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060-100-045
t -- _ 21.66-91B;PE JOHNSON, *Ben`'& 'Nanc ":.. r �s :,,.. rYt 212 Y; z S -� 66 Scout 'Rd,�pButte 'Meadows' (addition/sf) �'_ ' �,; r 0600 ":. , _ • ��' l" .-.� �` a � r 10=045 -PERMIT#95 0752`''` r�,JOHNSON,, rs } r , 21266 :Ben u a Scout",',Butte t`;' Add%SF �E x;Meadows s;' .. -A i i r ' 4 . a i I! _ f+ 6 r. F r , r , 7, 1 �{ � i. �d � C Zc t — � �— _v 1. � �. .. '' RESIDENTIAL r 060-100-045; PERMIT#95-0752 s JOHNSON, Ben( 21266 Scout Rd.,,.Butte Meadows t Add/SF a 94 '7/t 7,,* . , a�j • t. . r' OFFICE COPY i l • Address j a' GAS Meter By Dat����' ' ELECTRIC M Date r gqOFFICE COPY ." J Address t GAS Meter By Date ELECTRIC Meter By Date 2 7 ' OB FINALED�) • • SIg tur e V=OK O = Not OK Not Ready cable MOBILE HOMES Date/Initials MOBILE HOME UTILITIES (Plans) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Teat -Fall -C/O Concrete 4. Water; Location -Teat -Easement Needed (Sketch) - 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Teat -Wrap: / /"L"ft. / /"Nat. or/ P'L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date/Initials MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3.. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy MISCELLANEOUS Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posta-Beams-Rftrs: Connectors Shthg: Rfg.-Bracing S. Alum. Awn.; Columna -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date/Initials POOLS (Plans) OK except #'a 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness bead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-PaneIboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test-Water'Supply Test V=OK O = Not OK - = Not Applicable = Not Ready OK RESIDENTIAL (Single & Duplex) 1 JJ vim., Main; Soils-Elec. Grnd.- (1%Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth 4. Ft ., Porches & Decks; Soils -Steel-/ /Ftg. Depth -WIStepwalls, Main; Steel-Blockouts-Wrapped l�-gemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 87P Ftg.-Steel D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date/Initials PLUMBING (Permit) OK except #'s '16., W er Htr.; Vent -Access -Combustion Air -Baffle 1 ter Pipe; Test & Anchor -Nail Protection D.W.V.; Test -Fittings & Anchor-Naii Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'s 22. Fi!L4LT & Transformer Clearance -Ins. Protection lec. Receptacles Spacing -Lights & Switches at Doors Size Boxes & No. of Conductors -Stapled 29.-liomex Installed Close to Edge of Studs & C.J. 2ip. Ground made up w/Meth. Fastners-Bond Gas & Water �. Appliance Circuts in Kitchen & Conductor Size/GFI re ize / 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 Se ice -Riser Conductors & Ground -Main Disconnect bil E ip. Clearances Panels -Motors -Mach. Equip. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector _Date/Initials MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Ventanifxhaust above insulation 36. Conde to Drain & Overflow; Size & Grade 37. Furn c Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Atti Access & Platform if Furnance in Attic Date/Initials FRA LING (Plans) OK except #'s af S>rProper Material & Anchors 41I. -Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 4 Bearing Walls over Girders & Floor Nailing Ott Stop in Walls (rat proof) 43'Fire tops; Furred Ceilings -Stairs -Chases -Tub eaders & Beam -Size & Bearing Date/Initials FRAMING (Continued) 4 . He rs-Post Caps -Anchors -Connectors Cing. Joist-Rftr. ties -Pu rlin—roof Brac-Truss-Shthng.-Rfng. es or Type A Flue -Fireplace Throat clearance c Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Protection Framing _ r,pKhty Line Firewall & Openings 52�Ext. Doors -One T -Check Garage -3rd Story, 2 Exits eadroom-Rise-Run-Lending-Fire Protection y,wood on Roof Overhang -Attic Vents -Rafter Outriggers 55�Slding-Nailing Veneer 56 CLj_Qc hdesh-Drip Screed -Fd. Vents-Underflr. Access ;N Infiltration -Walls -Windows Comments at 89 -Corr 'Dns from Previous Inspections as Test -Meters Tagged; Gas -Electric I -C/0 to Grade -HD Date/Initials FINAL Plans OK except #'s Ext. Steps -Door & Sidelight Protection -Landings Smoke Detector Clearance -Comb. Air -Connector - In Ga e; Above Floor -Ducts -Meth. Protection om Exiting C F 1, Bath Fixtures & Tub Access -Spa St Elec. Trim & Subpanel; Breaker Sizes & Labels 67 Rtairc� &,�,�s love; Clearances -Hearth eS_a9tldrat Wood Panel; Int. & Ext. Arl it.Fixt_A-Appliance; Grnd: Air Gap -Cooking Clearance 71,.ere'c. Outlets & Receptacles at Kit. Counter 7.x-6 ge44e-Boor, Swing -Landing -Closer Ja.-A- --Bactirr Garage -Damper 74.-WM-NU--V.@nts-Clearance-Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection 7 ech. Equip. Listed for Location 16 9:18c -Recap gcles in Garage; (G.F.I.)-Romex Protection w-In—sulation-Foam-Looked in Attic ❑ Yes 7a Miard�. AAiie A Dock Construction -Post Caps 7�Fdn. Vents & Crawl Hole Door-Draina e & Wood -Earth Clearance Looked under Floor Yes 8 , ollowing instld.; Drive ❑ Yes Q_Ne-, M1ks ❑ Yes ❑-o; Planters ❑ Yes ❑ No 811r n- inish 8 sconnect, Electrical, Plumbing 8 nts Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings Disconnect, Electrical, Plumbing er' Elec. Trim; G.F.I. Receptacle -Underground entilation Throughout House Comments at 89 -Corr 'Dns from Previous Inspections as Test -Meters Tagged; Gas -Electric I -C/0 to Grade -HD 1 4�/ \i COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION • 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541©`PERMIT O. i� APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 060-100-045 ZONING U BUILDING PERMIT OWNER BEN JOHNSON TELEPHONE 873-1086 SO. FT. OCC. BUILDING VALUATION 72 R 3,888 OWNERS MAILING ADDRESS MEADOWS21266 SCOUT RD, BUTTE 5 42 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNIw0WN Total Valuation Is Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 63.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 40.95 Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS ADOWS PERMITFEE $123.95 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF 2 Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition 00 Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Mobile Home S G W @20.00 PERMITFEE S Contractor ELECTRICAL PERMIT Filin q Fee 20:00 Main Service EOOV OR LESS ( zooA OR LESS / 23.00 Main Service ( 200A TO I000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 011 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ACDNS. ( a ACC. BLDS. ) SO' 2.52 3.52 F7. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ,POWER ( POWER APPARATUS ) OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) BA2L 0 I•50 L SO Ex. Occup. ( OUFIXED APLNS. OR TLETS (RES D.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 22.52 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those pr isions. X Date .S _ 9 Signature of Ap^I t - Owner ❑ Contractor ❑ Agent An OSHA pais r quir for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 146.47 HAZ. D. FEES IMP �. FLO �9° F PARCEL --�YIxl 5S This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have Byz�2 PERMITEXPIRESON the applicable provisions Resolutions to do work been paid. Date dz_4elr f (Data) Receipt No. 17S-7// WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Insulation Certificate _ BUTLDING OWNER BUILDING PERMIT•#: -'� Zt BUILDING LOCATION:_ __ -%_.�. n -� G� c,�.(r fZp _Pa rs- Description of Installation ROOF cs e Material _ -�� Brand Name . Thickness .(inches) b - Thermal Resistance (R -Value) CEILING Batt gr.Blanket Type _ Brand Name G _ Thickness (inches). a . Thermal Resistance (R -Value) ,.Loose Fill Type Brand Name Contractor's minimum installed Wemt l lb Minimum thickness--: inches : Manufacturer's installed weight per sgnare:foot to acheive Thermal Resistarice,(R-Value) EXTERIOR WALL Z _IViraleFial Thickness.(inches).-_. -(P771, RAISED FLOOR' Material Thickness (inches), SLAB FLOOR ..Material . Thir. mess (inches) , Width (inches) FOUNDATION WALL —Material, Material Thickness..(inches)_ Declaration Brand Name Thermal Resistance (R -Value) dL Brand Name Thermal Resistance (R 'Value) Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) I here by cettifythat1he above insulation:was installed in the building at the above,location.in conformance with the current Building Eaergy•.hffaeiency Standards for new residential buildings comaing-d-in-Tide.-24 of the; Califomia Administrative Code. ii�l 1 cneral COIItr t uu ' nse Num i� �2 Signature_ d Tit e • Dae Sub-ConQamor (Insulation installer) - . - .... Cic=e Numoer Signature and Title Date THIS 'CERTIFICATE' MUST BI '`PROV.IDED -TO 111E BUILDING DEPARTMENT *PRIOR TO` FINAL ,INSPECTION APPROVAL AND A COPY SHALL BE -POSTED WITHIN THE BUILDING.:. JANUARY 1993 sir.�#�w-xr'7j..K2'�Ms�'k{kr"�.v;ttrv5�'�� .Y�.�+++^�e!s�.ct^ '."'N„7�"titF'+t•�le�'��°ta'e��.,�Y"'i^�7v+""ct.rcf'�'Tr"K�..-w},.�.�.,�.--,r'^�Y^'"i-'v`�.i�.rl•'^...r-�f--3.`, . . COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENTSERVICES -BUILDING DIVISION J 7COUNTY CENTER DRIVE -OROVILLE,CALIFORNIA1969g5.- TELEPHONE (916)538-7541 \ /� r � V PERMIT APPLICATION DATASHEET OWNER v /' A. P. No. V d ' lo - 41- Proposed Building Use rD /Building Inspector /� Date JT a At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets; signed by preparer of plans. .......... Complete plans, 3/4 sets, signed by preparer of plans. e.6v�ri .�3. 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. A 17 tatement of Intent for Non -Heated and A/C Buildings. . Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 3. Flood elevation letter (100 year flood) by California Engineer . ................. . Sanitation and plot plan approval Gf1« ' Health Department . ............ 15. City of Chico plumbing permit. ........................................ . 16. • Int, plan and business license approval from City of Biggs/Gridley. ............. 17. RIanning approval for (A) Use: (B) Parking: . ......... 18. Contact' Land Development about (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy). .. •Pe nspection r. . rIest 20. Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization. 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... ;- 28. Mobilehome utility clearance . ......................................... . 29. Documentation of legal access . ..................... :.................. 30. Docume tation of 50% subdivision developed or (A) Road improvements completed and FB) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When you issue the permit, process as follows: ,r/ Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant l Le?:2� Date 9� Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Copy of plans sent Health Dept. Fire Dept. Other i Date 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: By Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date _ Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date _ Plans checked by Date Plans approved by Date6 Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works �- f`a E.H. U Y f Plot PI= AURchad Floor Plan Attached Sect to B.D. e-1— �1— TO: Building Department f FROM: Environmental Health SUBJECT: Sanitation Clearance O ner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well t-� r m Lome. they Hold final for: Final clearance O.K. for: NOTE: Environmental (#ealth Specialist i_7L•Ti� Av q �� Date O.B.— I :.:::::.:....::::::.::::.:::.....::.:........ �:RIF ._ �..s�� �:>:::�...::::. 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[k] NO[ ]. 2. I -HAVE[ ] HAVE NOT[ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME . ADDRESS PHONE TYPE OF WORK SIGNEDo PROPERTY OWNER: SOCIAL SECURITY NUMBER: � DATE: -�z NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. . Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under Limited conditions. A frequent practice of unlicensed persons professing to be contractors is io secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners, unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sin&rel , MichaiIl C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSORPAVELNUMBER /0 ZONING j �' V BUILDING PERMIT ow, W TELEPHONE SO. FT. OCC. BUILDING VALUATION , NER'S I ADD�G u�'' � , IJ.,.CJ\ ' ` &"'v �•/f -� CONTRACTOR'S NAME V w a G r ^ D/ CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNIWOWN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee - $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGPDj1RESS� ���� p'� ��, n� [[//OO //VV- '`Z 'Y PERMITFEE PLUMBING PERMIT $ Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 151.00 TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Sl� Mobile Home I S I G W I @20.00 PERMITFEE s Contractor ELECTRICAL PERMIT Filing Fee 20.00 00V OR LESS Main Service 6 ( zOOA OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,( and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. 0 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NEW CONST DWELLING OCCUR NS. Z ( a ACC. BLDS. ) SO. �5 3.5¢ T. _OR NEW CONST.MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 SAL Q .50 EX. Occup. FIXED 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 22-37- Contractor MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for -work of a valuation of one hundred dollars ($100) or less. ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE _ TOTAL FEE $yb? HAZ. 1 D. FEES IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r ra y BUTTE COUNTY SCHOOLS- IMPACT FEE CERTIFICATION FORM (One Form'Per Building) School District Building Department No. C_ A.P. Number Jurisdiction `Y,City County-. Property Owner BeI4 Property Location/Address Subdivison Residential Development J No. of Living IVIHI Units —Lot No. �q, Footage 72 - Addition .(Group R) Commercial/Industrial Sq. Footage New Addition (Including Exterior -Roofed'Are.as) 7`1 Building _epdrfm- ent Repre,,KfativeDate (Floor Plans reviewed by School. District Personnel) Di trict Ideritifica,tion No. _07 School District certifies that JAPOli-cant) I X 7 5 , 100 0 kD (Street Address) (Phone ;N.ymber) (State) -, (Zip has complied with the requirements of Res6lution\.,No, by payment of $ t f representing square feet. 0 Check here if fee received represents "Full Mitigatiok',. �7Al. School Di9trict Representative Date "e , Paid by (fhelckl# Remarks: hvl� Bank Number. Paid by Cash If, subsequent to the School District Representative signing this Butte County Schools Impact -Fee:' - Certification Form, the School District is notified by the applicable, Local Planning Agency thafthis project is being reviewed under. the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.wkl (4/94) rermlc Applicant: Permit # 95-752 Date: May 1, 1995 The above referenced building plans were reviewed by this office. Provide additional information and/or -make appropriate revisions 'to plans, specifications.; and calculations as follows: 1.) PLOT PLANS IN TRIPLICATE. 2.) CROSS SECTION SHOWING PROPOSED CONSTRUCTION. 3.) ROOF FRAMING DETAIL. 4.) DETAIL SHOWING CONNECTION TO EXISTING. IF YOU HAVE ANY QUESTIONS, PLEASE CALL DAVE WASNEY OF THIS OFFICE AT 891-2751 MONDAY THROUGH THURSDAY, BETWEEN 8AM TO 12PM, AND 1PM TO 4PM. SINCERELY, r� DAVID WASNEY BUTTE COUNTY BUILDING DEPARTMENT 1469 HUMBOLDT RD, CHICO CA 95928 I Permit Applicant: Permit # Date: The above referenced building plans were reviewed by this office. Provide addi-tional.information and/or -make appropriate revisions to plan -s, specifications.,,, and. -calculations as follows: ® G sec. W7 A t f=ENTIAL 60-10-45 2166-91B,P,E d JOHNSON, Ben & Nancy 21266 Scout Rd, Butte Meadows (addition/sf). a f' JOB FINALE Signature COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orov'ille — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWN PERMIT N0. 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. Date7—/-7-177 Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — PlIone: 891-2751 - 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWN E _) PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above dress and should be corrected. Please notify this office when corr n of work is completed. If you have any question pertaining to this matt or need additional explanation, please contact this office immediately. N e Date ��` 0 ��� Inspector V, T2� ENERGY INSTALLATION CERTIFICATE Building Owner z`p ti.n�� Building Permit �O Building Location �/.� << 12,1 79 P DESCRIPTION OF I`ISUL.ATION ROOF 'Material Thic'_cess(incaes) c..= 3IOR WALL Material %2 � Thic?tnes s (inch es ) CEi,.iYG Batt or Blanket Type Thiel=ess (iaches) Loose :ill Type Mini�lm Thicknes2(Inc hes) Area covered(ft. ) FLOOR, ET..c-7ATI Material t / % Thicless (inches) FLOOR, SMAZ Nater=al Thic'_caess (inches) Width (i.nches ) Brand Name The= --.a! Resistance (R Value)___ Brand Name_ (- p r-" ; 1-s q Thermal Resistance(R Va' e) Brand Name 0 r -n "/' The=al Resistance(% Valde) Brand Name . Number of Bags Wt. per bag lb. Thermal Resistance(R Value) Brand Name 0VT-,., n .Thermal Resistamce(R Valu Brand Name Thermal Resistance(R Value)__ r CUNDATION - WALL Material Brand Name Th:c_k=ess (i_nc-es) Ther -.al Resistance(R Value)__ I hereby certif7 that the above insulation was installed in the above bu_ld_ng, - - • i:s cons �requft'ments approved building department plans -and attachments 'and con- forms w?th` of Chapter 2-53 of State of California Energy Requirement . -S"CONTRACTOR'S LICENSc N0. G:iATURE OF INS ION AnLICATOR 'DA—" I hereby cerlifv t, required features, devices, and equioment,.az shown on the aooroved Building Deo nt plans and attachments h,ie been installed and conform to the aDDli- ance standards and Chapter 2-53 of the State of California Energy Requirements. BUILDING CONTRACTOR/OWFNE.R (Please Print) (FIEt1 Ne�u�Br ) SIGN L OF I C TRACTO - STATE CONTRACTOR'S LICZNSE NO. DATE IR:I \W /OWNER (Please Print) STATE CONTRACTOR'S LICENSE NO. 7- 23 L-- ATUR£ OF RV—XC— CONTRACTO OWNER DATE THIS CERTIFICATE MUST BE ON Fri l�I 4 THE BUILDING DE?ART;•D:NT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE PCSir.D WITHIN THE BUILDI`1G. 1 CPR =0K O = Not OK ., Not Applicable MOBILE HOMES ' Not aeady • MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch, `• 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel - 3: 'Sewer; Location -Test -Fall -C/O Concrete t, 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors 5. Electricity; Location-Clearences-Grhd-/ /Amp -Concrete Shthg.-Rfg.-Bracing 6. Gas; Location -Test-Wrap:-/`/"L"ft. - ' - 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures / /"Nat. or/ /"L" ft./ /"LPG 6. Carports; Windows -Doors 7. Well Clearance & Disconnect 7. Electric 8. Utility Clearance 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh "+ `• 10. Roof; Shthg-Roofing Date Card B-1 Date Card B-1 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements Date Card B-1 Date Card B'1 2. Footings; Size -Spacing -Marriage Line Date Card B-1 Date Card B-1 3. Gas; MH Test -Demand -Valve -Connector Date POOLS (Plans) OK except #'s 4. Electricity; MH Test -Crossovers -Breakers -Clearances 1. Setbacks -Easements f = 5. Drain; MH Test -Fall -Flex Connector, 2. Soils; Compaction -Structure Stabilityj 6. Water; MH Test -Regulator -Connector t L 3. Pool Structure; Steel -Connections -Thickness . 7. Water and Sewer Connected -C/O to Grade -HD Approval .i * .Dead Men -Lining y 8. Gas and Electricity Tagged 4. Elec.; Receptacles and Lighting, Distances-GFI 9. Exits; Insp.-Sketch S r.t :. � 5. Elec.; Pool Lighting; 15 volts-GFI 10. Cert. of Occupancy 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. Date Card B-1 Date Card B=1 Boxes -Enclosures -Panel boards -Ins. to Main in Conduit Date Card B-1 Date Card B-1 9. Health Department Approval ?' 10. Plumb.; Cir. Test -Water Supply Test _ - Date Card B-1 Date Card B-1 , Date Card B-1 Date Card B-1 , 4 -OK . •- O -Not OK -=Not Applicable Not Ready RESIDENTIAL (Single & Duplex) = Date UN FLOOR (PI ) OK except N's Date FRAMI Hued) Z mg-Setbacks-Easem is -Flood -Slope 45. Ha rs-Po aps- rs-Connectors _ Ftg., Main; Soils-Ele . @rnd 7-T Ftg. Depth 46-6n Joist -R . ies-Purlin-roof Brac-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth -- 47 - 'Fly. Depth . cti-Draft Stop -Ins. Bafflesflit ccess; Size &mroteon to alls, Main; Steel -Bloc kouts-Wra pped 0rmwin sor ExHg Dimensions emwalls, Garage; Steel-Blockouts-Wrapped--------- 50. 6a. Hold o and Special Anchors 51. Property Line Firewall & Openings 7. S eel -Wrapped ------------------- P' rs-Fireplace Ftg.-Steel . D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe est -Anchor -Regulator -Service Test 12. Electri nderground 13. Pi ums &Ducts; Clearance -Material -Support -Ins. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 V - Date Card B-1 Date k /,i -sr/ Card B-1 M4 ,__Date Card B-1 Date PLUMBING (Permit),OK except ft's tE Water Htr.: Vent -Access -Combustion Air -Baffle -------- - --------------- --------------- -- Te Anchor -Nail Protection ---- ------------------- 18_9-W_V.; Tes rings & Anchor -Nail Protection ------------------- - ------------------ 19. 20. Test T C GI T SS 21. ors ----------- ------------ ------------------------------- Date�_/r7 �I-Card-B_1 V� Date Card B-1 - --------------------------------------- Date Card B-1 Date Card B-1 Date ELEC AL (Permit) OK except ft's Fi re & Transformer Clearance -Ins. Protection ------- 2 Elec eceptacles--Spacing-Lights & Switches at Doors ------- ---- - - --------------------------------------- ---- ---- 24. iz oxes & No. of Conductors -Stapled -- ------------------------------------------------------- 2 omex Installed Close to Edge of Studs & C.J. ------ -- --- -- - -- - - -- - --- - -- - --- ---- -- - -- --- -- 6. Equip Ground made up w!Mech. Fastners and Gas & Water ----------------------------------- - ----- ----- ------ -- 2- --A Ii $ize/GFI --------------------------- ---'- -------------------------- 2 (Ped Wire Sire ga^C n_.�� �„�' a Size ! / ga. Cu or AI 29. Circ. / / g a. Cu or Al. Insulated Neutral ❑ Nefs ❑ No -- --- ------------------- ---------------------- -------------------------------- 30. Service- s ain Disconnect -------------------------------------------------------------------------------- 31. Equip_Clearances Panels -Motors- ech. Equip. --------------------------------- 32. Clot es osel Light -Shower Light -Spa Light --------- --- ---- ------ ---- - -- -- --- --- --- ---- ----- ------- moke Detector ---------------------------------------------------------- ------------------------------------------------------------------------------- -Date-/O,- ---------------------------------------- Date /b.-��-{{� -- Card B_ 1 Vd Date Card B-1 ----------------------------------- Date Card B-1 Date / Card B-1 Date MECHANICAL (Permit) OK ex.Cl<t fr's 34. A.C. Ducts Insulatio Support --------------- -- ---- -- -- - ----- ------------------------------------ 35. Vent Fan: Exha above insulation ------------------------------ ------------------------------------------ 36. Condensa rain & Overflow: Size & Grade 37. -- Fur --n e -Vent: Access -Comb. Air -Return Air Vent -115 outlet ------------------------------------------------------------------------------ 38. ic Access & Platform if Furnance in Attic --------------------------------------------------------------------------------- Date Card B-1Date Card B-1 ------------------------------------------------------------------------------ Date Card B-1 Date Card B-1 Date FRAMI (Plan) OK except q's 3 s. Pr er Material & chors ails to - ailing, Spacing r in Plates -Sound ---------- - --- - ------------acing - ----------------------------- 4 ear' alts over Girders & Floor Nailing -- - ----- -- -------=---------------- ---------------------------------- 4 aft Stop in Walls (rat proof) ------------- ---=----- ---------------------------- -- ------------- -------------43 Fire Stops: Furred Ceilings -Stairs -Chases Tub _ -re--------------------- g ------- - ---------------- eaders & Bear�Size sarin 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection ---- - ---- 54�p1-ood on Roof Overhang -Attic Vents -Ratter Outriggers 5 Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts *&9. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows -------------------- Dateld _(0-44 - Card B-1'YP _ Date Card B-1 Date fd� 9� Card 8-1 �/ Date Card B-1 Date FINA Plans OK except ff's 6 . Exeps-Door & Sidelight Protection -Landings 6 Smoke Detector 63. r -Connector - In ove oor-Ducts- ec . Protection . B r m Exitin ---------------- -- ------ -- Fixtures & Tub Access -Spa 6. Elec. Trim & Subpanel: Breaker Sizes Labels 6 ------------- 64 ----------- 6 ----------------------------------- - n. x - -- - 7 nce; rnd.-AF Gap- oo i Clearance ----------- 1. Elec.--------------- r ---- --- --------------------- 7 r -------------- ------------------- ____ 7 in -rage-Damper 7 ---Mr. Ht r.: Vents -Clearance -Comb. Air-Connector-P.R.V. In Gara Above Floor -Meth. Protection ......... -- ----------I --- - 76-11-1b.. Elec. & Mech. Equip. Listed for Location ---------------------------------- 9 --- 7 - - - ara e_)xe - Romection --------------- Ir lat n -Foam -Looked in Attic Yes --------------- ------- ------------------ 7UCK ColinTucTion-Pos -ars ------------------------------------------- -- Fdn. Vents & Crawl Hole Door -Drainage ood-Earth C.jRarance Looked under Floor Yes -� do Following instld. Drive Yes ❑ No; Walks ❑ Yes E No; PI rs ❑ Yes No ------------------------------ rown ims nit Disconnec�tL. Ell rival, Plumbing ------------ ---------------�9 ri Vents Above_ Roof; P .-A lianc a to Openings - - - - - - - --- ----------------------------- - - ------ - - -- - ----- a4-. isconnect. Electrical, Plumbing - -- ------------------- ec. rim; G.F.I. Receptacle -Underground ------------------- a . i a ion Throughout House - ---------------------------------------------- _ o ecuon Corrections from Previous Inspections - ---------------------- ----------------------------------- 9 ------------------------------------ - r val ---- ------------ - ------------------ - - -- Energy Compliance Certificate -Other Certificates Daten,Card B-1 _ Date - Card B-1 - Date ov "Cit Card B-1 V4 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: -------------------------- -------------- ------------------------------------U�^^ a3 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 ADDI 11%ATIn1I A\1n mcniAir WR �► ���� nr r L -Ion I IVIS nllou r cnml I ASSESSOR PARCEL NUMBER 60-100=45 - .ZONING 14 BUILDING PERMIT OWNER 7�� - - p, Johnson BB TELEPHONE 873-1086 SO. FT. OCC. BUILDING VALUATION 60 R 3,060.00 MAILNancy OWNER'S 21266 Scout Rd. CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER VNKNO WN Total Valuation 1$3,060.00 Filing Fee $ '0,00 LENDER'S MAILING ADDRESS Perks' Fae$44.50 ARCHITECT OR LN 1.4 EER LICENSE NO. Plan Cher king Fee $22.25 Energy Plan Checking Fee n $15.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS _ Penalty $ BUILDING ADDRESS Permit fee $91.75 PLUMBING PERMIT Filing Fee 10.00 2 266 Scout Rd. S Each Trap 2.00 6.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 5.00 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFE] Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition R] Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: _ Add Area to RAth R RF,rlrnnm _ Permit Fee $ 26.00 ' Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000 AMP ORV OR LESS10.00 Main service EA. ADD'L 100 AMP 2.50 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 0CCUP.tr OR ACDNS, C ACC. BLDGS. ) /22Sq ft 1.50 NEW CONSTR.U TI.OUTLET NON-RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS tr SINGLE OUTLET CIR. ) Ex. OCCup(OUTLETS OR FIXTURES 200500 5AL030 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �virin 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. Ix 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. 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 a granting of this peeit Date �� Signature of App ' ant ner Contractor ❑ Agent ❑ An OSHA permit is r quire 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 $30.00 occ CONST TYPE TO AL FEE $ 171.25 E HAz. cuA PARK sc FLp PAR PD I 1 u This permit is hereby issued under the applicable provi- sions of the Butte County.Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By i Date PE IT EXPIRES Date -7-Y--2 Rece4�t31h3 94323'% WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT ��� ��� A ///� //�n � /j F ✓(// �V//l�w/�/Yv11/� \ aJ i F �%�� � r �(��� _. G ��, .mac • _„ .. ,- .. T ....n. ,,.r „ .^(" Nzi •.w+ �,. • •' •hv..�>-r;.K.� .. � ,;v..,i� � fr���r-?r r., -+ h.,...,.... -'Y K' -:.rr�:��rr1. � T COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 r // '-�PERMIT APPLICATION DATA SHEET Permit No. OWNER A. No. O - Proposed Building Use 4DIO 615A Building Inspector Date le At time .of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED All items have been submitted. 2. Plot plans in duplicate/triplicatey 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. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 2. Park feL/��...................................... Sdhool D' riot fees paid .............. " �14.Sanitation approval from Gam'`/C Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification' (Given to owner ❑, Mail to owner ❑) .....� 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Copy of Hdz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be s I tE 7- cc,, ./jor abo items No. 2. Additional item required: prior to permit issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone--nail counter Contractor, designer, owner, was advised of above required data by, phone_mall_countey Plans checked by Copy—DPW Date P approved by Sets of plans on hold in File cabinet AP folder _. date — date Date TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance 7-- ; X -,/-- Yr -- Owner Location AP# Plan Approved for: Sewage Disposal Water Supply Hold final for: Water Supply Final clearance O.R. for: Clearance for bedroom mobile home. Other — NOTE *** Water Supply let Sanitarian Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASS OR PARCEL NUMBER ZONING —� BUILDING PERMIT owN t ' / ELEPHONE SQ. FT. OC . BUILDING VALUATION -77 OWNER'S AILING ADDR�.;SJ�1/ CO TRAC- O 'S NAME ,ADDRESS TELEPHONE I II CONTRACTOR'S MA/LING Fireplace CONSTRUCTION LENDER VNKNOWN Total Valuation is i Filing F ee LENDER'S MA-LING=0ORE55 ARCr.:-E_T OR L __ .. ..__. .. .._.TL'CE7:SE ra 0. - " `' ' I -. _- Plan Che Fee <;ny $ Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING A [SEs^ /- cC t�J CO J v 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 OO Each oas water heater or vent 5.00 USE OF STRUCTURE SIX/Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 1 -Q Mobile Home I S I G JW 1 110.00 es TYPE OF WORK New❑ Addition Remodel[] utilities[] Installation❑Other❑ Describe work: DD /f 12- 14 —fD 477-1,g !C!//% 7 Permit Fee Contractor $�� ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS /� Main service EA. ADD'L 100 AMP �s CONTRACTORS LICENSE LAW I declare under penalty of perjury check one): P Y P t Y( ) ❑ 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.SINGLE 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.8i) OR AODNS. ACC. BLDGS. F2.50 NEW CONSTR. ULT'.OUTLET NON.RESID BRANCH CIRC ITS POWER APPARATUS &) OUTLET C'R. Ex. Occup OUTLETS OR FIXTURES 20 ® 50CeAL030 Ex. Occup. ou LETS ED (RESID.)REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor 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 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $49 occ I CONSTTVPE — TOTAL FEE $ HAz I CUA ' PARK SCHL FLD I cpF PA i Pp Hp. ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS M Date Receipt No. WHITE-D.P.W.. YELLOW-ASSC21SOR. PINK -INSPECTOR. GOLDENROD•APPL+CANT CO[NTY OF 8QT':'E - Deoart=ent of Public 'Works 7 County Center. Drive, Orov ille, CA 93965 OWNER-32ILDER VF -M ICMON Attention Property Owner: Phone: 916-538-7541 An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. I personally plan to provide the major labor andm terials for construction of the proposed property//improvement (yes or no) S; I (have/have not) signed an application for a building permit for the proposed work. -I have contracted with the following person (firm) to provide the proposed _ construction:. s _ ......... ..._. Name Phone Contractors License No. City 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 igned : Property Owner' Social Securit Numb .�% -- •—�-- - - _—_-- :Date--- G �-� -� - - --- _ _ _ .�__ _ 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. BUTTE COUNTY SCHOOLS DEVELOPMENT,'FEE CERTI•FICATION FORM (one Form per Bu'ld.ing) A.P. Number-Zo_/(,70a' Building Department No. School District p�/� City n County Jurisdiction. Property Owner Project Location/Address�GQl� 7.— /if Subdivision Lot Number Residential Development: [�rsq. Footage # of Living.MHI Addition (Group R) Units Commercial/Industrial: a 0 Sq. Footage New Addition (Including Exterior Roofed Areas) Buildin epartment Representative D to (Floor Plans reviewed by School District Personnel) i Di:str"Id No. ' School District certifies that _ e Yei ., _ iii cant (Name St,reet.Address), ity) - State p Code) has complied with t e r "uirements of Resolution No. .by the payment of representing square feet. S ool Distri t Representative Date PAID BY CHECK NO. REMARKS: BANK NO `. PAID BY CASH 1v white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) . x IPT w; IIr�erIloor acceaa and veper 2818, IIBC. - . to >' ffl;,e, r eT gip; iE'X.t$Y-1i �GNCl'k.T� _5�`i-• j ALT �"/WJ�i w A. set of���� � Scat � �I . plans an tl'ons This IS, kept on the job at all times and it is unraCWM---ft<- make any Changes, or alterations on same with, out written . -permission from the Department Of Public Works, County of Butte. NOM—Al Mcferials do Workmanship SWI 10 6 Accordance with RecognEwd Good Practices "d peel ed I In #a of a quality prescribed for theS *fi use Unifo�vl Building, Plumbing & MWIM119a CROGS 098 Jhe National Electrical Code. -7e e56 BUTTE COUNTY BUILDING DEPARTME1 rnr% APP9QVrm at, / 7////f// 100 A NftCk Of 6 ft. from the Property lines and a setback 01 50 ft. from the mad centerline shall be clear of structures or equipment ex9ept for a 2 ft. -save overhang. AW 0-- 42L 6A-s�4L&v - TV ; n t TV ; n .Owner FOR %. TO RESIDENTIAL BUILDINGS ENERGY SHEET PACKAGE "A" (Additions) / Climate Zone Permit # Floor Area The following data showing mandatory and required features of Package "A" shall be installed for additions to dwellings. Additions to dwellings.include room additions, converting garages and patios to living areas, house moves that add footage and attic conversions, and any space that is existing non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. ZONE 11 ZONE 16 APPLIES TO NEW AREA CEILING -3 R-38. WALL R-19 FLOOR R-19. SLAB AR R-7 GLAZING. 5.(Dual) U-.65 (Dual) SHADING SOUTH - OPTIMUM OVERHANG or .36 Shading Coefficient WEST .- .36 Shading Coefficient LOOSE FILL INSULATION (Density) INFILTRA 0 CONTROL (Weatherstrip -..doors, certified.windows, caulking) VAPOR BARRIER (Zone 16 DUCTS PER UNIFORM MECHANICAL CODE - Ch. 10 LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT MAXIMUM GLAZING 16% OF AREA PLUS REMOVED GLAZING NEW HEATING, VENTILATING, AIR CONDITIONING AND HOT WATER SYSTEMS IN CONJUNCTION WITH AN ADDITION SHALL BE INSTALLED AS SHOWN ON BACK OF THIS SHEET. APPROVFrl *1 - HEATING. VENTILATING, AIR CONDITIONING SYSTEM' (A) Heating ❑ Central Gas Furnace (brand and mdiel number) SE Btu/hr (heating capacity) ❑ Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) ❑ Active Solar type (liquid or air) Collectgr brand and ft model number solar fraction collector area collector orientation collector tilt , rated y -intercept rated slope ❑ Other (describe) *1 (B) Cooling ❑ Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) ❑ Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) ❑ Other (describe) DOMESTIC WATER SYSTEM ❑ (A) Gas Only Gallons (brand and model number) (tank size) ❑ Heat Pump w/Electric Backup (brand and model number) Gallons 2 (tank size) 13* Active Solar (collector brand and model number) (rated•y-intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) *l Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form fA) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load maximum outlet capacity gas furnace BTU Cooling: Summer design temperature-_*, cooling load BTU *2 Submit T.I.P.S.E. chart'or other approved system (form #5) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title 24, Part 2, Chapter 2-53 of the California Administration Code. Z E OF B IN DESI R OR APPLICANT U Op MUMMINOWAMM