Loading...
HomeMy WebLinkAbout058-330-058i 58-33-58 RICHARD C. BROWN 3621 Hoffman Rd., roville Permit -#1033- Q P, E( util ELEC. 7Z_ 0 — 2-0 IGAS 1-+9 _& IMPACTION " TEST __ RE ' Q ---------- SUPPORT STRUCTURE REQ. 58- -5 Permit #=_JqMR n,-,,tallat ISSUED. Permit#4307'-90MHI 5 3-58 (installation/ 808-1525 058-330-058 MISCELLANEOUS Demo-Fireo DEMO PERMIT - JUNE LIGHTNING F: 3621 HOFFMAN RD BROWN RICHARD C SS, � _tA �Avltl\:e, IG z 0o z MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 t` PERMIT N0. L --j Q 7 ` Address or location of mof bilehome 36 �� r� r,44., Owner's name k,r 44 11, f • 73k0t`�� Y Owner's address 7ti2 1 P4wu,>,� f. Insignia or hud number r Manufacturer's name t. Serial number of V.I.N. �11 Iy S j i J 3 ✓ Year of manufacture (Official Approving Installation) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. COUNTY OF BUTTE > DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 r.. CORRECTION NOTICE ER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. t+ Hn � inn i bi qe -5c- /1 Date./ Inspector 44 v .. ,.,, ..a ty .�-.Y..:v3c..+"�t'.►+Ft%:.i++*b:+.(1#-Yti-E,Y..+'i..�:o:.w'+Jho.=.:eu-e4..w=r.•.�-..,.--.+� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541' 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE T NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. i Date �� Inspector s COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 • 7 County Center Drive, Orovi Ile — Phone: 538-7541 a oA 747 Elliott Road, Paradise— Phone: 872-6307 L 2 y�� CORRECTION NOTICE R ERMIi NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please/contact this office immediately. /PO c�� (7 ��S C/)i� tf cc 2� /aivtrc`� L+dlwcTijv Inspector_'Aly Date___ U COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE vrvcn PERMIT NO. A routine inspection indicates that the following vio ioi�f ns of'County Ordinance exist at the above address and should be correc& Please notify this office when correction of work Is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector. / Date 7,2 ���! J AP # OWNER PERMIT IP 103 3 —R'9 MH UTIL.CLEARANCE DATE T— INSPECTOR Gtsdl ��t.o4/ i � M ELECTRIC GAS Support Compaction Struc. lTest.Req. Service Other Pipe YESI NOI YES -NO Size Load Type Size Length Z,00,4 It 20� 4)0 �Y 2,6 I a 91��� Sof a_/ <7 occ ccs;e cL,s 0, `X M NP tA /0 A setback nf�end a se back the property lines of 50ft from the road center) ne shall be rnent except of structures or eq p for a 2 ft. eave overhang. nections shall be Withini Utility co e e or W liber 4 ft. oft e r^,obilh,n the rear dire ly bel �{ the ,mw This set of plans and specifications MUST be kept on the job at all times and it is unlawful to make any chaAges or alterations on same without written permisson from the Department of Public Works, County of Butte. J Workmanship Shall Be in NOTE:--Af Materials & Accordance with R,ecognixed use in the d Good Practices and rescril!�ed 'for the Specifie o f a quality F Mechanical Codes arA Uniform Quilding, Plumbing the National Electrical Code. I 330' ,/ I e.�4k S3DlAH3s u�L1id0'I�A�f6� A.i.liti' 1 .k S r.nsr %o i .41 M Q ell + 0 4 0 �1 T✓„N � � r LA ..l i Ul ray .. / • `Ja 'S 144 i t VN 041 0 i J i " 3r :9 lit r I t W COTJNTv t O!AN zulz � _L w <.. DEVELUMENT SERVICES _ f BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds �.,ontractor Applicant: bquare rootage: UNKNOWN BROWN RICHARD C SS, Building Garage Remdl/Addn 3621 HOFFMAN RD OROVILLE, CA 95965 Other Porch/Patio Total (530)534-4826 FEE INFORMATION LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires UNKNOWN I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 8/4/2008 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the :tt:_performance of the work for which this permit is issued. I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 4y, Workers' Compensation insurance carrier and policy number are; Cartier: Policy Number: Exp. Date: (This section need not be completed if the permit is for one hundred dollars ($100) or ass. RCERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 4� X 8/4/2008 SignaSigna ure Date Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip totat unargea: su.Uu tees rata: Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION $0.00 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: IX & A � 4 �y 8/4/2008 � Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. 1 hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the prop y owner ram horized t act on the property owner's behalf. 8/4/2008 Name of Permittee [SIGN] Print Date Owner ❑ Contractor OR Agent for Owner Agent for Contractor FILE COPY PROJECT INFORMATION Site Address: 3621 HOFFMAN RD Owner: Permit NO: B08-1525 APN: 058-330-058 BROWN RICHARD C SS, Permit type: MISCELLANEOUS 3621 HOFFMAN RD Issued Date: 8/4/2008 By GLB Subtype: Demo-Fire08 OROVILLE, CA 95965 Expiration Date: 8/4/2009 Description: DEMO PERMIT - NNE LIGHTNN (530) 534-4826 Occupancy: Zoning: FR10 �.,ontractor Applicant: bquare rootage: UNKNOWN BROWN RICHARD C SS, Building Garage Remdl/Addn 3621 HOFFMAN RD OROVILLE, CA 95965 Other Porch/Patio Total (530)534-4826 FEE INFORMATION LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires UNKNOWN I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 8/4/2008 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the :tt:_performance of the work for which this permit is issued. I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 4y, Workers' Compensation insurance carrier and policy number are; Cartier: Policy Number: Exp. Date: (This section need not be completed if the permit is for one hundred dollars ($100) or ass. RCERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 4� X 8/4/2008 SignaSigna ure Date Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip totat unargea: su.Uu tees rata: Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION $0.00 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: IX & A � 4 �y 8/4/2008 � Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. 1 hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the prop y owner ram horized t act on the property owner's behalf. 8/4/2008 Name of Permittee [SIGN] Print Date Owner ❑ Contractor OR Agent for Owner Agent for Contractor FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name LAJ _\ First , . l Mailing Address 2j a `� City Q�V j ..� l� StateCA Zip C? 4g96 Phone [ t , Fax E-mail APPLICANT SIGNATURE PROJECT LOCATION CONTRACTOR Name_ > Lp Y%_ Address SRA City No State Zip Phone A—t V- A Fax E-mail Open Cov State License Number Class APPLICANT SIGNATURE PROJECT LOCATION ARCHITECT/ENGINEER Name > Lp Y%_ Address SRA City No State Zip Phone A—t V- A Fax E-mail Open Cov State License Number APPLICANT SIGNATURE PROJECT LOCATION APPLICANT INFORMATION Name > Lp Y%_ Address SRA City No State Zip Phone A—t V- A Fax E-mail Open Cov APPLICANT SIGNATURE PROJECT LOCATION AP# rD I Property Address TA City WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. h(\ 1'YL t, : food Zone SRA Yes No Occ. 2Wn A—t V- A Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use onl Zoning food Zone SRA Yes No Occ. Type Const. Butte County Department of Development Services TIM SNE.LLiNGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY PLATO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. OOR NO) 2.(HAV VE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO, 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS PHONE CITY CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: DEMO PERMIT - JUNE LIGHTNING FIRE 062208 Reference Number: B08-1525 Applicant Name: BROWN RICHARD C SS, Owner's Name: BROWN RICHARD C SS, AP # : 058-330-058 ,�ll C� Signature of Property Owner: gt��n� Date: O � 6 I — V U COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATI^I AN,,n PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TEL H NE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS r Rd-, Ornyillp CA 95966 CONTRA TOR'S NAM TELEPHONE CON A TOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN r Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15 00 Energy Plan Checking Fee $ ARCIH?fTflEp,T OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Hottinan Rd. 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❑ Mobilehomeo Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationKX Other ❑ Describe work: MHI replace #3377-89 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service soov OR LESS 100 AMP OR LESS 10.00 Main Service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 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. BLDG S. 2/zQsgft NEW CONSTR. ULTI-OUTLET NON•R ESID BRANCH CIRCITS 2.50 ea POWER APPARA-US e (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20050Q eAL030 FIXED Ex. Occup. OUTLETS PIRESID iREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. 1Virin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Fr—I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue again s saiou fy in consequence of the granting of this permit. X C /'� Date % Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over��3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 70.00 HAz CUA PARK SCHL FLD PAR PD HD IssuE This permit is hereby issued under sions of the Butte County Code and/or work i icated above for which fees CT F UBLIC By 11 4XS PERM Date the applicable provi- resolutions to do have been paid. WORKS Da Receipt No. �"-T � J5 -D WNITE-D.P.W., YELLOW-ASSrS3OR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville,'California 95965 - Telephone: 916/538-7541 APPLICATLON ANO PERMIT ASSESSOR PARC L NUMBER ZO RU.ILDJNG--PERMT-- OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S AILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 112 10, Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 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 [I Duplex[] Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00 ea TYPE OF WORK �,/` New [:]Addition ❑ Remodel[:] Utilities ❑ Instal latioJ Other ❑ Describe work: �� 24�— 53 77-22 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1,100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW F1 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. CWELLING OCCUP.h S. ( ACC. BLDGS. , �z¢sgit -NEW CONSTR. r ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea =OWER APPARATUS e ( SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 200SOC 5AL030 Ex. Occup. OUTLETS FIXED P(RESID )LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 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. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over S'l)" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee S occ CONST TYPE TOTAL FEE $ ��� HAZ cuA PARK scHL fLD PAR PD t+o ISSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-D.P.W.. YELLOW-ASaESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT �q PERMIT NO. — ell PERMIT'EXPIRES. 2 t.- . OWNER RICHARn c BROWN CONTR: et�rr�e;r. " ASSESSOR PARCEL 58-33-58 LOCATION X6-21 uhf fmap. Rd, orovi> > e J OL OFFICE COPY Address T! i GAS 1 Meter By ELECTRIC TI Meter By Called PG&E — JOB FINALED (Date) Signature Date I Date 17/ = OK 0 = Not OK = Not Readyiable MOBILE HOMES MISCELLANEOUS Date MO ILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s . Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements oils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails ater; Location-Test-Easexa 'ceded (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing Electricity;,Location-Clearances-Grnd.:&O Amp -Concrete . Gas; Location -Test -Wrap, / /"L"ft. /"Nat. oE*0 PV ft.�LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -131 Date Gd Card -B1 Date 10. Roof; Shthg-Roofing Card B1 Date T Card -131 Date 11. Ext.; Steps -Doors -Landings Date MO ILEHOME INSTALLATION (Plans) OK except #'s Zo ffg Requirements -Setbacks -Easements Card -131 Date Card -131 Date oo 'ngs; Size -Spacing -Marriage Line Card -131 Date Card -131 Date j6MsjbAH Test -Demand -Valve -Connector J,Iectribity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5 ain; MH Test -Fall -Flex Connector 1. Setbacks -Easements LOeVater; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7 ter and Sewer Con cted-C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining G and Electricit agged xi Insp -S c 4. Elec.; Receptacles and Lighting, Distances-GFI rt. of Occupancy 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 Card -131 Date Card -B1 Date Card -131 Date Card -131 Date 9. Health Department Approval A!1AfF A l l A r C 1 C1 Y n- 10. Plumb.; Cir. Test -Water Supply Test Card -81 Date Card -131 Date Card -131 Date Card -131 Date k V I = OK - 0 = Not OK Applicable - =Not Applicable RESIDENTIAL (Shigle and Duplex) = Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. Zoning requirements -Setbacks -Easements 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. De 3. Ftg., Garage; Soils -Steel-/ '/" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Del 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Material -Su pprt- Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -131 Date Card -B1 Date Card -131 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Flobr-Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -B1 Date Card -131 Date Card -131 Date Card -B1 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 27. 2 Appliance Circuits in Kitchen & Conductor Size 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light Card -B1 Date Card -B1 Date' Card -B1 Date Card -131 Date Date MECHANICAL (Permit) OK except #'s 33. A.C. Ducts Insulation & Support 34. Vent Fan; Exhaust above insulation 35. Condensate Drain & Overflow; Size & Grade 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 37. Attic Access & Platform if Furnace in Attic Card -131 Date Card -81 Date Card -131 Date Card -131 Date Date FRAMING (Plans) OK except #'s 38. Sills, Proper Material & Anchors 39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 40. Bearing Walls over Girders & Floor Nailing 41. Draft Stop in Walls (rat proof) 42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 43. Header & Beam -Size & Bearing Date FRAMING (Continued) 44. Hangers -Post Caps -Anchors -Connectors 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 46. Fireplace Ties or Type A Flue -Fireplace Throat 47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 49. Garage Fire Protection Framing 50. Property Line Firewall & Openings 51. Ext. Doors -One T -Check Garage -3rd story, 2 exits 52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 54. Siding -Nailing Veneer 55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 56. Glazing Area -Glass Protection -Skylights -Plastic 57. Shear Walls; Nailing -Bolts 58. Insulation-Walls-Clg. 59. Infiltration-Walls-Wndws Card -61 Date Card -131 Date Card -B1 Date Card -B1 Date Date FINAL (Plans) OK except #'s 60. Ext. Steps -Door & Sidelight Protection -Landings 61. Smoke Detector 62. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 63. Bedroom Exiting 64. G.F.I. & Bath Fixtures & Tub Access -Spa 65. Elec. Trim & Subpanel; Breaker Sizes -Labels 66. Stairs & Rails 67. Fireplace or Stove; Clearances -Hearth 68. Elec. Outlets at Wood Panel; Int. & Ext. 69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 70. Elec. Outlets & Receptacles at Kit. Counter 71. Garage Fire Door; Swing -Landing -Closer 72. A.C. Duct in Garage -Damper 73. Wtr. Mr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 74. Plb., Elec. & Mech. Equip. Listed for Location 75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 76. Insulation -Foam -Looked In Attic O Yes 77. Guard Rails & Deck Construction -Post Caps 78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑Yes 79. Following instld.; Drive o Yes 0 No; Walks O Yes O No; Planters O Yes o No 80. Stucco; Brown -Finish 81. A.C. Unit; Disconnect, Electrical, Plumbing 82. Vents Above Roof; Plbg.-Appliance-Firep I. -Clearance to Openings. 83. Water Well; Disconnect, Electrical, Plumbing 84. Exterior Elec. Trim; G.F.I. Receptacle -Underground 85. Ventilation throughout House 86. Glass Protection 87. Corrections from Previous Inpections 88. Gas Test -Meters Tagged; Gas -Electric 89. Water & Sewer Connected -C/O to Grade -HD Approval 90. Energy Compliance Certificate -Other Certificates Card -81 Date Card -81 Date Card -131 Date Card -B1 Date Card -B1 Date Card -Bt Date Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS — 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT 0. ASSESSOPARC MBER. -�5 ZO r;IG._ BUILDING PERMIT owR I n #, TELEPHONE — SQ. FT. OCC. BUILDING VA ATION ORN R'S A LING AD R`E CO TRACTOR'S NAME T LEPHONE C TRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN C Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Iq Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeK Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW I0.00 ea TYPE OF WORK New ❑ Addition ❑ / emod 1 ❑ Utilities ❑,t Installatio Other ❑ `j Describe work: IST �r'��� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eoov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 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 oa ADDNST DWELLING SDWELING CCUP.N) // y2Qsgft NEW CONSTR.TI.OUTLET NON.RESID BRANCH CIRCUITS) 2,50 ea POWER APPARATUS 6\ SINGLE OUTLET CIR. I Ex. Occu p OUTLETS OR FIXTURES 20@030 DAL@30 Ex. Occup. OUTLETS FIXED P(RESID )LNS REA.) 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 f Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 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 Coun in consequence of the granting of this permit. -ate-- _ -7 Q� Xc� C Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ IL TOTAL PERMIT FEE $ OcCUP. CON3T.TYPE SCHOOL OD PARCEL PO I NO I ISSW This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees D C Jnr BY PERMIT EX i ES Date the applicable provi- resolutions to do have been paid. WORKS / Date �w Receipt No. � WHITE-D.P.W.. YELLOW-A38C3SOR, PINK -INSPECTOR. GOLDENROD -APPLICANT 'M� \ COUNTY OF BUTTE - DEPAF(TMEMNT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICAYIUN DATA SHEET --� Permit No. OWNER 1 C V! Cl ✓ Cf 1 YQ Gtr A. . No. Proposed Building UseBuilding Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing andJor issuance: DATE RECEIVED APPROVED 1. All items.have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate, signed by preparer of plans. 3. Complete plans in duplicate./triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to ownerE] Improvements maybe required. . . . . . . . . 6. Mobi lehome Installation Data. . . . . . . Pre-Inspec. request to (Date) 17. Pre -Inspection for Required, Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of 21. Engineered trusses in duplicate (required prior to plan check). 22. " f When you issue the permit, rocess as follows: Mail toRowner, Mail to contractor. Telephone 5.3�-tfip and hold for pickup aLC Ooffice, Deliver w/inspector. Other M54) GV Applicant �Jy'""� c Date c% — 7 _ Q, Copy of plans sent Health Dept., Fire Dept., Other Date 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_—jnall—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Sets of plans on hold in File cabinet AP folder Coov—DPW e COUNTY OF BUTTE - Department of Public Works 7 County Center Drives,-Oroville, CA 95965 Phone: 916 -538 -7541 - OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan -to provide the major labor and materials for construction of the proposed property improvement (yes or no) Y 2 S 2. -I (have/have not) Y -e 5 . signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property OwnerSocial Security Security Number Date 4 — -7 - c?D 0 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to,our office before we are per- mitted to issue the permit. l BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 2. Installer's Name: 3. Is the site currently under permit? Yes FV -1 No F] \1D3 -5—) (If yes, furnish permit number , OR Is the site an existing site? Yes No (If yes, furnish two 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 IV -1 No 1-1 (If no, clarify 5. What is the mobilehome electrical rating? --------------- ��� Amps 6. What is the mobilehome site service rating? ------------- do v Amps 7. What is the mobilehome site circuit breaker rating? ----- /S-0 Amps 8. Is there any other electric load to be served by the ----------- --------------------- KI mobilehome site service? % Yes C No F (If es identify the load and size: (Load) S (Amps) a y , What is the mobilehome site gas pipe size? ---- �------- 10. What is the type of gas service? ------------------- Natural 11. What is the gas pipe length from meter or tank to the 7 — (in.) LPG X mobilehome?=-------------------------------------------- 12. What is the mobilehome gas demand? ---------------------- BTU ..:.... _( ,. *(This information not required if pipe length less thartj on COLTS natural gas or less than 50 ft. on LPG.) APPFjOVE I MOBILEHOME SUPtORT DATA If other than single wide, Mobilehome Mfr. ( ,4L A4ff— furnish Setup Model No. Width eo(ft.) Box Length i (ft.) Tagalong or Expando Size Year ft. x ft. 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). FOOTINGS (check one)�l. Wood -pressure treated or foundation grade. 2. Other (specify) SUPPORTS (check one) 1. Concrete block.a 2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Line 1 a .� Line 1 Line 2 Main Beams Linc 2 — — — � Main Beams Line I Piers: Size -Min. --------- Spacing -Max. --------- Frnm Inds -Max. ------- ' ,• Line 2 Piers: Size -Mill ------------- S pac ------------Spac J_L,g-Maw ---------- From ---------From Ends-Max-------- Line ------ Line 3 Woof loads: Size -Min. ------------ Tag or Triple Line 4 r Line 1 Line 1 Openings: Size -Min. ------------------ "x ' Each Side of Openings With Width Over --------- " Line 3 Piers: (Under Bearing Wall Only) Size -Min .------------------ x 'Sp4cing-Max.--------------- From Ends -Max -------------- _ F INI. '•x111"x "x -d . "x "x "x _'x Location (From FronL) Line 4 FLerss: Line 5 Piers: (Under Bearing Walls Only) Sizo-Min.------------Size-Min.------------------ ,k „x Spac L,g -Max.--------- , .. Spacing -Max .--------------- , From Ends -Max.------- From Ends -Max .------------- Linc 5_ hoof !nada: ' Slze-Mfn.------------ M A Y [A, Ch Lion (From Front) "x Ix COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS t 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERM 1 NO. .:711 ASSESSOR PARCEL NUMBER S - ZONING _ BUILDING PERMI Ow N43R e In + ✓I© At S TELE�1PPHO`J�E11 5 T, 7 SQ. FT. OCC. BUILDING VALUATION O R' AI I N G R 55 O ✓` O ` e, CRACTOR'S NAM OnW )I e7 ✓� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CON RUCTION LENDER O - UNKNOWN Total Valuation $ Filing Fee $ 10 -OT LENDER'S MAILING ADDRESS" Permit Fee $ ARCHi, ECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECTOR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADD ESS 6z , 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[] Mobilehomeg Other sPECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 0.00 eac 190 TYPE OF WORK j New ❑ Addition ❑ Remodel ❑ U�tilities R Installation❑ Other ❑ Describe work: % r/�'f� �• Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 500V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ❑ 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.61) OR ADDNS. ACC. BLDGS. +/Z�sgft NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRCUITS) 2,50 ea POWER APPARATUS el SINGLE OUTLET CSR. % Ex. Occup(OUTLETS OR FIXTURES eA 030 Ex. Occup. OUTLETSP(RESID FIXED AINIS )RE A.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 ✓I Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Cou,�J � in consequence of the granting of this permit. _/ 9 QThis X /I� C-�_— Date Signature of Applicant - Owner [r 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. CONBT.TYPE SCHOOL — FLOODLOICRCEL PD ND Iseu ' permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC P MI EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 6 Receipt No. �c WNIT[-D. P. W., TELLO W -A38 [780 R, PINK-INBP LCTOR, GOL OlN ROD -APPLICANT TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance ...... -.R - i A- (� (- o �rr -Y - 3,3 Owner. Location AP# Plan Approved for: Sewage Disposal __ Hold final for: Final clearance O.K. for: Clearance for bedroom obil home. NOTE *** Other Water Supply tic Water Supply Water Supply Sanitarian Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION a 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET _/' ' Permit No. OWNER 1 C ✓, �� A,%�P. No. 56^3' :��_ Proposed Building Use !/` Building Inspector Date t At time of permit application, I was advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECEIVED APPROVED 1. All items.have been submitted. . . . . . . . . . . 2. Plot plans in duplicate/triplicate, signed by preparer of plans. , 3. Complete plans in duplicate. /triplicate, signed by preparer of plans, 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. : . 8. Fees of $ . . . . . . . . Letter.of signature authorizati!on�. Sanitation approval from C/�'OV /Uea,th Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) , 14, Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) _15. Improvements may be required. . . . . . . . . . . . 16, Mobilehome Installation Data. . . . . . . . . Pre-Inspec. request to (Date) . ,i� Pre -Inspection for Required, Building Inspector �/_ 18. ,ecorded copy of Agricultural Acknowledgment Statement. driveway Permit. 20. Plot plan approval from city of X' 21. Engineered trusses in duplicate (required prior to plan check). 22. WhUp you issue the perm't, process as follows: —Mail to owner Mai I to contractor. Telephone - et 7-c;,1-4 and hold for pickup atl&;fice, Deliver w/inspector. Other Y►1 S Applicant 4� G 42 — Date V-7 _T8 a Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted pri9f Jo -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---mai I counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW 0 COUNTY OF BUTTE - Department of Public Works 7.County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 " OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) e S 2. I (have/have not) !C -e 5 signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I.will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property . Owner �� C ,Z" -- Social Security Number Date t/ — I_/9 ? P NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to�our office before we are per- mitted to issue the permit. f STATE OF CALIFORNIA {ss. AG STATEMENT MITAWBROWN COUNTY OF Butte I On .lune 17th, 1988 before me, the undersigned, a Notary Public in and for said State, personally appears Andrew J. Mital perso—fly known to me (or proved to me on the basis of the oath of a credible witness who is personally known to me) to be the person whose name is subscribed to the within instrument, as a witness thereto, who being by me dutyswom, deposed and said: That he/she resides Califer-Ria that he/she was present and saw Richard C. Brown personally known to him/her to be the same person(s) described in and who executed the within instrument, as a party(ies) thereto, sign, seal and deliver the same and that said party(ies) duty acknowledged in the presence of said affiant, that he/she/they executed the same, and that said affiant, thes+eupon at the partys(iesl request, subscribed his/her nam as a witness "hereto. W ITN ES�✓rt` ltd/� I`' tCiIr.G Signature MARION L BECKER NOTARY PuBLIGCAUFORNIA Butte County My Commission Exptres Feb.18,1989 (This area for official notarial seal) RcItur.n to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 8'8 -•2.0 �� 3 FOR RESIDENTIAL DEVELOPMENT S,ection 26-8.1 of the Butte County Code requi.res this acknowledgement be recorded prior to :issuance of a building permit. - The property described herein is adjacent 88-0201 14 Rec Fee 9.00 to 1 and or i..ncluded within an area zoned Cash 9.00 for agricultural purposes, and residents Recorded ' of Lhi-s property may be subject to incon- Official Records veniences or discomfort arising from the County of use of agricultural chemicals, including, Butte but not limited to herbicides, pesticides, Candace J. Grubbs and fertilizers; and from the pursuit Recorder of agricultural operations including, 8:01am 22 -Jun -88 1 RB 3 but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generale dust, smoke, noise, and odor. Butte County has esLabl.ishe(l z�fricul- tural zones which have as a priority use for productive agricultural. purposes, and residcnls within said zones and on adjacent property should be prepared to accept such i.nconvcu i crrcc or disconfor.m from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, describc(l ;is follows: V 3' Date: !Q-/%�"d0 Andrew J. ita , witness S L a t e of L/F ) ) SS. County of: &/VZV ) PROPERTY OWNERS: A 0 ,,- Richard C. Brown On this the day of , 19 before me, the undersigned Notary Public, personally appeared Person lly known to me .re on th'e•�bas i :v of satisfacL ev rd�4ic e to be the person(s) whose name(s) A subscribed to the within instrument and acknowl dged�,gtll�_ executed the same for the purposes therein con aned `�f WHEREOF I hereunto set my hand and official seal';1«�t c Present A.P. No. �`�� �3-_�O Notary Public .W1'.I'NVSS 8861 in'r .S� td a� olland z/o liclao a Qn _qo,�jIvrloo M R, DESCRIPTION: All that certain real property situate in the County of butte, State of California, described as follows: PARCEL I: Parcel 1, as shown on that certain Parcel Map being a portion of the Southwest quarter of Section 3, Township 22 North, Range 4 East, M.D.B. & M., filed in the Office of the Recorder, County of Butte, State of California, on November 25, 1981, in Book 86 of Parcel Maps, at Pages 98 and 99. PARCEL II: A non-exclusive easement for road and public utility purposes as shown on that certain Parcel Map being a portion of the Southwest quarter of Section 3, Township 22 North, Range 4 East, M.D.B. & M., filed in the Office of the Recorder, County of Butte, State of California, on November 25, 1981, in Book 86 of Parcel Maps, at Pages 98 and 99. PARCEL III: A non-exclusive easement for road purposes and public utility purposes 30 feet in width lying Easterly of and adjacent to the East line of Parcels 1 and 2, as shown on that certain Parcel Map being a portion of the Southwest quarter of Section 3, Township 22 North, Range 4 East, M.U.B. & M., filed in the Office of the Recorder, County of Butte, State of California, on November 250, 1981, in Book 86 of Parcel Maps, at Pages 98 and 99. PARCEL IV: A non-exclusive easement for road purposes and public utilities purposes over a strip of land 60.00 feet in width, lying 30.00 feet on each side of a line beginning at a point in the East line of the Southwest quarter of Section 3, Township 22 North, Range 4 East, M.D.B. & M., which point bears North 000 12' East, 30.00 feet from the Southeast corner thereof; thence from said point of beginning, parallel with the South line of said Section 3, North 89° 54' West, 512.00 feet; thence North 760 45' 30" West, 137.00 feet; thence North 360 31' 30" West, 292.66 feet; thence North 650 53' 45" West, 63.25 feet; thence North 890 44' 45" West, 164.53 feet; thence South 58° 53' 15" West, 170.15 feet; thence North 730 24' 30" West, 107.94 feet; thence North 300 00' West, 56.00 feet to the end of said centerline. PARCEL V: A non-exclusive easement for road purposes and public utilities purposes over a strip of land 60.00 feet in width, the South line of said easement being described as follows: BEGINNING at the quarter corner common to Sections 3 and 10, Township 22 North, Range 4 East, M.D.B. & M.; thence running Easterly along the South line of that certain property conveyed to L. A. Schager, et ux, by Deed dated July 8, 1955, recorded July 12, 1955, a distance of 720.00 feet; thence North 110 32' East, along the South line of said L. S. Schager property, a distance of 147.00 feet; thence continuing along said South line, North 56° 18' East, 774.00 feet, South 680 2B' East, 445.54 feet (continued) I 1�a S PARCFL V - CONT INUFu to the Northwest corner of that certain property conveyed to F. b. Marshall, dated October 30, 1942, and recorded Occember 3, 194'2, in Book 305 of Official Records, at Page 473; thence along the Northerly line of said F. S. Marshall property, Easterly to the Fast lire of Section 3, said point being 381.50 feet Northerly of the Southeast corner thereof. PARCEL VI: A non-exclusive easement for road purposes and public utility purposes 60.00 feet in width lying 30 feet on each side of a line beginning at the Southeast corner of Parcel 2, as shown on that certain Parcel Map being a portion of the Southwest quarter of Section 3, Township 22 North, Range 4 East, M.D.B. & M., filed in the Office of the Recorder, County of Butte, State of California, on November 25, 1981, in Book 86 of Parcel Maps, at Pages 98 and 99, and running thence South 1° 49' 23" West, 1012.09 feet to the end of said line. END OF DOCUMENT Vb .Butte County Department of Development Services PERMIT CENTER 7 County Center Drive; Otoville, CA,95965 Main Phone (530)538-7601 Permit Center Phone{530)538-6861 Fax (530)538-2140 s FORM NO DBP -5 SITE PLAN Assessor's. Parcel Number: ®E. J;-- ' ® f7] Permit #: apop- CA)vV$N& c M owner Name:. -^ w8 4lu.) C-_'• C;,2ocyy. r e 1„ . . Scale — wT .. . _-_ O O Address /.Phone: 3021 HyF NIf�iV .�D .• ORoV. CA � � 9 (n5 . / ►[ 530) J5.33 -��r. _ o Site !Location: o. Contact Name- Phone: u'1"►' c ua'�'t COUNTY 1::\vf, W Wfs(3ST.TR\IiuilJin�113ui.Iding.f Dims K DocumentAAppru.ved 301 1 forms -handout. rind on list\DBP=U5 3.23.1 1 Site Phuf P:µ�er.i Oc . Page :1 of 1 JAN 05-2012 DEVELOPMENT .. ..SERVICES ... .. ... �.. :' ... .. .... � :..-.:', :.. � , Butte County Department of Development'Services ' . PERMIT CENTER 7 County. -Center Drive; Oroville, CA 95965 Main Phone (530)53877601 Permit Center Phone (530)538-6861 Fax (530)538-2140 FORM NO . DBP -5 SITE PLAN Assessor's Parcel Number: 0 .0' 51;— = -- Fo- 1 F5_10 Permit ##: s Sof 1 ,r �?U �Jil lro "L -L4—