HomeMy WebLinkAbout058-290-010[Snn58-29$ /00seenn & Anita Wolfson
°/S Dogwoo Lane, 8 mi.E.of Concow Rd.,
Concow Awa ,
Permit Y4836 77P,E(utg-,MH)
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= 2 058-290-010
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MISCELLANEOUS Demo -Fire
_ 58- .9 "
' ` /
DEMO PERMIT DUE TO BUTTE LIGH
4200 KAKINI RD
_ .P��473-78MHI '
mit �d I�
WOLFSON-OSEN, FAMILY TRUST
Iss ed — _2z
58 Q
- -2 -
MISCELLANEOUS Electric Panel
Glenn Os
NEW ELECTRIC SERVICE DUE TO Bi
SIS Yellowod�d., app.8/10 mi.E.of
4200KAK1N
woIRD
Concow Rd . , Concow-11WOLFSON-OSEN,
FAMILY TRUST
Permit IF1>111-11UB,:P,E>*ne: single
family)_
--�
58-29-10
rmi - 2005-81B (1st renewal/1807-
L4 SF -
58-29-10 4174-89P,.
0/SEN, Glen
4200 Kakina Rd, Oroville
(gas piping)
058-2 01-0649
OSEN, GLE
4200 KAKINI RD., C01qGQW (A , �)
CONTR: OWNER
SOLAR PANELS FOR ELEC
,---
058-29 - -01-1034
OSEN, GLE �--
4200 KAKINI RD. OR LLEy--0
CONT: OWNER
SOLAR PHOTO VOLTAIC SYSTE
0101
• i � �
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 4200 KAKINI RD
Owner:
Permit NO: B0$-1473
APN: 058-290-010
WOLFSON-OSEN, FAMILY TR
Issued Date: 07/29/2008 By GLB
Permit type: MISCELLANEOUS
4200 KAKINI ROAD
Subtype: Electric Panel
OROVILLE, CA 95965
Expiration Date: 07/29/2009
Description: NEW ELECTRIC SERVICE DUE TC
(530) 518-6317
Occupancy: Zoning: FR5 0
Contractor
Applicant:
Square Footage:
WOLFSON-OSEN, FAMILY T.
Building Garage RemdUAddn
4200 KAKINI ROAD
OROVILLE, CA 95965
Other Porch/Patio Total
(530)518-6317
FEE INFORMATION
DBE Single Phase Service-Resid $0.00
Total Charged: $0.00 Fees Paid: $0.00
Balance Due: $0.00 Receipt No:
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
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
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
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
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
X 07/29/2008
the applicant to a civil penalty of not more than five hundred dollars ($500];
Please check one of the following:
Contractors Signature Date
1I, 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
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier: Policy Number: Exp. Date:
(This section nee not be competed if the permit is or on7 hum rllars ($100) or ess.
DI AM EXEMPT under Section B. & P.C. for this reason:
RCERTIFY 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'
�_ 07/29/2008
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
ns.
X
Signature Date
�p
.Owners
l__6�X 07/29/2008
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
,Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
'injury, including death, and property damage caused arising out of, in any way connected with
HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION,
( 1
the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County -to enter the above mentioned property for inspection purposes. I hereby certify that I am the
,Propgrty owner or am authorized to act on the property owner's behalf.
CONSTRUCTION LENDING AGENCY
_
if2 07/29/2008
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for.
,Name of Permittee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
❑ Owner ❑ Contractor OR; Agent for Owner DAgent for Contractor
FILE COPY
Lenders Address City State Zip
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. (5R OR NO)
2! I (/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:
ADDRESS CITY
PHONE CONTRACTORS 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 CITY
PHONE CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: NEW ELECTRIC SERVICE DUE TO BUTTE LIGHTNING FIRE
Reference Number: B08-1473
Applicant Name: WOLFSON-OSEN, FAMILY TRUST
Owner's Name: WOLFSON-OSEN, FAMILY TRUST AP # : 058-290-010
Signature of Property Owner:_ z2--a"e_ Date: % ' 9 — D
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION*
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
Website: www.buttecounty.net/dds
PLEASE PRINT CLEARLY
( 477'�
PERMIT
NO.
BIN #
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
OWNER INFORMATION
Last Names ��
Address
First Na e
Mailing Address .Zo 0
�� �LI n •I Kd
City i ! I I _P
State
Zip 9 ctb
Phones D - S� b'-
1 Fax
E-mail a
CONTRACTOR
Name o b e
Address
City
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
_a
Address
Zip
City
Fax
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X �•Q-Qi•i
PROJECT LOCATION
AP# CJ _oZe7
Property Address O v -
City O' v ✓ / / /
e I
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than licensed contractors, a certificate of
worker's compensation must be shown at the 6me of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
&_Ly c, -5- seri/r'c— e -
Sq FT- Living Garage Open Cov
O Structure Built without Permits
O Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
Flood Zone
SRA
I Yes
I No
Occ.
Type Const.
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 4200 KAKINI RD
Owner:
Permit NO: B08-1472
APN: 058-290-010
WOLFSON-OSEN, FAMILY TR
Issued Date: 07/29/2008 By GLB
Permit type: MISCELLANEOUS
4200 KAKINI ROAD
Subtype: Demo -Fire
OROVILLE, CA 95965
Expiration Date: 07/29/2009
Description: DEMO PERMIT DUE TO BUTTE LI
(530) 518-6317
Occupancy: Zoning: FR5 0
Contractor
Applicant:
Square Footage:
WOLFSON-OSEN, FAMILY T.
Building Garage Remdl/Addn
4200 KAKINI ROAD
OROVILLE, CA 95965
Other Porch/Patio Total
(530)518-6317
FEE INFORMATION
Total Charged: $0.00 Fees Paid: $0.00
Balance Due: $0.00 Receipt No:
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
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
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
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
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
X 07/29/2008
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractors Signature Date
-11. 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
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier: Policy Number: Exp. Date:
(This action nee not be comp elect if the permit is or oneadollars ($100) or less.
❑ I AM EXEMPT under Section B. & P.C. for this reason:
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'
07/29/2008
---x'\
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
r
.Owner's Signature Date
provisions. \
07/29/2008
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
. ,e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. 1 agree to defend, indemnity, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property owner or am authorized to on the property owners behalf.
, 07/29/2008
CONSTRUCTION LENDING AGENCY
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name of Permittee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
MOwner 1:1 Contractor OR. Agent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATIONS
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION
Website: www.buttecounty.net/dds
PLEASE PRINT CLEARLY
PERMIT
NO.
BIN #
"When filed, this application and all supporting material becomes subject to the California Public Records Act All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
OWNER INFORMATION
Last Namep� s ��
Name o 6
First Na
AddressLfAddr✓s p 0
�� �C I ri
City i 1 I
Fax
state
Zip C(�O
Phone D _ S �_
t
Fax
E-mail Q to 5 6 "1
(0 hu- ra<' S
APPLICANT INFORMATION
CONTRACTOR
Name o 6
2
Address
Zap
City
Fax
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
_a
Address
Zap
City
Fax
State
Tip
Phone
Fax
E-mail
State license Number
APPLICANT INFORMATION
Name
Address
City
State
Zap
Phone
Fax
E-mail
APPLICANT SIGAIATURE
PROJECT LOCATION
AP# 5g,_act_ /D
Property Address O v led -
city 0/Z.C) ✓�l'/
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than licensed contractors, a certificate of
worker's compensation must be shown at the time of permit Issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR WORK.
F_ `• Pi
Sq FT- Living Garage Open Cov
O Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
Flood Zone
SRA
I Yes
I No
Occ.
Type Const.
Butte County Department of Development Services
TIM SNELL'INGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
n If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
G income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
/PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
6
1./"1 PERSONALLY PLAN To PRDVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. (YES OR
Z2 +IHA��F. (HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
\.. V
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME
ADDRESS CITY
PHONE CONTRACTORS 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 CITY
PHONE CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: DEMO PERMIT DUE TO BUTTE LIGHTNING FIRE
Reference Number: B08-1472
Applicant Name: WOLFSON-OSEN, FAMILY TRUST
Owner's Name: WOLFSON-OSEN, FAMILY TRUST AP # : 058-290-010
r
Signature of Property Owner: (�Q�_ Date:
.t
i
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058-290-010 01-1034
OSEN, GLENN
4200 KAKINI RD. OROVILLE
CONT: OWNER
SOLAR PHOTO VOLTAIC SYSTEM
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Driver • Oroville, California 95965 • Telephone (530) 538-754 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
eAA sen
TELEPHONE
SYY-'7)19
SO. FT. OCC. BUILDING VALUATION
. OWNERS MAILING ADDRESS L
vxoo
CONTRACTOR'S NAME ,p A
Ow^�/
TELEPHONE
CONTRACTORS !AILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAKING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS L�
Energy Plan Checking Fee $
$
PERMIT FEE $
LAT NO.
SUBDIVISIONSNAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
�
SF C3✓Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat um 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 ❑
,t�t'� /+
Describe Work: �f` z [ („�11-91-TI � )/ i Ydn—K
61,wl / /Y I e f
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
(Q20.00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 'o� oA v=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:
f 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.
❑ 1, as owner of the property, ` m 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:
❑ I 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.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in, any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation . provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X, Date S ` 7 1 _
Signature of Applicant - ACOwner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
41
Main Service 200A TO 1000A
46.00
NEW CONST. 07UNG OCCUP. SO
OR ADDNS. ( 073.5QFT.
ACC. S.
CiITLET
�, @7,50
R ID BRANCH
POWER APPARATUS
a sINGL E OUTLET cIR.
O 1'50
Ex. Occup. OUTLET OR FIXTURES aAL @ .w
FIXED
Ex. Occup.oirr rs Rp.) F_
5.00
Temporary Service 23.00
Mobile Home Facilities
20.00
Misc. Wiring 23.00 ;23,4W
-
PERMIT FEE $t
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEI: $
Mobile Home Installation Fee. $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ `T
HAZ.
p. FEES IMP
FLOOD-
CDF
PARCEL Po
HD
ISSUE
This permit is ereby issued under the applicable provisions
of the Butte unty Code and/or Resolutions to do work
indicated ab a for which fees have been paid.
01
K ��
By - Date
3 �/
PERMIT EXPIRES ON ] 71 00
ate
Receipt No. S 3, S . �' -
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 PERMIT NO.
(Rev. 12/96) G APPLICATION AND PERMIT
J -/03y
ASSESSORPARCEL NUMBER.59 — All P/�®
ZONING
BUILDING PERMIT
OWNERTELEPHONE
_AA sen
,S34�-777
SO. FT. OCC. BUILDING VALUATION
. OWNERS MAILING ADDRESS
Z.UV a lv i _ o
CONTRACTOR'S NAME
a'-//) ev-
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS /J(^� �f
�
Energy Plan Checking Fee $
$
PERMIT FEE S
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
USEOFSTRUCTURE
/
SF Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
Solar or heat um water heater 23.00
Water piping 15.00
Each as water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Re/model ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work:` / l /(.(- fiL "`�7/12
� / -77 I
�yL
Gas piping system 1 - 5 outlets 15.00
-Building sewer 15.00
Mobile Home S G W Q20.00
—4—
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
Main Service 2o0A OR LESS 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
hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
i?f 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.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person In any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.This
X ��_ �jQ�—L� Date ` 7 " C2 I
Signature of Applicant - 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. SO
OR ADONS. ( a ACC_ Bios. 3.5¢FT:
I.OLm.ET @7,50
NOµREOSIo MULT.
POWGERLEUAPPARATUS
a SIN OTLET CIR.
ourLEroRPoctuREs 20 @'.0°
Ex. Occu SAL o .50
FIX1
Ex . Occup.OUTLErs(RESID °EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00 oG
PERMIT FEE S
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEI: $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
HAz.
D. PEES
IMP
PLooD
CDF
PARCEL
PD
HD
IS UE
permit i ereby issued under the applicable provisions
of the B e unty Code and/or Resolutions to do work
indicate ab a for which fees ve been paid.
r
By- Date/
PERMIT EXPIRES OW1 7 (/
Date
ReceiptNo. 3
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
NOTES
RESIDENTIAL
058-290-010 r �01-..0649
,OLSEN, GLENN
;4200 KAKINI RD. OROVILLE
CONT: JNK .
INSTALL SOLAR- RACKS
- o
oe
11 SPECIAL CONDITIONS 11
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date)/,//vA/
Signature
CHECKED
BY
✓ = OK
0 = Not OK
- = Not Applicable MOBILE HOMES
= Not Ready
Date MOBILE HOME UTILITIES (Plans) OK except Ws
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-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap; -/ /" L'ft.
/
/'Nat. or / /"L"ft./ PLPG
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 ti's
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
12.
Permanent Foundation Only: License Decal
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 t1'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.-Con nectors
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
FINAL (Plans) OK except q's
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Panelboards-Ins. to Main in Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
./= OK
0 = Not OK
- = Not Applicable
= Not Ready
FRAMING (Continued)
RESIDENTIAL (E
Date
47.
Underfloor (Plans) OK except #'s
48.
1.
Zoning -Setbacks -Easements -Flood -Slope
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
51.
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
Property Line Firewall & Openings
4.
Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
54.
5.
Stemwalls, Main; Ste el- Blockouts-Wrapped
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
57.
6a.
Hold Downs and Special Anchors
Glazing Area -Glass Protection -Skylights -Plastic
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftg.-Steel
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10.
UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11.
Water Pipe; Test -Anchors -Regulator -Service Test
Date
12.
Electric Underground
Date
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
Date
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
Comments at Final:
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 -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
23.
Fixture & Transformer Clearance -Ins. Protection
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
25.
Size Boxes & No. of Conductors Stapled
26.
Romex Installed Close to Edge of Studs & C.J.
27.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral O Yes ❑ No
31.
Service -Riser Conductors & Ground Main Disconnect
32.
Equip. Clearances Panels-Motors-Mech. Equip.
33.
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
35.
A.C. Ducts Insulation & Support
36.
Vent Fan, Exhaust above insulation
37.
Condensate Drain & Overflow, Size & Grade
38.
Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet
39.
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
40.
Sills Proper Materials & Anchors
41.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
42.
Bearing Walls over Girders & Floor Nailing
43.
Draft Stop in Walls (rat proof)
44.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45.
Headers & Beams -Size & Bearing
►ingle & Duplex)
Date
FRAMING (Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting. -Rfng.
