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056-120-038
- ------ ----- ----- - —� 56-12-38 GEORGE`M CLINTOCK Box, 138..Cohasset Stage, Chico SpecialLlnspection #19786 ZJY9 t 1 1 '056-120-'038:, '. - "'05,0273'-7 MCCLINTOCK;,GEORGE.D W 9730 COI-IASSET RD,''C"O-HASSE r Cont: MCCLELLAND'r�IR CON 'NEW.HVAC REPLACEM 0. X4`1 .i 3.1•c....+....z._. .._s..._..aira+zl...• t:.l. stir'.. a' 056-120,-038, .05 236 MCCLINTOCK 9730 COHASSET.RD,'C r . Cont: FOUR SEASONS G• RE - ROOF ca I Ea=mc � RESIDENTIAL PERMIT NO. 056-120-038 05-2363 MCCLINTOCK 9730 COHASSET RD, COHASSET Cont: FOUR SEASONS ROOFING RE -ROOF SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature t RESIDENTIAL PERMIT NO. 056-120-038 05-2363 MCCLINTOCK 9730 COHASSET RD, COHASSET Cont: FOUR SEASONS ROOFING RE -ROOF SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature I = OK 1 = Not OK = Not Avvkable _ +rot Heady RESI®ENTIAL (Single & Duplex) date UNDERFLOOR (Plans) OK except #'s 1. , Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Fig. Depth 3. Ftg., Garage; Sols-Steel-Elec. Gmd. / /" 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. Stab, 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 Card B-1 Date Card B-1 Date 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 19._ D.W.V.; Test Fittings & Anchor -Nal Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Cana B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes.Closet Ught-Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 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 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walis over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purfin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill HL & Dimensions 52. Garage Fre Protection Framing -RC Channel 53. Property line Firewall & Openings 54. Ext. Doors -One T -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fre Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Naffing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflc Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nairmg-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. IQL Fi xt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fre 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 -Meth. Protection 78. Plb.; Elec. & Mech. Equip: Listed for Location 79. Elec. Receptacles in Garage (F.El.)-Ramex Protection 80. Insulation -Foam -Looked in Attic 61. Guam Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor - O Yes 83. Following InslldJDrive 0 Yes 0 No/Walks O Yes O Nuftirrters O Yes O 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: J=OK 0 = Not OK //�� HOMES �/� . = Not Ready . IQQ��esl®B'LE OMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location=Test-Wrap;-/ P' L'fL / P Nat or/ . /" L'ftJ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance" Date Card B-1 Date Card B-1 Date Card B-1 : Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'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-learances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test-Regulator-Connectoe 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 Date Card B-1- Date Card B-1 Date . Cana 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 110. License Decals _ 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Cana B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except Vs 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 S. Alum. Awn.; Columns-Connections-Splice-Decal.Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Sidng; 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 Cana 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 -GA 5. Elec.; Pod UghtinM 15 Volts-GFl 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip: Heater 8. Elea; Grounding; Equip. w/5' Circulating Equip: Pool Lghtg. Boxes'Enclosures-Paneltwards-Ins. to Main Conduit 9. Health Department Approval 10.. Plumb.; Cir. Test -Water Supply Test 11. -Light Niche 12. Enclosure; Fencing -Alarms +Card Date B-1 Date Card B-1 Date Card B-1 Date Card B-1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:' (530) 538-7636'(OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 _ PERMIT NO. BP052363 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 09/02/2005 APN: 056-120-038-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force acid Site Address: 9730 COHASSET RD COH effect. 