
,V./Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing Veneer
Y. Atucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
lazing Area -Glass Protection -Skylights -Plastic
hear Walls; Nailing -Bolts
.. . Bale Wall Panels
62. Infiltration
Datb h
Date
Card B-1 YJW Date a '' Card Bt1
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s ,
Ext Steps -Door & Sidelight Protectio s
moke Detector z
6
. urnace; Vents -Clearance -Comb, Air-Conector- T
In Garage; Above Floor-Ducts-Mech. Protection
edr Exiting i
G.F.I. & Bath Fixtures &tea.. `
c S b reaker Sizes & Labels
airs & Rails
7
-
7
ec. Outlets at Woe�Partef'htt-R Etc
7
ix J. & Appliance; Gro .- a ap-Cooki earance
71.wFrec.
Outlets & Recep es at Kit. Counter
7.
7
in arage- am er
In Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
In e; Above Floor-Mech. Protection
Plb., Elec. & Mech. Equip. Listed for Location
787
EleglRecep;acies in ex rotection
nsul n -Foam -Looked in A
8IL
8
. n. VBent awl Hole Door Drainage & Wood -Earth
8 ollowing Instld./Drive es 0 No/uValks 0 Yes Ianters 0 Yes
8� ove Roof, PI p -
Water Well, Disconnect, EI lumbing
Exterior Elec. Trim, G... ecep erground
f a fon Throught House
srotection
9 rrections from Previous Inspections
9
Water & Sewer Connected -0/010 Grade -HD Approval
r99 Energy Compliance Certificate -Other Certificates
Dat Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
X
FA
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 n j oPER�IT NO.
APPLICATIONAND PERMIT %(p o
Af
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
XRX
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
486 R 26,244,
OWNERS MAILING ADDRESS
145 HOLLOW OAK DR., MEN CHICO, CA 95973
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNIwOWN
Total Valuation $
Filing Fee $
20.00
LENDER'S MAIUNG ADDRESS
Permit Fee $
265.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
2
Energy Plan Checking Fee $
23.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty $
BUILDING ADDRESS 145 HOILOW OAK DR
PERMITFEE $
480.00
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap 31
7.00 21.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
Water piping
15.00 15.00
USEOFSTRUCTURE
SF NX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition YX Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: ADDITION OF DINING ENLARGEMENT & FAMILY
—
ROOM
Mobile Home I S I GI W 1
920.00
PERMITFEE S
56.00
Contractor
ELECTRICAL PERMIT
Filing 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 for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
P9 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
NEW CONST. DWELLING OCCUR
OR ADDNS. ( & ACC. BLDS. )
3.50 SO. FT.
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
& SINGLE OUTLET CTR.
Ex. Occup. ( OUTLET OR FIXTURES)
20 @ 1.00
BAL .50
Ex. Occup. FIXED APPLNS.
)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE $
37.00
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for 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
MECHANICAL PERMIT
Filing Fee 20.00
9
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.)
IR 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 comply with those pro%tisions.
Xy Date g^ �`�_
Signatur f Applicant - ErOwner ❑ Co tractor ❑ Agent
An OSHkphrmit is required for excavations over 60" 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 $ 619.00
HAZ.
I D. FEES
I IMP I FLOOD
CDF PARCEL
I PD I HD
ISSUE
This permit is hereby issued under the applicable
of the Butte County Code ado r Resolutions
indicated above for which fes have been
By Date
PERMITEXPIRESON /
provisions
to do work
paid.
Receipt No. 202317
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
O.B.-1
i v.v::.+.K::v:. �.v::Yw:+•.v: 4:. �:.v:::. ::. :. v v, :. :+Ay\;:::.; •i: ':C:•::: A•: w. ^:ik ;C•
..::.........
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are personally
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 information 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 x300 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 Internal 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 employees, without a licensed 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
I work personally. -
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned
Sincerel , • :,
Michail C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owncr-Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
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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[ ] . NO[ ].
2. I HAVE[ A HAVE NOT[ ] signed an application for a building permit for the
proposed work
3. I have contracted with the followm •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: C I Y:
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 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.