48.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58.
Glazing Area -Glass Protection -Skylights -Plastic
59.
Shear Walls; Nailing -Bolts
60.
Brace Interior/Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
I nfiltration-Walls-W ihdows
84.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext. Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
66.
Bedroom Exiting
67.
G.F.I. & Bath Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70. Fireplace or Stove, Clearance -Hearth
71. Elec. Outlets at Wood Panel, Int. & Ext.
72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance
73. Elec. Outlets & Receptacles at Kit. Counter
74. Garage Fire Door; Swing -Landing -Closure
75. A.C. Duct in Garage -Damper
76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
77. Plb., Elec. & Mech. Equip. Listed for Location
78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
79. Insulation -Foam -Looked in Attic
80. Guard Rails & Deck Construction -Post Caps
81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor I] Yes
82.
Following Insild./Drive J Yes J No/Walks J Yes J No/Planters J Yes J No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical -Plumbing
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throughout House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92.
Water & Sewer Connected -C/O to Grade -HD Approval
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
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:
"COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
.. .L ... .-- -.N to l - 0 h�
(Rev. 12/96) APPLICATION AND PERMIT y
ASSESSOR PARCEL NUMBER
058-290-010
ZONING
BUILDING PERMIT
OWNERGLENN O SEN - _ _
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
. -
RD., CONCOW 95965
000.00
EST ,OWIMWpXMI
CONTRACTORSNAME
TELEPHONE
CONTRACTORS MAIUNG ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 1,000.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
25.00
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee $
23.00
BUILDING ADDRESS
42-00 KAKIN! •, CONGOW
Energy Plan Checking Fee $
$
PERMIT FEE $
68.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF,* Duplex ❑ Mobilehome ❑ Other
sPECIFv
Each Trap7.00
Solar or heat um water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Ublities W Installation ❑ Other ❑
Describe Work: PLACING SOLAR RACKS ON ROOF FOR --
FUTURE ELECTRIC (solar)
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
-Mobile Home. fS 17G.1 -Mf-
020.00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service noon oR LE:s
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:
'Ir 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.)
Ar I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X ^ .r- Dete _ - U
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Main Service s TO 46.00
NEW CONST. DWEWNG OCCUP. SO
EL Or-0000AUP.
OR ADDNS. ( 8 ACC. S.3.50Fr.
µR610 =LT 1. @7,50
POWER APPARATUS
a sINOLF oLmtT cIR.
.00
EX. Occup. OUTLET OR FIXTURES BAL @ 1. 0
Ex. Occup. OUT Tg R� D) E 5.00
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 $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 68.00
HAZ.
I D. FEES IMP
I FLOOD
CDF
PARCEL
PD
HD
UE
This permit is hereby Issued under the applicable provisions
of the Butte my Fode and/or Resolutions to do work
indicate b r Which fees have been paid.
By Dat4,3 0
PERMIT EXPIRES O
8fe
—
Receipt No.
._.5.1
WHITE-D.D.S.-B.D. CANARY -ASSESS PINK -IN CTOR GOLDENROD -APPLICANT
%owum s z vr- aw s vim ucm si mcn 1 Vr utvtLvrmr r OCrtvlt:ta I:%UILU1NG DIVISION
7 County Center Drive a Oroviller California 95965 a Telephone (530) 538-7541 PERMIT No
Rev.,2/'28i• , ~ APPLICATION AND. PERMIT - r3!-r,C,tie'•
76"' L� D— D mma 'BUILDING PERMIT
°iMN"
�7 9
S OCC. BUILDI
DATION
oorrtrNcroa� wv<ero .corers
--------------
OOrAtaucnorr uooa
moors mmume rooms
—Fireplace
Total Valuation =
APIC"" cT oa orooaot
Wong "o'
Filina Fee
S
20.00
wrcrea.T OR orarroa7 wows aooresa
Permit Fee
i
Plan Checking Fee
S
eJa0NOA0W411"
Energy Plan Checking Fee
i
i
S
PERMIT FEE
S
"O su0mmm Pom
rMca MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
Each Trap7.00
Solar or heat um water heater
29.00
SF O Duplex O Mobilehome O Other
Water piping
15.00
arecr
Each gas water heater or vent
15.00
TYPE OF WORK
Gar piping system 1 -5 outlets
15.00
New O Addition O R el O UtiLtlei O Installation O Other O
Building sewer
15.00
Des ibe Work:
Mobile Home ISIGIWI
020.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
Main ServicesT
29.00
Main Service 20" TO seem
44.00
co►a . owrusq occur.
a
aoo . a .ce. sws.
SOLw
9.50T.
NOWMo. ' rruuwun eT
Q7.50
rowEA ANMATIA
a o aR
Ex. Occup. ounLT om r man 1
200 1.00
SAL .2e
no"°►"n
Mow.Ex. Occup. a
5.00
Temporary Service
29.00
Mobile Home Facilities
20.00
IAsc. Wirin
29.00
PERMIT FEE
S
*PERMIT FEE PAID✓
MECHANICAL PERMIT
Filing Fee 20.00
Heating
SRA ' '
$
Coolie
SHERIFF
Hood
8.50
Ventilation
OTHER
PERMIT FELE
S
Mobile Home Installation Fee
$
Energy Inspection Fee
S
Q'
«c c'NN`T'rr` TOTAL FEE
$
/
AMOUNT RECEIVED
0
wiz o. neer wr rwoo eon
rMca ro " aut
*RECEIPT NUMBER
* TO BE PVT INTO
�a
`7 0
g
This permit Is hereby Issued under the applicable provisions
Of the Butte County Code and/or Resolutions to do work
Indicated above for which fees have been paid.
By Date
PERMIT EXPIRES ON
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.
I personally plan to provide the major labor and materials for construction of the
proposed property improvement: YES[M NO[ ].
0"HAVE[ ,V, j 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:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person` to
coordinate, supervise, and provide the major work:
NAME:
ADDRESS: —CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following -persons to
provide the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
DATE:
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health`and Safety Code.
This verification must be completed and returned to our office before
we are permitted to issue the permit.
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified. 1.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are personally
performing their own work. If your work is being performed by someone other than yourself, you may protect
yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put'their license number on all permits
for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you.
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and other costs) is 5300 or more for the entire project, and such persons. are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
-'a
0 There may be financial risks'for-you if you do not carry out these obtiptions,Wand.these risks are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your
obligations under State Law, contact the Department of Benefit Payments and the Division'of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees, without a licensed contractor or subcontractor, only
under limited conditions.
A. frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
building permit, erroneously implying that the property owner is providing his or her own labor and material.
personally. Building permits are not required to be signed by property owners unless they are performing their octan
work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm.
that you are aware of these matters. The building permit will not be issued until the verification is returned .
t
y,
m4fael C. Vi ira, C.B.O.
Madager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
c�
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XAAA12�r
ech
Verticaffechnology
Engineering
3650 Morrow Lane, Chico, CA 95928
Ph. (530) 899-8716 Fax (530) 899-0688
Email MDHPE@cs.com
Structural Calculations
Client: Glen Osen
Project: Solar Panel Support
Location: 4200 Kakini Road
ovtlfcssio
D.
PI
va-
ApP
of c�►uF°P
Attention: This engineer is not responsible for on site inspection to assure compliance with the
standards, sizes, materials, or workmanship specified herein. This engineer is not responsible for any
structural element or system not specifically noted in this set of specifications unless authorized in
writing by this engineer. Workmanship is to be of the highest quality and in all cases follow accepted
construction practice, the latest edition of the Unform Building Code, and local building department
standards.
PA RJ E Cl -
ENGINEER
DESIGN OF S:t
VERTECH ENGINEERING
PAGE
DATE
LL (Zoc)�' --
1997 UBC Wind Loads
VerTech Engineering
Project: Osen Solar Panel Frame Date: 3/21/2001
Comments:
Wind Speed: 75 mph
Importance:
1
Exposure: B
0One Story or Partially Enclosed Multi-StoryStructure
Primary Frame
Elevation
Elevation
Elevation
Method A
Is
25
38
Windward Wall
..... ... ..
. .
7.2
8.3
9.3
.................................................................................-4.5
Leeward
...........................................................................................................................................................................................
.... . ..
. . ..........................
-5.2 ........................
. . ............
.... . ..
-5.8
Roof
Leeward or Flat Roof
-6.3
-7.3
-8.1
Windward Roof
Slope<2:12
-6.3
-7.3
-8.1
2:12 .....
-8.1
3""l3.5
4T�..i ...................................................................................
0
. ..........................................................................................................
Y.6 ..........................
:
Z� .........................
4..6 .............
:
>12:12
................................................................
6.3
7.3
................
8.1
Windra H e I to Ridge
.Parallel
...
..W�i4
6 3
-7.3
-8.1
o d B ................................................ : ............................................................................................................................
On Vertical Projected Area
Structure <=.40'.Hiq.q
... ...... .... ...... =.......'
.�§i.
11.7
13.5
15.0
Structure re 0
........................>4 ...........
1 2 6
......
1 4 6
1 6 2
..........................................................................................................................................................
On Horizontal Projected Area
....... .. .. Projected
..Elements .
. -6.3
-7.3
-8.1
. .. .. ...... ... .
. . . .. and .. Components . . . .. not ... i . n ... areas . . ..
.. ................. .. .... .. .. . ........
.. . ... .. .. .. .. . .. .. ....
. . . . . . . . . . ............................................................
o . f .. discontinuity
Wall Elements
Allstructures
.. .. .. .... .. ..
10.8
12.5
13.9
.. ..
Enclosed and U n e*n*cI'***
................................................. ; osedS*tru`ctu`r*es
......................................................................................................................................................
Partially Enclosed
............................................................................................
-14.3
-16.7
-18.5
Parapet Walls
fi. .7 ...... 11.7 .. .. ......-13.5
. .. .. .... . .... ..
. 1 . 3 . .5 ...... 13.5 . . ......-15.0
.. ....
. 1 .. 5. . 0 ...... 15.0
RoofElemenis"************* ..... : .................................................................................................................................
Enclosed and Unenclosed Structures
-*
-11.7
-13.5
-15.0
*-
.7:12 toi1.TY
....
:i************'***"*""***********........
..............OiiiiififfncIose�
�!�p.�.<2:112
-15.2
-17.7
-19.7
2:12 to 7:12
6..i.i T� ......................................................................-15.2
>7:12 . .
......... .. . ..
..Elements
.e .
.. .. ..
. 1 .. 5 . 2 ...... 15.2 . ........
. .. .. ... . .... ..
1 7 . .7 ....... 17.7 . . ......-19.7
.. ....
. I .. 9 . 7 ...... 19.7
......... ... .. .... .. ................. ... .. . .. .. .. ..... ... .. .. ........ .. .. .....
. . . . . . . .....................................................................
ffiem n t s .. and .. Components . . . . .. i . n .. areas . . . . .. of . discontinuity
Wall Corners
.....;.............
-13.5 10.8
-15.6 12.5
-17.4 13.9
...................................................................................................................................................................
or ridges without overhangs
...40�ftavesrakes
-20.6
-24.0
-26.6
2:12 to7:1'2"* ... ....... * ......
.....-23..3.....
.....
2*7*.,l,,* ...
......
................................................................................
>7:2 :1
.................................................................................
3.......................
-
Tdj ......................
....................
-18.5
...................
Slope <212 at overhangs, canopies
.............................................................................................................................................................................................
-25.1
....................................
-29.2
-32.4
OSj
PrNOJE6T VERTECH ENGINEERING PAGE -3
ENGINEER ri
D
DESIGN OF
2-
4ri-i
t
-T^, 1,s`21-% ct<JtoA:,l
m
PROJECT
ENGINEER
DESIGN OF
-, VERTECH ENGINEERING
c�iPq D L V) 0
PAG E
DATE
AtjPROJECT 0
VERTECH
ENGINEERING
PAGE
ENGINEER.,,!!j�
DATE
DESIGN OF
0
A/
NJ
2
1 -F6 I
.4- 96 Al- VNI Zc
-F-,, )<2e. a 33"C -'r.'
A4'�-' Ale
3A
Lag Screws Design Values
VerTech Engineering
Wood -Metal Conn (min controls)
Eq 9.3-1
87 lbs
Eq 9.3-2
116 lbs
Eq 9.3-3
165 lbs
Shank Diam
3/16 in
thickness of metal
0.0516 in
Fern
5600 psi
Fes
36000 psi
Fyb
70000 psi
KO=
1 k=
12.88 Re=
Theta Max, Angle
of load to grain
Fern par
5600 psi
Fe prp
FeO
5600
0.16
0 deg
5500 psi
61
PROJECT ' ns VERTECHENGINEERING'
ENGINEER
DESIGN OF 4;%Q(V,.r
PAGE
DATE
011
PROJECT
ENGINEER
DESIGN OF
VERTECH ENGINEERING
y
V,,,
PAGE S�
DATE
6-
`n
.6�_sj
-`x(33)
58-29-10 4174-89P,
OLSEN, Glen
4200 Kakina Rd, Oroville
(gas piping)
�y
/ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, iialifornia 95965 - Telephone: 916/538-7541 , /_. ,001?.—"
APPLICATION 'AAND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
r BUILDING .PERMIT
OWNER
ELErPHJ�
n
S:
SO. FT. OCC. BUILDING VALUATION
OW!!� 'S MAILIN ADDRESS
4 {C A
C TRACT R'S NAME
TELEPHONE
C NTRACTO 'S MAILING ADDRESS
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 F_
Penalty
$
BUILDING ADDRESS
�p /c Qlc y ,�b
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
t
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE j
SF S �i-Pyy1%(�
[IDuplex❑ Mobilehome❑ Other SPECIFY ;
Gas piping system 1 - 5 outlets
5.00 -�
Building sewer
5.00
Mobile Home S G W I
10-00ea
TYPE OF WORK f
New Addition [I Remode9l Utilities❑ Instaalllla�tion❑ ',Other ❑
Describe work: P C4!E�� S V % �`a' `' 1 _
CS6-cr—
AA V 2[G cV3
lei -"'r /UV'�
Permit Fee
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
I
Main service e00V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW I
I
I declare under penalty of perjury (check one):
'
❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the ,Business
and Professions Code and my license is in full force and effect.
License No. Classification
[� I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.&
OR ADDNS. ( ACC. BLDGS.
, /20sq It
NEW CONSTR. ULTI.OUTLET
NON.RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS 6
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
2ALO 30
eAL930
Ex. Occup. OUED PR
TLETS (RESID.)EA.)
1 2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ 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
FiIingFee 10.00
Heating
Cooling
Hood
3.00
Ventilation.
permit Fee
$
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence the granting of this permit.
X� �.Z.
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�st�oriiees�in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
HAz
I CUA I
PARK
I SCHL
I FLo
I PAR
PD
HD
',SSU
This permit is hereby issued under
of the Butte County. Code and/or
work indicated o�,or which fees
1 CTOR�OF PUBLIC
—
B
ERMIT EXPIRES Date_
the applicable
provi-sions
resolutions to do
have been paid.
WORKS
/}
DatgZ ���'7
12-
Receipt No.
WHITE-D.P.W.. YELLOW-ASeE350R, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE,- PfEP�ARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California.95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
rELEPHIlNE
SO. FT. OCC. BUILDING VALUAtION
01ryMAI L'< ADDRESS
L
C TRA T R'S NAME
TELEPHONE
TOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
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
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 I
SF [IDuplex❑ Mobilehome❑ Other �.S 4 -+ G
SPECIFY G
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00e
TYPE OF WORK
Newk Addition❑ Remodel Utilities[:] Installation❑ Other❑
Describe work: ��� _
neLw�&c- MNAC-
10 o—
Permit Fee
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP OR1 OR LESS10.00
Main service EA. ADD'L too AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
F -1I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.k
OR ADONS. ( ACC. BLDGS.
, h¢sgft
NEW CONSTR. ULT' -OUTLET
NON.RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20®600
eALO 30
Ex. Occup. our OUTLETS PR
IRESID )EA.1
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. �yirin 9
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
f Consent to Self -Insure.
L[J ' shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation.
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 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 ronsequence a qEanting of this permit.
X M����
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
on of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
�_ J
TOTAL FEE $ 4
HAz
I CUA I
PARK
I SCHL
I FLD
PAR
PD
HD
ISSU
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated ove f r which fees
CT F PUBLIC
B
ERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
-Q,
Dat V
, 1
Receipt No. 646W 6
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DepsA?iJnen't of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538_7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has' been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (des or no) S
2. I (have/have not) v e signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted.(hired) the following
persons to provide the work indicated:
Name Address . Phone Type of Work
Signed:
Property Owner
Social Security Number
Date / �_ - 1 2 — 5—;'(
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831.and
19832 of the California Health and Safety Code.
This verification must be completed and.returned to our office before we are per-
mitted to issue the permit.
PERMIT N0. 483.6-%7P,E
PERMIT EXPIRES
OWNER Glenn 0�se�n & Anita Wolfson
CONTR. owner
LOCATION (A.P. 58-29-6
S/S Dogwood Lane,8 mi. E.of Concow Rd., Concow
Area
P-jgj'� rumd,tom--
f.ee.�te�- �-,, ,Q-�..,
,w� m...
•n .
t
.J. V
S"
Temp. Power Pole
Called PG&E
Temp. Elea Serv. cnn1
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED
• (Date)
(Signature)
k
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RtCORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Sidinq
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for phsically
handica pe.1
Conformance of ex.
structure
Appliances
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rou h
Relnf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
r-raming
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
MOBILEHOME UTILITIES ------------------
Elec. Service /
Elec. Pedestal
Water Piping - `
Sewer I — 0-
Gas Piping
E ftLLU§1&L&1M ....... . . . . . .
Water Piping _ ft_)
Support -:7- --!1
Drainage 2_ F�
Elec. Continuity
Gas Piping
DATE REMARKS OR`CORRECT O_N_S
I � ,� �% � ®,�-- ��. �. �..f - � �. , i.�;,,,v�,,G� �'11t,6�r� o,,,,,,w�;a'L � �O�C,�v-. c�0-•�L ..�
6-6 UJJ jm)
/,-7
4�
(NOTE: An entry must be made on this form each time you visit the job site.)
4
i COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS
�'County:Center Drive — Oroville, California 95965
telephone: 534-4541
APPLICATION AND PERMIT
—"I-- Iv1JI000IIIaUVCJ UI LIIC I,UUIILY UI DULIC LU CIILUi Uf1U11 LFIU
above-mentioned property for inspection purposes.
X �2, 9.... Date 2 ' / � _7q
Signature of Permitee or Agent
Receipt No. 1 (0(/b?E,--�
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 O BLIC WORKS
By Date 7-- 7-- 7,
alding permit expires Date zlL 7
BUILDING
Owner G 0-sQ/VSO.
FT. OCC. BUILDING V
Mailing Address
I
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee $
Building Address 8JPM C&APLUMBING
No. @ FEE
PERMIT FILING FEE $3.00
r
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. — ---
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
W.
ire Dept. Fire Zone
Use Permit
Building sewer 5.00
ECA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im provements
Lawn sprinkler system 2.00
F_
Parcel royal
Planspproval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE J$3.00
1 , —
V OR
Main service 100 AMP ORSS 5.00
Main service EA. ADD -L 100 AMP 2.50
Main service OVER s 25.00
100 AMP O OR LESS
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service EA. ADD -L 100 AMP 1.00
NEW OR ADDNST ( DACCLCCUP. &
BLDGS.) 22sgft
NEW CONSTR. MULTI.OUTLET
NON.RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &
NON•RESID. (SINGLE OUTLET CIR.
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:
Ex. Occup(OUTLETS OR FIXTURES)50 @25¢
BAL01
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
.
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of Cali fomia.
Permit Fee $
$
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.
❑1 have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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
t1r.30
.&T
TOTAL PERMIT FEE
$ 3Q
—"I-- Iv1JI000IIIaUVCJ UI LIIC I,UUIILY UI DULIC LU CIILUi Uf1U11 LFIU
above-mentioned property for inspection purposes.
X �2, 9.... Date 2 ' / � _7q
Signature of Permitee or Agent
Receipt No. 1 (0(/b?E,--�
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 O BLIC WORKS
By Date 7-- 7-- 7,
alding permit expires Date zlL 7
► COUNTY OF BUTTE = DEPARTMENT OF PUBLIC WORKS '�`�
7 County Center Drive — OroviIle, California 95965
Tel ephonh: 534-4541 ;✓'/
APPLICATION AND PERMIT
X _ - �.,o�.� Date % ' / ' 7 7
Signature of Permitee or Agent
Receipt No. E7n?DAG
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the butte county Lode and/or resolutions to do work indicated
above for which fees have been paid.
DIRE ROF P BLIC WORKS
BY Date
g permit expires Date ���/�
BUILDING
OwnerPIN
SQ. FT. OCC. BUILDING VALUATION
Mailing Address 1
Telephone No.
Fireplace
Contractor Vi,�
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Addres
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
s S
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50 ,
A. P. No.
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F s
J
vlw C.
gaaii+eA
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parkin
Plans�
Declare ion
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
B1der-PialP
Parcel Approval
Plans Approval
Permit Fee $ , a
(
NEWADDITION
❑ ❑ UTILITIES OTHER �
ELECTRICAL No. @ FEE
PERMIT FILING FEE J$3.00
'Vt 4t
Add I 1_�X 1 N4 me_4-Z_ 3 4,3L
Main service 1111 OR
100 AMP ORLESS5.00
Main service EA. AOD•L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
OVER 600V
Main service 1100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONST.DWELLING OCP. &
OR AODNS. ( CU
ACC. BLDGS. ) 2¢sgft
NEW CONSTR. MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS)2.50ea
NEW CONSTR. (POSINWER APPARATUS &
NON-RESID. GLE OUTLET CIR.
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:
Ex. Occup(OUTLETS OR FIXTURES)@L29¢
BAL�1
Ex. Occup.( IFIXEI
OUTLETS P(RESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
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.
❑'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 em
P to an employ y 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 $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
n')
above-Er111 tlr1 P.r1 mmnPrty fnr incncr•tinn nu c ec
mn
TOTAL PERMIT FEE
$ �C
This permit is hereby issued under the applicable provisions
of
X _ - �.,o�.� Date % ' / ' 7 7
Signature of Permitee or Agent
Receipt No. E7n?DAG
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the butte county Lode and/or resolutions to do work indicated
above for which fees have been paid.
DIRE ROF P BLIC WORKS
BY Date
g permit expires Date ���/�
. f f
f,} MOBILEHOME.SUPPORT DATA
Mobilehome Mfr. v Setup Model No. Year
i 7 f 3 'rc.7., o
Width .(f t.) Length 4'0 (ft.) Expando Size ft.x ft.
(Draw support details below)
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
Center
Support
Locations
(ft.; in.
(ft) (in)
I——
-
f E.* in.
*If center piers are.other than drawn above,
draw in locations,.spacing-, and dimensions.
6 0
�FFootings (check one)
/ 7/ 1. Wood either
pressure treated or
fdn. grade,
2. Concrete pad.
3. Other, specify'
Supports (check one)
T77'1'. Concrete block
2. Concrete piers
3. Steel piers
4. Other, specify
Typical Support
P x 3 Footing Size
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
i
i
QMax. Pier
Spacing
j Max.
l Overhang
f ft:3j.�iri.)
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS '
7 County Center Drive, Oroville, CA.
PHONE: -,534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's name: '61e,,
2. Installer's name: s,, U,,, p, +
3. Is the site currently under permit? Yes No
(If yes, furnish permit number 4� S3 OR
Is the site an existing site? Yes / / No
(If yes, furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5 ft_, away from septic'tank and leach fields and
clear of'all setbacks and easements? Yes No
(If no, clarify )
�. What is the mobilehome electrical rating? ----------------------- 3 4 Amps
;6. What is the mobilehome site service rating? -----------------"---- z U o Amps
7. What is the mobilehome site circuit breaker rating? ------------- B 4 Amps
8.
Is there any other electric load to be
served by the mobilehome
`
site
service? ---------------------------------------------------
Yes /L
No
(If yes, identify the load and size: i;, arier r^ A (Load)
2
r
0 (Amps)
9.
What
is the mobilehome site gas pipe size? ----------------------
(in.
10.
What
is the type of gas service? ------------------------------
Natural
/ /
LPG /
11.
What
is the gas pipe length from meter
or tank to,the mobile ome?
Z"y-
(ft.)
12.
What
is the mobilehome gas demand? -,-----------------------
-----
(BTU
(This information not required if
pipe length less t n 6 ft. on natural
gas
11"
or less .than ,50 .,ft. on LPG.)
Z+ COUNTY OF BUTTE - . DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
Telephone: 534-4541 /
APPLICATION AND PERMIT >/
✓
BUILDING
Owner �p F9 (� S®,
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
a
Telephone No.
39
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee
Building AddressPLUMBING
1
No. @ FEE
PERMIT FILING FEE $3.00
D D p °
Each Trap 1.50
Repair drainage or vent piping 1.50
Zoning Verifiicafion Only
Water piping1.50
Each gas water heater or vent 1.50
A. P. No. - --
nZa �, '
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
S t ion
FireDept.
Fire Zone
Use Permit
Building sewer 5.00 R(�Q
EQA
Parking Parcel
Plans Declaration
Parcel Ma
60' R/W
lm rov ents
P
Lawn sprinkler system 2.00
Bldg. ns Rec'd
Parce r Approval
Plan pp royal
Permit Fee $ A 3i0
$ 7&7a73
NEW ADDITIONELECTRICAL
❑ UTILITIES OTHER ❑
No. @ FEE
PERMIT FILING FEE $3.00. 00
Main service 10000 AMP V OR ORSLESS 5.00 S160
_
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service 1100EAMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NE W
OR ADDNS. CONST. ( DWEACCLBLDGS.LING CCUP. &) 2¢sgft
NEW CONSTR. MULTI -OUTLET
NON-RE51D. BRANCH CIRCUITS) 2.50ea
NEW CON5TR (POWER APPARATUS &
NON -RESID. SINGLE OUTLET CIR.
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:
3
Ex. Occup(OUTLETS OR FIXTURES)@�
BAL@1
FIXED APLNS.
Ex. Occup. ( OUTLETS P(RESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of Cali fomia.
Permit Fee $ r
$
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.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
—th—iec ren.e�.,...�.:...... -1.1 —_.._1.. -. .-... •- --- ..
TOTAL PERMI FEE
$ Z
above-mentioned property for inspection purposes.
X /lit. Date / - /� ' 7
Signature of Permiittee or Agent
Receipt No. ' ` 0
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
Inis 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.
DIRECTOC-O"IF PUBLIC WORKS
ByDate %- 3;--'L
B ding permit expires Date 7 -7�- -7
NOTE:=AII Materials & Workmanship Shall Be in
Accordance with Recognized Good Practices and
of -a quality prescribed for the Specified use in the
Ur;fform Building, Plumbing & Mechanical Codes and
the National Electrical Code.
A
M
NI
-(-i %, y3
Pf �
6 Ae A A Ose A
,h is . S
This set of plans and specifications MUST br_
kepi on the job at all times and it is unlaw-54 '<=
make any changes or alterations an same witlac,: r
wriMen permission from the Department of r'ub-
lic Works, County of Butte.
MR
The VA. Setback shall be 5 ft. from the
side property line and 50 ft. from the
centerline of the road. permitting a maxi-
mum of a 2 ft. eave overhang but entirely
out of all easements.
F rMs7;�& 4X36— 7'
All utility conn%ctions shall be
1'10crfed within 4 ft, outside the rear
t'*d section of the mobile .home
on the left (road) side of the mobile
home.
s.F I F t4j,
Septic systemand lo
tcc-Hon afi�}d,
Butte + to be as per
County.. Health De
quirements. ft• Re -
6UT_TE COUNTY
BUILDING DEPARTMENI
APPROVED
PERMIT NO. 1807-80.B P,E,,M
PERMIT EXPIRES CCJ KJ /J
Glenn Osen
OWNER
CONTR. iga owner
58-29-8
LOCATION (A.P.
S/S Yellow Wood Rd.., app.8/10 mi.E.of Concow
Rd., Concow
OUVO
v44
aAlf'
All
'41
Yt
Temp. Power Pole
Called PG&E
Temp. E I e c. S e r v.
Called PG&E -.4
Temp. Gas Serv.
Called PG$
JOB
FINALE
v(Date)
(Signature)
t
!ZZ
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILD G INSPECTIRECORD
-
Permanent
BUILDING
BUILDING (Cont'd)
PLUMBING
f
Setback
Q
Firewall �� - (- '-ar2 left,
Soil Piping
Water Piping
Forms
Gas Piping
Parapets
1st Floor
Support
Main Bldg.
P
Restroom Finish
2nd Floor
Gas Piping
Footings
DATE
Windows
3rd Floor
V
Stem II
Siding
To out
Sla
%
Roof Sheathing 3—
Water Pining/
Piers
/ — %S
Roofing
Sewer
Garage
Fdn. Vents
Fixtures I - ZCAI—
)
Footings
Footin s
StemwaII
Garage Vents
Insulation
Water Htr.
Heaters
.Slab
Carport
Footings
Prov. for ph sically
handica ed
Conformance of ex.
structure
Appliances
Gas Piping & Test
Temp. Gas
\\\
Slab
Final tL 1 !-
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rou h -
Reinf. Steel
15
Final " I - 82,
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing-
Q-
Test
Water Htr.
Stucco
I
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault
Scratch
Heating
Service
U
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
f
MOBILEHOME UTILITIES ------------------
Elec_ Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
MOBILEHOME INSTALLATION - - - - - -- - - - - - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE
REMARKS OR CORRECTIONS
V
071�-o WdA
`-�
PAW(N try must be m de on this foLeach time you visit the job si
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS
AT Z U O k -H h"A I /Q,/ or .2 V, //e G a
(location)
BUILDING PERMIT NO. I qO 7 q O Ai P. NO. S g - Z q - lo
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED..PLANS:
(Check each item or write N/A if not applicable)
INSULATION: GLAZING:
Slab Edge /i �r �o���,� Single Glazed
Fdn. Walls fllf— Special (Insulated)
Floors - /I/ but/cCERT. & LABELED WDS.
Walls R,lq & SLIDING DRS. C'ctraa/e-v
Ceiling/Roof 39 WEATHERSTRIPPED DRS.
Ducts Jv /q BACK DAMPERED FANS y e$
Circulating Pipes z d µ Fvn .INTERMITTENT IGNITION DEVICES s'
APPROVED HEATER CERT. APPLIANCES v es
APPROVED WTR.HT . e AA/
I DECLARE•THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS -CERTIFICATE AS SUBMITTED.
Insulation Applicator Name G l e h, O Seo
Signature of
(please print)
QQ ��
Insulation Applicator �sZ.(%�_. 0•--j2^---
State Contractors
License No. _
General Contractor/Owner Name G % e A , �)S e ^
Signature of (please print)
General Contractor/Owner Date
State Contractors
License No. /-)_ G( _
THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
Check List
❑ Permit
❑ Underfloor Stage
❑ D.W.V.:. (1) Sizing. (2) Materials. (3) Fittings. (4) Grade & Support.
(5) Cleanouts & Accessibility. (6) Clearances. (7) Rough -in Locations..
❑* (8) Wrapping. (9) Test - including "Ts". (10) Additional test not
required.*
❑ Water: (1) Sizing. (2) Materials. (3) Support. (4) Test. (5) Wrapping.
❑* (6) Dissimilar metals. (7) Service regulator installed or not required.*
❑ Gas: (1) Sizing. (2) Materials. (3) Support. (4) Log Lighter. (5) Wrapping.
❑ Framin Stage (Top Out
D.W.V.: (1) Size. (2) Vent Area & Termination. (3) Materials. (4) Fittings.
(5) Grade & Support. (6) Cleanouts. (7) Traps. (8) Nail Protection.
(9) Plumbing Access. (10) Toilet Clearances. (11) Shower size.
(12) Shower Pan Test. (13) Vents - turns, horiz., runs, loop, wet, etc.
❑* (14) Additional 2nd floor test not required.*
❑ Water: (1) Pipe Test. (2) Mixer Valves. (3) Support. (4) Roof drains.
❑ Gas: (1) Size.'(2) Materials. (3) PR Valve Drain.
❑ Water Heater: (1) Vent. (2)_Location; (3).PR Valve Drain.
❑ Final
�-D.W.V.: (1) Connected to sewer system. (2) Special systems.
❑ Water: (1) Water Source. (2) Shut-off. (3) Anti -siphon Valves.
❑ Gas: (1) Test. (2) Connectors.
❑ Water Heater: (1) Location. (2) Accessibility. (3) Clearances. (4) Stability.
(5) 18" Garage Floor. (6) Mechanical protection. (7) Combustion Air.
(8) Draft Diverter. (9) Vent Connector. (10) Vent. (11) Shut-off and
connector. (12) PR Valve & Drain.
❑ Fixtures: (1) Approved. (2) Stability. (3) Clearances. (4) Trapped.
(5) Connections. (6) Cross -connections. (7) Dishwasher Air Gap.
COUNTY OF IBUTT[t_ - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
-W APPLICATION AND PERMIT
PERMIT NO.
ASSS R PA�}•CEy NUMBER
-Zr _/
ZONING
BUILDING PERMI
OWN R /
Lai N
✓ P
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILIN ADDRESS
CF 1,30 230 A -Z
i
CONTRACTOR'S NAME 41ek—
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LEN;F7
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee Z
$
ARCHITECT OR ENGIN ER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR EN INEER'S MAILING ADDRESS
Permit fee
$ �f d
BUILDIN AESkc
s s PjZ1AJi � . �4pp. /Ul/L�
PLUMBING PERMIT
Filing Fee 10.00
OG �,^ � �,- I e� ,
W 41
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
,-� USE OF STRUCTURE
SF L2' Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other
Describe work:—
151- Ry A'L � ��I 1907 -,?0
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMOR P ORLESS5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.N1
OR ADONS. \ ACC. BLOGS. /
20 sq it
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
ElNON-RESID.
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
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 CONSTR-OU LET 2,50 ea
NON-RESID BRANCH CIRCUITS)
NEW CONSTR POWER APPARATUS Q
SINGLE OUTLET CIR.
80@290
Ex. Occup(OUTLETS OR FIXTURES BAL@1 00
Ex. OCCu IFIXED APPLES, OR
p•\OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee
$
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
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.
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X _ Date d_( `91
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 $
TOTAL PERMIT FEE $
occuP. GROUP
I TYPE OF CONST.
PARCEL
PD
HD
IssuE
This permit is hereby issued under
si of the Butte County Code and/or
ork indicated above for which
CTOR OF PUBLIC
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Datta
��_��
Receipt No. 5310 0�
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE —, DEPARTMENT OF PUCLIC KS
7 County Center Drive - Oroville, California 95965
- Telephone: 534=4541
APPLICATION AND PERMIT
aau allvllcc IcNlcacU,a,I vca VI IIla VVullly VI IDUll6 LU CIIICI UVU11 Ult7
above-mentioned property for inspection purposes.
X .-&- 0, — (%. Date 1� -/o - 'i;- G
Signature of Permitee or Agent
Receipt No. -3?0 3r C
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY
Pldi�ngper�Rexpires Date
B ING
Owner 64LEEVILJ 0 Ell/
SO. FT. OCC. BUILDING VALUATION
Mailing Address %2% J BOX 2 3 0 A 29-3
g T. -1�d
C> Oo ✓1 L1 GSI- 9s�
X32 t-°779
oa
Contractor
Mailing Address
Fireplace
1-5-60,
Total Valuation 1 90.6993, 00
Telephone No.
