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058-530-011
JACK L. BRYSON 7(-,,- 7Dfor NIS pri rd, app 400' E of 800:' N of Ishi Trail., --app Of Oro Concow Rd,.Concow Permit #2990-77E(perm polfuture SF & well) fut lot A 58-36-79 Permit 5881�7*,�,M new SF) ,,CONTR: Wentl'�nd Co�1r aradise r 0- 058-530-011. 06-1478 DAFALIA, JESSICA 4141 JACK DALE WY, CONCOW Cont: CONRADS PLUMBING HEATER(WATER)�e ?i 08=1384 058-530-011 MISCELLANEOUS Electric Panel NEW POWER POLE AND ELECTRIC F 4141 JACK DALE WAY JESSICA DAFALIA CD CD h �a� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 4141 JACK DALE WAY Owner: Permit No: B08-1384 APN: 058-530-011 JESSICA DAFALIA Issued Date: 7/21/2008 By GLB Permit type: MISCELLANEOUS 4141 JACK DALE LANE Subtype: Electric Panel OROVILLE, CA 95965 Expiration Date: 7/21/2009 Description: NEW POWER POLE AND ELECTR: Occupancy: Zoning: FR10 I Contractor Applicant: Square Footage: D T G ELECTRIC D T G ELECTRIC Building Garage Remdl/Addn P O BOX 8923 P O BOX 8923 CHICO, CA 95927 CHICO, CA 95927 Other Porch/Patio Total (530) 321-6233 (530) 321-6233 FEE INFORMATION DBE Single Phase Service-Resid $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B8028 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License D T G ELECTRIC 825782 / C10 / 10/31/2009 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PE URY that I am licensed under provisions of Chapter 9 (commend g ith Section 700,P) of D7''3 the Busine sand Professions Code, and my license Pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full jorce�and effect. of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the 1 basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects !/ X7/21/2008 the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: Contractor's Signature Date ❑ 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: r on (This section need not a completed if the permit is oe hundred dollars ($100) or less. ❑ I AM EXEMPT under Section B. & P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any in any to become Workers' X 7/21/2008 person manner so as subject to the Compe 91.on Laws of California, and a a that if I should become subject to the workers' compo sat on provisions Section 0 of the Labor Code, I s II forthwith comply with those Owner's Signature Date provi ions X 7/21/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signet a Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with o,o HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owner' behalf. ,1/rGL Gni , 7/21/2008 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner Eq ontractor OR; Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip -BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICEStBIN MIT BUILDING PERMIT APPLICATION* * OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY "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. APPLICANT INFORMATION OWNER INFORMATION Last Nam _ ..-- lil-11ame Mailing Address City City +Ialale Zi Z Phon g E-mail E-mail Lic. # " APPLICANT INFORMATION CONTRACTOR Name ..-- Address Zi City /C State Zi Ph ne 3 t, ti Fax E-mail Lic. # " 5T%9. -e-- Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City©, Address Zi City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name IL/ C Address 30' City©, States _ C �► Zi P ne - 53 " Fax mail � IN PROJECT LOCATION AP# o 7 0 . � L Property Address city (De v `T T LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. a Oc�TG� Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA Yes INo Occ. I Type Const. 1�1 A 1/1, 0 6 65o, Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buffecounty.net/dds www.buttegeneralplan.net APPLICATION FOR ADMINISTRATIVE PERMIT FOR SPECIAL TEMPORARY TRAVEL TRAILER - 20x08 BUTTE COUNTY FIRES* Owner�� U' c., I Phone #: t 6 J 9 T/T.ilinrt A�riracc `l n —1'\ �. iir r F_mail ArlrlrPcc- Assessor's Parcel Number: 059 —X30 %i l — 000 Street Address of Site: "l l q ) Jac ic— c) G L w-, nyw; i � , CA - The temporary travel trailer is allowed for a maximum of 24 months from the date of the event; however, the use of the travel trailer will fall under the jurisdiction of Butte County Code Section 24-300(c) following the issuance of a building permit for a residential unit (stick -built or