Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
061-460-037
9 74 ..... ......... �4, IK / / • /� 4� 6/ _ qN AVID A. FOST Rq/S of Berry Creek Rd, app mi. � f Berry Creek School LL ermit #4819-77E(ele se ch) SF 61 61-46-37 JORDAN E 41 . SHARON KAELIN ' - - -Old Bloomer Rd 2 {' ®bl . - - - Coritr: Ron Holland I ��- PErmit#196-88B,P,E(reroof, .upgrade ele! Berry Creek .Station Road, 1/4 mi north t 'e A flue & re air dr rot SF Oro Quincy Road. u YP - P Y. Oroville 061746-0-037' 93-1473 BIP ;M KAELIN., SHAREN �,(lide10 BLOOMER HILL RD,BERRY GREY4_'_;�' �:: '-- CONTR : --COMM ACTION+ -- - - - REPAIRS/SF A �� 4 061-460-037 05-1031 BENSON, DANNY 10 BLOOMER HILL RD, BERRY CREEK CONT: GEORGE ROOFING REROOF 15 SQ 061-460-037 GRIFFIN, DON 10 BLOOMER HILL RD, BE Cont: OWNER ENCLOSE PORCH/RELOC ELC ROTES `RESIDENTIAL, PERMIT NO. _,--061-460-037 OS -1135 ' GRIFFIN, DON 10 BLOOMER HILLRD, BERRY CREEK I Coni: OWNER ENCLOSE PORCH/RFLOC ELC DaNe 9 SPECS CONDITIONS CHECKED BY SRA ? FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS I VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER A6FORc- &q LD OL0c14— -e.D , aFF .8E21Ly 0126eK P-4). JOB FINALED (Date) Signature �� 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. BPO51135 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/02/2005 APN: 061-460-037-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 10 BLOOMER HILL RD BCK Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: ENCLOSE EX PORCH/SF RELOCATE WTR Contractors' State License Law for the following reason (Sec. 7031.5 HTR Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: GRIFFIN, DONALD R. & MICHELE L. signed statement that he or she is licensed pursuant to the provisions of 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 220 PROVENZA DRIVE she is exempt therefrom and the basis for the alleged exemption. Any OROVILLE CA 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).): 95966 1 7s+- I, as owner of the property, or my employees with wages as their (530)589-5042 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 such work himself or herself or through his or her own employees, Applicant: GRIFFIN, DONALD provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 220 PONVENZA DR year of completion, the owner -builder will have the burden of OROVILLE, CA proving that- he or she did not build or improve for the purpose of 95966 sale.). ❑ 1, as owner of the property, am exclusively contracting with (530)589-5042 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: ❑ I am Exempt under Article/So-111VBusiness and Pessi ns Code Date: 29 - Owner: WORKERS' COMPENSATION DECLARATION I 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 License #: 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Engineer: Carrier: Policy #: I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall J forthwith co ly with t ose provisions. Date: z• f e4� 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 1 hereby affirm that there is a construction lending agency for the Resolution to o work indica d abov `for w ich fees have been paid. _ performance of the work for which this permit is issued (Sec 3097 Civ.) A4e 1) QS Name: By: /) Date: PERMIT EXPIRES ON: v Address: D 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 ow 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 subs ce of a official form or document of Butte County. I hereby authorize reprgse\ntatives of Butte County to enter upon the above mentioned property for inspection rposes. Print Name: V O• ✓�L 6�-I/.�✓ Signature: Date: A'Owner ❑ Contractor 0 Agent for Owner ❑ Agent for Contractor J=OK 0 =Not OK = Not Applicable o =Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fail -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ftJ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance id' ; Nailing -Veneer -Stucco -Mesh 44 -Roofing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date . - 1. Zoning Requirements -Setbacks -Easements Date 2. Footings; Size -Spacing -Marriage Line Date 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 S. Gas and Electricity Tagged °. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 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 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements -Setbacks -Easements Date 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ELLAE®VS Date C DEC Cg)4ER51 CARPORTS, GARAGES (Plans) OK except #'s uirements-Setbacks-Easements ootings; Soils -Size -Depth -Spacing -Connectors -Steel s, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. C rts; Windows -Doors Elec 'c Ftmg. Sills-Anchors-Studs-Rftrs-Trusses id' ; Nailing -Veneer -Stucco -Mesh 44 -Roofing 44-15A.p 12. Braced Wall Panels Date . - Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-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-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ P' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /' Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fre Sprinkler; Test 57. Siding -Nailing Veneer Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) .OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled Date 27. Romex Installed Close to Edge of Studs & C.J. Date 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Date 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 70. Stairs & Rails Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) _ 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrrn. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Cana B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor -Meth. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following lnstld"ve D Yes O No/Walks D Yes O NcAarrters O Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 95. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: i ,U Inter .Departm_eni" Memorandum FROM: SUBJECT: DATE: �� Yov kwQtL� ";;tc ��Fxzr -ro vs-g4py s 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. BP051135 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/02/2005 APN• 061-460-037-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 10 BLOOMER HILL RD BCK Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: ENCLOSE EX PORCH/SF RELOCATE WTR Contractors' State License Law for the following reason (Sec. 7031.5 HTR Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file aOwner: GRIFFIN, DONALD R. & MICHELE L. signed statement that he or she is licensed pursuant to the provisions of 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 220 PROVENZA DRIVE she is exempt therefrom and the basis for: the alleged exemption. Any OROVILLE, CA 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).): 95966 1 (530)589-5042 7�. 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 such work himself or herself or through his or her own employees, Applicant: GRIFFIN, DONALD provided that such improvements are not intended or offered for pp sale. If however, the building or improvements are sold within one 220 PONVENZA DR year of completion, the owner -builder will have the burden of OROVILLE, CA proving that he or she did not build or improve for the purpose of sale.). 95966 ❑ I, as owner of the property, am exclusively contracting with (530)589-5042 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: ❑ lam Exempt under Article of N Business and Pessi ns Code Date: Owner: WORKERS' COMPENSATION DECLARATION I 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 License #: Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Engineer: Carrier: Total Square Ft: 0 S. F. Policy #: 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 Valuation: $0.00 become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith co ply with t ose provisions. r J Z C1 Date: O 'V `'' 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 Resolution to o work indic d abov for w ich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) BY Date: Q Name: /j PERMIT EXPIRES ON: v Address: D 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 ow 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 subs ce of a official form or document of Butte County. I hereby authorize repr sentatives of Butte County to enter upon the above mentioned property for inspection rposes. 01 Print Name: B �� G(C_� ���6�7' �i✓ Signature: Date: 7 /�Q% /•6 'Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor rIT I.. LyliY Ir �J I _ .. 0 '® 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 Last Name /f- , irst Name N D Address ZW nA6v�� t50/vE "F, City OAD yr L(, State Cg Z11 9sw Phone5Y7-50q,Z Fax E-mail APPLICANT NAME CONTRACTOR Name City 0Ul LCState IL Address Zipr 7 9,9,04Phone City Fax State Zip Phone Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City 0Ul LCState IL Address Zipr 7 9,9,04Phone City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name bevyotb 0Fr-PU Address 2 W Plqo vim Z4 NI21V C City 0Ul LCState IL J6 Zipr 7 9,9,04Phone � Z Fax E-mail APPLICANT SIGNATURE X /�Z:2��-d - For office use only: Zoning Property Address (st°r�om >G(. /&.41 Flood Zone I I 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. /3T BIN # LOCATION AP# 0 61 -'-160 60 - 0 37— 000 Property Address (st°r�om >G(. /&.41 Cit Cross Street a2mY C129K 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 Page 1 of 2 Description or Scope of Work: &01JC(4S,',2 sCie2g v 1-0 ExJ,671-v6 Ij& 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 byq* Receipt #: Amount: Bldg SRA Sheriff SMIP Date: '� Other O Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a ermit. INCOMPLET UBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. 1. Site plan, 3j 2. Complete p ansr'r 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 inst, (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. Detached Accessory Building Form filled out by the owner (if required). ❑ 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. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 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 I KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER (�' / ASSESSOR PARCEL NUM ER v 03 O ' 0 - Proposed Building Use: Permit Technician. Date: OF Items required in order to apply for a permit. An boxes MUST be checked OR marked NA in order to apply. -1- 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ _ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ 19. _ Erosion Control Plan Required........................................................................ ❑ 20. _ Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. _ City of Chico Plumbing permit........................................................................ ❑ 22. _ Site plan and business license approval from the City of Biggs .............................. ❑ 23. _ California Department of Forestry plan approval ❑ paid. Sent by: ............. _ ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ _ ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ _ ❑ 26. NPDES Form............................................................................................. _ ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... _ ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... _ ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... _ ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... _ ❑ 31. Letter of Signature authorization.................................................................... _ ❑ 32. Recorded copy of Agricultural Acknowledgment Statement :................................ _ ❑ 313. Existing violations and/or expired permits......................................................... _ ❑ 34. Deed Restriction ......................... ........ ............ ...........:................................. _ ❑ 35. 36. ❑ Legal description ❑ .H. Title, itle search, registration or MCO ......................... Other: fQ D p ❑ 37. Other: When issued Telephone and hold for pickup. I have been '�fo m�e of the above items and requirements for obtaining a building permit. Applicant:C=Z= Z Date: ( 7 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division ' %i A` t a i ,& , Attention' Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 0 I personally plan to provide the major labor and material for construction of this proposed 20property improvement: YES [�! ] NO [ ]. 1 HAVE [7!] 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: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: 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 SIGN D: PROPERTY OWNER: DATE: y L2�� 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. Revd 11/4/2004 Butte County Department of Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: An application for a building pen -nit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their ''own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. i4r�_� Mic el C. Vieir4 C.B.O. M ager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. Im rte. RECORDING REQUESTED BY Mid Valley Title & Escrow Company AND WHEN RECORDED MAIL TO: Donald R. Griffin and Michele L. Griffin 220 Provenza Drive Oroville, CA 95966 A.P.N.: 061-460-037-000 Recorded Official Records CoBunnty Of TTE CANM J. BRUBBS Recorder RObWRY DIOGUN Assistant 09:UM 14 -Apr -2M REC FEE I& a TAX 11®.99 KxM 18.00 Barbara Page 1 of 2 Above This Line for Recorder's Use Only File No.: 04034780004 (AM) GRANT DEED op The Undersigned Grantor(s) Dedare(s): DOCUMENTARY TRANSFER TAX $ (/ P. c[TY TRANSFER TAX $0.00; SURVEY MONUMENT FEE $ X computed on the consideration or full value of property conveyed, OR computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale, X unincorporated area; [ ] City of Berry Creek, and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Krishna Benson, a widow hereby GRANTS to Donald R. Griffin and Michele L. Griffin, husband and wife as joint tenants the following described property in the uni8ncorporated area of Berry Creek, County of Butte, State of California: A PORTION OF THE NORTHEAST. QUARTER OF THE SOUTHEAST QUARTER OF SECTION 29, TOWNSHIP 21 NORTH, RANGE 5 EAST, M.D.B. R M., DESCRIBED AS FOLLOWS: BEGINNING AT A POINT IN 'THE EAST LINE OF SAID SECTION 29, FROM WHICH POINT THE SOUTHEAST CORNER OF SAID SECTION 29 BEARS SOUTH 3° 14' EAST, 1338.15 FEET DISTANT; THENCE NORTH 880 43' WEST 308.42 FEET TO THE INTERSECTION OF THE CENTERLINE OF BLOOMER ROAD AND BERRY CREEK STATION ROAD. AND THE TRUE POINT OF BEGINNING FOR THIS DESCRIPTION; THENCE ALONG SAID BLOOMER ROAD CENTERLINE NORTH 60 38' WEST, 154.36 FEET, THENCE NORTH 250 08'. WEST, 208.58 FEET; THENCE LEAVING SAID CENTERLINE NORTH 16' 28' EAST, 155.32 FEET; THENCE NORTH 640 02' EAST, 42.61 FEET TO A POINT IN SAID BERRY CREEK STATION ROAD CENTERLINE; THENCE ALONG SAID LAST DESCRIBED CENTERLINE SOUTH 250 35' EAST, 107.17 FEET; THENCE SOUTH 4' 04' EAST 202.84 FEET; THENCE SOUTH 90 52' WEST, 213.15 FEET TO THE TRUE POINT OF BEGINNING. EXCEPTING THAT PORTION OF THE ABOVE DESCRIBED PARCEL LYING WITHIN SAID BLOOMER ROAD AND BERRY CREEK STATION. ROAD. Dated: 04/08/2005 Mail Tax Statements To: SAME AS ABOVE A. P. N .: 061=460-47-000 IIN A ai enson STATE OF _California COUNTY OF _Butte Grant Deed - continued File No.:0403-1780004 (AM) Date: 04/08/2005 On . 11 • U before appeared _-n - — - - -personally personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose names)-is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capadty(les) and drat his/her/their signature(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the Instrument. WITNESS my hand and official seal. This area for oftlai notariaiseai My Commission Ex Notary Name: AA��aid Z)- oO ASM4 Notary Registration Number: N ANGELA D. MASTELOTTO n Commission #13(31124 U o tic-Caiifomia Butte county 1� My Comm. Exp. OCT• 22, 2006 Notary Phone: County of Principal Place of Business: Page 2 of 2 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. BP051031 LICENSED CONTRACTORS DECLARATION , I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 04/22/2005 APN: 061-460-037-000 the Business and Professions Code, and my license is in full force and effect' License Class : _ G� -39 License Number: SitAdd e Address: 10 BLOOMER HILL RD BCK Dale: 4:A24contractor. Q."40094r";42 Index: Description: RE ROOF 15 SQ.'S COMP OWNER -BUILDER