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COUNTYOF BUTTE- DEPARTMENTOF DEVELOPMENTSERVICES -BUILDING DIVISION
7COUNTY CENTERDRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541
OWNER 01.J��CJ
Proposed Building Use
PERMIT APPLICATION DATA SHEET
Building Inspector
P. No. :5(o- I I -0(o
- 910'^ Date 8- 04 -r!(b
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.
2.
3.
4.
---,..".-- 5.
6.
7.
8.
9.
10.
tl� 11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
All items have been submitted . ....................................... .
Plot plans, 3/4 sets, signed by preparer of plans . ......................... .
Complete plans, 3/4 sets, signed by preparer of plans . ..................... .
Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
Hazardous Material Form . ...........................................
Energy Design Compliance and supporting documentation . ..................
Statement of Intent for Non -Heated and A/C Buildings . ......................
Engineered truss details and layout in duplicate (required prior to plan check). ....
Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
Feesof $ . .............. ... ..................... .
Impact fees as shown on attached schedule. se .. .... ...... .
California Department of Forestry plan approval/f s. . 5&V1" ..$ . M 16> .... .
Flood elevation letter (100 year flo by California gineer.................. .
Sanitation and plot plan approval Health Department . ............
City of Chico plumbing permit . .........................................
Plot plan and business license approval from City of Biggs/Gridley. .............
Planning approval for (A) Use: (B) Parking: . .........
Contact Land Development about (A) Improvements (B) Drainage. .......... .
Driveway permit (construction approval required prior to occupancy). .. .. ... .
Fre-Inspection request
Pre -inspection for required. -
.. to Building inspector (Date)
Contractor's license information. (No., Name Style, Classification) . ..............
Certificate of Workmans Compensation Insurance . ..........................
Owner -Builder Verification (Given to owner , Mail to owner . .......... .
Recorded copy of Agricultural Acknowledgement Statement . ..................
Letter of signature authorization . ........................................
Copy of recorded deed of parcel creation and 60 right of way to a_public road. .....
Letter of intent on building use . .........................................
Mobilehome utility clearance . ..........................................
Documentation of legal access . ..................... :..................
Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
Existing violations/expired permits . ......................................
Plan check list . .....................................................
When you issue the ermit,,_process as follows: Mai t owner. Mail to contractor.
X Telephone - 7 77 and hold for pickup at office. Deliver with inspector.
Other AM rJ I �CaS e_
Parcel Creation
Acreage Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter Date
Contractor, designer, owner, was advised of above required data by _phone _ mailI • C nt 'by Date
Plans checked by Date Plans approved by'.� � �'"'""r,�' Date
Sets of plans on hold in File cabinet AP folder j df : �F-
Copy - Department of Public Works j
COUNTY OF. BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541
OWNER A. P.
PROPOSED BUILDING SE S F DATE t(4 - q j�
} " . EC. #DATE REC
f w , r• ,z
` ' 3. .•- _i.`C: t, y:. -i._ •_:.� •- ♦ ::Y:. '�' ` iy J ,,� � is
i S OOL DISTRICT
(pai District Office) ,
''2. SHERIFF FEES (paid at Budding Division) ,
� -�r �.• Residential �' �`� �'e��t::` ,:,., • •z ,�,,,; _$. t- ;. _ - - :� •�� `.-
�Y. v unit ni_ amt.
,Commercial (sq.ft) - $ _
.. �F 1 '1 •-y yJ
_ 3. •URBAN AREA FEES
" (paid at Building Division) ` • 1' a
'Residential (per unit). x
1
#units amt.
Commercial (sq.ft.).. x _$
1 _ _ • i
` sq. fL amt.