modular home). I [OWNER NAME] certify that the above information is correct. Owners' Signature: Shu - Date QJ k-1/ 42, a —09 * Temporary Travel Trailer permit specifically for those properties with residences impacted by the 2008 Butte County Fires. Residences not impacted by the 2008 Butte County Fires are eligible for a Temporary Travel Trailer pursuant to Butte County Code Section 24-300(c). Date revised: August 6, 2008 , K:\BUILDING\Fire Storr;'�008\Forms\ADM_Special Temp Travel Trailer -08 BC Application.doc i. s i PERMIT NO. 5881-77 B;P,E,M PERMIT EXPIRES ,OWNER Jack Bryson CONTR. Wentland Construction, Paradise LOCATION (A.P. 58-36-79 r n/s private road'app. 400' E. of Yana Trail, 800' N. of Ishi Trail, app. 2 mi. E. of Concow Rd., Concow area, S P l f /� I u. Pr.h 1 . .e • r t c f Temp. Power Pole y Called PG&E i1 Temp. Elec. Serv. Called PG&E Temp. Gas Serv. °Called PG&E �I �r ^ JOB C2- :: �. FINALED (Date) lee i t s. 10;�Yo '(Signa r i r COUNTY OF BUTTE `9EPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback I - Firewal .. Soil Piping Forms Parapet 1st Floor r 0-77 Bldg. Restroom Finish 2nd Floor Footings — Windows 3rd Floor Stemwall ' -/1, — Slab Siding Roof Sheathin To out _ Water 011RAg Piers - pj Roofing Sewer Gara a Fdn. Vents Fixtures Footin s Stemw Garage Vents --a --------- insulation Water Htr. Heaters Carpo Footings Prov. for physlcally handica ed Conformanc �,9.f Qx �— structure 4, ofTemp. Appliances Gas Piping & Test as Slab Final Sanitation Patio 91046LACE Final Footings Footling ELE RI AL Masonr Wa Throat Rou h Relnf. Steel Final F I x tu re W U Z-70 Bond Beam FIRE hPANK121116 Motors Framing -• /lo-, Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. 2 Scratch Heating Service Brown Cooling Temp. Pole Finish"'Ducts Underground La Interior th Ventilation Pe nent . Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec:•'Service Elec. Pecrestal Water Piping Sewer Gas Piping M9BI6EHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE /�� REMARKS OR CORRECTIONS �'4`I/3- � x 14 kie, (z 47,1 CP ®.��� ' . It Sar". e",71 %0�uo i� Wentry be�rpad t fio��g_h time y jo�slii.,?� • 4 � f C-0 Y .ERTIFICATIONS �s required by the State regulations,, -both the builder and the insulation ipp.lica or must sign a card certifying that 'the proper "R" values for all Lnsula-tion Ioca:ti-ons have been .installed.. An example-of_a_certifica.tion :ard, which .is .furnished by the builder or insulation applicator is shown Ln Fig. 13.. 0 THIS IS TMT TWIT INSULATION HAS BEET INSTALLE11 IN'CONFOMA4CE WITH THE CURRENT ENEMY REWUTIOYS, CALIFORNIA ADMINISTRATIVE .CODE, TITLE 25, STATE OF 4ALIFORNIA, IN -THE .BUILDI LOCATED AT: rat 'EXTERIOR WALLS 1 - :#Wnrifacturer -%� TAirkness/TYRe C.L AS S R'Ns1us CEILIISS 1� __.8atts:_w__ftanufectorar" ?—Thickness 7TOW l RAM'it valuo ........ _Hlmin: Manufacturer 17-` Thickness NO. Eggs Wt. Mfic�_ -.. Sq.. Ft. Covered R VMue -:FLOORS ? lR-// Manufacture►...__ _ Thi.cfa+ess/Type��D)r' R YalU. r, s SLAB'ON.GRADE t .. • Mameacturer ThiziumsfType — R Value _ Width of Insulation .Inches _ J FOUNDATION VkLLS Manufacturer 'Thickness/Type ^� R valve F E CONTRA R L S� (-() LICENSE AMBER 3I6� 6 _ BY c,J TITLE UUNE�' _ DATE 3 5 I T TION L 4 / LICENSE NUMBER 6 J� 6 S' -BY TITLE Q t,J (/E2 DATE Y 0 y Fig. 13 -8-14 d - COUNTY OF BUTTE-- — DEPARTMENT OF PUBLIC WORKS 7 bounty Center Drive — Uroville, California 95965 ' Telephone: 534-4541 APPLICATION AND PERMIT e` %_77 BUILDING Owner G� 2 d SQ. FT. OCC. PUILDING VALUATION Mailing Address 2 Telephone No. %0 1 Fireplace Contractor n (, V) D, Total Valuation Mai l i ng Address 6 , jW A- Permit Fee Plan Checking Fee &/or Penalty PA vz* 013 -72,-Permit Fee $ ' Building Address r '` • `�''�r PLUMBING No. @ FEE PERMIT FILING FEE $3.00 r Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 c.e��oeitn i ' U;11 Each gas water heater or vent 1.50 .- -7ei r A. P. No. / I —Z Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W Sat' Fire Dept. Fire ne Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improve ents Lawn sprinkler system 2.00 Bldg ans Recd l.Pf �"--r arce�roval Plan pproval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3, LE00V ORSS Main service 100 AMP 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELLING O & OR ADDNS. ACC. BLDG P. ) 2¢sgft NEW CONSTR. MULTI.OU E NON.RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. I 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 Ex. Occup(OUTLETS OR FIXTURE style of: Ex. QCCU P• FIXED APPLNS. OR OUTLETS (RESID.) EA LZE4ff?