DECLA ATION 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 whlch requires a permit to construct, alter, Improve, demolish, or repair any structure, prior Owner: BENSON DANNY & KRISTINA to its Issuance, also requires the applicant for such permit to file a 10 BLOOMER HILL RD signed statement that he or she Is licensed pursuant to the provisions of BERRY CREEK CA the Contractor's Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95916=9636 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 penally of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Applicant: GEORGE ROOFING Code: The Contractors' Slate License Law does not apply to an SHIRLEY TREW owner of properly who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 6810 LINCOLN BLVD provided that such Improvements are not Intended or offered for OROVILLE CA 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530) 533-6393 proving that he or she did not build or Improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Slate License Law does Contractor: GEORGE ROOFING not apply to an owner of properly who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 6810 LINCOLN BLVD ❑ i am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 (530) 533-6393 Dale: Owner: - License #: 452266 .WORKERS'COMPENSATION DECLARATION. I hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: Is Issued. Engineer: 11 I have and will maintain workers' compensation Insurance, as 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 #:_A 7 - Valuation: $0.00 Census Code: ❑ 1 certify that in the performance of the work for which this permit Is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisidns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dale:, eC/ Applicant: /in /NiosQ9li, WARNING: Fallure 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. / / n� lei CONSTRUCTION LENDING AGENCY This permit Is he by Issued under th licable provisions of the Butte County Code and/or Resolu ions to work indlcal,pd ab a fo %yhic fees have been paid. I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is issued (Sec 3097 Civ.) By. Dale. / Name: _ PERMIT EXPIRES ON: Address: (Date O I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. b Notification In accordance with O Attached are copies of the required E.P.A. notification forms. 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 I hereby certify that I have read County. I hereby and stale laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official form or document of Butte all county authorize representatives of Butte County enter the above mentioned property for inspection purposes. ` QtoopJupon Y u!`v"`� Signature: Print Name: Date:..h3 f.ZT — ❑ Owner ❑ Contractor Agent for Owner ElAgent for Contractor B. C. Building Permit 01-16-04 on 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION APPLICANT SIGNATURE X Shidevv—r w� Agent for George o ng For office use only: OWNER Name Don Griffin Address 220 Provenza Dr. City Oroville State CA Zip 95966 Phone 589-5042 Fax E-mail Lic.# APPLICANT SIGNATURE X Shidevv—r w� Agent for George o ng For office use only: CONTRACTOR Name GEORGE ROOFING Address 6810 Lincoln Blvd City Oroville State CA Zip Phone (530)533-6393 Fax (530)533-0287 E-mail dan@abcgc.com Lic.# Class dan@abcgc.com 452266 1 C39 APPLICANT SIGNATURE X Shidevv—r w� Agent for George o ng For office use only: ARCHITECT/ENGINEER Name N/A Address. 6810 Lincoln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax E-mail dan@abcgc.com State License Number APPLICANT SIGNATURE X Shidevv—r w� Agent for George o ng For office use only: APPLICANT NAME Name GEORGE ROOFING Address 6810 Lincoln Blvd City Oroville State CA Zip 95966 Phone (530) 533-6393 Fax (530)533-0287 E-mail dan@abcgc.com APPLICANT SIGNATURE X Shidevv—r w� Agent for George o ng For office use only: Zoning Flood Zone $RA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. 05 BP BIN # LOCATION AP# (Q/ O.0 3 r7 r Property Address 10 Bloomer Hill Rd. Berry Creek, Ca. Cross Street WORKER'S COMPENSATION Policy Number 272-596-02 Carrier STATE FUND If hiring anyone other than license contractors, a certificate of workers compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work Overlay - House - Comp Sq. Footage 15 Squares ❑ 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 -P, Amount: Bldg SRA Receipt #:� Sheriff 1(J c3OV SMIP / Other Date: ��� �� �� r1 `� bd Total REV: George Roofing ev.,Y COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — OroviIle, California 95965 Tel ephordv: 534-4,541 APPLICATION AND PERMIT - •�r'•-����•�••�•�� is vwiiiy ui ouuc W cniei UNUM ule above-mentioned property for inspection purposes. X Date _ Signature of Permitee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date BUILDING Owner3 SQ. FT. OCC. BUILDING VALUATION Mailing Address f' �%1f'•/1 �• ri 3 1\ f r ' ( ? • .� ; : �'�i�-, Telephone No. 3t/ ^//)z.t ' Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. A Permit Fee $ Buildin Address ,� n t— 9 �` R 01 T' tis 0 Tr_, fC PLUMBING No. @ FEE PERMIT FILING FEE J$3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. I f rJ C. i) - ��►\ Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. Sanitation- Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W m Improvements— provements Lawn sprinkler system 2.00 Bldg. Plans Recd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 V OR L Main service 10000 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 r Single Family 0 Duplex ❑ Mobil Home ❑ Others ® Main service 1100EAMP oR LESS 1 25.00 Main service EA. ADD•L 100 AMP 1 1.00 ' ! � )4 ys r' r,,r al r Cry .