4. .RECREATION DISTRICT FEES
.(paid at District Office)
_• . _ . _ . 5. THERMALTTO DRAINAGE DISTRICT -FEES
$400.00 (paid at Building Division)
6. SRA FIRE INS TION AND PLAN_ . CHECK
.$89.00 at Building Di.. 40j�
vision) _Q
7. -.WATER TENDER FEES
# (BATTALION # ) -
$200.00 (paid at Building Division) '
-8. . s. " CSA 87 TRAFFIC FEE
3 $2500.00 (paid at Building Division)
,,OTHER .. , _ F • ..__ . '� .. - .. -:,
�._ ..
At time of permit application, I was advised the above fees are required to Abe paid pno' 'to issuance�of the
APPLICANT DATE -- l t:i, *•�(�
,
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BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form Per Building)
School District � (1`S-0 Building Department No.
A.P. Number 56-1/-()(o Jurisdiction: 0 City F>9 County
Property Owner
Property Locatic
Subdivison
Residential Development
No. of Living MHI
Units
Commercial/Industrial
Department Representative
0
New
Lot No.
�
��I Sq. Footage 44Vp
Addition (Group R)
0 Sq. Footage
Addition
(Including Exterior
Roofed Areas)
9- IC/
Date
(Floor Plans reviewed by School District Personnel).
~ Y .
District Identification No. 1V 64
S..S6hool`D,istrict certifies,that rn nLtamA
(Applicant)
14.5 s
(Street Address),, ", (Phone Number)
�.f pis Q13
(City) i (Stale ) (Zip Code)
has complied with the requirements of Resolution No. �% lt-� by payment of $
representing 46 square feet.
Paid by Check # Remarks:
Bank Number
Paid by Cash
AB 2926 $
FULL MITIGATION $
Date
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to
additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeformmkl (11/94)dmm
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVMI-± CA 95965 TELEPHONE (916) 538-7541
OWNER A.P. #
PROPOSED BUILDING USE S ^ _ DATE _ S)- % cl -q( �
REC. # DATE REC
1. SCHOOL DISTRICT FEES
(paid at District Office)
2. SHERIFF FEES (paid at Building Division) ,
Residential.: x =$
e .. • unit amt.
Commercial (sq.ft.). x _$
3. URBAN AREA FEES
(paid at Building Division)
Residential (per unit). x =$
#units amt.
Commercial (sq.ft.).. x =$
sq. ft. amt.
.. 4.
5.
L- 6
7.
8.
RECREATION DISTRICT FEES
(paid at District Office)
THERMALITO DRAINAGE DISTRICT FEES
$400.00 (paid at Building Division)
SRA FIRE INSMC TION AND PLAN CHECK
$89.00 at Building Division)
WATER TENDER FEES
(BATTALION # )
$200.00 (paid at Building Division)
CSA 87 TRAFFIC FEE
$2500.00 (paid at Building Division)
9. OTHER
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the
permit.
APPLICANT
-��-�0
AP#
CDF FIRE SAFE REQUIREMENTS
96 —�4 l Z3a y ZV1,eOA)
PERMIT # NAME
Under authority of PRC 4290, the following checked items are required
by the Butte County Fire Department and are made a part of this permit.
These requirements are minimums and will be superseded by Butte County
local regulations which equal or exceed these standards. Field
inspections will be made by the Butte County Building Department for
compliance.
1272.00 Maintenance of Defensible Space. To ensure continued
/\ maintenance of properties in conformance with these
standards and measures and to assure continued avail-
ability, access and utilization of the defensible space
provided for in these standards, annual maintenance
must be provide for by the land owner.
Driveway Standards
1273.02 Surface. All driveway surfaces and structures (bridges,
1273.07 culverts and other appurtenant structures which supple-
ment the roadway bed or shoulders) shall provide unob-
structed access to conventional drive vehicles, includ-
ing sedans and fire apparatus weighing up to 40,000
pounds.
[�] 1273.03 Grade. Not to exceed 16 percent unless paved.
1273.04 Driveway Radius
[�] 1. No roadway shall have a horizontal inside radius of
curvature of less than 50 feet and additional sur-
face width of 4 feet shall be added to curves of 50-
100 feet radius; 2 feet to those from 100-200 feet.
[�) 2. The length of vertical.curves in roadways exclusive
of gutters, ditches and drainage structures designed
to hold or divert water shall be not less than 100
feet.
[�] 1273.05 Turnarounds. If required, will have a minimum turning
radius of 40 feet from the center of the road.
1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30
feet long with a minimum 25 foot taper on each end.
[� 1270.10 Width. All driveways shall provide a minimum 10 foot
traffic lane and unobstructed vertical clearance of 15
feet along its entire length.
Page 1 o;f - 3- ,
676 rl(- 'F6 --I& / Z_ o&sy 6 /3
AP # PERMIT # NAME
] 1273.10 Turnouts. Driveways exceeding 150 feet in length, but
less than 800 feet in length, shall provide a turnout
near the midpoint of the driveway. Where a driveway
exceeds 800 feet, turnouts shall be provided no more
than 400 feet apart.
�J 1273.10 Turnaround. A turnaround shall be provided at all
/ building sites on driveways over 300 feet in length and
shall be within 50 feet of the building.
1273.11 Gates
[�] 1. Gate entrances shall be at least two feet wider than
the roadway it serves.
[�] 2. The gates must be located at least 30 feet from the
roadway and shall open to allow a vehicle to stop
without obstructing traffic on that roadway.
[ ] 3. Where a one-way road with a single traffic lane
provides entrance, a 50 foot turning radius shall be
used.
Fuel Modification
1276.01 Setback for Structure Defensible Space.
[�] 1. All parcels 1 acre and larger shall provide a mini-
mum 30 foot setback for buildings and accessory
buildings from ul] property lines and/or the center
of the road.
[ ] 2. For parcels less than 1 acre, local jurisdiction
shall provide for the same practical effect. See
Other Requirements below.
[�] 1276.02 Disposal of Vegetation and Fuels. Disposal, including
chipping, burying, burning or removal to a landfill site
approved by the local jurisdiction, of flammable
vegetation and fuels caused by site development and
construction, road and driveway construction and fuel
modification shall be completed prior to completion of
road construction )r fi:ial inspection of a building
permit.
Page 2 of 3
AP # PERMIT # NAME
Other Requirements
[ ] If Building Setback is 15 to 30 Feet:
- Class A or B roof
- Enclosed eaves
[ ] If Building Setback is Less Than 15 Feet
Choose any 3 of the following:
- Metal or no doors on side toward property line with insuffi-
cient setback
- Class A or B roof with enclosed eaves
- Interior automatic sprinkler system per NFPA.I3D
- Glass area not to exceed 10t of wall area toward property
line with insufficient setback
-;Siding from the following list:
Stucco - 3 coat.
Hardi-Board or Plank
Masonry
Masonry veneer
Metal
Other Butte County Fire Department approved materials
Date
Signature
Page 3 of 3
jel a
s'cl e
s isrl
,� ttc
Ssn
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
OWNER
,:**)' -/A� /
PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
COUNTY OF BUTTE
_ BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT' SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Croville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
y �6 -/Ot4
OWNER PERMIT NO.
A /abovea
n indicates that the following violations of Butte County Ordinances exist at
thand should be corrected. Please notify this office when correction of work
is u have any questions pertaining to this matter, or need additional explanation,
plis office immediately.
A-t�
f
r
Date �'� Inspector4(2�1'2
REV 10/92
it t+t� :�' -r ` . L. . � a� : •�' i','rF' � ? t: e t -�� p4'y �•�i.
{T COUNTYOF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street, Chico; CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
CORRECTION (NOTICE
O NER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
R please contact this office immediately. ,-� $
Date — Inspector
REV 10/92
ILN
M
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
4 469 Humboldt Road, Chico, CA - .(916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
{ CORRECTI.ON NOTICE
A routine inspecti,gr i<dicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed if you have any questions pertaining to this matter, or need additional explanation,
plec tact this office immediately.
Date / L Z inspector
REV 10192
f�
Date / L Z inspector
REV 10192
" ''r'�-'+a- s�f±.� "+'•t.� x .1 s£ 1�.j9 t �. �.r _ _ i:,• r :%3L 1.:r�}r•�ncr '" ;..� ''V`'*..t3..>'— '
y y.....! •�..:« .die .�*r;^„•x :Y :' 5..,.^ry'U-^i r' • .,�..
56-11-60 t
,1940-`91B
LIBBEY, Byron
145 Hollow.0ak Ln,i Cohasset
' cont: Sierra Roofing
(reroof/sf)
AP
• � Viz. Ali � �p�`- {
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION A b"PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
Byrun Libbey-
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
17 wams
OWNER'S MAlLINGADDRESS
145 %1IrysOk D Mico,
CONTRACTOR'S NAME
Sierra Roofi CO.
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
P0 BOX 22Chico Ca.
Fireplace
CONSTRUCTION LENDER
UNKNOWN
C
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 19 .00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
M Fbllow Oak L!1
Permit fee
PLUMBING PERMIT
Filing Fee 10.00
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 STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00e
TYPE OF WORK
New Addition [I Remodel[] Utilities❑ Installation El Other ❑
Describe work: 17 ci w2es of 2ymr comosition mroof _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
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—,
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 6
F-1 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)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.&
OR ADDNS. (ACC. BLDGS.
,
2/z¢sgft
NEW RESID.CONSTULTI.OUTLET
NON •R ESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup( OR FIXTURES
BAL@ALe30ao
Ex. Occup. OUTLETS P(RESID )FIXED APLNS. REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
9
15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
n I have placed on file with the County of Butte Building Department
L� 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 W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
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
against said County in cons quence of the granting of this permit.
X �� f}-11_91
24.k. Date
Signature of Applicant — Owner ❑j 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 $
occ
CONST TYPE
TOTAL AL E �
FEE $ �.00
HAz
CUA
PARK
PAR
PD
HD
1 ISSUE.
,.
This permit is nereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
Zr
By ` /�% D -)
PERMIT EXPIRES ;Date +�-'
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
(
• 1 `�
Receipt No. �1�s��/
WNIT.-..P.W.. pELLOW-ASSE330R, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
'17)
ASSESSOR PARCEL NUMB R
ZONING
BUILDING PERMIT
OWNER
Bvron Libbe
TELEPHONE
-
SO. FT. OCC.1 BUILDING VALUATION
17 s uare1020
OWNER'S MAILING ADDRESS
145 Fbllow Oak Dr.
CONTRACTOR'S NAME
Sierra Roofing Co.
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
PO BOX 252 Chico Ca.
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 19.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
,$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
145 Fbllo
Permit fee
$ 29.00
PLUMBING PERMIT
Filing Fee 10.00
5
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 STRUCTURE
SF Q Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I G JW
0.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
r—I
I`J"F'I 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. 2998AA Classification - 39
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST.(DWELLING OCCUP.&
OR ADDNS. ACC. SLOGS.
,
2/20sgit
NEW CONSTR. ULT' -OUTLET
NON-RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS &)
(SINGLE OUTLET C'R.
Ex. Occup(OUTLETS OR FIXTURES
20050C
BAL®3o
K
Ex. Occup. OUTLETS P(RESID )EA.)
2.00
Temporary service
10.00
me Facilities
Mobile Home
15.00
Misc. H g
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
n I have placed on file with the County of Butte Building Department
L� 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 accrueSCH
against said County in cons quence of the granting of this permit.
X6-11-91
Date
Signature of Applicant — Owner J Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in h ight.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
ALL
TOTAL FEE $
29.00
00
HAZ
CLIA
PARK
EE
PAR
PD
HD
11_*1
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
By (;?D EC OR OF PUBLIC
PER IT EXPIRES ate
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
'` =--
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
�itE w a IdG %1
1*401
PERMIT NO. 5822-75B
P
E
M
MHU TIL.
!PERMIT NO.
r
PERMIT EXPIRES 11112176
6
`OWNER Byron Libby
�ONTR. owner
LOCATION (A.P. 56-11-60 )
'App.1200' off W/S Cohasset Rd., app 900'
+S/ of Church(back of. Gary Hart house,
1Cohasset..
r.�
t
�I
t
;i
s
Temp. Power Pole
r Called PG&E
Temp. Elec. Serv.
Called PG&E
,! Temp. Gas Serv.
Called PG&E
JOB
FINALED
(Date)
(Signature)
y
COUNTY OF BUTTE — DEPARTMENT OF PUBLICI WORKS
I
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
e
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwall
Slab
Prov. for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of'ex.
structure
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framinq
Test
Water Htr.
Mesh
Scratch
Brown
Finish
Interior Lath
Door Closer
Heath
Coolie
Ducts
Ventil
Final
DATE RE KS OR CORREC
ti
Subpanels
4NICAL Grd. Fault Prot.
Service
Temp. Pole
Underground
Permanent
Final
TIONS
g. 2 4f
County of Butte S
DEPARTMENT OF PUBLIC WORKS
REQUEST FONSPECTION
Date I' 7S Time Received
Job Address ,p i'
Owner "+M Contrac
BLDG.
PLUMBING
Form
Rough
Frame
Gas Piping
Lath
Sewer
F;A.place
Water Pipe
Final
Final
ELECTRICAL
Rough
Appliances
Meter
Temp. Service
Final
Ready for Insp. on 1911- p.m. Date
m.
,GG4h q-a�,r..vV.,� Inspection made:
OTHER
CI
(400.2)
COUNTY OF BUTTE — DEPARTMENT'OF PUBLIC WORKS
7 County Center Drive—• OroviIIe, California 95965
Telephone: 53424541
APPLICATION AND PERMIT -
_0�� 7s
Receipt No. %500D4 4I"-' Wing
nn-pate It — r .�
White-D.P.W. - Yellow -Assessor -- Pink -Inspector - Goldenrod -Applicant Permit expires Date _
BUILDI G
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I ing Addr
Tele one No.
`
Fireplace
Contractor
Total Valuation
Mai I i ng Address
Permit Fee
Plan Checking Fee &/or Penalty
elephone No.
Permit Fee
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
® �
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. -. "/II//- f�
Zoning & Planning
Gas piping system 1 -.5 outlets 1.50
Each additional outlet .30
F sk'J
SaO)�
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma p
60' R/W ,
Im rovements
p
Lawn sprinkler system 42.00
Bldg. ns Recd
�� ��
Parcel �proval
Plans Approval
Permit Fee $
$
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
Single Family ❑ Duplex ❑ Mobil Home ❑ Others
Range, Cook -top or Oven 1.00
`
Water Heater or`Space Heater 1.00
Light fixtures b P25
a 10
Receps., switches & fix outlets
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F.A. Furn. Motor 1.00
Evap. cooler, gar, disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
El I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL No. @ FEE
t'
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor.
Code which requires every employer to be insured against liability
for Workmen's Compensation. r
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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 the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
[Ventilation
Hood 2.00
Permit.Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X - Date��/:7
Signature of Permitee or '4
ent P
TOTAL PERMIT FEE
T
$ a
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.
n DIRECTOR OF IC WORKS
B �` _ •7_' -
Receipt No. %500D4 4I"-' Wing
nn-pate It — r .�
White-D.P.W. - Yellow -Assessor -- Pink -Inspector - Goldenrod -Applicant Permit expires Date _
0
056-110=006 ':PERMIT#96-2780
LIBBY,,Byron E,
145 Hollow Oak Dr.., Cohasseb
Cont: Jessee Htg'& Air
Htg & Gas Line/SF.''
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' -
ASSESSOR PARCEL NUMBER
56-11
ZONING
BUILDING PERMIT
6-�
OWNER
BYRON E B
TELEPHONE
342-7327
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
145 HOLLOW OA DR, CHICO 95973
CONTRACTOR'S NAME
JESSEE HEATING AIR
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNINOWN
Total Valuation Is
Fling Fee
$ 20.00
LENDER'S MAIUNG ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 145 HOLLOW OAi DR, COHASSET
PERMITFEE
$
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
Water piping
.15.00
USE OF STRUCTURE
SF 0 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent
15.00 "
Gas piping system 1 - 5 outlets
15.00 f 5, ()D
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: HEATING SYSTEM INSTALLATION PROPALE GAS
—
PIPE INSTALLATION
Mobile Home IS I GI W 1
920.00
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
Filinq Fee 20:00
Main Service E00V 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 for the following reason:
Ll I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. I
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCURSo.
OR 8 ACC. BIOS. )
3.5¢ FT.
NEW CNS.
CONST.MULTI-OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.00
9AL 0 .50
EX. Occup. (OFIXED APPLNS. UTLETS (RES D.) R
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for 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
MECHANICAL PERMIT
Filing Fee 20.00
9
Heating
1-5.(30 ),5,00
Cooling
Hood
6.50
Ventilation
PERMITFEE
$ 35.00
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.)
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 ' .,_ �_��••_Uh,L Date 1 �– 1(c=�
Signature`6f' Applicant -,0 Owner ❑jContractor ❑ Agent
An OSHA - ermit is required'for excavation..??s over 5'0" dee and demolition or construction
of structures over 3 stories in height. p
Mobile Home Installation Fee 77T
—
Energy Inspection Fee $
OCCCQNST.
R ,3
TYPE
TOTAL FEE $ `�- U, (� O
HAZ.
I D. FEES
I IMP
I FLOOD
I CDF I PARCEL
PD HD
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.
)
BYEfo. ' k-�� �`' tm Date
PERMITEXPIRESON � � - /T 9
(Date)
Receipt No. l Ql4q V V
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI
7 County Center Drive - Oroville, ,CaliforiSia 95965 - Telephone (916) 538-754 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
56-11-06
ZONING
BUI G PERMIT
OWNER
BYRON F. LIBBY
TELEPHONE
342-7327
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
145 HOLLOW OAK DR, CHICO 95971
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Fling Fee $ 20.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty $
BUILDINGADDRESS 145 HOLLOW OAR DR, COHASSET
PERMITFEE $
PLUMBINGPERMIT Filing Fee 20.00
Each Trap 7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater 23.00
Water piping 15.00
USEOFSTRUCTURE
SF II Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent 15.00
Gas piping system 1 - 5 outlets ' 15.00 f UD
Building sewer 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: HEATING SYSTEM INSTALLATION PROPALE GAS
—
PIPE INSTALLATION
Mobile Home I S I GI W 1 920.00
PERMITFEE s 3S.00
Contractor
ELECTRICAL PERMIT Filinci Fee 20.'00
Main Service a OV OR LESS
( z00A 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
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
Ar I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
�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
NEW CONST. DWELLING OCCUR SO.
DR ADONS. ( a BUDS. ) 3.52 FT.
MULTI -OUTLET
NEW CONST. MULTI -
NON-RESIO. ( BRANCH CIRCUITS ) @7.50
( a POWER APPARATUS )
SINGLE OUTLET CIR.
Ex. Occup. (OUTLET OR FO(TURES) 20 0 1.00
BAL 0 .50
Ex. Occup. (FIXED
IEOUTLETS .
PPLNS.OEA 5.00R )
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMITFEE $
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for 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
MECHANICAL PERMIT Filing Fee 20.00
9
Heating 5.00 )5100
Cooling
Hood 6.50
Ventilation
PERMITFEE $ 35.00
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 comply with those provisions.
__zaof
X F_ Date Date
Signature Applicant - �[ Owner Contractor ❑ Agen—tom
An OSHA p rmit is required for excavatio S over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
R- 3
CONST. TYPE
TOTAL FEE $
HA—Z.
O. FEES
I IMP
I FLOOD
FFOf PARCEL PD HD
ISSUE
This permit is hereby issued under the applicable provisions
the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
B�,.t Date v1 '/�-9�
y
PERMITEXPIRESON )9-/s -9--)1-
I (Date)
Receipt No. 6C?
WHITE-D.D.S.-B.D. CANAR -A SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT