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N 56 22 HOUSTON,Jerry� & ,9766'-C6ha4set,Rd. " Chi o - oy K-Deslgn2rsz (vinyl �'�� ,; Tom' f�:., s-,r:y�,iS t;�i,� � F /��( " .; JN• x� 0'56 120 050,; PERMITWq' 0014 i 9766„Cohasset Rd':•, X6 asset ”} ►Gas Li�riei& ;Gas HtY/SF�� 0 :•� cc , ! � E,-(-) 0 1 �-A ' OFFICE CrOPPY/, Address(�J VT�JSC7,-" i y GAS Meter By Date' ELECTRIC Meter By Date COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 56-12-50 ZONING TM -2 BUILDING PERMIT OWNER LUCIEN PELLETIER TEL�°X4788 SO. FT. OCC. BUILDING VALUATION DWNERS MAR,ItG�1QD "60HASSET RD. CHICO 95973 CONTRACTOR'SI�N�AMME� TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation 3 ARCHITECT OR ENGINEER LICENSE NO. Fllin Fee $ 20.00 Permit Fee S ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checkina Fee 3 BUILDING ADDRESS 9766 COHASSET RD. Energy Plan Checking Fee $ 5 COHASSET PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL IAAF PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF R Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New O Addition ❑ Remodel ❑ Utilities ❑ Installation O Other)b Describe Work: NEW GAS SERVICE Gas piping sy2tern 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W I@20.00 PERMIT FEE : — ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( *.oa u=ss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. — OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: O 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 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 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 com those provisions. 00, X / /1�t� _ ___ Date Signature of Applicant - ❑ Owner O Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service sow To I000A 46.00 NEW CONST. DWEwNG OCCUR SO OR ADDNS. ( DIT ACC. S.3.50FT. =REBID. T.MULTI.OUTLE7 @7,50 POWER APPARATUS 8 SINGLE OUTLET CIR. OUTLET OR FDCTUREs Ex. Occup. 20 ® I o flXED APPLNS. OR 5,00 Ex. Occup. ouTLErs =. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ 35.00 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEES 70.00 P FLOOD COF PARCEL PO HD u This permit is hereby issued under the applicable provisions of the Butte County Code end/or Resolutions to do work indicated above for which fees have been paid. G q Date V� / By - PERMIT EXPIRES ON (o Def Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS 7 County Center Drive - Oroiille,-Nlifor'nia 95965 - Telephone (916) 538-7 �RMIT NO. (Rev. 12/96) APPLICATION AND PERMIT `V ASSESSOR PARCEL NUMBER 56-12-50 TM -2 ZONING BUILDING PERMIT OWNER LUCIEN PELLETIER TELTM4788 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILIIgES6OHASSET RD. CHICO 95973 CONTRACTOR'SI�N�AMME(� TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Felin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 9766 COHASSET RD. Energy Plan Checking Fee $ $ COHASSET PERMIT FEE $ LOT NO. S UBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF IR Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other)7 Describe Work: NEW GAS SERVICE Gas piping system 1 - 5 outlets 15.00 UU Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service ioonoAESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWER 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: O 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 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 Main Service 200A TO I000A 46.00 NEW CONST. DWELLING OCCUR OR ADONs. ( a ACC. BLDS. SO 3.5QFT: NEW NON-RESIDT ANCI cU CUI 97.50 APPARATUS 8 SINGLE OUTLET CIR. EX. Occup. OUTLET OR FDRURES BAL @ �: o Ex. Occup. ouTLEEDrs AEslooen 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating 15 00 Cooling Hood 6.50 Ventilation PERMIT FEE $ 35.00 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.) R/ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comp those provisions. X _ Date C= Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or constructionfjU of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 70.00 P FtooD cDF PARCEL PD HD SU This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By _--"'_/Datee PERMIT EXPIRES ON ` Del provisions to do work paid. _ 4 Receipt No. `J c% WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Owvill@,Xalil'ornia 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER _ �—Q Z. 0. ') BUILDING PERMIT OWNER TELEPHHO'NE SO. FT. OCC. BUILDING VALUATION OWNEA'S IUNG ADOR SS 7C�[�/ SS� C/' C /(lL �S�/ �✓ CONTRACTOR'S NAME U.,JkJ60 AW TELEPHONE " CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fire lace LENDER'S MAILING ADDRESS ` Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ $ / PERMIT FEE _ IAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF O/Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: %�erJ 5 SG2LJ / L e Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ 3S - ELECTRICAL PERMIT Fling Fee 20.00 800V OR LESS Main Service 200AORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class LIc. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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 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 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.) O 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 N 1 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - O Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. S° OR ADDNS. ( 6 ACC. BLAS. 3.5¢FT. =RESI. MULTI.OUTLEr 97,50 POWER APPARATUS 8 SINGLE OurLET CIR. 20 Q 1'50 Ex. Occup. OUTLET OR FOCTURES BAL p .so Ex. Occup. ouTltis aE�slD.°�L 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating / /C Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee 1 $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HA2. 0. FEES IMP I FLOOD I CDF PARCEL Po HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date _ Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ..' :., .,, . . Its`; .-4' .: *•rte �, ...,,. :�,, 4,..:`c�:4f'i'i`j•%MCAf''.'SCit''10'r't'•.R".+ga'•'"ri:,e..f •. •1:' ,^j+ .ya,` s 56-12=50 1424-89B HOUSTON, Jerry &Vera 9766 Cohasset Rd . , -ehd;ro• Cott � ase Cont;.K-Designers ,.�. (vinyl siding/SF) t 1 i i a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS Z PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541j (� _ APPLICATION AND PERMIT I / r r f ASSESSOR PARCEL NUMBER r / 12 — 'N 0 ' " ZONING '- BUILDING PERMIT OWN .- I - P f �,�� TELEPHONE I r � tea- S0. FT. OCC. BUILDING VALUATION OWNER'S MAIL ^NG ADDRESS WN CONTRACTOR'S'NAM. ` TELEPHONE "CON ACT-OR.S MAILING ADDRESS _ f r, ( _ , 1 • r i 1�7 r I Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS r i `• F 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 I S I G I WF 10-00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installations Other EJ Descri be work:j ! !tR l� G� I 1 l (l : I % i 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): (� I7-I I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessPOWER T and Professions Code and my license is in full force aAd effect. License No. Classification ❑ 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. ( a OR ADDNS. 1 DWELLING OCCUP.ACC. BLDGS. ) yz�sgft NEW CONSTR. ULTI.OUTLET 2,50 ea NON.RESID BRANCH CRC., / APPARATUS e) (SINGLE OUTLET CIR. z0es0C EX. OCCUR OUTLETS OR FIXTURES eALY 30 FIXED APLNS. Ex. Occup. OUTLETS PR (RESID 1EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 g Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. loi I have placed on file with the County of Butte Building Department J� 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 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 consequence of the granting of this permit. X ---Date ", „�_ 6 -This Signature of Applicant — Owner El Contractor ❑--Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories In height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ Occu P. CON 9T.Tr PC ISCHOOLI FLOOD PARCCI PD I ND I ISSUE permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By ,/ ° PERMIT EXPIRES- -Date the applicable provi- resolutions to do fees have been paid. WORKS t Date % Receipt No. �/ �- ' WNITL-D. P. W., YELLOW-ASS[39011, INK -IN 9P CCTOK, GOLDENROD -APPLICANT COUNTY OF BUTTE - D.E'PARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovillt, Cali4nia 95965 - Telephone: 9'16/538-7541 APPLICATION AND PERMIT [' PERMIT N T T^ ASSESSOR PARCEL NUM ZONING BUILDING PERMIT Ow �- Ue n?a-3�5 TELEP ONE S0. FT. OCC. BUILDING VALUATION O �ER'S AI IN ADDR SS ^ CO RACTq R'S NAME ` 1c2i nittrJ TELEP O E i CONTRACT AILING ADDRESS 31"In R Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation I $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee _ 3 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BU IG ADDR S qr) Permit S /_ -fee PLUMBING PERMIT Fil(iingFee 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 bile Home S I G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationEl Other ❑ Describe work: � Ind 1 <:_�— I no, Permit Fee $ Contractor 0 ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 OR LESS 100 OROR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business /J and Professions Code and my license is in full force and effect. License No. Classification ❑ 1, as the owner, Or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 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.9 yZ�sgft OR ADONS. 1 ACC. BLDGS. NEW CONSTR. MULTI -OUTLET 2,50 ea NON-RESID .BRANCH CIRC ITS POWER APPARATUS &) (SINGLE OUTLET CIR. ) Ex. Occup OUTLETS OR FIXTURES BAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA. 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. INirin 15.00 g E I Permit Fee $ 2 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation penult 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses�_Avhich may in any way accrue against said Count in consequence of gr1 g of this permit. ^ X T(� Signature of Applicant - Owner ❑ Contractor Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ , OCCUP. CONST.TYPEJ SCHOOL FLOOD PARCEL PU I ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. _ DIRECTO OF UBLIC WORKS Date—�� PERMIT EXPIRE ate �� / /�_ Receipt No. WNITE-O.P.W.. YELLOW -ASSESSOR INK -INSPECTOR. aOL DENROO.APPLICANT I i SECTION XI -A-7 ICf30 EvalLiation Service, Inc. EXPIRES 06-1988 A susirfkUYcorporxionofdic IrlternationaI Conference of Building Officials EVALUATION REPORT peport No. 3985 un r. 9R/, 1 Flling Category: WALL COVERING ALCM Slll'rR-V FXTFRIOR VINV1, SIDING ALCOA BUILDING PRODUC'T'S (A DIVISION OF -1-1IF S -1'(11,1.r CORP.) 1501 MI('IIIGAN S-hRFF;f SIMElo', OIIM 45365 Snhjecl: AIc„a Super -V lixtcrimr Vinvl Siding 11. Descrlpllnn: A. General: The siding, Clive soffits and accessmrics arc made frmmr si rigid polyvinyl chloride mnfrrial with n CCI classification and have in average 40 -mil thickness. -three types of siding me available: the AV44'1-siding with a double 4 -inch hmrizrnttal wood grain texture, the AVRT with in R -inch horizontal -mod grain texture, and the AVVS ION Which is a double 5 -inch vcrlical wmrxl grain tcxhnr eidinl: and an AVS ItIV sollit. 'I he hm iznnlal siding is available in 12 -firm! 6 -inch leagues ;uul has nn R -inch exposure. The vertical siding is availooble in 10-Gx+1 and 12-fon1 lengths find has a 10 -inch exposure. The siding and carves soffits nyttst fie installed over solid structural sheathing conoplying with C'h;rptcr 25 mf the code. Weather prmteclion must be prrrvidcd in ac'curdancC with Scc6mn 1707 of the cmcic. 'I he fasteners are V--inch-diameter-head. 0.1211.inch- diameter shank, corrosion-resistnnl nails Icing cnnugh to penctrtc framing III least I inch fir thickness of Il,c shealhing. whichever ie Icss. R, lnslnllallnn: Ilariznntal s1dl"g—ATI inside and nuleidC curncr poets and l channck mi: first applied yv;III moiling :t 12 inchcs nn center. l Indcreill trims :Intl Iloilo caps are inet:tlled with nailing ;it R inchcs fill center. A special Matter strip is installed at the lowest curncr 4 the building and atlaehed at R Inches on center. 'I he hnriznnlul siding and p:Incls arc interlocked irtm the starter strip and arc nailed into file center of the nail slot 16 inchcs fin center. The panels arc all overlapped %, inch at hull joints and held'/. inch clear at all will crick and am,und (openings. Vertical sl(fill R—C(orncr posts rind Irims arc inslnllcd as far licit izmnlal applic Limns. Vertical Irim is inslnllcd starting at the Imwc•sl corner and nniled R inchcs cin center. 'file vertical siding panel is cut it, limper Iengl}t leaving r(oom fur expansion and the hull end is filled inkfi the channel cin the• corner pmtl. Icavin nailing slats Iarlhesl frfirn the curncr. Lach panel is hr. era vcrticaliv and nailed in floe center of the slut at 16 inches on center Succeeding panels are interlocked and nniled it Ili inches on center. Eave solflts—Soffil systems erucic of panel secliuns used as finkhrrl ncucrial on cave overhang. On an enclmscd overhang, soffit 1 trim i-. installed fit the outside edge find inside curncr and nniled at 12 inchcc mi center. Smflit panels site slipped In the J Dion and nailed Ire inchcc ccntcr. each cuccceding panel inlcrloK king with the previmus panel. C. Identification.- The vinyl siding proxlucts are shipped in canon, carrying the company name, the type of vinyl. number of pieces, length, and color with labels applied 1(o the end of the carton. III. F.vldence Submitted: Repurls mf lege cmnducicd in arum (hit' r will, U.B.C. Standards No. 32-2. 51-3 and 52.4, tfigcthcr with inslallatimn Inctruclions are submitted. Findings IV. Findings: That the Alena Supper -V F itterltrr Vinyl Sldlnd he rerng- nb.ed as approved plastic complvinR with Chapter 52 of the 19145 11nlrorrm nulldlnR Cmle, subject In the follorwing conditions: I. ApplirntIon 1.5 In accordance with Ihls rrporrt. Sectlrrn 5205 anal the mnmtfaclurer's Inslrudlons. e. Wren nmtrmions and uppnrallrrn requlremenls speclrled In See - film 3105 lel of the code are applicable, except fife "IN -pe V -N cnnstrttcllon hnuslnR Crntrp R or 111 Occupancies. 3. Walls mull he braced as set rnrlh In Chapter 25 or the code. 4. The sldlnR can he Installed In Arens where the basic wind speed dnes not exceed RO miles per hour and the building height Is lest than 40 reel. This repnrt Is suhJect In re-examinallnn In two years. :valualian reports of K'Btl Evaluation .SFrI•ire, Inc., err i.r.curd safrly to provide information to C'lars A member, 61 1010, fttifizirtR the code upon which the report is hated. Evaluation reports Orr. nal ►o he con.trrrrrd as representing ofWhetirt or any other ntfribufer not sprclfrcally addre.r.sed fear as an rndnrtrmrnr nr rrenmmrndalinn far axrr, n%thr .tnhircr rr•pnrt. Thix rrporl i.y ho.rrd upon indrpr•ndcnr fr.tts err other Ire -hnical darn .erthmitfrd by the, opplirant. ?'he IC110I. valuatlan Nervlre, Inc., tech nir•ol.ttafJho.t rcvierr rd the Incl rrcrrllt and/fir Other data, heel dne.t nal pn.c.rrss Intl jarilitir.t hr make an Independent verijirafion. ?'here Is no warranty by W110 F.-valualinn .Sm ice, lac., rxpre.ty or Implird, air to any " finding" or Other matter in the reparf or not to any product covered by the reparf. This disclaimer inchrdr_t, beer isnot timirrd fn, merchantability. Page ' ` ANDERSON RALPH ANDERSO 561-12 . n/s Fisher : k44 X rden -- �e�� X4 mi. "�c �m" Chico e 3370-74B,E � Cont: 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. BP0601.35 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 04/28/2006 APN: 056-120-058-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 108 WHISPERING PINES CIR CHI Dale: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 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 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 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, 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 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 not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of thequsiness and Professions Cod, DaIAL wner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally 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 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: Policy #: �. 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 those provisions. Date: / _ D Applicant: Map Index: Description: ADDITION TO SF (480) Owner: KAVENAUGH SUSAN M . 108 WHISPERING PINES CIR CHICO, CA 95926 Applicant: KAVENAUGH SUSAN M 108 WHISPERING PINES CIR CHICO, CA 95926 (530) 345-9845 Contractor: License #: Architect: Engineer: Total Square Ft: 480 S.F. Valuation: $31,200.00 Census Code: WARNING: Failure to secure workers' compensation coverage is `! n 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. ,// 1 C r CONSTRUCTION LENDING AGENCY This permit is h reby issued under he pplicabie provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol tions to o work indicated bo for which fees have been paid. By performance of the work for which this permit Is issued (Sec 3097 Civ.) Date: �' Name: PERMIT EXPIRES ON: Address: ❑ 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 document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: c J 5(xia H uV)San__ 'd Signature Date: �'',,z — 6J�;, owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor - - n...-_- ,7-.- C — — 9 J� T'r BUTTE COUNTY PERMIT /0 o DEPARTMENT OF DEVELOPMENT SERVICES NO. o o BUILDING PERMIT APPLICATION o o AND SUBMITTAL REQUIREMENTS o _, .r p 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BP o ='_.-_©.; . o OFFICE #: (530) 538-7541 A FEE I-VILL BE REO UIRED AT TIME OF APPLICATION BIN # Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Names ame Address C t C CityeC 1. S, ;,fFax Phone � 345- E-mail APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number. APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATU , X For office use only: Zoning I -TM _5 1 Flood Zone I Y,, I SRA es I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PROJECT LOCATION AN / 5 C, Proped Address City C A Cross Street M e--- L tA _Q Sheriff WORKER'S COMPENSATION - Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address ` . Description or Scope of Work: 0- \1 Sq FT- Living 8 . 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: 1 6. Amount: Bldg ZOII."I D SRA Receipt MIL[ 5S 13 Sheriff SMIP Date: Other 5.a_Total 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 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. ❑ . 1 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, orMCO. ❑ 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 K:IFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION ' 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: o Vk na Loh ASSESSOR PARCEL NUMBER 066-12-0-059 Proposed Building Use: Ad i flan of IMA/bedroom/wORPermit Technician: \.6 • Date: I'/_ ncb It s required in order to apply for a permit. AII`boxes MUST be checked OR marked NA in order to apply. VjV 1. Site plans,or � r 4 sets, signed by the preparer of the plans. _J:W 2. Complete plans�r 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl 5. Letter from Engineer or Architect for truss design review. I X4 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non�Residential Buildings. ❑ 8. Manufactured homes: (A)�Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other h. Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) =N 14. Sanitation and site plan approval from the Environmental Health Department in WChico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑ Erosion Control Plan Required........................................................................ 19 ees as shown on the attached Schedule of Fees Due Sheet .............................. 28 ❑ 20. City of Chico Plumbing permit........................................................................ ❑ 21. Site plan and business license approval from the Sty of Biggs........, . = ..................... 22. California Department of Forestry plan approva paid. Sent by: II49/oorp... 23. Planning approval for (A) Use: �(B) Parking: (C) Parcel Check :............ o? iJ(D ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ / 25. Fire Marshall Review (commercial projects only). Sent by: ...................... _� 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... Nom,( 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... Cl 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement. ................................ ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone Lao) 345 - qgy J ownw and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for a above items numbered: Plan Check Letter 2. Additional items re wred 1 , Contractor, desi r owne s advised of the above data byhon , mail, ❑ counter, ` Date: �t&'� Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Dale: Plans approved by: Date: Structural reviewed by- Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. u�� atrtr Plot Ren Attaches Flout Ran Attache Sent to B.D. 1-19-0 y� Y6 U fin. ��s a►� t%vb ba r4v an / og Wk u p� w 4 f i wd 41 OSa - l ZD -os- r Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well �[ Clearance fordwelling. Other X44 4A ova `. ,"f i �S Hold final for: Final clearance O.K. for: NOTE: vironmental Health Specialist 8/96 Date G� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner KAVENAUGH Application Date 1/20/2006 APN No: 056-120-058 Permit No: BP 060135 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION Plan Check portion of Permit Fee 2 FEMA Yes Flood Elevation Review $109.98 3 SRA* Rx Yes Fire Plan Check - Non -Refundable $95.00 (State Responsibility Area) Building Inspection $109.98 NON-REFUNDABLE portion of fees due at application $852.35 $340.94 Permit Type: ADDITION TO SF $511.41 Balance of Building Permit Fee 0 $95.00 $204.98 $109.98 $435.94 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $545.92 FEES (RELOW1 DUE PRIOR TO ISSUANCE OF PERMIT $514.52 Ddid11G6 ul Ouaumq r-urimt rtmb kirum imu. 1 duVVCI SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system) Additional Plan Check Fees (NON-REFUNDABLE) Other*: Other*: 12 SCHOOL DISTRICT FEES* 12a RECREATION DISTRICT FEES* RECEIPT DATE Tech/Asst 113;45 1/20/06 Kourtni .➢.7 1 I.Y 1'��a(J $3.12 DATE Tech/Asst At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. Applicant: ...� Date: Pursuant to Government code Section 66020, you are herebnotified those Items foll an "" may have been imposed on your project. You have 90 days from the date of approval of the porject or from the impostion of the above reference ' ems during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 121205 Department of Public Works 1 o u n t y o f B Q t..t e d ;� a J. Michael Crump, Director LAND DEVELOPMENT DIV1510N Storm Water Mana;ement Program 7 Cdunry Center Drive lle. CA 95 965 A UC W�F`�5 Oro(530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase. lI Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement LLESS THAN I ACRE] Project Description: ct_8A% A'kay\ Project Location and/or Parcel Number: By signing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board - I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project. that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: ��__A�Vw.w,,Mkuww_mw Date: � qy --Oto OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary. delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [ ] NO [ 7C]. 2. I HAVE [)C] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: 1 NAME: _ (Ay1 Ci�e_A � k n ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: 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: DATE: %—�2n—O;, lorl 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.. Rev'd 11/4/2004 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (Ore form per Building) School District Civ Building Department No. A.P. Number U V Jurisdiction: City County Property Owner Property Location/Address d� �\� `� 1 �� YDS ► \J t ' 9 Subdivision Lot No. ............................................................................. Residential Development Q Q Sq. Footage O Q No of Living Mobile Home`ddj,oN Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation inspection) :........................................................................................ Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial 0 0 Sq. Footage New Addition (Including Exterior Roofed Areas) (its Building Department Representative Date ' District, Identification, No. M ' School District certifies that'Z vC Cil (Applicant) 11y4 (Street Address)(Phone Number) m (City) has complied with the requirements of Resolution No. representing square feet. (State) (Zip Code) 9,!b7-614 _ by payment of $ School District Representative Paid by Check # 104 Remarks: fU8LL2926 $ MITIGATION $ Date 1A] Notice: You may protest the Imposition of the fees IderMed above by submitting a written protest to the District. In cohWiance with Govemment Code Section 66020(a), within 90 days from the dab fees are paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fees In any covet action. H, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is notlAed by the applicable Local Planning Agency that this project Is being reviewed under the California Environmentid Quality Act (CEM), this project may be subject to additional school fees to fully mitigate Its Impact on the school district's schools. White (school district), Yellow (building department), Pink (applicant) feeform.xls (30SWam BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORD)[ 0 FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ACHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Property Owner (s)_ Project Location /Address Subdivision Name v6 � • 1'a-vy� q \�ti�)b C'�- Building Pen -nit Number C)(, - ULP50 CIO Assessable Sq. Ftge 4 Type of Residential Development (check one) New Development Single Family -Detached Single Family -Attached ,New A dition Ds Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified by Building Department Comments: Building Department kepr+nt4tive Date ❑ FRRPD ❑ CARD ❑ PUD ❑ DUD certifies that: Applicant Name Phone Number Mailing Addred., City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Paymdnt of: Dwelling Units @ $ Square Feet @ $ _ per unit for a total of $ per sq foot for a total of $ T--% TTT rnDI AO\_., -1. -s,......, A—A Fn.... r ? 1 rinr. C� `v 5 ' ,mac., C4 C 7� c��r �v mss ��C� L � �.��. ����- •,� � � �� BUTTE OUN�' RRJJQ 2001 DEVELOPNV[ENT SEPMIC-ES . 4 Tk ..�: r' TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. USE ONLY Plot Plan AttadW Floor PI. Atteuhe Seat to E.D. / 0 Kr,\mnat&�, 7D �s � Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public_ Private Well Clearance for bedroom mobile home. Other Hold final for: Final clearance O.K. for: NOTE: Health Specialist 8/92 Date PERMIT NO. P E M 2?3847-74B,°P�r.. MH UTIL. PERMIT NO. PERMIT EXPIRES QWNER Ralph Anderson CONTR. .j '�LOCATION (A.P.6- — ) ,y x n/side Fisher Garden Road appro a ti mile east of Cohassett Rd., o,assett I 7 ' r a t f t i' Temp. Power Pole Called PG&E Temp. Elec. Serv—;19. '^ i r; Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date) (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD ' BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor 1, S Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water i in Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Gara a Vents Water Htr. StemwaII 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 Framing 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 OR •- • O r* �- • 7:7 r J 1 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive OroviIIe, California 95965 Telephone: 534-4541 / APPLICATION AND PERMIT auurunce iupresentauves of the county of isutte to enter upon the above-mentioned property for inspection purposes. X le, Date Z gnature of Permitee or Agent Receipt No. 1223.' 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 F PUBLIC WORKS By DatX_-_ZZ— i V ilding permit expires Date ............................................ BUILDING Owner SQ. FT. OCC. BUILDING VALUATION D Mai I i ng Address Z, Cb e n C GV Tele hone No. 34 Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address Sl� PLUMBING No. @ FEE PERMIT FILING FEE $2.00 Jej ia 9, J2/ .�C Each Trap 1.50 �2all- ij Repair drainage or vent piping 1.50 Water piping 1.50 Ge 4d Each gas water heater or vent 1.50 A. P. No. �� .a (� – j Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe 4ri W. . S Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval Plans Approval Permit Fee $ $ NEW B ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 3Cd G t�vfr�� Z Main service incl. 1 meter 3 /��? Additional meters, each 1.00 Sub -panel (12 or less) more than �y Single Family tJ Duplex Mobil Home ❑ Others [I Range, ook-to r Oven 1.00 1,60 Water Heater or Space Heater 1.00 ?) Light fixtures 2. 20 bal%io ReJqe., swdZhes & fix lets CONTRACTORS LICENSE LAW 1 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 ptj Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump 11410 {ce! ( C,0 Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ ? %f WORKMEN'S COMPENSATION INSURANCE 1 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. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. YSJI 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. MECHANICAL No. @ FEE 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 2..7,*7.5 TOTAL PERMIT FEE $ auurunce iupresentauves of the county of isutte to enter upon the above-mentioned property for inspection purposes. X le, Date Z gnature of Permitee or Agent Receipt No. 1223.' 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 F PUBLIC WORKS By DatX_-_ZZ— i V ilding permit expires Date ............................................ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC S 7 County Center Drive Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT BUILDING Owner �,� Y SQ. FT. OCC. BUILDING VALUAT ON 7 Mailing Address I / Telephone No. If OF Contractor Mai I ing Address Building Address e„ 4 M elephone No. A. P. No. gr� Z- % Zoning & Planning F es 11�C. a n Fire Dept. Fire Zone Use Permit EQA I Parking Parcel Parcel M I 60' R/W I improvements Plans Dt3claration �p p Bldg. Plans Rek0d I Parcel `Approval I P6tffsApprovol NEW [2- ADDITION ❑ UTILITIES ❑ OTHER ❑ Single Family �& Duplex ❑ Mobil Home ❑ Others ❑ 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: License No. Classificat I am exempt from the Contractors License Laws of the State of California. 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. ❑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. I certify that 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 -mention property for inspection purposes. i � Y Date 2- / y ignatu/re of Permitee or Agent Receipt No. � /j©(� CJ . La2 /,<2�— White-D.P.W. — Yello 1� o 0nk-Inspector—Aq�e" can t Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional meters, each Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven Water Heater or Space Heater Light fixtures Receps., switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. lisp. or D.W. Air conditioner or heat pump Water pump Mobil Home Facilities Temp. Power Pole Misc. wiring $2.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 FEE -i,Z Permit Fee $ MECHANICAL No.1 @ PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee S FEE TOTAL PERMIT FEE 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 BLIC WORKS BY / 01Date �/�-7 Bu ing permit expires Date ..................7:. ................... 30, 0 55 55. fir'+' —•-� _ 1 S 4 8 1.-.5 1 p '6 •. 124, 9 O 31 2.03 3.43 A �. 9 W ac I O J3.47AC qj 1AC 4-3 A Ci 27 26 (I A i This `. _; . v. Gio i3Cd; but is \\'f. comp:' --d From AzCa shown by the public records Assessor's NOTE -ASSESSOR'S' PARCEL BLOCK Cc & . LOT NUMBERS - SHOWN 1N CIRCLES ./