=&/1) CDAIS— : CO . Temporary service Mobile Home Facilities n License No. ��,�a �j � Classification F.�--- Misc. Wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT FILING FEE I am aware of the provisions of Section3700 of the California Labor Heating Code which requires every employer to be insured against liability WW1, men's Compensation. have placed on file with the County of Butte a certificate of for Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certify that have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby au ize representatives of the unty of Butte to enter upon the ove- entioned pr ert iInspectio urposes. C X Date Signature ol Permitee or Agent Receipt No. 17 0 A 2_ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Cool i Ventilation Hood Permit Fee 2.00 10.00 15.00 6.25 0 mom _um fi•it[�� 2.00 $ IX L�_ TOTAL PERMIT FEE This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date l/—! j — Butlding permit expires Date l/—t 7-7 RESIDENTIAL PLAN CHECKING GUIDE , .(5.F., DUPLEX, & MISC. ONLY) `3R�(�al. . Bldg. Permit # OWNER A.P. # A. GEAT ning requirements (sideyards and parking). luation. Signature by R.C.E. or Architect (if required). B. PLOT- PLAN omplete parcel size and dimensions. backq, sideyards, easements, etc. Other buildings or structures. Grading, fills, drainage. C. FLOOR PLAN / Complete to scale plan with dimensions. Required windows for light and ventilation (Sec. 1405). / Required windows for second exit (Sec. 1404). Allowable glazing for energy requirements (20% -max. per State law). ,5! Human impact glass (Sec. 5406). Required room sizes, ceiling heights (Sec. 1407). G.F.C.I.'s in baths and exterior outlets (Sec. 210-8). �! Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. Locations of water heater, heating & cooling equipment, other electrical or gas equipment, and plumbing fixtures. Garage firewall, door size, and closer (Sec. 503(d)(4)). 1 - 3'0" exterior exit -door (Sec. 3303d). Fireplace location. 1 Smoke detectors (Sec. 1413). D. STRUCTURAL DETAILS Jl" Foundation plan complete enough to construct building. F1,qu construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. Roof construction details complete enough to construct building. Fireplace construction details and calcs if over one-story in height. . Sufficient data and details to satisfy energy insulation requirements (State law). E. MISCELLANEOUS ITEMS TO LOOK OUT FOR CCX plywood on exposed locations and overhangs.' Stairway details (Sec. 3305). Guardrail details (Sec. 1716). Brick or stone veneer (Chapter 30). Exterior plaster --weep screeds (Sec. 4706 & 4708). Proper roof pitch for roof covering (Chapter 32). y: Rafter ties or bearing ridge beam. j: Garage door or porch header sizes. t".1 . Adequate bracing. Living area over garage - complete 1 -hour separation required including supporting walls and posts, etc. 1 Two (2) exits on three-story dwellings (Sec. 3302). r COUNTY OFIB'UTTE — DEPARTMENT OF PUBLIC WORKS V County Center Drive —tt Uroville, California 9596-,5 Tel ephone:f534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. r Xti • , , /, A.A, - Date Signature of Permitee or Agent Receipt No. 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 ' ` `� „'bt/- Date Building permit expires Date f —. 21/ - %t> BUILDING . Owner,KaC k LJru SUnq SO. FT. OCC. BUILDING VALUATION Mai l i ng Address 12),p 1 Vi o a o, (� /e( VAdIse Telephone`No. Ff97-5K Fireplace Contractor V7% -.zy(ro Total Valuation (/ "" 't Mailing Address Permit Fee • Plan Checking Fee &/or Penalty ' Telephone No. Permit Fee $ Is /� Building Address Al/ -j �I/llfli t i/o/1,-,1 y PLUMBING No. @ FEE PERMIT FILING FEE $3.00 r .,� �' ,d' Ila h.,. fv� � l � stun ' h 1. � � Each Trap 1.50 / .I F -} l l f /s► I ,Q/.ek H 1' IAb Repair drainage or vent piping 1.50 Water piping 1.50 tayrJ /Y� „ t1.��fl,) /!.7.l1 Each gas water heater or vent 1.50 A. P. No. ,� �j -�Zoni Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees' W.C: I Sanitation FireDept. FireZone Use Permit Building sewer 5.00 EOA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 Bldg. -Plans Rec',d �. / � Parcel Approvol Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 'R ELECTRICAL No. @ FEE FILING FEE $3.00 �L r fPERMIT �'it'Yt���1l1 •Qw�p 'f [n, �� Main service 100 AMP ORSLESS 5.00 AA Main service EA. ADO'L 100 AMP 2.50 Single Family•❑ Duplex ❑ Mobil Home ❑ Others 0 OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 Ld �d1 / ..(I'1 �•'lf/Y�J.G1 Qifi NEW CONST. DWELLING OCCUP. & OR ADDNS. ACC• BLDGS. 20Sq ft NEWCONSTR. //MULTI -OUTLET NON .RESID, (BRANCH CIRCUITS) 2.50ea - NEW CONSTR. (POWER APPARATUS &) NON.R ESID. 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 st le of: Y Ex. Occup(OUTLETS OR FIXTURES)@L N'5C1 BA 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 r❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 10?"C v$ /,� .� 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. 0 I certify that in the performance of the work for which this / permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. r Xti • , , /, A.A, - Date Signature of Permitee or Agent Receipt No. 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 ' ` `� „'bt/- Date Building permit expires Date f —. 21/ - %t> COA)CO �w7 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Orovi Ile, California 95965 TiRtpfione 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the This permit is hereby issued under the applicable provisions of above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated 1� ) above for which fees have been paid. ate � � 17 / � 7 41=:OF LIC WORKS gnature of Permitee or Age%t ,— /��� By Date /' Receipt No. b White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant permit expires Date t1a ';�W-- e BUILDING OwnerCi SQ. FT. OCC. BUILDING VALUATION Mailing Address 0 Telep of Fireplace Contractor r% ^ZIV� Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty e Tlephone No. Permit Fee $ Building Address A11-5 1" i ver. te 0 ' PLUMBING No. @ FEE PERMIT FILING FEE $3.00 ' Each Trap 1.50 b Repair drainage or vent piping 1.50 Water piping 1.50 r Each gas water heater or vent 1.50 A. P. No.Zoni ng & Planning Gas piping system 1 - 5 outlets 1.510 Each additional outlet .30 Fee W. Fire Dept. FeiireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Va cel M P 60' R/W Improvements p Lawn sprinkler system 2.00 BWu9. Flaw ° '� Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHERJA ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 411a I� 4Q j.TMain service 100v DR LESS 5.00 100 AMP ORLESS Main service EA. ADD'L 100 AMP 2.50 Main service OVER e O 25.00 100 AMP OR LESS Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELLING OCCUP. & OR ADDNS. (ACC. BLDGS. � 2¢sgft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) '2.50ea NEW CONSTR. (POWER APPARATUS & NON•RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name le of: style Ex. Occup(OUTLETS OR FIXTURES)50 @25� 109 Ex. OCCU FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 i7se No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 71.2mis �3 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 orkmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner ,/so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEEPERMIT 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 TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the This permit is hereby issued under the applicable provisions of above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated 1� ) above for which fees have been paid. ate � � 17 / � 7 41=:OF LIC WORKS gnature of Permitee or Age%t ,— /��� By Date /' Receipt No. b White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant permit expires Date t1a ';�W-- e Butte County Fire Assistance Center 7 County Center Drive Oroville, CA 95965 (530) 532-5662 Telephone (530) 538-7785 Facsimile December 15, 2008 Jessica Dafalia 5310 D St. Sacramento, CA. 95819 RE: ADM08-0032 Temporary Travel Trailer Permit, 058-530-011 Dear Jessica, Your temporary travel trailer permit has been approved. As I promised, I am mailing it to you for you to sign and return to me. Please sign the enclosed copy, keep the original and return our copy to me as soon as possible. Your permit is not valid until it is signed and returned. If you have any questions please don't hesitate to contact me at 530-532-5662. Sincerely' I�areii E. Jones Permit Technician COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES - 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE 0 1 cf 7� 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 call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. � � 1���� l /ice /�� � � �•yE' %/�'1a �, I/� 1�L�3 T/�'1,--. cj" �. .w� a Date Inspector /'__-7L4'ty z L/� REV 4/05 Phone # Fx FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 [,. �6- 6A OWNER COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE C\, I . 06 -1 �?y PERMIT NO. K A routine inspection indicates that the following violations of Butte County Ordinances exist at 'IK the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. t; C;I d Ing I oc�d(_ti y: sR ,y+r Date Inspector i„ c2 .' REV 4105 / Phone # l bL w FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 vy K BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT'NO. BP061478 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/20/2006 APN: 058-530-011-000 the Business and Professions Code, and my license Is in full force and Site Address: effect. License Class : License Number. 4141 JACK DALE WAY CON Date: Contractor: Map Index' OWNER -BUILDER DECLARATION Description: h2o heater I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: DAFALIA, JESSICA to its issuance, also requires the applicant for such permit to file a 4141 JACK DALE WAY signed statement that he or she Is licensed pursuant to the provisions of OROVILLE CA the Contractor's State License Law (Chapter 9 commencing with Section , 7000) of Divislon 3 of the Business and Professions Code) or that he or 95965 she is exempt therefrom and the. basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred, dollars ($500).): ❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: DAFALIA, JESSICA Code: The Contractors' Slate License Law does not apply to an pp owner of property who builds or improves thereon, and who does 4141 JACK DALE WAY such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not Intended or offered for sale. If however, the building or Improvements are sold within one 95965 year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). /I, as owner.' of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: CONRADS PLUMBING not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 954 E LASSEN AVE ❑ 1 am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 6'-�0 ot. _ (530) 893-1124 Date: own r: CON RADSPLBG@SBCGLOBAL.NET WORKERS' COUS161SATION DECLARATION License #: 670692 1 hereby affirm under penally of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is Issued. ❑ I have and will maintain workers' compensation Insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier:i Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 �lJ I certify that in the performance of the work for which this permit Is Census Code: j i Issued, I shall not employ any person In any manner so as to { become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: Q WARNING: Failure io secure workers' compensation coverage is , unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permi 's 1lere b.' ssue and he ap 'cable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolul' s to do rk (ndicat above which fees have been paid. 6_ rZ v �� performance of the work for which this permit is issued (Sec 3097 CIV.) By. Date: Name: _ PERMIT EXPIRES ON: Address: ate ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that ['have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and stale laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes. \ KJ Print Name: Signature: -- Date: �� '. 