( T, (%4J NEW CONST. DWELLING OCCUP. & OR ADDNS. ( ACC. BLDGS. 20sgft NEW CONSTR. MULTI -OUTLET NON•RESID. ( BRANCH CIRCUITS) 12.50ea -- NEWCONSTR. POWER APPARATUS & NON .RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) 109 Ex. Occup.FIXED APPLNS. OR (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 dCC_VN ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ in $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not em P to an employ y person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ Jo I - •�r'•-����•�••�•�� is vwiiiy ui ouuc W cniei UNUM ule above-mentioned property for inspection purposes. X Date _ Signature of Permitee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date I COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 Telephone:; 524-4541 APPLICATION AND PERMIT auulun r Nresentat(ves ort co my of butte to enter upon the above ent'oned property for 'nspe do urposes. t ` 1-77 % X — " V �C 'Date `A / / ignoture of Permitee or Agent Receipt No. 16q (7 3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have b n paid. DIRECTO 0 PUBLIC WORKS BY Date Z_2`0 —7z__ [ding permit expires Date 7J BUILDING Owner S SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address el pho �No.� 0 Fireplace IF Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee&/orPenalty Telephone No. Permit Fee Building AddressC� C PLUMBING No. @ FEE PERMIT FILING FEE $3.00 //11 c'7 VY� ,Oi1' l_ Each Trap 1.50 DA Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 _/� r, 1 A. P. No. (p o` "ZJ 1 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F@/sl Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Plans Parking Declare ion Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 s ec'd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 10 0 100 AMP OR LESS 5•00 Main service so0v OR LESS t D� Main service EA. ADD•L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others gL Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 e- clr - v NEW CONST. I DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. ) 20sgft NEW CONSTR MULTI.OUTLET NON-RESID- (BRANCH CIRCUITS)2.50ea NEW CONSTR. POWER APPARATUS &) NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)@L25¢ BAL�1 Ex. Occu FIXED APPLNS. P•(OUTLETS (RESIDOR.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 10 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner o as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to c ply to all County Ordinances and State Laws relating to by,'r>d�yig construction, and hereby TOTAL PERMIT FEE $ auulun r Nresentat(ves ort co my of butte to enter upon the above ent'oned property for 'nspe do urposes. t ` 1-77 % X — " V �C 'Date `A / / ignoture of Permitee or Agent Receipt No. 16q (7 3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have b n paid. DIRECTO 0 PUBLIC WORKS BY Date Z_2`0 —7z__ [ding permit expires Date 7J vzaY e�'°7AX'+lyak;�q::-`m��!rr�*'�,?",...r..�v�,-vi-}..oa'Y%;;`�'+""•7�"�,it��7�."Ys•A'.i;,t�7<7pX*•;x►.IC .*1'!»'%�art�.Ty�"n .T .:i.N,.d�-.`^-'w :�-v,.-,.r:.�r'Rp:xr�y •`�yl"•« . � •. - ;yt V # 061-46-0-037 r '�¢ KAELIN, SHAREN 93-1473 B,P 10 BLOODIER HILL RD, BERRY CREEK wl�� CON TR r , .COQ ACTION REPAIRS%SF i ' 4 � R r 9 i I a i 1 �YY 1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone, 916.'538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING It I BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS �+ Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS - Permit fee $ , PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 , Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G W @ 15.00 TYPE OF WORK New Addition _ Remodel;_, Utilities ❑ InstallationC Other ❑ Describe work: Permit Fee $, _ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS Main service 200A TO 10o0A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): �.--1 _ 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 ;Jo. Classification464 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) j] I, as the owner, am exclusively contracting with licensed contract ors. (Sec. 7044) [j I am exempt under Sec. -,Business and Professions Code for this reason NEW CONST.(DWELLING OCCUP.p OR ACDNS. ACC. BLDGS. 3.64sq.ft. NEW CON5TR ULTI.OUTLET @ 5 00 NON-RESID BRANCH CIRCITSPOWER APPARATUS 1 R. / (SINGLE OUTLET CIe Ex. Occup(OUTLETS OR FIXTURES 20 764 FIXED APLNS. Ex. OCCUp. OUTLETS P(RESID.)REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 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 Bitte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Fj 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 15.00 Heating Cooling g Hood 6.50 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 Date Signature of Applicant – ownerC 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 S Energy Inspection Fee $ OCC CONST TYPE 1 TOTAL FEE $ ' HAz I DFEES IMP FLOOD CDF 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 Date PERMIT EXPIRES Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AMD PERMIT PERMIT N0. _A� ASSESSOR PARCEL NUMBER 061-460-037 ZONfNG U • BUILDING PERMIT OWNER Sharen Kaeli TEUEPHONE SO. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 10 Bloomerhill Rd., Berry Creek 94916 Est. 300,00 CONTRACTOR'S NAME TELEPHONE 538-2534 CONTRACTOR'S MAILING ADDRESS 2255 Del Oro Blvd., roville 95965 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation J$300.00 LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 30.00 PLUMBING PERMIT FilingFee 15.00 10 Bloomer 14TIl Rd-, Rt-rrV Each Trap 2 1 5.001 10.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF;� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition D Remodel X Utilities ❑ Installation❑ Other ❑ Describe work: Replace Dryrotted Floor in Bath & Install New Plumbing Fixtures Permit Fee $ 25,00 Contractor ELECTRICAL PERMIT FilingFee 15.00 Main service 600V OR LESS 18.50 Main service 200A TO IOOOA) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): I am licensed under provisions of Chapt. 9, Div. 3 of the Business IT and Professions Code and my license is in full force and effect. LicenseClassification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.�\ OR ADDNS. ACC. BLDGS. // 3.6j sq.ft. NEW CONSTR. ULT '.OUTLET NON•RESID BRANCH CIRCUITS @ 5.00 (POWER APPARATUS 6) SINGLE OUT LETcIR. Ex. Occup(OUTLETS OR FIXTURESFIXED 20 76 APPNS. EX. Occup. OUTLETS (RESID )REAJ 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ( I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FilingFee 15.00 Heating Cooling g Hood 6.50 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. ✓ Date ^jam XAa-,r, Signature of Applican ❑ Contractor ❑ Agent - Owner r\ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ co"s" PE TOTAL FEES 55.00 I HAz DFEES IMP I FLOOD CDF PARCEL PD HD ISWE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for Which fees j2 DIR R O UBLIC PERMIT EXPI • E Date _ applicable provi I resolutions to do have been paid. WORKS �© ate j Receipt No. 141372 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT AAs S EE SSSjO(" o.—A-ELN]U,w�eI )wNEA 3 MAwLIVG ADORE: ,VNTR AC TOR 'S NAME —_ EON TOR'S MAIL1� � CONSTAUC TION LENDER LENOEA•S MAILING AOORESS A RCI•IITECT OR ENGINEER ARC-'TECT OR ENGINEER'S M BUILDING ♦DOR ESS LOT NO. SUBOI VI S,ON NAME APPLICATION AND PERMIT LOr.ING �� T ELE+U ••ONE � SO,FT 'E LEoE UNKNOWN ICE PARCEL- MAP USE OF STRUCTUR SF]VJ Duplex[] Mobilehome[] Other SPEC$ FV BUILDING PERMIT OCC. � BUILDING VALUATION Fireplace Total Valuation S Filing Fee Permit Fee Plan Checking Fee Energy Plan Checking Fee Penalty Permit fee PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping Each qas water heater or vent Gas piping system 1 - 5 outlets Building sewer Filing Fee 15.00 TYPE OF WORK Mobile Home S G W @ 1500 NewO AdditionC] Remodel Utilities Installation Other o Permit Describe work: ?�(�1� ��_ �jJ Fee s , G Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service =00AORLFSS 18.50 CONTRACTORS LICENSE LAW declare Main service 200A TO 1000A. 37.50 under penalty of perjury (check one): NEW CONST, // OwELLING OCCUP.Ik) OR AOONS- t I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and ACC. SLOGS. 3.6•sq.rt. NEw CONSTIC UL I.OU LET `EON.RESIO BRAN N IR ITS @ 5.00 my license is in full force and effect. ) License No [O/%�C'/ Classification % POWER APPARATUS p tSNGLE OUTLET CIR ) Ex. Occu 1, as the owner, -or my employees with wages as their sole compen- sation, will do the work, and p(ouTLErs OR FIXTURES 20 76a Ex. Occup.' 0IE the structure is not intended or offered for sale. (Sec. 7044) A.) I 3.00 .00 Temporary service 1, as the owner, am exclusively contracting with licensed contract- s. ors. _ ors. (Sec. 7044) 15.00 Mobile Home Facilities — 15.00 exempt under Sec. ----___, Business and Professions Misc. Wiring, 15.00 for this reason Code Permit Fee WORKMEN'S COMPENSATION INSURANCE leclare under penalty s Contractor of perjury (check one): %] The permit is for 5100.00 MECHANICAL PERMIT (valuation) or less. I have placed on file with Filing Fee 15.00 Heating the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Of Consent t0 Self -Insure. J I shall not employ an y Y Person In any manner so Cooling t0 the W. as to become subject C. laws of California. Hood lice to Applicant: If after making this statement. should you become sublect the W. C. provisions of the labor Code, 6.50 Ventilation 'visions or this permit shall you must forthwith COmpry with SUCK be deemed revoked. Permit Fee s ertrfy that I have read this application and Contractor state that the above information Mobile Home installation Fee )ulldmg construction• ,urrect. I agree ;0 comply to all County Ordinances and State Laws relating S arid herebyauthorize rr , to to enter n esenta;cllo ul the County of upon the above-mentioned oropeny Ior lnsct:ctlun aurooses. so Energy Inspection Fee 1 S agree to save. indemnityI judgments, Costs. and�eppenrses Svh1''h `an6 Wac ,gal i occ coNsT r.PE _ TOTAL FEE $ I^SDI,-tiles, avCounty d Count In g til s y v accrue I y consequence dt the rail; 171 •,r U Oermlt. - -_ --r'T-- L °`ELS IMV a000 Cor PAR I CEL I ro �o iSUL Gate alure ul Avot'conl _ Owner � - '— — --- This permit is hereby issued under the applicablt'. prove — �o^'•,clot , t )SHA yen. ; oerm,l • - — stuns othe Butte County y Code and/or resolutions ' � reau.red lot a.co�^Ion� !'Q �'' �' �clu•es o..t ] tI rles ;e^c —C ..unor con T,,c•. to do •.vurk indicated above for which fees have � been ,! f41/37Z- O;1H.1. � DIRECTOR OF PUBLIC WORKS 3v t ,. • t :.... �----�_._ --- � _ •c�In- - •• . , .c •,. - ------ _ „�..... ... ---- Date PERMIT EXPIRES — -`— Date Permit#196-88 Sharon Keelin N/SBer r'"`Creek 4 mi � Y�I, Rd N-Berry Creek School Old Bloomer Mtn Rd � o 'D J 1 i Address OFFICE COPY Me` ``►► y ELECTRlc -e Meter By j a--3t t � t Q COUNTY OF BUTTE ` DEPART c 7 County Center Drive - OroVille, Califor X rA,PPLICA .1a {'��'74€y 'm����°°°'8�, �?,-r�^s��>%rtj°"�y',��g�,'+l•.�#1c'�r�rt�".•C'+��1}l��:c"'S„'.,�'!',,�?°a�� MENT OF :PUBLIC WORKSt r PERMIT N0 Ira 95965%-, Te, l.ephone. 91,6/538-75,41:,.3WTERMIT ASSESSOR PARCEL NUMBER t,. _ t --j • ZONINGS :,w,.'r�y,� ••' - "+y ''• t •,a+;;,�,+, + :B.0 ILDIP�IG PERMI T G OWNER •fit - Y r- t „ v TELE?.HONE-.• , .,SD FT ,' OCC' BUILDING VALUATION wn OWNER.S'MjA�ILING ADDRESS; . P' �C`�� ��Et1.`."r?r,) �� -•% .'f/w-.�'lr'•Y.''!,�'E ��%`ice E i �im,r,� �.xi`.•1 ..rt}:'••. •ti.��4•:ld�: �#, � I. , CONTRACTORS. NAME -.TELEP HONE,' K. 1xr `R`r; ° CO NTR A,CTOR'S,MAILING ADDRESS f 6. -"• F,.ir, place ,t t CONSTRUCTION L ENDER, UNKNOWNValuation. Total., Filing F,ee, -LENDER'S MAILING ADDRESS-. P,ennit, Fee: 'ARCHITECT OR -ENGINEER - `•` .. LICENE NO w,• 1 Plan Checking Fee, • ,t $, '�. fEne-rgyTPl'an ' ARCHITECT OR- ENGIN£'ER S MAILING ADDRESS."• yF �.V .. Penalty.' `. $ H . - BUILDING ADDRESS # Yc -. r t j t i/ y,.i +{f t` jE ��,d 41 P+.di� ,Permit fee,'f. „' rr�""«°�j $ 4.1• S :.� /�t hy"'!a,i PLUMBING PERMIT Filing Fee to on' r t Each Trap., Solar. or heat pump: wafer heater, -• 20 00 LOT NO: SUBDIVISION NAME• :•�� •'' PARCEL MAP.+ i +- ''. Water PlPin9 %" 500 . ��. i y` �4,_ •1 f r,} ,' �� ', r l 1 �f t `_Each gasiwater.heater or vent ` ; 500 t I USE OF STRUCTURE - /° Gas piprng'system? 1 5 outlets 5 00 r BuildrngYsewer t I .5 00 r� . ., a . I ` s> SF �,' Duplex❑ Mobi1.6 e❑ Other RMobi le,;Hoine ° S G W `; O.00 ea F , r" SPECIFY �` 'TYPE�OF WORKz: �. New ❑ Addition ❑ Remodel " ` O Utrlrtres ❑ Installation❑ °Other 0� Permit Fee 'Describe work: {l`C� V Ld `) t f'r =f r� x"f ' �'.; ' 1� _ f 'Contractor.,` , 1 411 _7 .1 1.4 i 3?`f! !moi (�i^91t Jt f; f •i tT y^ it l,f✓�1 t� ELECTRIC AL PERMIT" . Filing Fee '. 10.0Q'¢ �+, p EJ 100v OR LESS R service 100. AMP OR.. LESS Main service EA: ADD L• 100 AMP i �« C A 2 50. CONT.RAC TORS LICENSE L"AW p` * ',. '"�' ( r i -.. 4 j - NE,W. CONST.• DWELLI'NG',0CCUP.Bi ,77 ( )I' /zOsgft OR ADDNS.� •ACC.,B.LDGS NEW C-0NSTR'- TLOUTLET ' • '0 2 S0ea a f t, .NON RESID. -.BRA CH -CIRC IT.S f' ,•. POWER APPARATUS 6 j! rr I: declare under penalty,of perjury (check one): 10 •� j'�It i' ^-�, '-y} Y• , s; v f -1 am,-Ticensetl;•under provisions of �Chaptr 9, Div .`3' of,theAjusiness a� Land Prof essions 'Code and tmyF}Incense s .i n'+fuli f aridjeffect I '}' ('SINGLE OUTLET {IR. ?� 20®yOC - 1Ex: 0CCUp ('0UTlET3 OR FIXTU�R ES eAL090 • .'+License No ,,�iLi'.� Z�'�''Classrfication r:+-- rEX. OCCUP• OUTLETS PlRES1D )REA.�� .rL• +`"q'k"�....,,.:. •' r is .. '.# ❑• I,,as the owner, or.•my employees with wag-s,ai their:sole compen T.emporary':service sation will do; tbe. work, and structure is not intended .the .ortoffe[ed -' for sale (Sec: 7044) ~e`cy y �• c Mobile Home Facilrtles '' i 15 00 ', I as 'the owner, am ,exclusively contracting, with 'Gicensed:contract . ors (Sec 7044,) L ... t s 4 4 Misc Wiring 5". �;' _ ❑' • I am exempt underrSec j Business and Profes,"sions Code t f for•.this reason Contractor - F & ik WORKMEN S COMPENSATION INSURANCE . I declare underspenalty of.perlury (cheek one)`., S , s• °f , ❑€ The:permrt"rs for $`00:00 (valuation)'or less:��' ) #� MECHANICAL PERMIT; Filing Fee 10 00 Heating c l have placed:on f;ile;wrth' the County 0f`f3utte Building Departr,ient r tla `Certificate of Workmen s""Compensation Insurance or a Gertificateq, Coolin ;• g t' Y -of Consent:to S61f=Insure. I ashal.l, Any to becomeYsublect Hood . not employ any person n manner so as, Ventilation ; ; .• to the'W. C. taws ofltCaliforinia ,)' •` ::Notice to Appllcant:.If. after making this statement .shouldyou become,sub- —t permit to the . W. C. provisions of.the Labor C6de,.you mostforthwith comply;wlth Such - p�ovisions or this permit shali'ybe;deemed revokedContractor, +a k'certify. that,-l:have read this application an ,state that .the.•above information..... Mobile Home.lnsfallation Fee I $ : - Energy Inspect ion. Fee,;' .� $�:- • . is.correct. I,ageee to,comply. to: alf.County`.Ordinances and State.,Laws relating tozbuilding'construction and •hereby authonzejrepresentatives of,the County,ot Butte to upon the above-mentioned for inspection 'TOTA'L'.PERMIT ,enter property purposes FEE: also,agree toaave Eindemnify and kpep.'armless the .Countyof Butte against :oceuP. coN9T.TrPL ,.. scHDOL FLOOD ,PDE ND, 199UE all Iiabifitles„rjudgrhents �costs,.an'd.expenses-which'may. iii ariy,wayiaccrue -a. r 1PARCECI ”. against said Count ,i 'co sequenc f the granting of this permit. #� ' ,.� o X'' Date �� n 1 -',. . :This ermit is hereby issued under the :a licable royi- P . Y '. --app P sions,of the Butte .County Code and/or to,•do , s #' �: < t Signature 'of Applicant Owner controctor Agent ❑ tpermi4�'is _resolutions work 1ndIcated'above .for Which' fees' have been paid. , .An OSHArequ red for,excevations`over S%0 d'eeprdnd demolition;or construct • 1 " "DIRECT0R,OF PUBLIC WORKS' ion of structures over,3 stones .in height. BYf /Yr.;�t�:tDate ce i.,t N0.l R@C@7. . WNITL=D:P. W., 7LL LO W-A98L990 R, PINE-IN9PLC?OR, GOLDLNROD'APPLICANT� •. PE RMI T'. EX P I RES 'Date ` %-` •�% . �.! COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PER I' N0.' >� / 7 County Center Drive - Oroville, California 95965 -Telephone: 916/538-7541. APPLICATION AND PERMIT ASSESSOR PARCEL 14UMBEJR ,,/( ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION 17,29 OWNER'S �tN� DDRESS V % 0 CONTRAC 'SN ME Q TELEPHONE CONTRACTOR'S MAILING AD ESS.11Q C. yS/% Fireplace CONSTRUCTION LENDER !�JNKNO WN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 0 Rob Permit fee PLUMBINGLorvent Filing Fee 10.00 Each Trap 2.00 Solar or heat pump r 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 _.00 Each pas water he 5.00USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping systems 5.00 Building sewer 5.00 Mobile Home 0-o0ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other i Describe work: UG�/�Qfil�, �2/ f/lCei , AL,e �G�� �y d(�V/yPI w,ryy1 Permit Fee $ _ Q Contractor ELECTRICAL PERMIT Filing Fee 10.00 r�—"��' Main service 100v OR LESS10010.00 1AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 a' 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 f and effect. / f License No. � / / — v 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) ❑ 1, 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.a` , OR ADDNS. ACC. BLDGS. / /20sq ft NEW CONSTR U TI -OUTLET NON-RESID .BRA CH CIRC ITS 2.50 ea / POWER APPARATUS e (SINGLE OUTLET CIR. / z0050a EX. Occup( OUTLETS OR FIXTURES eALO 30 EX. Occup. OUTLETS ((RESID 1FIXED APPLNS. REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Yirin 15.00 g Permit Fee $ , Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. �j I have placed on file with the County of Butte Building Department /yam 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 Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation pertnit 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 ag", sa Count i co uenc f the granting of this permit. / _ /�,� X Date Signature of Applicant — Owner Contractor �' Agent ❑ An OSHA permit is required for excavations over 5' deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ !, TOTAL PERMIT FEE $ v occup. CONST.TYPC ISCHOOLIFLOODIPARCELI PbNO 'SUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC PERMIT EXPIRES Dat@ the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. 01.3aBy WNITL-D.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT SITE PLAN ....._...... .. .. ... .. .. ... .. .. ... ._ .. .............. .. .............. ... ._ .. ... ............. ... .. ... .. .. .. ... ._ .. ............. ............. •' .. .. ............ .. 1. e... ..... .... .. ............ .. .. ® u-�� StO�1 - '... .. .. .. .. •.- ...................................................... .. ... ._ .. ... .. .. .. .. .. :............ :......:.................:.... .. .. .. .. .. .. .. .. .. ._ ... .. .. ..- . .. _ .. .. .. .. ... .. .. _... .._... .. _.. ........ .........: .. .. .. .. .. ... ._ .. t... .. _.t.......... .. .. .. ._ .. .. .. ._ .. .. ._ ... .. .. .. .. ... .. .. .. .. ............ .. ... ............ .. ....................... .. .. .. .............. ............. .. .. ... .. .. ... .. .. .. .. .. ... .. .. .. .. .... .. ... .. .. .... .. . _... .. ... _. .. ............ .. .. .. .. .. ._ .. .. ............. ... .. .. .. ... .. ` ... .. ... .. .. .. .. .. ............ .. .. .. .. .. .. .. .. .. .. ... ...... {.. .t...... _.... i...... •.....:..... %............ r......... .. ... .. .. ... .. ._..............!F .. ... .. ._ .. .. .. ... .. .. ........................ .. .. .. .. ._ .. ... ..i.. :. ..:.. :_.. .. ._ .. .. .. ... .:.. ..:.. __ : _. .. ... .. l .i ... .. .. ... _. .. .. .. .. .. .. .. ... ._ .. ... .. .. ... __ ._ ... .. .. ... .. .. .. .. .. .. .. .. .. .. .. .. .. ... .. .. .. _. _. .. .. .. .. .. .. _.. ............. .. .. .. .. .. _ .. _. ......:......;.....;......;......;......;._....;....._}.... ...... ... .. .. ... .. ._ .. .. .. ............. .. ... .. .. ............. .....:......:...............__..:............ �......:......�_....:._.. .. ... .. .. ... .. .. ... .. yy..�� . .. ... ._ .. ........................ ... .. I.. .fp._.. .. _. .. _.. .. .. ._ .. .. .. .. .. .. .. ... .. .. .. .. .. ... _. Y• 1 1b .....:...... i...... i............ i .. ... ....................... .. ... .. .. ... .. .. ... .. .............. .. ........................................ .... ... .. ... _ .. .. .. _ .. .. .. .. .. .. i ........................ % ...... ...... ......... :. . .............. .......................... S .. .. .. ... .. ... .. .. ... .. .. ... .. .. ... .. .. ... .. .. .. .. ... ._ .. .. .. .. .. .. .. ._ .. ... .. .. ... .: .. ... .. -• . .... �. .. : : : : : : : : : : : : ............ ...... ...... ...... ..:....:.. ..:....:.. ............. ...... ............. ............ ................... ............ ...... ...... ...... ...... ....... :� :......:............:.................:....._.............:.....................:.... ... .. .. ............ .. ............ .. .. ... .. .. :. ;.. . . . . . . . . . . . . . . ......:...._.;.....<......:......;...... ;.... _ ............. .................. .. ........................ ... ......................... ............. .. ............. .. . . . . . . . . . . . . . . . . . . . . IAssessoes Parcel Number: ❑ ❑ ❑ — ❑ ❑ ❑ — ❑ ❑ ❑ Scale: 1" = Owner Name Address / Phone No. Site Location Contact: Name _ Phone Ddebcr-A 20g3 FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres 4.00" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: