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HomeMy WebLinkAbout061-350-063-� - GEORGE ROBISO 040 �,) Ap End of Tipsoo PeakF Rd, S of Enum Claw .Rd, 4201E Bald Rock Rd, Berry Creek 7 Permit#165-85P,E(temp ele.for well & fu ' g/l t Permit#343-85B(new covered deck & storage) 41- 35l hermit#3058-85B P.E, (new ca -sport) 061-350-070 .02-3368 VANDERVORT, STEVE 101 TIPSOO PEAK, BERRY CREEK WOODSTOVE 061-350-070 05-2459 JABORSKI, ANDREW 101 TIPSOO PEAK RD, BERRY CREEK Cont: OWNER PROPANE TANK & GAS LINE ^061-2350-070-.— - - - — - JABROSKI, ANDREW OS=2394 101 TIPSOO PEAK RD, BERRY CREEK Cont: OWNER GENERATOR 061-350-070 05-2712 JABORSKI, ANDREW 101 TIPSOO PEAK RD, BERRY CREEK CONT: OWNER WOOD STOVE 1 E E� J f` 1 i i I I f 11 f a 4tj6 / 1 -� - GEORGE ROBISO 040 �,) Ap End of Tipsoo PeakF Rd, S of Enum Claw .Rd, 4201E Bald Rock Rd, Berry Creek 7 Permit#165-85P,E(temp ele.for well & fu ' g/l t Permit#343-85B(new covered deck & storage) 41- 35l hermit#3058-85B P.E, (new ca -sport) 061-350-070 .02-3368 VANDERVORT, STEVE 101 TIPSOO PEAK, BERRY CREEK WOODSTOVE 061-350-070 05-2459 JABORSKI, ANDREW 101 TIPSOO PEAK RD, BERRY CREEK Cont: OWNER PROPANE TANK & GAS LINE ^061-2350-070-.— - - - — - JABROSKI, ANDREW OS=2394 101 TIPSOO PEAK RD, BERRY CREEK Cont: OWNER GENERATOR 061-350-070 05-2712 JABORSKI, ANDREW 101 TIPSOO PEAK RD, BERRY CREEK CONT: OWNER WOOD STOVE COUNTY OF BUTTE BUILDING DIVISION _ DEPARTMENT OF DEVELOPMENT SERVICES =' 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538=7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OrWN R PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at _ the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, - please contact this office immediately. r+, 5µ v s �t �' P r/ � C P � Gi .�� r•o � �� t�J/�irr �—c� C � �. ;,' 1 �. , s; rtl 'i ti a+� a REV 10/92 Y y r To: Building Department From: T�nvironmental Health Subject! Sanitatio Clearance • � �(J�l�(�'�� Ott U �o comer TQ Location plan Approved for: Sewage disposal Hold final for.:. . AP// water supply water supply Final clearance O.K. for: wa er supply Clearance for bedroom mobile home. Other Sanitarian Date sw=' COUNTY OF BUTTE BUILDING DIVISION r ` DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916).891-2751 7 County Center Drive, Oroville, CA - (916)538J541 _ 747 Elliott Road, Paradise, CA - (916) 872-6307 • - ..3 ,a CORRECTION NOTICE- y cog - c5' OWNER PERMIT NO. - ' A routine inspection indicates that the following violations of Butte County Ordinances exist at the above ddress and should be corrected. Please notify this office when correcti n of work is comp) ed. If you have any questions pertaining to this matter, or need additiona xplanation, plea contact this office immediately. u! �� ✓ o GcF iBAl 1f re I k9 o 4,4f Wx �i •y ^7 3 ` Date Inspector REV 10/9 ; COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541: ? 747 Elliott Road, Paradise, CA - (916) 872-6307.. . CORRECTION NOTICE i=5'= '7 OWNER I/ y� PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at 4 the above address and should be corrected. Please notify this office. when correction of work is corr.pleted. If you have any questions pertaining to this matter, or need additional explanation, please co ct this office immediately. J. l?�Cd2_r Ott T �7 ^ e -c Al C6. Date l % 4/Inspector r / r REV 10192 '' • i 1 1 • .PERMIT N0. 343-85B (� PERMIT EXPIRES__ % 2- B GEORGE ROBISON OWNER CONTR. owner ASSESSOR PARCEL 61-35-22 LOCATION End Tipspo.Peak Rd, S Enum Claw Rd, 420' E Bald Rock Rd, 1.25 mi past end of pavement, Berry Creek OFFICE COPY €Address t !�}*.44 - xsa� ;y r Temp ,GAS r Metr By Dat�a;C7� «f Le fC tw- • -Metter By Dat^ Temp., , . 1 •I Called PG&E Temp. Gas Service Cal led PG&E JOB FINALED (Date) Signature I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSORPARCEL NUMBER 7 ,- ZONING BUILDING PERMIT OWNER' h, TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE Li! I! ( �� ~ AK -4 CONTRACTOR'S MAILING ADDRESS Fireplace CT CONSTRUCTION LENDER An r• /' UNKNOWN Total Valuation $ 1 _ 1 tit - Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS '- Permit fee $ / (., •' ;' BUILDING ADDRESS J PLUMBING PERMIT Filing Fee 10.00 y i •'f u. t Each Trap 2.00 Solar Water Heater 20.00 A.4f c 7. , ;+ �r Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home ISI G W 10.00 e TYPE OF WORK NewQYN Addition ❑ Remodel❑ Utilities❑ Installation❑ Other 1:1 Describe work: n'' �� < <`'C �� + — Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 10.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING 0CUP.& t OR ADDNS. C ACC, BLDGS. 2/20sgff 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 Q 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 CO ID R. BRANCH CIRCTITS) 2.50 ea NEw CONSTR POWER APPARATUS &` NON.RESID. SINGLE OUTLET CIR. / Ex. Occu X20@50e P TS DR FIXTURES BAL@30 FAPP LNS, OR D Ex. QCCUp. FIXED OUTLETS (RESID,) EA,) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. O 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 Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree. to.comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. %�'�' ' �` t'''""` Date j �' Signature of Applicant — Owner E Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE O' $ CCUP. GROUP I TYPE OF CONST. PARCEL PD HD ISSUE 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 e•' �' 1 Date ' PERMIT EXPIRES Date Receipt No n #) � ' WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 1 V = OK i 0 = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) ' �E = Not Ready / r Date UNDERF OR Pans OK exce t#'s Date FRAMING (Continued) on' quirements-Setbacks-Easements g., Main; Soils-Steel-Elec. Grnd.- %" Ftg. Depth 48. 49. Property Line Firewall & Openings Ext. Doors -One 3' -Check 6arage-3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. De th 50. Stairs; Width-Headroom-Aisi:-Run-Landing-Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Deoh 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers &--Sfe'mwalls, Main; Steel-Blockouts-Wrapped- 52. Siding -Nailing -Veneer 6. emwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7 Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic IiLD.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9? -Gas Pipe; Size -Anchors 1 Water Pipe; Test-Anchors-Regulator-Seryice Test 11 Electric; Underground 12,L Plenums & Ducts; Clearance -Material -Support -Ins. 13!'Girders-Sills-Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date a Card -BI Date Card -BI Date C d -BI Date -4 P - and -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except p's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. 71. Plb., Elec. &Mech. Equip. Listed for Location Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. i 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w./Mech. Fasteners -Bond Gas & Water 72• Insulation -Foam -Looked in Attic E) Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails & Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes El No 75. Following instld.: Drive ❑Yes ❑ No; Walks (-)Yes No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 29. Equip. Clearances; Panels-Motors-Mech. Equip. 76. Stucco; Brown -Finish 30. Clothes Closet Light -Shower Light 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Date MECHANICAL (Permit) OK except N's 31. A.C. Ducts; Insulation & Support 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. 34. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 86. Energy Compliance Certificate -Other Certificates 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FRAMING Plans OK except p's Card -BI Date Card -BI Date Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. 45. Cing. Joist-Rftr. Ties-Purlin- Roof _Brac.-Truss-Shthng.-Rfn_g_.__ Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. 47. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing (NOTE:Anentrymust be made each time y0uvisit jobsite) J =r OK 0 = Not OK = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except p's 1. Zoning Requirements -Setbacks -.Easements 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; LocationrTest-Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except a's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI S. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date COUNTY OF BUTTE k Department of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIF ICAT ION 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 in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will be issued until this verification is received. 1. I personally,plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) Ye S 2. I (have/have not)_ kayer signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address. City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NTame1 1 Address �f p Phone Type of LWork 1/4a.pYQiI�IS Cet�STf�t.G�Oh L'�G. �� /�� / �Ota.N�4T1G1 Signed: Property Owner Social Security numbe Date /,,,1. — 8—SS 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 permitted to issue the permit. '4 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPL'ICATi10N DATA SHEET r Permit No. _ OWNER ge 0 trae k6 �U -/.SO V1 A. P..No. Proposed Building Use e re C' C Al S v Q '1l �C� C�U C Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector. 1 / IT�l�Date C; 0-11 V At time of permit applicationyl was advised the following data must be submitted prior to permit processing and:/or, issuance: DATE RECEIVED. APPROVED \/ 1 II items have been submitted. . . . . . . . . . . . t plans in duplicate./triplicate kloj .. 3. Complete plans in duplicate./triplicate. . . . . . ® Complete engineered plans and calcs. F,oR, Qol.is- C.ariST. , 5. Plans with Energy Design Compliance Statement. 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . t 10 anitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . • 17. Pre -Inspection for RequiredPre-Inspec. request to , Building Inspector (Date) 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Other 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 Applicant Date _ �S Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail—Other By 6"—Date Plans checked by 'Date Plans approved by Date Other: Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7'County Center Drive, Oroville, CA 95965 PHONE: 916-534-4541 DATE February.20, 1985 George Robison ME: Building Permit Application X6343-85 'P.O. Box 176 Oroville, CA 95965 A.P. # 61-35-22 i ,With reference to the above subject: 1� Attached is: Application for permit Building Plans Engr. Calcs Owner -Builder Verification Form OTHER Mobilehome Utilities Installation Sheet Mobilehome Installation Information Sheet Typical Plan Sheet List of Codes Enforced LL We need the following information: Permit application signed and completed where indicated with all copies returned. Fees.of $ payable to Butte County Treasurer. Certificate of'Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in including plot plans. Structural details in FOR PgLE COgS RU ION c' Complete plans and calcs in dt.c y registered en ineer or architect. t Energy design including Street and'drainage improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. ±:' z Sanitation approval from Butte County Health Department at: 196 Memorial Way,' Chico !; 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Ooner-Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. ' L� OTHER Should you have any questions concerning the above, please contact this office. Yours very truly, William Cheff Director of Public Works F. Glander JFGG/, jn Chief Building Inspector IJ • l Ib5ItS5 �► . 343-85 I PERMIT NO. 3058-85B, P, E,M PERMIT EXPIRES OWNER GEORGE ROBISON " CONTR. owner ASSESSOR PARCEL 61-35-37 LOCATION End Tipsoo.Peak Rd, S Enum Claw Rd 420'E Bald Rock Rd, BC r • Mir 1-1 '44,r AL ��e�r jLf %�Z �/[ v rj c�• l wb j` HCl c-� i 4 U11 o' P) A4b / " ,; �"9 0 a!-vrlt�v �j-(n.ei'I Of 2t. ��✓z-�.�o :� S t C7�S".cW/ El Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Cal led PG&E � C JOB FINALED (Date) Signature t :y J = OK 0 = Not OK = Not Applicable �E = Not Ready RESIDENTIAL (Single and Duplex) - ' c Date UND FLOOR Plans OK except #'s Date FRAMING (Continued) Zoning requirements -Setbacks -Easements Firewall & Openings Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth I. Doors -One 3' -Check Garage -3rd story, 2 exits f�eFtg., Garage; Soils -Steel- / /" Ftg. Depth 0. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth ood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab42ing-Nailing-Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab C2-StuCCa Nle'sh=Drip Screed-Fdn. Vents-Underflr. Access 7.piers- Fireplace Ftg.-Steel 54.lazingea-Glass Protection -Skylights -Plastic D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test Sheaf Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI ---Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except H's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except N's --,Vent- Access -Combust ion Air §A,-Ezt. Steps -Door & Sidelight Protection -Landings 5Z,_Smoke-OeteWor 58 F��ra �n_ca„_.• pie -5s -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection )l§ ater Pipe; Test & Anchors -Nail Protection ie P.,W,.V.; Test-Fttngs & Anchors -Nail Protection 59_-Beelmm Exiting Shower Pan; Test, First Floor -Tub Access j_60!G.F.I. & Bath Fixtures & Tub Access 1 st Tub & Shower, 2nd Floor -Tub Access jAr Elec. Trim & Subpanel; Breaker Sizes -Labels was"Pipe; Size & Anchors 6p, -Stairs & Rails __%_--Bireptaee or Stove; Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. -�1,65. Kit. Fixt. & Appliance; Grnd -Air Gap -Cooking Clearance Card -BI Date Card -BI Date Card -BI Date Card -BI Date tic. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's kZ ^�Fire Door; Swing -Landing -Closer 68 ^ °o Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection - learance-Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Mach. Protection ; 21. Elec. Receptacles Spacing -Lights & Switches at Doors 22. Size Boxes & No. of Conductors -Stapled Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water mien -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size• Guard Rails & Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI �� Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes r, 27. Range Circ. / / ga. Cu or AI=Oven Circ. / / ga. Cu or Al, Insulated Neutral []Yeses ❑No Z5- Eo11i:g,instld.: Drive El Yes [3 No; Walks ❑ Yes No; ovPlanters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 29. Equip. Clearances; Panels-Motors-Mech. Equip. 7Brown-Finish �"f 30. Clothes Closet Light -Shower Light -7-7�A:'E." it; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. -Water Well; Disconnect, Electrical, Plumbing Card B -I Date Card BI Date 0. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Date Card -BI Date MECHANICAL (Permit) OK except q's 181. Ventilation throughout House Glass Protection 83. Corrections from Previous Inspections •&4. -114. -Meters Tagged; Gas -Electric 31 atio &lSupport Ale -Water &Sewer Connected -C/O to Grade -HD Approval 2. Vent Fan; Exha above Insulation omp nce Certificate -Other Certificates 33. Co ensat rain & Overflow; Size & Grade 34. Furna -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. At ' Acc s & Platform if Furnace in Attic Card -BI Date , Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card-BI Date Card -BI Date Comments at Final: Date F ING Plans OK except q's 6. Sills; Proper Material & Anchors '137. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing IDraft Stop in Walls (rat proof) ire Stops; Furred Ceilings -Stairs -Chases -Tub ,-Header & Beam -Size & Bearing 5.42. ,HSngers-Post Caps -Anchors -Connectors [98� Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthn_q.-Rfn_q_._ 47t'-Pireptar6e Ties or Type A Flue -Fireplace Throat AS --446"'^ Access; Size & Romex Protection -Draft Stop -Ins. Baffles aa- Wndows or Exiting Doors -Sill Hgt. & Dimensions -49,�aga_ire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) J = OK 0 = Not OK = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except a's 1. Zoning Requirements -Setbacks -.Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rig.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1, Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date OWNER COUNTY OF BUTTE - DEPARTMENT' OF PUEJL�C-W-ORKS�- BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLEf &kVPOR'TcI-A 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Proposed Building Use �078"Im o r^ r - Permit No. A. P. No.l Permit Fee Based Upon: Complete Contract Price A`DPW Valuation Other (Exp ain) Building Inspector � .��.�� Date__ �o �a At time of permit application, I was advised the following data must be submitted prior to permit processing and/or Issuance: DATE RECEIVED APPROVED ? 1. All items have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate/triplicate. . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. . . . . 8. Fees of $ . . . . . . . . A. Letter of signature authorization. f .. j7 `Sanitation approval from Ov4V / Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. -Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to ownerE]) ' 15. Improvements may be required. . . . . . . . ... . . 16. Mobilehome Installation Data. . . . . . . . . . 17. Pre=Ins ection for Required. request to (Date) p q Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement . . . 19. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor.,. Te IeI)hone�23 3 — FZ_ZE and hold for pickup at /6fiice. Deliver w/inspk�,to'r, Other 9/7- . - Applicant Date Copy of plans sent Health Dept. *f Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required:` A (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by —Date D Other: Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541OL�_ APPLICATION AND PERMIT ASSESSOR PARCEL N MBER ZO NG BUILDING PERMIT O R Of* 10 TELEPHONE 15ay-9isq?OWN SQ. FT. OCC. BUILDING VALUATION R'S IL G AD RESS ©rov; CONTRAC TORSNAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CO S RUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 41 AR TECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 3 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUI DIN ADDRESS— Permit fee $ PLUMBING PERMIT Filing Fee 10.00 a Each Trap 2.00 4.00 •t�S ` O �� Solar or heat pump water heater 20.00 LOT NO. SUB VISION NAME PARCEL MAP Water piping 5.00 ', ,00 Each qas water heater o -v nt 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other _ G ►� ©r S ECI FY Gas piping system 1 - 5.00 Building sewer 5.00 Mobile Home S G W1 10.00 ea TYPE OF WORK Newt' Addition[] Remodel[] Utilities[- Installation❑ Other E] Describe work: _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Busine$$ 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 OCC u 1/z2sgft OR ADDNS. \ ACC. BLDGS. NEW CONSTR MULTI -OUTLET 2.50 ea NON.RESID BRANCH CI5C"' Ts POWER APPARATUS e1 SINGLE OUTLET CIR. z0®S0C Ex. Occup( OUTLETS OR FIXTURES 5ALO 30 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESIO.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I'V I shall not employ any person in any manner so as to become subject WN to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 3� Ventilation Permit Fee perm ; % •� Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against id County i consequence of the granting of this permit. �O /zL�gs X Date 6 Signature of plicant - 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 $ TOTAL PERMIT FEE $ /� Occup. CONST.TYPE FLOOD PARCEL I P11 I No V/ ISSUE ✓/ This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which By 9Y511311REC R OF PUBLIC PER T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date p`^ /moi !� ? `-' Receipt No. "U WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT / 9 COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner-builder",building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) Y2S 2. I (have/have not) ka., JL_ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: .Name Address City Phone Contractors License No. 4. I plan to provide,portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: w Property Owner Social•Security Number Date 10—'2_2_— 9 -5 - NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. r44,1?Il. 51. W _ s `WELL • .�-. St: Primo I i N N CAPpORTI 0 CT awER ul f N T7 fA setback of 5 ft. from the cl I o property lines and a seibetk I I of 50ft: from the road Yrl centerline shall be clear Of structures or equipment except I� for a 2 ft. eave overhang. r I +. 57� -- -�% O • ' . NOTE—All Materials & Worimmsmp Ssca % 1a Accordance with Recognized Good Prvc*iotss Md of a quality prescribed for the 5 ecifisi ws in IM Uniform Building, Plumbing & Mechanical Cotes aed the National Bectrical Coda L O T This set of plans and specifications MUST be kept on the iob at all times and it is unlawful to A N make any changes or alterations on some without written pirmission from tiro Department of Pubiic Works, County of Bu#e. 3056-8S BUTTE COUNTY BUILDING DEPARTME APPROVED : ROB1S0�A CARPOR . e.n l0 2Z�93 G.2. ' SERRY CREEI< CA AP3-7 ...�..,._ - f . _ .. tivc Y, !rnfa�'p'p.]"hn'i.�i'4.f 4a...+yT�.^ .'!++•rr r _ n • .. ,. � ti Y� I .. ,(� l STA Ill�llll'I�Ill�l►I III Ililll 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. BP052459 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: APN: 061-350-070-000 the Business and Professions Code, and my license is in full force and effect. Site Address -'101 TIPSOO PEAK RD BCK License Class : License Number: Map Index: Date: Contractor: Description: NEW PROPANE TANK 8, GAS LINE 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 Owner: JABORSKI, ANDREW J. AND CATHLEEN E. permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 101 TIPSOO PEAK RD the Contractor's State License Law (Chapter 9 commencing with Section he BERRY CREEK, CA 7000) of Division 3 of the Business and Professions Code) or that or she is exempt therefrom and the basis for the alleged exemption. Any 95916-9644 violat'on of Section 7031.5 by any applicant for a permit subjects the (530) 589-4566 appli ant to a civil penalty of not more than five hundred dollars ($500).): as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: JABORSKI, ANDREW J. AND CATHLEEN E. owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 101 TIPSOO PEAK RD sale. If however, the building or improvements are sold within one have burden BERRY CREEK, CA year of completion, the owner -builder will the of proving that he or she did not build or improve for the purpose of 95916-9644 sale.). (530) 589-4566 ❑ 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 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.). Contractor: ❑ 1 am Exempt under Article 3 of the Ejusiness and Profe sions Code Date: Owner: W RKERS' COMPENSATION DECC#R&kN I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Policy#: otal Square Ft: 0 S.F. ElI certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person In any manner so as to Census Code: 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: WARNING: Failure to 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 permit Is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the Resolutions to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) By. �<(v Date: Name Address: PERMIT EXPIRES ON: Date ❑• 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 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. /", / -- — - Print Name: Y10 � �% el)a�2r^ ✓ Signature: j d 0 10 Date: 1 9wner 0 Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT 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� i orSK, Firs Na e Address to I Soo PAY_ P18• City &(T e -K State CA Zip �� ) Phone 5 30 - 5 �9 - y FaX530-591-1q564 E-mail _ I l sbc lobed ,naf APPLICANT INFORMATION CONTRACTOR Name City Q _ r LP K Address 7d I City Fax53o -50- � 5 i State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Q _ r LP K Address 7d I City Fax53o -50- � 5 i State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION i .7.' Pt.[(- (Zd Address . 181 City Q _ r LP K State eA 7d I Phon 0 / Jrg . 5 6,6 Fax53o -50- � 5 i E-mail I G &-5 S �C to I f12 K� u APPLICANT SIGNATURE x For office use only: Zoning Property Address c�nsOp pew PA Flood Zone Cross Stree y I G J/) Lk SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BPOS29 BIN # PROJECT LOCATION AP#0(0( 1 3, D �J Property Address c�nsOp pew PA City ff &K Cross Stree y I G J/) Lk 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: PRO o-nel T&n�<\ 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 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. Received by: Cb , Amount: �� Bldg Receipt #: I�jG 31 Sheriff ap-Ck W SMIP I I Date: C'- O'j c �y'CU � Other 11 i l. Total Page 1 of 2 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 A/C 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 -Builder 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 and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS1BIdgAppJSubRgmts.doc Page 2 of 2 REV 8-12-05 BUTTE COUNTY DEPARTMENT 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 CONTRACTOR Last Name nY1 FirshName Address 0 l City Q„ y,r�_'c City e, State City Fa3� J gf�o — Phone Fa� ry 6 _ • 5 E-mail I Fax APPLICANT INFORMATION CONTRACTOR Name City Q„ y,r�_'c Address Zip (�S g City Fa3� J gf�o — State Zip Phone Book Fax E-mail. Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Q„ y,r�_'c Address Zip (�S g City Fa3� J gf�o — State Zip Phone Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name- & (-,SKI Address � " City Q„ y,r�_'c State Zip (�S g Phone 530 ._s� S� 6 Fa3� J gf�o — Email , /�ne APPLICANT SIGNATURE X For office use only: Zoning Property Address o K_ Flood Zone Cross Street C/ SRA Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. PROJECT LOCATION AP# "' —07D—Q Q Property Address o K_ C' y Cross Street C/ 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 Descri ion or Scope of Work: 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. Received by: Amount: Bldg Receipt #:3�7�5� I Date: Page 1 of 2 SRA Sheriff Other Total 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 -Builder 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 and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 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. BP052594 B. C. Building Permit 01-16-04 pg 1 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: 09/26/2005 APN: 061-350-070-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 101 TIPSOO PEAK RD BCK Map Index: Date: Contractor: Description: GENERATOR 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 Owner: JggROSKI, ANDREW J. & CATHRLEEN E. permit to construct, alter, improve, demolish; or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 101 TIPSOO PEAK RD 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 BERRY CREEK, CA she is exempt therefrom and the basis for the alleged exemption. Any 95916-9644 violation of Section 7031.5 by any applicant for a permit subjects the (530)589-4566 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 Code: The Contractors' State License..Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: JABORSKI, ANDREW such work himself or herself or through his or her own employees, 101 TIPSOO PEAK RD provided that such improvements are not intended or offered for BERRY CREEK CA sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 95916 proving that he or she did not build or improve for the purpose of (530)589-4566 le.). 1, 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 not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' State License Law.). ❑ 1 le 3 of the Business and Professions Code i Date: ��Owner: WORKERS'COMPENSAJON DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ 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. Architect: ❑ 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 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' / �1 compensation provisions of Section 3700 of the Labor Code, I shall (*-' qt a J forthwith comply with those provisions. Date: Applicant: WARNING: Failure o 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 I hereby affirm that there is a construction lending agency for the This permit is hereby issued under the.applicable provisions of the Butte County Code and/or Resolutio do work indic t abo for hich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) �^ Name: BY Date: Address: PERMIT EXPIRES ON: e ❑ 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 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 up n the above mentioned property for inspection pur es. APrint Je �Y. Signature: / Name: �I(L,h�j�? [ f� , _ Date: ❑ ❑ ❑ Owner Contractor Agent for Owner Agent for Contractor B. C. Building Permit 01-16-04 pg 1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSO P��,ELNUMBER _--350-070 ZONING BUILDING PERMIT OWNER STEVE VANDERVORT TELEPHONE 589-250 SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 1.01 TIPS00 PEAK RD, BERRY CREEK 95916 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1 Energy Plan Checking Fee $ $ - - PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF C Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Cl Describe Work: Y Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full f rce and effect. O� 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: 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( s Acc. glpS. SO 3.5QFT; rNiOON•pEOSIDT MULTI.OUTLEr 97,50 POWER APPARATUS S SINGLE OUTLET CIR. Ex. OCCUp. OUTLET OR FDRURES 20 @ 1'00 BAL o .50 Ex. Occup. oFlx Ds J E A 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the erformance of the work for which this permit is issued, I shall rg not employ pe Ina manner so as to become subject to workers' com ensatio I lifornia, and agree that if I should become subject to the ers ens 'on provisi ns of section 3700 of the Labor Code, I shall orthwith co th those pro sions. X Date 2 1� Sig ature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An O permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CYPE TOTAL FEE $ 55.00 :HAIZ.O.FEES IMP I FLOOD I CDF PARCEL I PO HD SSUE This permit is hereby issued under of the Butte County Code and/or indi ated a ve for which fees have JByg� PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date / Date Receipt No. '(� WHITE-D.D.S.-B.D. C ARY-ASSESSOR I K. R R GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive a Oroville, California 95965 a Telephone (530) 538-7541 IR.ev.12/96) APPLICATION AND PERMIT _ -5(,rMIT NC Ar SESSOR PARCEL NUMBER ZONIN Q 7U BUILDING PERMIT OWNER // TELEPHONE V� Q yG D SO. FT. OCC. BUILDING VALUATION OWNERS MA DRES!J�r _ Dso CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER LENDER S MAILING ADDRESS ARCHITECT OR ENGINEER ARCHITECT OR ENGINEERS MAILING ADDRESS BUILDING ADDRESS I ^ / —1 –7, LOT NO. I SUBDNISIONS NAME USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY TYPE OF WORK New ❑ Addition ❑ RemodelCa Utilities ❑ Installation(IV Other ❑ Describe Work: U ©rAs �`� U ;�!. *PERI IT FEE PAlb SPA • . SHERIFF O ' AA 6VNT RECEMb in = -•RM-StrT N, �6�� v * TO to " INTO COMPMM Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Total Valuation Is Filing Fee Permit Fee Plan Checkinq Fee Energv Plan Checking Fee b PERMIT FEE I S PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets ougaing sewer Mobile Home 20.00 Filing Feel 20.00 7.00 23.00 15.00 15.001 15.00 15.001 @20.001 EX. OCCU . PERMIT FEE S 20 O 1.00 g.SO ELECTRICAL PERMIT Fling Feel 20.00 Main Service e00V OR LESS 200A OR LESS 23.00 Main Service zooA TO '-.A � 46.001 NEW CONST. OR ADDNS. OW8ACCM—'LM or.-C. , BLDS. 3.SCFTSO. N CONS / NON•RESID. \ MULTI.OUTLET 80.uru r-mr me . @7.501 EX. OCCU . OUTLET OR FIXTURES 20 O 1.00 g.SO EX. Occup. ONED O 1 . EIO.EA IBAL 5.00 Temporary Service 23.00, Mobile Home Facilities 20.00 Misc. Wiring 23.0011 PERMIT FEE $ MECHANICAL PERMIT Flina Fee 20.00 6.50 PERMIT FEE I S Mobile Home Installation Fee $ Energy Inspection Fee $ DX:D coNST. Tri TOTAL FEE $ "� j HA2. I D. FEES I IMP I FLOOD CDF I PARCEL I PO I HD ; ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON 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. BPO52712 B. C. Building Permit 01-16-04 pg 1 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: 09/30/2005 APN: 061-350-070-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 101 TIPSOO PEAK RD BCK Map Index: Date: Contractor: Description: wood stove to final 02-3368 OWNER -BUILDER DECLARATION 1 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 Owner: JABORSKI ANDREW permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 101 TIPSOO PEAK RD signed statement that he or she is licensed pursuant to the provisions of P.O. BOX 55 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 BERRY CREEK CA 95916-9644 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).): 1;11/1, 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 (Sec. 7044, Business and Professions Applicant: JABORSKI ANDREW Code: The Contractors' State License Law does not apply to an 101 TIPSOO PEAK RD owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, P.O. BOX 55 provided that such improvements are not intended or offered for BERRY CREEK CA 95916-9644 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.). O 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: 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.). ❑ 1 am Exem t under Article 3 of the Business and Professions Code Date: 15i 10T TF BUTTE COUNTY o DEPARTMENT OF DEVELOPMENT SERVICES o BUILDING PERMIT APPLICATION o AND SUBMITTAL REQUIREMENTS _'• 024 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 o OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME 0 F A PPLICA TION "PLEASE PRINT CLEARLY" For office use o • Name WE Address Addreqswn al FNo State Zip Phone Book Fax E-mail Planner For office use o CONTRACTOR Name WE Address SRA City FNo State Zip Phone Book Fax E-mail Planner Lic. # Class For office use o ARCHITECT/ENGINEER Name WE Address SRA City FNo State Zip Phone Book Fax E-mail Planner State License Number For office use o APPLICANT _ WE Address SRA I Yes FNo Occ. Type Const. Subdivision Name Map Book Page Lot # Planner For office use o Zoning Property Address Flood Zone Cross Street SRA I Yes FNo Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2 PERMIT NO. 5, -2,(7 P BIN # LOCATION AP# _ Property Address City 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: Sq. Footage ❑ 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 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. Received bq7P GV Amount: �- Bldg SRA Receipt #: Sheriff SMIP Date: Other Total REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BEACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. o 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (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. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2.. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (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. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 COUNTY OF BUTTE - DPARTMENT OF PUBLIC WORKS 7 County Center Drive = Oroville, 6' iforni�:.a95965 - Telephone 916/534-4541 APPLICATION AND'PERMIT PERMIT NO. / . ---} S, J - ASSESSOR PARCEL NUMBER - 'Z..- ZONING BUILDING PERMIT OWNER TELEPHONE x. - SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS_ CONTRACTOR'S NAME � TELEPHONE - CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER /'/CW rz— UNKNOWN Total Valuation $ Filjn Fee Fling—Fee 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER 't /1 J,1(1) /t— LICENSE NO. - PI n Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS _ •: t_itr, nr 7/r'S:Ob t-''T..�lJ� (��� �� D(` ;.'�J; l - - PLUMBING PERMIT Filing Fee 10.00 /� r (G#>. q0p0 Dc� U�%� do �GtL• t� Each Trap 2.00 Solar Water Heater 20.80 (.�)5 &I tKS-C fA)p Df- g_, '! soil • Water piping 5.00 6100 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE .Ir SF ❑ Duplex ❑ Mobi lehome ®. Other F L tZ L SPECIFY Building sewer 5.00 Mobile Home S I G I W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other Q, Describe work: rr.4.1 P F 1. ir 'T tJ11JkLC MMt�-..� ;�)J j� � V (!` �� �.l.;� Permit Fee $ /,:yt}U Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 /3•0 Main service EA. ADD'L 100 AMP 2.50 p%•� NEW CONST. / DWELLING OCCUP.& OR ADDNS. C ACC. BLDGS. 2t/2Qsgft - 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 Q; I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR ULTI.OUTLET ON.RES'D BRANCH CIRC., TS 2.50 ea NEW CONSTR. POWER APPARATUS &) NON.RESID. SINGLE OUTLET CIR. Ex. OCCu / OR FIXTURES P\o 20@50a BAL®30 FIXED A Ex. OCCUp. OUTLETS. P(RESID )LINIS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Jll f -a C..w ,5 _ �r Q4 Permit Fee $ 15 U Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X �, ` � ,,, t'-' 2 Z .. + - Date Signature of Applicant — Owner N Contractor ❑ Agent F1work An OSHA permit is required for excavations over 5'0" deep and demolition or construct. ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE L 1 $ r � OCCUP. GROUP TYPE OF CONST. PARCEL' jO PD HD IssuE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS �y �f, / By ', rD� At � Date kdP e5 PERMIT EXPIRES Date Receipt No. -�, !� WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Permit#165-85P,E George Robison Berry Creek COUNTY OF BUTTE - DEPA ITMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,,Call'IfA is 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT /NO. 5/t ASSESS �q ZONIN BUILDING PERMIT OWNSe- �P..6r� TELEPHONE . SQ. FT. OCC. BUILDING VALUATION ' OW ER^'S MAILING ADDRESS " t Va (3m< 175 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS ' Fireplace CONSTR CTIOND ER UNKNOWN Total valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS - Permit Fee $ ARCHITECT ORE GI EER wwWWOR'' LICENSE NO. Plan Checking Fee .$ Penalty $ ARCH TECT ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS 4 / /� �j/ i n S ao r C 64 Piz &/dwl PLUMBING PERMIT Filing Fee 10.00- ILAW`Tai ©(� Q� p . C Each Trap 2.00 Solar Water Heater 20.QO ?XC4j$04EgT, j�W� Nater piping 5100 S',Qp LOT NO. SUBDIVISION NAMEPARCE MAP Each gas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other F L SPECIFY Building sewer 5.00 Mobile Home S I G I W I 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Otherx Describe work: 'rztZl T C-0 R, VJ Fu'�g,& I_o -' ba:a Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP 001 OR LESS 10.00 /b,C)n Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2I/20sgft 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 19 I, as the owner, or my employees with wages as their sole compen• sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONSTR U TI -OUTLET 2,50 ea No N.RESID BRANCH CIRCUITS) NEW CONSTR. /POWER APPARATUS &1 NON -R ESID, %SINGLE OUTLET CIR. / Ex. Occu 20@50C P�o OR FIXTURES BAL®30 FIXED APPLNS. OR FIXED A Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 C.� 5, ®cam 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. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against aid Count in consequence of the granting of this permit. X Date �—Z2-8S Signature o Applicant — Owner �4 Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCIIP, GROUP I TYPE OF CONST. PARCEL (/ PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated aboveforwhich DIR CT „ PU By PERMIT EXP E Date the applicable provi- resolutions to do fees have been paid. 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