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058-300-010
DORAN HINTZ e/s Concow Rd., s/s i'f rail, Concow Permit# 2858-75EP,E( il.,s )_ ELEC .t5 —� GAS_ SUPPOR STRUCTURE REQ . _ - r-= _ COMPACTION TEST RDQ.- - l/lC7 58-30i8 Permit ##6278-75MHI _ Issued 58-30 `0 Perm i }378-76B single f_ mily) 58 -30 - Permit ##2116-' - lb -ec 7� (p g. & elect for 378- SF __— -- 'W-3 12928 Coficow Rd, Concow C:)//V 6P re lace gas linea/MH Pe�;mit�k275 8 ( P � 058-300-010PERMIT#96-2030 MORRIS, David & Dorothy 12928 Concow Rd. , Oroville Reroof & Replace Propane Line/SF i 058-300-010 PERMIT#96-2444 MORRIS, Dot 12928 Concow Rd., Oroville Porch Extension,Pellet Stove,Htr, 5 Windows & Slider/SF 058-300-010 PERMIT#97-1426 MORRIS, Dave 12928 Concow Rd., Concow o Cont: Ely Roofing Inc. Reroof/SF & Shop O r i {_ RESIDENTIAL 058-300-010 PERMIT#96-2444 MORRIS, Dot ' 12928 Concow Rd., Oroville yr Porch Extension, Pellet Stove,Htr, 1 5 Windows & Slider/SF 1 EY 1 1 1 c , 1 f t' 1 4 F JOB FINALED (Date) Signature I t ►, .a N V=OK O = Not OK `=NottRepady MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 1. Zoning Requirements - Setbacks - Easements 6. Carports; Windows -Doors 2. Soils; Special MH Support Sketch 7. Electric 3. Sewer, Location -Test -Fall -CYO -Concrete 8. Frmg.; Sils-AnchorsStuds-Rftrs-Trusses 4. Water, location -Test -Easement Needed (Sketch) 9. Siding; Nailing -Veneer -Stucco -Mesh 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 10. Roof; Shthg-Roofing 6. Gas; Location -Test -Wrap; / /'9_'ft. / /Nat. or/ /°L'(t./ /LPG 11. Ext.; Steps -Doors -Lendings 7. Well Clearance & Disconnect S. Utility Clearance Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 2. Soils; Compaction -Structure Stability 1. Zoning Requirements- Setbacks Easements 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 2. Footings; Size -Spacing -Marriage Line 4. Elec.; Receptacles and Lighting, Distance -GR 3. Gas; MH Test -Demand -Vale -Connector 5. Elec.; Pool Lighting; 15 Volts-GFI 4. Electricity; MH Test -Crossovers -Breakers -Clearances 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 5. Drain; MH Test -Fall -Flex Connector 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 6. Water; MH Test -Regulator -Connector 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 7. Water and Sewer Connected -C/O to Grade -HD Approval 9. Health Department Approval 8. Gas and Electricity Tagged 10. Plumb.; Cir. Test -Water Supply Test 9. Tie Downs -Type -Installation Cert. 10. Exits;Insp.Sketch 11. Cert of Occupancy r Card B-1 Date Card B-1 r Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-S'rze-DepthSpacing-ConnectorsSteel 3. Decks; Girders and/or Joists-Decking-BracingStairs-Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg: Rfg: Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sils-AnchorsStuds-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Lendings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GR 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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 o = No OK RESIDENTIAL (Single & Duplex) - = Not A licable pP Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. ZoningSetbacks-Easments-Flood-Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /' Ftg. Depth 3. Ftg. Garage; Soils-Steel-Elec. Gmd/ P Ftg. Depth 4. Ftg. Porches & Decks; Soils -Steel-/ N Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts- Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped Garage Fire Protection Framing 6a. Hold Downs and Special Anchors Property Line Firewall & Openings 7. Slab, Steel -Wrapped Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test Siding -Nailing Veneer 11. Water Pipe; Test -Anchors -Regulator -Service Test Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric Underground Glazing Area -Glass Protection -Skylights -Plastic 13. Pienums & Ducts; Clearance -Material -Support -Ins. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists Vents-Crippies Brace Wall Panels 15. Access & Ventilation Insulation -Walls -Ceilings 16. Insulation Infiltration -Walls -Windows Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card E-1 Date Date PLUMBING (Permit) OK except #'s FINAL (Plans) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 63. 18. Water Pipe; Test & Anchor -Nail Protection 64. 19. D.W.V.; Test Fittings & Anchor -Nail Protection 65. 20. Shower Pan; Test, First Floor -Tub Access 66. 21. Test Tub & Shower, Second Floor -Tub Access 67. 22. Gas Pipe; Sixe & Anchors 68. Elec. Trim & Subpanel, Breaker Sizes & Labels Date Stairs & Rails Card B-1 Date Card B-1 Date Fireplace or Stove, Clearance -Hearth Card B-1 Date Card B-1 Date Elec. Outlets at Wood Panel, Int. & Ext. ELECTRICAL (Permit) OK except #'s 72. 23. Fixture & Transformer Clearance -Ins. Protection 73. 24. Elec. Receptacles Spacing -Lights & Switches at Doors 74. 25. Size Boxes & No. of Conductors Stapled 75. 26. Romex Installed Close to Edge of Studs & C.J. 76. 27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water 77. 28. 2 Appliance Circuts in Kitchen & Conductor Size GFI 78. 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al 79. 30. Range Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or AI Insulated Neutral 0 Yes 0 No 80. 31. Service -Riser Conductors & Ground -Main Disconect 81. 32. Equip. Clearances Panels-Motors-Mech. Epuip. 82. 33. Clothes Closet Light -Shower Light -Spa Light 83. 34. Smoke Detector 84. A.C. Unit Disconnect, Electrical -Plumbing Date Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Card B-1 Date Card B-1 Date Water Well, Disconnect, Electrical, Plumbing Card B-1 Date Card B-1 Date Exterior Elec. Trim, G.F.I. Receptacle -Underground MECHANICAL (Permit) OK except #'s 88. 35. A.C. Ducts Insulation & Support 89. 36. Vent Fan, Exhaust above insulation 90. 37. Condensate Drain & Overflow, Size & Grade 91. 38. Furnance-Vent Access -Comb. Air -Return Air Vent 115 outlet 92. 39. Attic Access & Platform if Furnace in Attic 93. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 FRAMING (Plans) OK except #'s 40. Sits 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 Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-roff 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 Hgt. & 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 Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace; Vents -Clearance -Comb, Air-Conector- 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 & Recepticales 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 (G.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 0 Yes 82. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 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 Throught 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 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: . ...�.. -v^f�•.w,.4-{r,l!�,;._,-►�'i?` i ,W''Ri.'. y`, `.":i:�{r ' 1 v„+r"` ;�-!'�.ir`as"" s �wr'Xnr.. 9 'M: z COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION -4"'P7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT NO. APPLICATION AND PERMIT 16`''r`'� ASSESSOR PARC0.NUMBER: -058-300-010 20NING BUILDING PERMIT - OWNER bUT MORRIS �,'�J� 1lilS.J TELEPHONE SQ. FT. OCC. BUILDING VALUATION 6,7 .OG OWNERS MAILING ADDRESS 9887 BF114ONT TERRACE St?IdMAJI", 94086 EST 2, 000.00 CONTRACTOR'S NAME TELEPHONE 534-5668 CONTRACTORS MAILING ADDRESS Fireplace 1,500.00 CONSTRUCTION LENDER UNKNOWN Total Valuation $ 10, 260.00 Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 126.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 58.50 • Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS O my v!) PERMITFEE $ 204,50 -cm, A 95-065 PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SFNK' Duplex ❑ Mobilehome Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition k Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: PORCH EKTFNSION, PEIU'"r STOVE, ITLAATER (WALL: FURNACE) WINDOWS(5) & SLIDING Mobile Home ISI GI W1 920.00 PERMITFEE S Contractor ELECTRICAL PERMIT Filinq Fee 20:00 GLASS DOOR. Main Service 000v OR LESS ( zooA OR LESS ) 23.00 Main Service ( 200A To 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, ar.d my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCURSO. OR ADDNS. ( & ACC. BLDS. ) 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CHR. Ex. Occup. (OUTLET OR FIXTURES ) 20 @ 1.00 BAIL .50 Ex. Occup. (oFIXED PLNS. EAR) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ 35.00 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 19/1 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 for hwith co ,ply with those provisions. X _ Date !_( Signature of App% c/ nt - Owner ❑ Contractor ❑ Agent An Opermit iI equired for excavations over 60" deep and demolition or construction SHA of structures over 3 stories in height. Mobile Home Installation Fee is Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 239.50 HA2. D. FEES ..... IMP ,,, FLOOD COF PARCEL I PO HD ISSUE .0 This permit is hereby issued under trie applicable provisions of the Butte County Code and/or Resolutions to do work indicatrtd above for" which fees have been paid. E�' Date PERMITEXPIRESON (Date) ReceiptNo. 206715 -WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER PERMIT Nd. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work 1 is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 91 r ra ;a . •-ar '=S 21 h r t•; s: 'f Date Inspector REV 10/92 COUNTY OF BUTTE BUILDING DIVISION .t DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (9.16) 891-2751: 7 County Center Drive, Oroville, CA - (916) 538-7541- . 747 Elliott Road, Paradise, CA - (9116).872-6307 CORRECTION NOTICE 9�2 oc OWNER PERMIT Nd. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work 1 is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 91 r ra ;a . •-ar '=S 21 h r t•; s: 'f Date Inspector REV 10/92 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES rt' n 1469 Humboldt Road, Chico, CA - (9-16) 891- 27-57 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE 6,hKCR PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work _t, —is compleled,111f u have any questions pertaining to this matter, or need additional explanation, xw please co t this office immediately. Z1111- �rcl� 11:io n 4--1 142 42 51 C4 j,-; -4 Date Inspector LY REV 10/9Z COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 ill CORRECTION NOTICE 2-0 OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. yo ave any questions pertaining to this matter, or need additional explanation, �3. please lease con this office immediately. lap Date Inspector REV 10/92 4��' L A N D O F N A T U R A L W E A L T H A N D B E A U T Y BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (916) 538-7541 FAX: 1916) 538-2140 9/24/97 MORRIS 7 BELMONT TERRACE NYVALE, CA 94086 RE: Building Permit # 96-2444 Expiration Date: 11/25/97 A. P. # 058-300-010 th reference to the above subject, our records indicate that your ilding permit expires on the above date and your permit falls into the tegory marked below: Permit work started, but not completed. Permit may be renewed for 1/2 the original building permit fee (plus a $20.00 filing fee). The renewal permit will extend the building permit for an additional year from the original expiration date. Should you not renew your permit within 30 days of the expiration date, all work must cease until a new building permit has been issued. For your convenience, we are enclosing a renewal application form and owner -builder form to be completed and signed by you where indicated and returned to this office together with the fee shown. Please return all copies of the application form. X] No inspections have been made on permit work. Inspections are required to verify code compliance. We are unable to renew a permit where the work has not been started and inspected prior to permit expiration. After expiration of your permit, no work may be started until a new permit has been issued. 'f our records are in'error or should you have any questions concerning :his matter, please contact the OROVTLLE office. you for your prompt attention concerning this matter. Yours very truly, Michfael C.1 Vieira, C.B.O. MCV:ahb Manager, Building Inspection Attachments Chico Office - 1469 Humboldt Rd/891-2751 �J n z D s 3 G � 0 C {o � ,to 1 m n z D s 3 COUNi'Y OF OUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION ' 7 County Center Drive - Oroville, California 95965 -Telephone (916) 538-754/ � PERMIT NO. APPLICATION AND PERMIT ((J ASSESSOR PARCEL NUMBER—058-300-010 ZONING BUILDING PERMIT OWNER DOT MORRISTELEPHONE SQ. FT. OCC. BUILDING VALUATION 520 C 6,760.00 OWNERS MAILING ADDRESS 9887 BEJ14ONT TERRACE SUPINYVALE, 94086 EST 2,000.00 CONTRACTOR'S NAME TELEPHONE 534-5668 CONTRACTORS MAILING ADDRESS Fireplace 1,500.00 CONSTRUCTION LENDER UNKNOWN Total Valuation $ 10 260.00 Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 126.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 58.50 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS PERMITFEE $ 204.50 1122929 GONGOW RD LE, 95965 PLUMBINGPERMIT Fling Fee 20.00 Each Trap 7.00 LOT NO. SUBDNIS IONS NAM PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome �i Other `'s SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation ❑ Other] Describe Work: PORCH EXTENSION, PELLET STOVE, HEATER — (WALL FURNACE) WINDOWS(5) & SLIDING Mobile Home IS I G W 920.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filina Fee 20.00 OF GLASS DOOR. 000V OR LESS Mein Service ( 200A OR LESS ) 23.00 Main Service ( 200A To I000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCURSD. OR AooNs. ( s BIOS. ) 3.52 FT. MULTACCI- NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL 0 .50 Ex. Occup. (oFTiE7s (REBID.) ERA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) VI 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 font with co ply with those provisions. / / y X ' Date `" Signature of App nt - Owner ❑ Contractor ❑ Agent An OSHA permit i equired for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee77 $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 239.50 HA2. _.. D. FEES �- IMP FLOOD — CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work ind" at ab ve f which fees have been paid. S Date /�_z PERM IT EXPIRES ON 2S 9% (Date) Receipt No. 206715 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 0 "�a:•rt�a., ... t1R3,' �'4 i"�� +:-ir.r'yv'N COUNTYO - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET OWNER 4)07- M 0 9,P- l Proposed Building UseC 0 VF- .rJ Po Inspector _ A. P. Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1 _All items have been submitted . ....................................... . 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............ . 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ..................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ............:::.. /J r 14. Sanitation and plot plan approval Health Department. . 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. .. ... 20. Pre -inspection for Freanspe�on req° st fequired. . . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ........................... 23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ........................... `: ........... 32. Plan check list . ..................................................... 33. 34: - When you issue the a roce s as follows: Mail to ow�ner.Mail to contractor. Telephone and hold for pickup at �_-_ office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date (^ ,By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by �� Date �y - Sets of plans on hold in File cabinet AP folder - Copy - Department of Public Works E.H. USE Mf Plot Plan Attached �. Floor Plan Attached Sent to B.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance -0 Ljy Ow er Location AP# Plan Approved for: Sewage Disposa!,Z Water Supply: Publi . Private Well Clearance for dwell'ng. Other C.• v '�►'' \ �S OL9. / / S k -1 ;V dr fes, Lva.r r Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist 8/96 Date O.B.- I 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 roperty improvement: YES, NO[ 1. 2. I HAVE HAVE NOT[ 1 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 followingpersons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: � SOCIAL SECURITY NUMBER: DATE: /0 /2- Iq & ... NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. May 1995 This verification must be completed and returned to our office before we are permitted to issue the permit. 2.26 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also, required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 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. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own 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. Sincerely, Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 Rb COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO, APPLICATION AND PERMIT ASSESSOR PARCEL NUMBED 2 0 Q J�C ZDNNG BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION 6� OWNERS RES/1-iQ�� �" L-�/" CONTRACTOR'S NAME TELEPFIONE ��� CONTRACTOR'S MAILING ADDRESS ' Fireplace CONSTRUCTION LENDERUNgNOWN Total Valuation $ of Filing Fee 5 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ° ARCHRECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS �J J .PERMITFEE $ L. o PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOTNO. SUBDNISIONSNAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UUI'Ibes ❑ Installation ❑ Other ❑ Describe Work: -Apt E� F�'4r-� ) S / n N — J t� -ILAU��L��1 �/iil f %1��� e��j Mobile Home S G I W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filin Fee 20.00 SL 1,010 6 C /9–S S y 6z2 _ Main Service ( q800V OR LESS ) OR LIE S 23.00 Main Service ( zooA TO I000A ) 46.00 NEW CONST. OWELUNG OCCUR SO. OR AODNS. ( & ACC. BLDS. 3.5d FT. - LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 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 cense Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. _ Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which, this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 Signature of Applicant - ❑Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction structures over 3 stories in height. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ( a SINGLE OUTLET cIR. ) Ex. Occup. (ourLET OR FocTuaEs) zo Q I.50 BAL .00 EX. Occup.FIXED APPLNS. OR (OUTLETS IRES10.1 EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee is Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ HA2. 1 D. FEES IMP FLOOD COF PARCEL PD HDI ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. BY Date PERMIT EXPIRES ON (Date) �eceiptNoQ ( ,rte re Awv.ecSF3SOR PINK -INSPECTOR GOLDENROD -APPLICANT ®® ..... M.Pq b 4 r1 1 gZ • ^ 1 \ C Y •`�7 or L� q IJ e r1 1 • ^ 1 \ C Y •`�7 or L� q CIO Iv d z iv all CIO D d z Q all x i 70 S T d m d I � all x O �1 a Ilk� d 70 S T a psoo- 2.33— Ex 7SbaZ , environmental Health LFAcN t-I'n1Er ( I i'Ro PRwE, �. Zo :�7 Ordville, Calitor, ; ADD !S'X2a' STA1 Q + W AL14- ROOF i rr 1 wELL Houses z Haiss- �- TIZ �p S2'X�S' DEej� �©off • I E j 3olr 0/0 0,0 i AOVED P� n Butte Cou ty Environipe ta-1 Health qqr� I to 1-4 Signatelrc) r. 1�8-300-010 �' PERMIT#97-1426 RRIS, Dave :.` LReroof/SF Concow Rd., Concow y Ely Roofing Inc. `- & Shop 1 Ile COUNTY OF BUTTE- DEPARTMENTiPF DEVELOPMENT SERVICES - BUILDING D 7 County Center Drive - Oroville, Cal#ornia 95965 - Telephone (916) 538-7/54r-7EFj�11T No. APPLICATION AND PERMIT ` ASSESSOR PARCEL NUMBER U-)r.',–aJU-- J i U ZONING BUILDING PERMIT OWNERTELEPHONE �.aVu i•,ort.1.: 4Lti-7 is-%;fli✓ SO. FT. OCC. BUILDING VALUATION zo OWNERS MAILING ADDRESS ybu-/ bel,-�OiI n f,, CC Juiin rva 94v":J,) CONTRACTOR'S NAME L. L Y X0U11:i. luc TELEPHONE '31 4:5-76"1 3 CONTRACTORS MAILING ADDRESS 1_32 J L Co,i t Ctii- to!: z;, jr t;41.CU i;'i 5j91_3 Fireplace CONSTRUCTION LENDER UNW40WN Total Valuation $ Filing Fee $ 20.00 LENDERS MAILING ADDRESS Permit Fee $ J 3 . i;11 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS g Penalty $ BUILDINGADDRESS lly2�i ::u�lc:oFi Lt is PERMITFEE $ l..,. . - � !r �._..- >:., PLUMBING PERMIT Filing Fee 20.00 •_Eac�rTaa�k: -- ..;, ..� •- - •_x:00 - - , LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 US STRUCTUR SF -.Duplex ❑ Mobilehome ❑ {ther SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 E OF WORK New ❑ Addition ❑ Remodel ❑ Ublibes ❑ Installation ❑ Other ,; , ; Describe Work: ,/k CoofirL? w/..'J yr --CC11 – 2.2 mq;i Mobile Home S G W 920.00 PERMITFEE s Contractor ELECTRICAL PERMIT Filinq Fee 20.00 Main ServiceOOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force la7nd effect. {{� } /� (✓`1`� V—J�j V�/. 36 License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. 0. 1 am .exempt under Sec.! Business .and Professions Code;for.this. reason NEW CONST. DWELLING OCCUR OR AI)ONS. ( a ACC. BUDS. ) SO. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS (a SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL .50 Ex. Occup. (OUTLETS RES D.) R ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ CnTTtractor; - - 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. 0 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 ins ance carrigr and policy number are: Carrier 1rllUri _ l C@ MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 6 L L3 3,4 (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 o1 the Labor Co, I shall forthwith comply with th se provisions. – – / X /�'�•f' Date — ----- Signatu of Applicant - ❑ Owner 21D Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height..- Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 53.V0 HA2. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been Date PERMITEXPIRESON (Date) provisions to do work p aid. l +A_a C: Receipt No. �o WHITE-D.D.S.-B.D. CANARY -ASSES PINK-INSRECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPINENT SERVICES -BUILDING DIVISI N 7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538-754IT No. APPLICATION AND PERMIT `7- ASSESSOR PARCEL NUMBER 058-300-010 ZONING BUILDING PERMIT OWNER Dave iKorris 408-732-7910 TELEPHONE SO, FT. OCC. BUILDING VALUATION 1320 OWNERS MAILING ADDRESS 988-7 Belmont Terr Sunnyvale CA 94086 CONTRACTOR'S NAME Ely Roofing Inc TELEPHONE 343-7663 CONTRACTORS MAILING ADDRESS 13291 Contractors Dr Chico CA Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 33.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS - . 12928 ConcoW Rd PERMITFEE S PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISION'S NAME PARCEL MAP-.-, Px A Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ff Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other EX Describe Work: RJR roofing w/25 yr arch - 22 sqs Mobile Home TTFG Ew7 @20.00 PERMITFEE $ Contractor ??;' 20:00 Filin Fee oll.i �.' ,• JR 1 .x4 i J �,n. �- :? �� "T t' �! 1 'a t F ? I I 17 �, �.•+ I ,.St !` t •"L * }� S k i i li,.;t r y rT�'f '�Ye,,J 4 -••• ~, , - - _ -- Mal690y OR -LESS f -1 n Service t< < \ , ('+31200A OR LESS Ll 23:00 MaPn''Servlce 200A'.TOI000A - ('ry `) 46.00 • - .. LICENSED CONTRACTOR'S DECLARATION+ I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class C — 1 , C — 3 9 Lic. No. 607386 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR SO. OR ( 8 ACC. BIDS. ) 3.50 FT. CNS. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPOUTLEARATUS ) 8 SINGLE T CIR. Ex. Occup. (OUTLET OR FIXTURES) zo B" 50 Ex. Occup. (OUTLETS (RES D.�EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I 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 Nat 1 Union Fire Policy Number 8241332 (rhe above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ - I'oeriify 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 wit th se provisions. Date _ 7-3.-97 Signatu of Applicant - ❑ Owner ]7 Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height.Q)atel-//7, MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 53.00 HAZ. I D. FEES 1, IMP I FLOOD' t CDF PARCEL' PD HD ISSUE rL 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. /C? - PERMITEXPIRESON VV 0, 71A1_195 (Date) ReceiptNo. hy' WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 058-300-010. PERMIT#96-2030,f MORRIS, David & Dorothy, 12928 Concow Rd., Oroville Reroof & Repla6e Propane Line/SF.-• 0 .xr-r - a r ......�lyl'Mnr�,�yti�p.�.�..-.. - ..'�rt^°'a:'F"0.�:, ,y �i�'"M>r'.R"+.'�'` '�f14�; gjf•M,'Y'1b.+�Mwx.C. �;'+zr.�s*'1'pa^'aaPwl'�` COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISI 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75 PERMIT NO. APPLICATION�AND' PERMIT " ASSESSOR PARCEL NUMBER 58-300-010 ZONING FRBUILD NG PERMIT OWNER ` . DAVID & DOROTHY MORRIS (408 732—"7910 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 988-7 BELMONT TURACE SUNMAM 155 CONTRACTOR'S NAME OWNER TELEPHONE f/ I CONTRACTORS MAILING ADDRESS I Fireplace CONSTRUCTION LENDER UN -OWN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 12928 CONCOtd RD I ! PERMITFEE S 47.00 ORMUZ PLUMBINGPERMIT Fling Fee 20.00 Each Trap 7.00 LOT NO.SUBDNISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF O'L Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 rJ. 1 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other O Describe Work: REROOF W/CW IN REPLACE PROPANE CAS LE Mobile Home I S I GI W 1 @20.00 PERMITFEE g i Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service 000V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 t LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisior+is 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: , )k 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 IMECHANICAL NEW CONST. DWELLING OCCUR OR ADONS. ( 8 ACC. BLDS. ) SO. 3.50 F7. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH ) 97.50 APRATCIRCUITS (a SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES) BAL 0 1.5 Ex. Occup. (oFIXED PLN o.j ea ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations. ❑ 1 have and will maintain a certificate of consent to self-insurel 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 PERMIT Filing Fee 20.00 g Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work'of a valuation of one hundred dollars ($100) or less.) X 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 fo'l^thwith cc ply with those provisions. r X _ _4� ''Date-���--- Signature of Applic� t - ❑Owner ❑Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee is Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 82.00 HAZ. I D. FEES IMP I FLOOD COF PARCEL I PD HD ISSUE This permit is hereby issued under ttre of the Butte County Code and/or in_ dicated above for which fees have By ;%_/'� c X- PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date — "9l (Date) Receipt No. 202587 WHITE-D.D.S.-R.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI 7 County Center Drive - Oi6ville-,"Califorriiia 95965 - Telephone (916) 538-75 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 58-300-010 ZONING FR 5 BUIkONG PERMIT OWNER DAVID & DOROTHY MORRIS (408)732-7910 TELEPHONE SO. FT. OCC. BUILDING VALUATION 18 1,ogn-on OWNERS MAILING ADDRESS 988-7 BELMONT TERRACE SUNNYVALLE CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAIUNG ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 12928 CONCOW RD PERMITFEE $ 47.00 OROVILLE PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF f Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: REROOF W/COMP — REPLACE PROPANE GAS LINE Mobile Home I S I G W 920.00 PERMITFEE S 35.00 Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service 0 OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A To 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law ;or the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR DR ADONS. ( s ACC. ) SO. 3.5¢ Fr. NEW CONST. MULTI.OUTLEUTLE T NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL .50 FIXED PES D. Ex. Occup. (GuEDrs OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE _ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) x 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 w rkers' compensation provisions of section 3700 of the Labor Code, I shall f with co ply ith t a provisions. s _ X Date _ / s_--_ Signa ure of A lic nt - ❑ Owner ❑ Contractor ❑ Agent � 9 PP An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ coNsr. TYPE TOTAL FEE $ HAZ. 1 D. FEES I IMP I FLOOD I CDF PARCEL 1 D HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRES N applicable provisions Resolutions to do work been paid. Date pp — 9"E6:C (Date) Receipt No. 202587 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES[' NO[ ]. x 2. I HAVE[] HAVE NOT[ ] 'signed an application fora 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 SIGNED: , PROPERTY OWNER: SOCIAL SECURITY NUMBER: DATE: NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: . 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an ` ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own 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. SI. ncerel , Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER Ur d PERMIT NO. 378-76B P. E M MH UTIL. PERMIT NO. ik PERMIT EXPIRES /y�y OWNER Doran Hintz L"ON TR. OWrier j LOCATION (A.P. 58-30-1 ..,,,E/S Concow Rd., app 22 mi. N. Deadwood Rd. 'N. lot -line is Ishi Trail c� t! 9/7 G Temp. Power ole Called P &E Temp. EI . Serv. Call PG&E 6 7�o �. a Temp. as Serv. } C lied PG&E JO Jb r F AILED (Dat (Signal e) 6" COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD Bond Beam r FIRE PRI KLERS Motors fir' ' / Framino — IYII Test Water Htr. �_✓1 Stucco B ILD NG BUILDING (Cont'd) PLUMBING Setback Z /O Firewall Soil Piping Forms Brown Parapets 1st Floor Main Bldg loe 09 Restroom Finish 2nd Floor Footings Z /U 6 WindowsIr- jd' 3rd Floor Stemwall DATE Siding To out -7 Slab U Cv Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall ,Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Te t f Temp. Gas Slab Final Sanitation Patio I FIREPLACE Final Footings Footing ELECTRICA IWacnnry Wnllc P Thrnnt ii s f ��� Anunh �_ �il Bond Beam r FIRE PRI KLERS Motors fir' ' / Framino — IYII Test Water Htr. �_✓1 Stucco Final ' Subpanels t-' Mesh MECHANICAL Grd. Fault_RTot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation—•- '7& Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS ��zo-ice w� COUNTY OF BUTTE ILI DE�PAn I IZ_NT OF PUBLIC WORKS 7 County Center Drive — Urovil-le, California 95965 Telephone: 5341-4541 ✓< / y/�" APPLICATION AND PERMIT .+ 1VF1VQmn0uvaa V1 me Uumny UI bulle W enter upon the above-mentioned property for inspection purposes. X i�1�Gt„c .,�f/ Date /-- -2 G Signature of Perrmitee or Age Receipt No. / 41 1-/ 4/-3 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 Date ilding permit expires Date __ L -3-77 BUILDING Owner 0 Yq� j,v% Z SQ. FT. OCC. BUILDING VALUATION Mailing Address Fr -;#1 Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee O,6 $ /Colcn Building Address ®Z:" l.� CO(AJ PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 &0 ✓ Each Trap 1.50 'I e_ /• S / ✓A/ Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 / A. P. No. J—y— z O '- 1 � Zork4:g & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 FA W. . SaQ on Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans V *Cf ration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldgs Recd Parc Approval Plans A,pproval Permit Fee $ $ NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE J$3.00 Main service ;000V OR 0 AMP ORLESS5.00 Main service EA, ADD'L too AMP 2.50 Single -Family ® Duplex ❑ Mobil Home ❑ Others ❑ OVR 600V Main service 100E EAMP OR LE55 25.00 Main service EA. ADD'(_ too AMP 1.00 NEW CONST. DWELLING OCCUP. & OR ADONS. ( ACC• BLDGS. ) 22sgft NEW CONSTR. MULTI.OUTLET NON-RESID. 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: Ex. Occup(OUTLETS OR FIXTURES)`'25C BAL@t Ex. Occu // FIXED APPLNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.Classification Misc. Wiring 6.25 0-1 am exempt from the Contractors License Laws of the State of California. 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. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 1773-1 certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the 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 T TOTAL PERMIT FEE $ e"Vo fj .+ 1VF1VQmn0uvaa V1 me Uumny UI bulle W enter upon the above-mentioned property for inspection purposes. X i�1�Gt„c .,�f/ Date /-- -2 G Signature of Perrmitee or Age Receipt No. / 41 1-/ 4/-3 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 Date ilding permit expires Date __ L -3-77 a COUNTY OF BUTTE — "DEPARTMENT OF. PUBLIC WORKS 7 County Center Drivti - O�oville, California 95965 _ Telephone: 534-4541 APPLICATION AND PERMIT BUILDING Owner SQ. FT. OCC. BUILDING. VALUATION Mailing Address 2 L Va Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee 01 t^ Building Addres�w- o. .PLUMBING N @ FEE PERMIT FILING FEE $3.00 0 t/ Y Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping f/ 1.50 Each gas water heater or vent 1.50 2 Q / A. P. No. J Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe , Sani n I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. PI ec'd Parcel Approval Plans Approval Permit Fee $ NEW [__JADDITION UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Iry - Single Family L,4 Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures b20 25i Receps., switches & fix outlets 20025 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. d i sp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home.Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring %Z S F..r- y s 1 am exempt from the Contractors License Laws of the State of California. 'Permit Fee $ 3 7 - WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 MECHANICAL• @ 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. x'ZOL , a��_ Date Signature of Permitee or Age Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant . TOTAL PERMIT FEE $ IIY15Y This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above fpywhich fees have been paid. D ECTOFOF BLIC:WORKS 81Z V Datew— permit expires Date-�i��l� CERTIFICATIONS As required by the State regulations, -both the builder and the insulation applicator must sign a card certifying that the -proper "R" values for all insulation locations have been installed. An example of -a certification card, which is furnished by the builder or insulation applicator is shown in Fig. THIS IS TO CMIFT THAT INSULATION MAS BEEN INSTALLED IN CONFOMMAKE WITH THE CURRENT ENERGY REGULATIONS, CAL �ORM"MINISTRATrn CODE TITLE 25. STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: cec Tract No. ,-EXTERIOR WALLS Manufacturer Thickness/Type - CEILINGS Batts: Manufacturer—' —Thickness R Valu®—Li--- Blow, Manufacturer Thickness— Bags Sq. Ft. Covered R Value FLOORS Manufacturer Q C, Thickness/Type_ R'Valu. SLAB ON GRAOE Manufacturer Thickness/Type R Value Width of Insulati®Znchez FOUNDATION WALLS Manufacturer Thickness/Type R Value GENERAL. CONTRACTOR LICENSE Numon BY TITLE. DATE. INS i NTRACTO LICENSE NUMBER DATE � j—'p- Fig. 13 8-14 ` C Lest i �y than_ �s c,wner of i:ll^ property acquired by 0,,eecl Jn VC)�.U,na7 �, Wa92 Official Records of Buttc County, (ESP. i am rcqiiesting permission to build or in_,tal•1 an Jc'dit:ie;n31 living unit cn thi. property., I will not divide the afore- tet'Liaiied property for sale, lease, rent, or financsno unless all .• J'1p7�_ _�';J`t�lt?-].c]zld-�7i.�T.LS-! 0[3-1iliiS--c1 C1 Ci-; In clp•-:C'E'C1L1� rrJ' �1�'!1t:i--c)rt'-cc;lL)� �2C1-'�i-tCl• . rC aii conversant with thy' p-ese.nt Zoning regulations a'LfecLi.no the aforUaasntioned property, .and declore that I shall not violate same. I reor`sent that the proposed use of the additional living L>_nit is Ar�rs U _. • and- .hat• further I -shall -not-- hange -this proposed- Ls? -of -the--additi onal ? iz;i.n4 unit unless and unt- 1 'I eceil written approval therefe: - . tiZ_ County of Butte. ` I fully understand that .pursuant to Chapter 20 of the Butte County Code and §11535 et seq of. the Business and Professions. Code that if I, an t:e future, sell, lease, or finance.the-area on or adiacent to said -oveiment without fully complying with the applicable laws bnd - Ordi ances, that 1 s�iall be -gul lty of a misdem. eanor -and therefore,. subjec ' to the aforesaid penImprisonment irnprisonnent parsuant to law. Ftarth?r; -this statelmeat- shall -be--properly acknowledged and --recorded at the request _-county--of...Butte e •�: - 20330 zl Owner,� .. M TY - CALIF dd LOUISL K.LUE..f' DI`J? _ rEE Dates C J -- - CCl�ii_L .0 Oi ! . t h i_ _ 774d a o T= !. f"�, _�, 19 7.; , b e x o -C,2 ;: < :-- - - -- - - - ��,,71 1..y l: D-0_ J. 'qtr(` Off' C.r)i01,rli3 residi_ri� i=:1erein � Gll_�•' ` ': ----- ---- -- — � cJ ]C O:.;Il >jlOi?CC1 rl`t S?'*OL:?� �C'rsOLl��_ly appeared ;Llo Tn to 1 Ie to bt: CMC: pc -_r soli- WL_IoS(:'_ Il0;'17 C! -- __,U.C)SCt-lt)�-d to Che w whin aiid. acknol 11.cC gee co mc, th Ll C� ;E:0 -7- ��Lt.l�,_o sem. my }17ClCt L;s:t:): saq�:;:[jtartstso)tssti:e:ie? 7[94Ct�.�.Cytdda��Cd- -. �rp liti�tC,au(-I, f the Clrl�r ]I �^ t.:VO�S2`k 'Ciu1LT,Lti- QAC�rM All �)iJ fL i -1r t -C MINCi°AL OFFICF. IN BUTTE �OUNTY Fky C:,mmis_ion Expires July 1, 1979 ;G BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,.CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: .5-- v septic tank and leach fields and 3. Is the site currently under permit? Yes / / No (If yes, furnish permit number ) 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 -&7/ No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----=------------------ Amps 6. What is the mobilehome site service rating? --------------------- ,� �� Amps' 7. What is the mobilehome site circuit breaker rating? ------------- Amps .8. Is there any other electric load to be served by the,mobilehome siteservice? ---------------------=----------------------------- Yes ,( / No (If yes, identify the load and size: (Load) (Amps) � 9. What .is the mobilehome as P.. size. g P ?---------------------- site pipe 1 ( in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) .Z 12. What is the mobilehome gas demand? ----------------------------- ,97, (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft, on LPG.) -- -- f MOBILEHOME SUPPORT ORT DNIA y r Mobilehome Mfr. Z�fp Setup Model No. Year Width. (ft.) Length:j—:�j� (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). yA" " 4. .�y� wo Sin le — Footings (check . ones / � 1. Wood either pressure treated or Center Csei fer'"ST-port '• fdn. `grade. Support Footing. S izes /� 2. Locations (pis. � -Concrete pad. 3. Other, 'specify .; in. „ , . , in..Z nj Supports (check one) Concrete block C _ 2. Concrete piers (ft T_� in ( in;,)- in. ) / 7t 3. Steel piers ;:.. / / 4. Other, specify --�..----- — — — — — —Ell-� _ Typical Support �-� Footing Size (TM . x n (in.)(in.) �. . - ..... .... ..... . Ell 1, - -- -- — - Max. Pier Spacing n. Fft . in. in.) (in ).(in.) - Max. Overhang *If center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COUNTY . BUILDING DEPARTMENT APPROVED This set Kept of Plans Make 0 * n the lob Ob *at an all an'y ch. tin9es a. W��tan. Pe rrnis 17007 Or at and ft teratio., Is Unt COUnt," On frorn on Sam awful to of Wifhajjt All utility hcated -cOnnectioird " Within 4 ft ns� shall be h section 3f - Outside 0" ' e left (road) the M 0 - b Outside it the rear _Orne. side'.f. e 'hor6e the rnobi/,, / ': /`1)V. / e, �e the *. Setback the side pro shaii b. 5 ft 'fror I/ rhePerty line and 50 ft' center/ine f 1* roaxi 0 the frorn, Maximum of of 2 ft. road' SP gym' eave Overhan: Septic Sys tern au. tj t te and /0cati %J& on n quire Count w r t er7 ts. . oHealth bea,�4s�- De,,t Per h►yn 8(Jkbj1v OLIN TY lio e re 44e rclulrecl for . f4'9 RO a R t MH Util. PERMIT NO. 2868 NO. P �I ), E i4 M w 1• ,�H UTIL. rrPERMIT NO. r PERMIT EXPIRES OWNER Doran Hintz CONTR. ,1 LOCATION (A.P. 58-30-01 ) j e/s Concow Rd., s1s of Ishi Trail, Concow y Temp. Power Fb� / ' Called PG&E ,Temp. Elec. Serv. Called PG&E Temp. Gas Serv. �+ Called PG&E JOB t FINALED i to t ,1 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water PipjAg Piers Roofing Sewer % Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Prov. for physically Heaters Slab handicapped Appliances Carport Conformance of ex. Gas Pi ing & Test Footings structure Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. 4bT` Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS TO: Building -Department' FROM: environmental Healtn Sewage and/or dater Clearance 04N_eR LOCATION A .P# Has been..approved for: SedAG?, DISPOSAL :,:ATTER SUPPLY a� Sanitarian Date 595-775 U 3 TO: Building -Department' FROM: environmental Healtn Sewage and/or dater Clearance 04N_eR LOCATION A .P# Has been..approved for: SedAG?, DISPOSAL :,:ATTER SUPPLY a� Sanitarian Date 595-775 zef COUNTY OF BUTTE — DEPARTMENT OF PUBLI S6? � 7C 7 County Center Driv6 — Drovilye, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. r X� —Date f/ /%-P'r - " Signature of Permitee or Went Receipt No.,/ -5�? 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 Date l6 _?_V --•?j Zing,permit expires Date 7� BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address ell,3J192. Telephone No. Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee o� Building Address �S- C� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 ��, dQ Each gas water heater or vent 1.50 A. P. No. ✓ _ 30~-'t!� Gas piping system 1 - 5 outlets 1.50 /0 Each additional outlet .30 4`51 W. S tion Fire Dept. Fire Zone Use Permit Building sewer 5.00 Old,e9d EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improve nts Lawn sprinkler system 2.00 ���� Parceli4pproval Plans Approval Permit Fee $ / 60 $ 3.1 OG NEW ❑ ADDITION ❑ UTILITIES OTHER [:] ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 D'D Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) - Single Family ❑ Duplex ❑ Mobil Home`& Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 20 balRIn Receps., switches & fix outlets MJ2 LI_ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump 11ty. Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring X[A 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ g.2 is a cx WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. X 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 $ $ 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 TOTAL PERMIT FEE J�- authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. r X� —Date f/ /%-P'r - " Signature of Permitee or Went Receipt No.,/ -5�? 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 Date l6 _?_V --•?j Zing,permit expires Date 7� VVV/' COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drivel- --kOR-ov4114, California 95965 ��� Telephone: 534-4541 APPLICATION AND PERMITA" i By / / r�r"'"'�.'Tr Date /(/-1 7 - 7� Receipt No.�Z J��p s L�OF White-D.P.W. _ Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B Ilding permit expires Date 2- 7j(� BUILDINb Owner 121 / SQ. FT. OCC. BUILDING VALUATION Mailing Address 1/ Telephone No. ' Contractor Fireplace Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address s, �j PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. NO. 3D '-U� Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma 60' R/W P proveM Improve Lawn sprinkler system 2.00 Bldg. la`�ns Itzc'd I Parcel proval Plans pproval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 -7 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) �-�^ Single Family ❑ Duplex ❑ Mobil Home Others ❑ L.� Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures b 1�2 Receps., switches & fix outlets L b2M5 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ is 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. Elhave placed on file with the County of Butte a certificate of 'workmen's Compensation Insurance. ❑-hcertify 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date lo lo -75 TOTAL PERMIT FEE $ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been p DIRECTOR OF U LIC WORKS r, _ By / / r�r"'"'�.'Tr Date /(/-1 7 - 7� Receipt No.�Z J��p s L�OF White-D.P.W. _ Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B Ilding permit expires Date 2- 7j(� 9. �ectrical .40 Is service large enough to provide a-dequate.amperage- to mobileliome (w1ust equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes No Is there proper clearances around panels? Yes No Is power supply cord or feeder assembly properly fused? Yes 04' No_ 5—Z_� A �S Is continuity test satisfactory as per the following procedure? Yes4 No 1 De -energize electrical wiring system of the mobilehome at the pedestal. a Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3/ Switch all breakers and switches in the mobilehome to the "on" position. 4,Connect one lead of a test.instrument to the mobilehome grounding conductor and apply the other "Lead to each m.obilehorne supply conductor, including neutral. $. All non-current., carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. Upon completion of the above procedure, the power supply cord or feeder.assembly conductors. shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment maybe approved for energizing. 10. Is job card signed by Health 'Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length � Width Q Vehicle Serial No, State Identification No. Additional.Information or Comments: MOBILEHOME INSTAL4ATIVN INSPECTION CHECK LIST Is the mobilehome located with required=separatlon from lot lines and buildings and generally conform to plot plan? Yes No �Does -the mobilehome have required clearances above ground? (Sec. 5085) Yes t<No �re footings and supports properly sized, spaced, and braced as er approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No �is the mobilehome level? (Sec. 5088) Yes No .5-` I,f more than a si gle unit, are crossover connections properly installed? (Sec. 5088) Yes No � Wa 'er Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No ' Test - Does water piping withstand working pressure or 50 lbs, air test? Yes No KBackflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No A 7. Wastes and Drains Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No Does it have minimum" per foot slope and is it properly supported? Yes4 No Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? YesNo If coach is not State of California approved, does station have required trap and vent? Yes No NA 8. Gas Piping and Gas Vents Aa A. Connector - Is mobilehome connected to the gas supply with an 'approved 3/4" minimum mobilehome connector not more than 6 ft. long?- Note: All piping is to be at least as lalzK as the mobilehome gas line inlet without reductions other than the mobilehome, conned r. Yes No B. Test OK as r following procedure? Yes- No 1. Open.all a'15Rliance connector valves. 2.. Shut off appl 3. Air test with 6oz.-maximum drop. burner and of valves. to10"-14" water column, or test Edith slope gauge (minimum .) cal rated in tenth pound increments. Test for 10 min. without 4.onnect gas meter to mobilehome with connector, turn on gas, test connections with `soapy water. C. Are all appliance vents properly installed. Yes No /�R � � � �rv�� � COUNTY OF BUTTE - DEP TN�ENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, C' rnia}95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER. , ZONING BUILDING PERMIT OWNER r + lil !1 �,, TELEPHONE 1�f f�,/ SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS N CONTRACTOR'S NAME - TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER /J") r. UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER r LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS r /1 �l '•�� T5 � 7 ii f� f , Lt ' /� � . Permit fee $ PLUMBING PERMIT FiiingFee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeI' Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S 1,61W1 10.00ea TYPE OF WORK New ❑ Addition ❑ Re//model ❑ Uti lities ❑ Installation❑ Other ❑ Describe work: (':'r t fft (C _ V Permit Fee $ ,7 , t�f, Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of p y perjury y (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 ACDNS. ACC. BLDGS. '/xtsgft NEW CONST R. MULTI -OUT LET NON•RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. ) Ex. Occup OUTLETS OR FIXTURES o eaoe e zAL030 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.I EA.) 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. ❑11 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 I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 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. I X - ' - Date Signature of Applicant — O ner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ ,'�/) �•;.�, OCCUP. CONST.TYPC I IFLOODIPARCELI PD ND ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees :DIRECTOR -OF PUBLIC • r, By ""��1' PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS l r , Date / r - j, �~/ l / Receipt No. r r• WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT r COUNTY OF BUTTE - DEPA ENT OF PUBLIC WORKS 7 County Center Drive - Oroville,-Cal a 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO / 67 1 ASSESSOR PAR I1,NUM/E o ZONING - BUILDING PERMIT OWN[R �' T€LEPHONE SO. FT. OCC. BUILDING VALUATION Ow 'S MAI I G A ESS fr®v , C RACTOWS NA fit TELEPHONE C RVCTIORAS MAILING ADDRESS Fireplace CONST CTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCH )ECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARC ITECT OR ENGINEER'S MAILING ADDRESS 01 Penalty $ 1 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 SF ❑ Duplex❑ Mobilehome� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S 10.00ea TYPE OF WORK New ❑ Additi ❑ Re del ❑ Uti ities ❑ Installation[] Other ❑ Describe work: I f4 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 LE0V ORSS Main service 100 AMP 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the Busines$ and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ i am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& , ) �2¢sgft New CONSTR.(AMULTI-OUTLET NO N.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. OCCup(OUTLETS OR FIXTURES 20050¢ eAL030 FIXED APLNS. Ex. OCCUp. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. IYirin 15.00 9 ± I 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 Qertificate of Workmen's Compensation Insurance or a Certificate Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrueain! aga d County in en a of the granting of this permit. Si Date J Signature of Applicant — Owner El Contractor El Agent F1work An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPEJ I IFLOODIPARCEL PD ND ss This permit is hereby issued under cions of the Butte County Code and/or indicated above for which IRE F PU /fz BY PERMIT XPIRES Date the applicable provi- resolutions to do fees have been paid. tIORKS / _22(Receipt No. V WHITE-O.r.W.. YELLOW-ASSCSSOR. P Nx•IN9PECTOR, GOLDENROD -APPLICANT