Permit Fee j q, 00
`, '
Building Address rj 15 YE(_,L�W
PanCheckin Fee /or Penalty
,<j0
�Z� rjZ
Permit Fee 3,�0
y► /�-
APP. 8 o M1. � OF COn! COW
PLUMBING
No. @
FEE
F—D.
PERMIT FILING FEE
$3.00,Q,
Each Trap
Repair drainage or vent piping 1.50
rr (
Jg" 2� g
A. P. No. 7 7
-?i
Zoning & Planning
Water piping
1.60
, 00
Each gas water heater or vent 1_59. 2, OC)
esS
n Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50- 2, O0
EGA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. Plans Recd
P rovol
Plans wooroval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $ 'Z3: O0
$ Z-3 OZ
ELECTRICAL
No. @
FEE
PERMIT FILING FEE
$3.00
r01�
600V OR LESS
Main service 100 AMP OR LESS 5.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER e00V
100 AMP OR LESS
25.00
Main service EA. ADD'L 100 A,�M'jP 1.00
NEW CONST. DWELING
OR ADDNS. ( ACCLBLD (/ sq
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:
NEW
NON CONSTR MULTI -OUT T
RESID-, (BRANCH CIRCUITS)
2.50ea
NEWCONSTR. POWER APPARATUS a
NON -RESID, (SINGLE OUTLET CIR,
EX. OCcup(OUTLETS OR FIXTIIRES) BAL2FIXED
ALNS.0
Ex. Occup. ( OU LETS P(RESID )REAP ?.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
oLt - wzErc4r. ozo
I am exempt from the Contractors License Laws of the State of California.
Permit Fee I kl /i,
$ 58'. q0
$
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
�4 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. @
FEEPERMIT
FILING FEE $3.0o 3• do
Heating
Cooling
Ventilation
Hood 2.00 .00
Permit Fee $ 57,00
$ 6 C
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
Land Development Fee
Is 25-, vC
TOTAL PERMIT FEE
1p
$J /-r 9 C
aau allvllcc IcNlcacU,a,I vca VI IIla VVullly VI IDUll6 LU CIIICI UVU11 Ult7
above-mentioned property for inspection purposes.
X .-&- 0, — (%. Date 1� -/o - 'i;- G
Signature of Permitee or Agent
Receipt No. -3?0 3r C
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY
Pldi�ngper�Rexpires Date
.,� COUNTY OF BUTTE—�D�PARTMEs'1!F'OF PUBLIC'WORKS —BUILDING DIVISION
County Center Drive — 0roville, California 95965 — Telephone 534.4541
PERMIT APPLICATION DATA SHEET
OWNER ( -_i ( (-- .k
Proposed Building Use
Permit fee based ur
Building Inspector
At time of permit app
issuance:
Complete Contract Price
Win /e(explain)
->w.
on, I was advised the following data must be su
Permit No.
A.P. No.
r/6PW Valuation
Date 4- in
itted prior to permit processing and/c
DATE RECEIVED APPROVED
1.
All items have been submitted...................................................................
2.
3.
Plot plans in duplicate/triplicate...............................................................
Complete plans in duplicate/triplicate...................................................
4.
Complete engineered plans and calcs...... ...............................................
5.
Plans with Energy Design Compliance Statement ............................
6.
State Energy Forms No. ....................
7.
Statement of Intent for Non -Heated & AC Buildings ...................
8.
Fees of $..................................................
Letter of signature authorization............................................................
0.
Sanitation approval from OP -0 Health Dept....
11.
Planning approval for
.............
12.
Certificate of Workmen's Compensation Insurance ........................
13.
Contractors License Information (no., name style,
classification) ...............................
14.
Improvements may be required. Contact Land
Development Section of Dept. Public Works (see
addressbelow).................................................................................................
15.
Pre -inspection for required.
Pre-inspec. request to
bldg. inspector (date)
16.
Other
When you issue
the permit, process as follows: Mail to ow
-Z-
Mail to contractor.
Telephone
435 - /79 an � d or pickup -
fic Deliver w/inspection.
Other
-5-3 cl- 7 82 f 4A.vlrfi kIC�LFsv,t11
t,
t.,
Applicant
Date Y --
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time I' ation, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer ner as advised of above required data by >t Telephone
Mail 1
/9'C Other
A Date
rians cnecicea Dy
Plans approved by
OTHER:
Copy/DPW
)ate
Date ^ �O
To JiUldi.ng Department ">—' ,
:'rom: f:nvironmental fie,:lth
=*ubja�t: Sanitation Clearance
�oc�
Y?Ili tU u�oo d - 5 ' _?10�?7ner Location
Plane approved for: Sewage Diaposal *- r .dater Supply
ilnld final for-, Water Supply
Final 'Clearance O.K, for: ,•dater .Suppl.y
1.1aavance for -Z— bedroom ===Lp home- Other
Llearaaca for adaition of
Note"
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l"� c am, • "" Va t o
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_ ��.� ��
RESIDENTIAL PLAN CHECKING GUIDE
'(S.F., DUPLEX, & MISC. ONLY) 3Bld07-90NNER �fw ��� A.Pg.# 5 mi �Z
A. GE RAL
S- Zoning requirements.(sideyards and parking).
V uation.
1.gnature by R.C.E. or Architect (if required)
B. PLOT PLAN
Complete parcel size and dimensions.
2. Setbacks, sideyards, easements, etc.
3. Other buildings or structures.
4.' Grading, fills, drainage.
-A_
G"C IL S�� ` ��•
c4%m1Jey 1
C FLOOR PLAN
Complete to scale plan with dimensions. ' ��
Required windows for light and ventilation Wec. 1405`
Required windows for second exit (Sec. 1404).
Allowable glazing for energy requirements (20% max. pe
uman impact glass (Sec. 5406).
_�?Required room sizes, ceiling heights (Sec. 1407).
G.F.C.I.'s in baths and exterior outlets (Sec. 210-8).
Light fixtures, switches, receptacles, and exterior
mechanical equipment.
receptacles for maintenance of
8� Locations of water heater, heating & cooling equipment, other electrical or gas
equipment, and plumbing fixtures.
10 arage firewall, door size, and closer (Sec. 503(d)(4)).
- 3'0" exterior exit door (Sec. 3303d).
1 Fireplace location.
I Smoke detectors (Sec. 1413).
D. �. —STRUCTURAL DETAILS
Foundation plan complete enough to construct building.
Floor construction details complete enough to construct building.
evations.and wall construction details complete enough to,construct
Roof construction details complete enough to construct building.
Fireplace construction details and calcs if over one-story in height.
Sufficient data and details to satisfy energy insulation requirements
4
E. MISCELLANEOUS ITEMS TO LOOK OUT FOR
X plywood on exposed locations and overhangs.
Stairway details (Sec. 3305).
'Guardrail details (Sec. 1716).
Brick'or stone veneer (Chapter 30).
Exterior plaster - weep screeds (Sec. 4706 & 4708).
Proper roof pitch for roof covering (Chapter 32).
7.000itafter ties or bearing ridge beam.
8 #70" Garage door or porch header sizes.
building.
(State law).
Adequate bracing.
1 Living area over garage - complete 1 -hour separation required including supporting
walls and posts, etc.
Two (2) exits on three-story dwellings (Sec. 3302).
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