6 (� License Class:('(' 3°1 License Number: lE �07 3 J Map Index: Date: 'G 5 Contractor: Description: RE -ROOF (35 SQ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Owner: MCCLINTOCK GEORGE W & DORIS V JT Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior + to its issuance, also requires the applicant for such permit to file a 9730 COHASSET RD signed statement that he or she is licensed pursuant to the provisions of CHICO, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95926 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 five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: FOUR SEASONS ROOFING Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, #11 COMMERCE COURT provided that such improvements are not intended or offered for SUITE #1 95928 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-895-0418 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: FOUR SEASONS ROOFING 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.). #11 COMMERCE COURT ❑ I am Exempt under Article 3 of the Business and Professions Code SUITE #1 95928 530-895-0418 Date: Owner: License #: 659073 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 Architect: is issued. Engineer: El 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: ert&m Total Square Ft: 0 S. F. Policy #: rQbq onoa A2 --i Cp S 1 Valuation: $0.00 Census Code: ❑ 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' }- i7N' I n i_ O compensation provisions of Section 3700 of the Labor Code, I shall I LC Jl + forthwith comply with those provisions. 0 E. Date:ZJ //'�� ``� Applicant: f� �'1 i' i S AT WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated ab ve for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) p � /� r Dale: �-/11�W1r \(� Name: By:r�Q��1/l t� PERMIT EXPIRES ON: SL ' �� C Address: (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or d ume yof Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purp oses. x Print Name: ) Signature: i " Chr�` 5 11� n (��e�9 2 Date: ❑ ❑ Contractor ❑ Agent for Owner Agent for Contractor Owner BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 . PERMIT NO. BP052363 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 09/02/2005 APN: 056-120-038-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Site Address' 9730 COHASSET RD COH effect. License Class : P 3� License Number: �07 3 Map Index: Date: — 3 GS Contractor: Description: RE -ROOF (35 SQ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Owner: MCCLINTOCK GEORGE W & DORIS V JT Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 9730 COHASSET RD signed statement that he or she is licensed pursuant to the provisions of CHICO, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95926 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 five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: FOUR SEASONS ROOFING Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, #11 COMMERCE COURT provided that such improvements are not intended or offered for SUITE #1 95928 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-895-0418 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: FOUR SEASONS ROOFING 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.). #11 COMMERCE COURT ❑ 1 am Exempt under Article 3 of the Business and Professions Code SU ITE #1 95928 530-895-0418 Date: Owner: License #: 659073 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 Architect: is issued. Engineer: El 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: (.CLA.M Total Square Ft: 0 S. F. Policy #: Q04 ()06) IQ 3 (ZS k Valuation: $0.00 Census Code: ❑ 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 the workers' compensation laws of California, and agree that if I should become subject to the workers' l ^ ''U'�(/�J\► compensation provisions of Section 3700 of the Labor Code, I shall "I forthwith comply with those provisions. Date: Applicant:Y r S - k \-)Mra WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated abve for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) bA _ �_ Name: V By: Datte:y Address: (� C� PERMIT EXPIRES ON: C) 11Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or do me f Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. � r Print Name: rl�.� A4 (WDCA Signature: Date: ❑ Owner ❑ Contractor 0 Agent for Owner Agent for Contractor BUTTE COUNTY DEPARTMENT OF -DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name First Na Address O Coha,1. 6 City ® Stat Zip q5q 2 3 Phone 3a ©335 Fax E-mail CONTRACTOR Name Lc so�ISQMR t Address m- 5U City StaLp La Zipg6-ga6 Phone�.3D 5 D�ilg Fax E-mail Llp. # O,2 3 Class APPLICANT INFORMATION For ARCHITECT/ENGINEER Name City f \ StateeG Address Phone Fax City No State Zip Phone Book Fax E-mail Planner State License Number APPLICANT INFORMATION For Name Address City f \ StateeG Zip ?5q&3 Phone Fax -mai E-mail— For office use only: Zoning Property Address �` eo�" it Flood Zone Cross Street SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP BIN # PROJECT LOCATION AP# 0CO -120 03Y Property Address �` eo�" it Ci Cross Street WORKER'S COMPENSATION Policy�um�ber 6- Carrier 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: Lej3y. �S 7 Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: 6 Amount: � l g 2. s() Bldg 2� SRA Receipt #: 35 1 Shert SMIP Other Date: c' `Z- b (VP�� 2.5p Total K:\FORMS\BUILDING FORMS\BldgADPISubRgmts.doc Page 1 of 2 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 1 REV 8-12-05 NOTES r QS , - �4���,rC (—� ✓j - (� RESIDENTIAL PERMIT NO.,' 056-120-038 05-0273 MCCLINTOCK, GEORGE 9730 COHASSET RD, COHASSET Cont: MCCLELLAND AIR COND NEW HVAC REPLACEMENT I SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER B JOB FINALED (Date) • rSignature J=OK 0 = Not OK . = Not Readyable 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 Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 3. Sewer; Location-Test-Fall-C/0-Concrete Wood Awn.; Posts- Beams-Rftrs-Connectors Shthg-Frg-Bracing 4. Water; Location-Test-Easement Needed (Sketch) Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 5. Electricity; Location-Clearances-Grnd-/ /Amp-Concrete 6. 6. Gas; Location-Test-Wrap;-/ P' L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. 7. Well Clearance & Disconnect 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 8. Utility Clearance Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements-Setbacks-Easements 2. Footings; Size-Spacing-Marriage Line POOLS (Plans) OK except #'s 3. Gas; MH Test-Demand-Valve-Connector Setbacks -Easements 4. Electricity; MH Test-Crossovers-Breakers-Clearances Soils; Compaction -Structure Stability 5. Drain; MH Test-Fall-Flex Connector Pool Structure; Steel -Connections -Thickness Dead Men -Lining 6. Water; MH Test-Regulator-Connector Elec.; Receptacles and Lighting, Distance-GFI 7. Water and Sewer Connected-C/O to Grade-HD Approval 5. 8. Gas and Electricity Tagged 6. 9. Tie Downs-Type-Installation Cert. 7. 10. Exits; Insp.-Sketch 8. 11. Cert. of Occupancy 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Light Niche Card B-1 Date Card B-1 Date Enclosure; Fencing -Alarms Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements-Setbacks-Easements Date 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- Panel boards- 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/0 -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) Date Hangers -Post Caps -Anchors -Connectors Card B-1 Date Card B-1 Date Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng. 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 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 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 Infiltration -Walls -Windows 27. Romex Installed Close to Edge of Studs & C.J. Card B-1 Date Card B-1 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 0 Yes O No 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 71. Card B-1 Date Card B-1 Date 72. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 36. A.C. Ducts Insulation & Support Elec. Outlets & Receptacles at Kit. Counter 37. Vent Fan, Exhaust above insulation Garage Fire Door; Swing -Landing -Closure 38. Condensate Drain & Overflow, Size & Grade A.C. Duct in Garage -Damper 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 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 81. 41. Sills Proper Materials & Anchors 82. 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 83. 44. Draft Stop in Walls (rat proof) 84. 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 85. 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purl in -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 0 Yes _ 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters O Yes O 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/0 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 DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION O OFFICE M (530) 538 7541 (FAX#:I2834 (CHICO) (530)538-2140 WEBSITE:: www.buttecounty.netldds PERMIT NO. BP050273' LICENSED CONTRACTORS DECLARATION i 1 hereby affirm under penally of perjury that I am licensed .under of Chapter 9 (commencing with Section 7000) of Division 3of.I ' �'.. Issued Date: 02/04/2005 APN: 056-120-038-000 provisions the Business and Professions Code, and my license is In full force and effect. License Number-— Address: 9730 COHASSET RD COH License Class:_. .Site Date: Contractor. Map Index: OWNER -BUILDER DECLARATION Description: NEW COOLING UNIT & HEATING p I hereby affirm under penally of perjury that I am exempt from. the . Law for the following reason (Sec. 7031.6 ; i I UNIT/REPLACEMENT Contractors' State License Business and Professions Code: Any cily,or county which requires a 1 permit to construct, alter, improve, demolish; or repair any structure, priorMCCLINTOCK the applicant for such permit to file a Owner: GEORGE W & DORIS V JT to its issuance, also requires signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9. commencing with Section Business and Professions Code) or that he or 9730 COHASSET RD 7000) of Division 3 of the she is exempt therefrom and the basis for the alleged exemption. Any CHICO, CA violation of Section 7031.5 by any applicant for a permit subjects the of not more than five hundred dollars ($500).): 95926 applicant to a civil penally ❑ I, as owner of the property, or my employees with. wages as their sole compensation, will do the work, and the -structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Slate License Liw does not apply to an owner of property who builds or Improves thereon, and who does himself or herself or through his or her own employees, Applicant: MCCLINTOCK GEORGE W & DORIS V JT such work provided that such Improvements are not intended or offered for sale. If however, the building or Improvements' are sold within one year of completion, the owner -builder will have the burden of 9730 COHASSET RD proving that he or she did not build or Improve for the purpose Of CHICO, CA sate')' 95926 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Proldssions Code. The Contractors' Slate License Law does not apply to an owner of property who builds or Improves (hereon, for such with a contractor(s) licensed and who contracts projects pursuant to the Contractors' State License Law.). Contractor: MCCLELLAND AIR CONDITIONING, INC P�rooffe-ssions Code ❑ '1 am Exempt under Article 3 of the Business and Professions -y �,/- 0 wner Dale: .E-- O i 690 THUNDERBOLT STREET WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1e. ;' ; CHICO, CA 95973 ❑ I have and will maintain a certillcale of consent to self -Insure for (530) 891-6202 workers' compensation, as provided for by Section 3700 of the.. of the work for which this permit Labor Code, (or the performance Is issued. License #: 345121 ❑ I have and will maintain workers' compensation insurance, as 1 Section 3700 the Labor Code, for the performance,o(•M . required by the work for which this permit Is Issued. My workers' compensationfl Insurance carrier and policy number are: , l IteCt: Architect: i s Engineer: Carrier. j Policy M i 06 1 certify that in the performance of the work for which this permit Is 0 S. F. Issued, I shall not employ any person In any manner so as • to ) to the workers' compensation laws of California, ; Total Square Ft: become subject and agree that if I should become subject to the workers'; Valuation: $0.00 N compensation provisions of Section 3700 of the Labor Code, I'shall Census Code: forthwith -comply with those provisions. i Date: Applicant: WARN 11G; Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one. hundred thousand dollars ($100,000), In addition to the cost of. compensation, damages as provided for in Section 3706 of the Labor. fees. f 1 (a Anol)17t J code, Interest, and attorney's � CONSTRUCTION LENDING AGENCY This permit is l: rehy issued under i�ll pltcebla provisions of Iha Outte County Coda a. nrVOr Indicated tfove or which fees have been paid. I hereby affirm that there is a construction lending agency for the 3097 Civ.) Resolutions to o work c Date:,i2— Z2L performance of the work for which this peril is issued (Sec ; By Name: J /1 PERMIT EXPIRES ON: - Address: 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. of California He alth 8 Safety Code Is not applicable to the scheduled construction of this project. ❑ Notification In accordance with Section 19827.5 ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information I It is correct, and Ihet'I am the owner or the duly authorized agent of the owner. I agree to comply with Is unlawful to alter the substance of any ificlal form or document of Butte County. I hereby all county and stale laws relating to building construction. acknowledge of Butte County to enter upon the above mentioned property for Inspection purposes. authorize representatives 'Signature: 7 -Print Name: O �L —, Dale: Owner ❑ Contractor '❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE:: www.buttecounty.netldds PERMIT NO. BP050273• i I I • LICENSED CONTRACTORS DECLARATION j 1 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: 02/04/2005 APN: 056-120-038-000 I Business and Professions Code, and my Iicense'ls In full force and 1 effect. i License Class : License Number: • Site Address: 9730 COHASSET RD COH I Date: Contractor. MapIndex: OWNER -BUILDER DECLARATION Description: NEW COOLING UNIT & HEATING I hereby affirm under penalty of perjury that I am exempt from• the p Contractors' State License Law for the following reason (Sec. 7031.5 UNIT/REPLACEMENT Business and Professions Code: Any clly or county which requires a r permit to construct, alter. Improve, demolish; or repair any structure, prior MCCLINTOCK GEORGE W & DORIS V JT to its Issuance, also requires the applicant for such permit to file a Owner: signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter g.commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 9730 COHASSET RD she is exempt therefrom and the basis for the alleged exemption. Any CHICO CA violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 95926 ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Liw does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, Applicant: MCCLINTOCK GEORGE W & DORIS V JT provided that such Improvements are not Intended or offered for sale. If however, the building or Improvements' are sold within one } . year of completion, the owner-bullder will have the burden of 9730 COHASSET RD proving that he or she did not build or Improve for the purpose of CHICO, CA sale.). 95926 114 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profdssions Code. The Contractors' Slate License Law does not apply to an owner of property who builds or Improves (hereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Slate License Law.). ❑ `I am Exempt under Article 3 of the Business and Professions Code Contractor: MCCLELLAND AIR CONDITIONING, INC Date: Owner WORKERS'COMPENSATIONDECLARATION 690 THUNDERBOLT STREET I hereby affirm under penally of perjury one of the following declarations: t:i fo CHICO, CA 95973 ❑ 1 have and will maintain a certificate of consent to self -Insure for ; ?.i.; ; : )i? : f (530) 891-6202 workers' compensation, as provided for by Section 3700 of the. Labor Code, for the performance of the work for which this permit i Is Issued. , License #: 345121 ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance ,of y - the work for which [his permit Is Issued. My workers' compensation!; Insurance carrier and policy number are: Architect: Carrier. Engineer: Policy #: 96, 1 certify that in the performance of the work for which this peril Is issued, I shall not employ any person In any manner so as•to'i Total Square Ft: 0 S. F. become subject to the workers' compensation laws of California,' and agree that if I should become subject to the workers'l Valuation: $0.00 N compensation provisions of Section 3700 of the Labor Code, I'shall' forthwithcomply with those provisions. { Census Code: Dale: Applicant• WAR NG1 Failure to secure workers' compensation coverage Is ` unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor �a code, interest, and attorney's fees. i �]� U GU CONSTRUCTION LENDING AGENCY This permit Is h reby issued under t plicable provisions of the Butte County Coda enrUor Flher.by affirm That there Is a construc8on lending agency for theResolutions to o work Indicated ova or which Pass have been paid.formance of the work for which this permit Is Issued (Sec 3097 Civ.) Date: �1 By: Name: //�� ' PERMIT EXPIRES ON:Q 62 Address: Date ❑ 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 materiels. C3 Notification In accordance with Section 19827.5 of California Health 8 Safely Code Is not applicable to the scheduled con strucllon of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that 1 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 stale laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any {clal form or document of Bulle County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes -Print Name: �/ l� /�e, �/� 'Signatur Dale: ,�I Owner 0 Contractor " • ; i 1 ; ' ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.neddds "PLEASE PRINT CLEARLY" APPLICANT SIGNATURE l X e For office use only: OWNER Last Name i v irst Name � Address City City State State Zi� Phone Fax E-mail Lic. # APPLICANT SIGNATURE l X e For office use only: CONTRACTOR Name /'l/-/ y (� Address City I Yes State Zip Phone Type Const. Fax E-mail Map Book Lic. # Class APPLICANT SIGNATURE l X e For office use only: ARCHITECT/ENGINEER Name /l� Address City I Yes State Zip Phone Type Const. Fax E-mail Map Book State License Number APPLICANT SIGNATURE l X e For office use only: APPLICANT NAME Name /l� Address City I Yes State �� Z. Phone Type Const. Fax E-mail Map Book APPLICANT SIGNATURE l X e For office use only: AP# OJ7c• i__2401 638 Zoning CityC. e -i - Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Address Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BIN it LOCATION AP# OJ7c• i__2401 638 Propert Address CityC. e -i - Cross Str et WORKER'S COMPENSATION Policy Number Carrier 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 Page 1 of 2 Description or Sco a of Work: C� Sq. Footage - ❑ 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 required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by77e Amount: / w Bldg / SRA Receipt #: 4/1ag Sheriff Date: ( /,I;h SMIP CU Total REV 7-27-04 r SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 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). ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ - 2. Impact Fees: ❑ 3.. California -Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment -Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ 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 be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SUbRgmts.doc Page 2 of 2 REV 7-27-04 File No. Q� BUTTE COUNTY a (For Action 1, 2, 3) Public Works Dept. (For Information ✓ ) 5Dep. or Dir. Sec. Rd. & Br. Mtce. i Shop & Yards I Bldg. Insp. Admin. Design Engr. Bridge Engr. i Constr. Engr. Surveys Mapping T ran sp. Land DLV. Drng. /S.I. Sub. & Pcl. Maps Permits LAddr. =-� FA August 12, 1986 George McClintock RE: Special Inspection #19-86 Box 138, Cohasset Stage A.P. #56-12-38 Chico, CA 95926 Dear Mr. McClintock:, With reference to -the above subject and my letter to you dated June 17, 1986, concerning the garage conversion to living at the above address, a reinspec- tion on August 8, 1986,.revealed the stairway was corrected. The garage conversion. is consistent with and meets the objectives of the Uniform Housing Code. Should you have any questions concerning this matter, please contact this, office. Yours very truly, -William Cheff Director of Public Works Original signer! by I F. Glander J.F. Glander JFG:ahb Chief Building Inspector c U4� lips r 1� June 17, 1986 George McClintock RE: Special Inspection #19-86 Box 138, Cohasset Stage A.P. #56-12-38 Chico, CA 95926 Dear Mr. McClintock: With reference to the above subject and your request for inspection of the garage conversion to living area at the above address, the inspection was made on June 16, 1986. The garage conversion to a family room was constructed without permits and inspection from this office, so we were not able to perform the required inspections during construction. We therefore made a reasonable visual inspection, without going on the roof, under the building, or in the attic and found the conversion appears to conform to the intent of code requirements except for the following item which must be corrected: _77' On the stairway between the conversion and the dwelling, the riser heights must be uniform or not exceed 3/8" tolerance between the smallest and -highest riser. This inspection by the County of Butte does not act as a guarantee or war- ranty as to the internal soundness of said conversion. Should you have any questions concerning this matter, please contact this office. JFG:ahb cc: Assessor Yours very truly, William Cheff Director of Public Works Original signed by ,I• F. Giander J.F. Glander Chief Building Inspector BI�'8�s� —� ., v� i ian.P. Land Dev. Drng. /S.I. Sub.& Pc 1. Maps Permits Addt. George McClintock Box 138, Cohasset Stage Chico, CA 95926 Dear Mr. McClintock: June i7, 1986 RE: Special Inspection #19-86 A.P. #56-12-38 With reference to the above subject and your request for inspection of the garage conversion to living area at the above address, the inspection was made on June 16, 1986. The garage conversion to a family room was constructed without permits and inspection from this office, so we were not able to perform the required inspections during construction. We therefore made a reasonable visual inspection,.without going on the roof, under the building, or in the attic and found the conversion appears to conform to the intent of code requirements except for, the following. item which must be corrected: (1) On the stairway between the conversion and the dwelling, the riser heights must be uniform or not exceed 3/8" tolerance between the smallest and highest riser. This inspection by the County of Butte does not act as a guarantee or war- ranty as to the internal soundness of said conversion. Should you have any questions concerning this matter, please contact this office. Yours very truly, William Cheff Director of Public Works Original signed by J. F. Glande► J.F. Glander JFG:ahb Chief Building Inspector cc: Assessor MA s iu L C ❑..Complaint -Da -e _ ❑ Other- a e BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS j SPECIAL INSPECTION REPORT Owner:. �� o v C- Y Z' ° -3 O 3 Address e-- b. -Z- `— Tenant: Building Location: 2-`.L► a-4e�c r4,..0- -2::�! —.1 tia�".A— a ZONING A. P. # .57 (-- / Z—.3Y Date of Inspection Inspector Type of Inspection requested:(i C-1 1. Housing / 2. Financing 3. Change of Occupancy to 4. Work W/0 Permit / / 5. Other (specify) Present use of building: Sf- A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: Heating facilities: 0 /c' <� Natural light and ventilation: (Gor— 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water supply: 13. Rubbish and garbage facilities: Stairs:(Rise, Run, Headroom, 1HR, Tolerance$,Handrails)�,�� v 15. Comments: v Structural 1. Piers and footings: 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: G�. Electrical 1. 2. 3. 4. Service and ground: Receptacles: &..i„ Fusing:• Comments: :f D. Plumbing 1. Fixtures connected and vented: �? Gas water heater: 3. Gas heating vents: 4. Comments: E. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 0 Weather protection: —P- ? 5. Underfloor and attic ventilation:. 6. Energy:. 7. Comments: F. Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: 4. Restroom floors and walls: 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: / /-A. Information only - file. B. Hold for ten days, then write letter. C. Write letter. D. Other: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION FOR SPECIAL INSPECTION Owner fp, /yI�G�`�.�y7�p/ A. P. No. Mailing Address ??X /:4Q dokaS'5'e7_ S 7mPre Telephone No. (-)9 41 Applicant ("),Orw A /.i), �t4y/g/ r', /P Telephone No. Mailing Address "R-)( / �" I j � 4CC1,7 '-477'0 eli% �ia � 00 1"'A � �._� � 6 Building Location n ,lj4y 4/ r'?,),1/F? <7 e ,d1ni Aoc .4 A„ ao J4-1,0 PIP ,4A,7,1P '�';'- %Aa) lira Seg I hereby request a special inspection of the following building:" / Yl 1. Dwelling (if only a portion, specify) 611719PAgp ("mlyPR Sie.d 2. Apartment House (if only a portion, specify) / / / 3. Commercial (specify present occupancy) / / 4. Other (specify) I am requesting a special inspection for the purpose of: 1. Moving the building. 2. Financing (specify agency) OVA,o%ap ,gA1/1 3. Change of occupancy to / / 4. Other (specify) Case No. I hereby certify that I will obtain the necessary permits and make any necessary corrections, alterations, or repairs required by the County of Butte, as a result of this inspection, to comply with building and housing code requirements. I also certify that prior to the use or occupancy of this building, I will complete the above required corrections, alterations, or repairs, or, if the building is presently occupied, I will complete the above required corrections, alterations, or repairs within thirty (30) days. I certify that I have read this application and state the above information is correct and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 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