0 n (� Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16.04 pg 1 058-530-011 _ t06-1478 �rr • a� NOTES DAFALIA, JESSICA 4141 JACK DALE WY, CONCOW cuMt+• Cont: CONRADS PLUMBING HEATER(WATER) v r.4 APN: Permit No. Owner. Site Address: t Contractor. Type of Permit: r r DATE JOB SIGNATURI CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE 1� s J .B T_ r t r DATE JOB SIGNATURI CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE = OK 0 = Not OK MANUFACTURED HOMES DATE L_j PERMANENT FOUNDATION LJ SOFTSET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clmcs-Gmd 'Am -Concrete 6 Yard Gas; Loctn-Test Wrap Nat or LP❑ Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Une 8 Gas; MH Test -Demand Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clmcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers ' MISCELLANEOUS - DECKS -COVERS -CARPORTS -GARAGES 1 ZoningSetbacks-Easements 2 Ftgs; SailsSz-0pthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-RfIrs Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roeftng 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls lip 1$ 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Foal Lting; l5 volts-GFI 6 EIec.Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Banding; Metal w/5'-Drcitng Egp-Htr 8 Elec Grndng; Eqp wl5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pnlboardsansultn to Main Conduit 9 Health Dept: Ap'M 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide Drawing RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR, DATE PLUMBING.` 1 ZoningSettiacks-Easements-FloodSlope 2 Ftg Main; Soils-Elec Gmd Ftg DRth 3 Ftg Garage; SoilsSteel-Elec Gmd Ftg Dpth 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwalis Main; Steel-Blockouts-Wrapped 6 Stemwalis Garage; Steel-Biockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12, Elec Undrgmd 13 Plenums & Ducts; Clrnc-MaterialSupportdnsultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Ace & VnUtn 16 Insulation o'er e`41 DATE FRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Wails over Girders flr Nailing 20 Draft Stop in Walls (rat proo&f) 21 Fire Stops; Furred CeilingsStairs-Chasers-Tubs 22 Headers & Beams- &' Bearing'. 23 Hangers-Posf. Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-Truss L.25 Frplc Ties or Type A Flue=FrQlc Throat Clmc 26 Attic Acc; Sz &Rini Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctri Framing -RC Channel 29 Prprty Une Firewall .& Opngs' 30 Ext Doors -One 3' -Check Garage 3rd, Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Otitrgrs _ 33 Siding -Nailing Veneer 34 Stucco Lath Weep Screed-Fndtn Vnts-Undrflr Ace 35 Glazing Area -Glass PrtctnSkyLts-Plastic . 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnis 38 Insultn-W ails -Ceilings 39 Infiltration•W ails -W ndws ° 4' " ' DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires In Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz 9 ❑ CU or Q AL AC Wire Sz Qe Q CU or QAL 48 Range Circ ya Q CU or Q AL Oven Circ pa Q CU or QAL Insulated Neutral [—]Yes QNo' 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Clrnes pnis-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o'• ds' o'er o+�. 53 Wtr Htr; Vent Act-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr• Nail Pr(6M 56 Shwr Pan; Test, First fir -Tub Ace 57 Test Tuti & Shwr, 2nd flr - Tub Ace ° 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping DATE IMECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrfiw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Ace & Pltfrm if Furnace In attic FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Meth Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Ace -Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handralls 74 Frplc or Stove, CImc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct In Garage -Damper. 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 PImb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Cimc Dmge Planters Q Yes Q No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-PImb 89 Vnts abv Roof, PImb-Appinc-Frplc-Clint to Opngs 90 Wtr Well, Dscnnct, Elec, PImb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntitn thru House 93 Glass Prtctn 94 Corrections from previous Irispctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT*NO. BP061478 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/20/2006 APN: 058-530-011-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 4141 JACK DALE WAY CON Date: Contractor: Map Index: Description: h2o heater OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: DAFALIA, JESSICA to its issuance, also requires the applicant for such permit to file a 4141 JACK DALE WAY signed statement that he or she is licensed pursuant to the provisions of OROVILLE CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95965 she is exempt therefrom and the. basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: DAFALIA, JESSICA pP Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 4141 JACK DALE WAY such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95965 sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). with la I, as owner. of the property, am exclusively contracting licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: CONRADS PLUMBING and who contracts for such projects with a contractor(s) licensed , pursuant to the Contractors' State License Law.). 954 E LASSEN AVE ❑ I am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 0 � (530) 893-1124 Date: own r: CONRADS PLBG@SBCGLOBAL.NET License #: 670692 WORKERS' CO SATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier:/ Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to / become subject to the workers' compensation laws of California, /J and agree that if I should become subject to the workers' /� compensation provisions of Section 3700 of the Labor Code, I shall VV^ l forthwith comply with those provisions. 6''a0 `tg� Date: C, Applicant: TG WARNING Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars (5100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This perms hereb, ssue, and he ap 'cable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resoluf • ns to do kindicat above which fees have been paid. 6- b performance of the work for which this permit is issued (Sec 3097 Civ.) By. / Date: Name: PERMIT EXPIRES ON: Address: (Date) O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. C3 Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. 0 Attached are copies of the required E.P.A. notification forms. I hereby certify that I'have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it Is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. ` ` r SS Signature: Print Name: i G,G. t 1CG "'� Date: V *Owner❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Budding Permit 01-16.04 pg 1 BUTTE COUNTY ' 1SEP�kRTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Namel .n irst Name , Address Szo` City S State E-mail Phone l6 _ �, Fax E-mail VV\ &C-11 - cowl V V CONTRACTOR Name Address City I C-0 State Zig, a Y Phone s-11� Fax E-mail Lic. # � 699, Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name Address 3 (� 1r\ �J I Address State City Phone State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name n c?I— Address 3 (� 1r\ �J I City City State Zip Phone Fax E-mail APPLICANT SIGNATURE X 'L , ` c - For o ice use only: Zoning Property Address Flood Zone Cross Street SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BPO6IL17 BIN # PROJECT LOCATION Property Address Cit. 'n Y\ (A Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: y� Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Receiv�ed—bye: ) l/ / Receipt #: �16 kIc' M7-06 6 Amount: Bldg / SRA Sheriff SMTP Other Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 3 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS`. ` " The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. , Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3.. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner-Buiider Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits Issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees -for work plan checked avid other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORM BUILDING F0RMS0dgApp1SubRgmts.doc Page 2 of 3 REV 8-12-05 S1 TEPLAN ._....__ . -- -- - . -- _. ... - . .. - - --_. .- - -•• -- -- - -- - - .. ---- -- - - ----- ----- - -- - ...... .. ----------- . - - - - - - - - - - - - - - -- - ._..............., ...... ............. - ... .. -. ._ .. .................... . L . r�__8 -- - X30 � _ - • � - � -- - .. .. _ --- '- . •• ..4 aL G . G -y - -- . --- -• .. ... ._ .. .. --- --- --• . - - As$e$soes Parcel Nuimber ®L� ®. e . 0 0 m ©0 Sole: I " e �-•�� 4�.�. Ov9u9eP Ham.m •J �i`j�J t L fJ'.. Address / Phone Ne. 53 p D 16. She Location A FOR OFFICE USE ONLY PROVIDE FOR ALL Z®nin ADJACENT PARCELS 9= SVE (AC) - General Plan Ssg: ZONiNC: Size, Acmes CEN PLAN: 4.0T USES: