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061-540-025
061-54-0-025 92-3582E ATCHISON, Richard 9741 Oro Quincy Rd,',Berry'Cr,eek (§f/upgrade elec service) 93-204-7 BPEM'-- ATCHISON, RICHARD & MARION AD DITION & REMODEL/SF ~ r-- — --�---- , ---~~ � . . ` '14` ~ . y\ ~^� 11 r i RESIDENTIAL- .- � 061-54-0-025 � ~ ,'� 93-2047 BPEM ATCHISON, RICHARD & MARION 9741 ORO QUINCY HWY, OROVILLE CONTR: DON BERGER ADDITION & REMODEL/SF V=OK O = Not OK NaRppable eeaad'yMOBILE HOMES Date/Initials MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Locatlon-Teat-Fall-C/O Concrete 4. Water; Location -Teat -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Teat -Wrap: / /"L"ft. / /"Nat. or/ P'L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date/Initials MOBILE HOME INSTALLATION (Plans) OK except #'a 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3.. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fell -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy MISCELLANEOUS Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columna -Connections -Splice -Decal -Enclosures 6. Carports: Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date/Initials POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness bead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosu res -Panel boa rds- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date/Initials UNDERFLOOR Pians OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /' Ftg. Depth j3. Ftg., Ferag9'Soils-Steel-Elec. Grnd.- Ftg. Depth «cr . 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth (y 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/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Material -Support -Ina. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16, Insulation Date/Initials PLUMBING (Permit.) -OK except #'s Q§J ater Htr.; en - ccess-Combustion Air -Baffle / Water Pipe; Test & Anchor -Neil Protect! W.V.; Test -Fittings & Anchor- I Protecti n .19._ShowerPan; Test; -"First Floor -Tub Access 2G.-Xest- jub & Shower, Second Floor -Tub Access as Pipe; Size & Anchors tI=- - Date/initials ELECTRICAL (Permit) OK except #'a 22. F ure & Transformer Clearance -Ins. Protection lec. Receptacles Spacing -Lights & Switches at Doors 4. Size Boxes & No. of Conductors -Stapled mex Installed Close to Edge of Studs & C.J. uip. Ground made up w/Mach. Fastners-Bond Gas & Water 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. ize / ga. Cu orAI-A.C. Wire Size / / ga. Cu or Al 29. Rance Cirn i i ga r„ Lnr I -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes 17 No e- iser Conductors-&-Ground-Main Disconnect LEG. Smoke Detector Date/Initials MEC NICAL Permit OK except #'a L84A.C. Ducts Insulation & Support st above Insulation 3 ndensate Drain & Overflow; Size & Grade rnance • ccess-Comb. Air -Return Air Vent -115 outlet Attic Access & Platform if Furnance in Attic Date/Initials FRAMING Plans OK except #'s 9. -SI s, Proper Material & Anchors . alls Studs -Nailing, Spacing & Bracing -Plates -Sound 1`141. Bearing Wells over Girders & Floor Nailing raft Stop in Wells (rat proof) 3. re Stops; Furred Ceilings -Stairs -Chases -Tub Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) 6&A -Hangers -post Caps -Anchors -Connectors Cing. Joist-Rftr. ties-Purlin=roof Brac-Truss-Shthng.-Ring. Fireplace Ties or Type A Flue -Fireplace Throat clearance tf(c Access; Size & Romex Protection -Draft Stop -Ins. Baffles LOf Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50.-9ars9V ftrrPT6fe�tion Framing 54 --Property Line Firewall & Openings L52!Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 53. ir% Width -Hearitoom-Rise-Run-Landing-FI re Protection be plywood on Roof Overhang -Attic Vents -Rafter Outriggers be4liding-Nailing Veneer 54.7PW6co-Mash-Drip Screed -Fd. Vents-Underflr. Access 187. Glazing Area -Glass Protection -Skylights -Plastic 58. S ar Walls; Nailing -Bolts Insulation -Wells -Ceilings 60. InfiltraIon-Walls-Windows is) OK except #'s ps-Doo Detector Furnace; Vents -Clearance -Comb. Air -Connector - 1 arage; Above Floor -Ducts -Mach. Protection -.64"B-O&oom Exiting G .. & Bath Fixtures & Tub Access -Spa EI . Trim & Subpanel; Breaker Sizes & Labels 4*f,'§JaftV & Rads . Fireniace or Stove; Clearances -Hearth I /_0BiEle�Outlets at Wood Panel; Int. & Ext. ) L;R.-Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance ( Q�ec. Outlets & Receptacles at Kit. Counter Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. U 4y5!P1b., Elec. & Mach. Equip. Listed for Location 7 p ac a F.I.)-Romex Protection nsy)ation-Foam-Looked in Attic ❑ Yes )'1 W*Guard, Rails & Deck Construction -Post Caps X34!Fdn. Vents & Crawl Hole Door-Drainagge & Wood -Earth Clearance Looked under Floor O Yes 80. Following instld.; Drive es 13 No; Walks es 0 No; Planters 13 Yea No Electrical. PI Above Roof; Plbg.-Appliance-Fireplace.-Clearance to t84 Wate-Well; Disconnect, Electrical, Plumbing tenor Elec. Trim; G.F.I. Receptacle -Underground eptilation Throuahout House ' o-er Glass Protection �ons om Previous Inspections as Test -Meters Tagged; Gas -Electric 90. Wat ewer Connected -C/O to Grade -HD Approval Ls*-I-nergy Compliance Certificate -Other Certificates Comn»nts at Final. i 1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, E alifornia 95965 - Telephone: 916.538-7541 APPLICARON AWPERMIT PERMIT NO. 93-2047 ASSE♦$S!" PARCEL NUMBER OZ*,.- `A0-025 ZONING U BUILDING PERMIT OWNER RICHARD & MARION ATCHISON TELEPHONE 589-1896 SQ. FT. OCC. BUILDING VALUATION 499 R 25,548 RMAILING ADDRESS OWNER'S D S 9741 ORO QUINCY RD., BERRY CREEK CA 95916 342 0 2,394 CONTRACTOR'S NAME DON CTOR RGSMAILING T%EEPHONE ` 9-2711 420 C 9,360 t 20 M 360 C ADDRESS 130 MT OAK RD., OROVILLE CA 95966 Fireplace A tEST 3000 1,500 CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is 42,162 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 327.00 OR ENGINEER NONE LICENSE LICENSE NO. Plan Checking Fee $ 163.50 Energy Plan Checking Fee $ 20.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 9741 ORO QUINCY RD., OROVILLE Permit fee $ 525.50 PLUMBING PERMIT FilingFee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 7.00 Each qas water heater or vent 7-001 7.00 USE OF STRUCTURE SFDuplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.001 5.00 Building sewer 15.00 Mobile Home I S I G JW @ 15.00 TYPE OF WORK New a Addition tX l Remodel ❑ Uti Iities ❑ Installation Ell Other ❑ Describe work: EXTEND 2 BEDROOMS, DECK, CARPORT AND REMODEL EXISTING, Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 PLUMBING 200A OR LESS Main service 600V OR LESSUPGRADE 18.50 Main service 200ATO1000A) CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): ) ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Busines$ 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 CONST. DWELLING OCCUP.&` NEW ACC. BLDGS. I17.45 oR ACDNS. ( _37.50 3.6Q sq.ft. NEW CONSTR ULTI-OUTLET NON -11. SID BRANCH CIRCUITS @ 5•00 POWER APPARATUS fi (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 764 FIXED Ex. Occup. OUTLETS IPRESID INSREA.) I 3.001. Temporary service 1 15.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 15.00 Permit Fee $ 47.45 - WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating 9.00 FORCED AIR HTR ONLY Coolin g Hood 6.50 Ventilation permit Fee $ 2 4.00 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 h 'Iities, dgments, costs, and expenses which may in any way accrue a nst a' o n n equ a of the granting of this permit.. Date AC �/ Agent , �3E:% Signature of Applicant - Owner caneraatar ❑ El P-160'./ An OSHA permit is required for excavations o r 5;q- deep and demolition o CVstruct- ion of structures over 3 stories in height. -ei Mobile Home Installation Fee $ Energy Inspection Fee $ 40.00 OCC CONST TYPE TOTAL FEES 670.95 I HAz - I DFEES I X IMP - FLOODCDF X - PARCEL - PD - H `// S E This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIREC By EXPIRES Date applicable provi- resolutions to do have been aid. p VORKS Date 143511-243.00// t f 01'r^ TO 2/z7y„�- Receipt No.PERMIT WHITE-D.P.W..`/ELLOW-ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT . I TO: Building Departmcnt FROM: Environmental Health SUWECi: Sanitation Clearance I'lul flan Altuahed I'loor Phm Alui6hcd Sy.nl to If,l),_��sd�l�� KtcCL U-^10 7 -I (,/- Owner Location ���2%y � i� AP# Plan Approved for: Sewmw Disposal Water Supply. ( Public Private Well Clearance for . Other Hula fill Final clbarance ,O. K. for: NOTE: Envi 8/92 ental Health Specialist COUIJTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER G ( SQ /v A. P �o o /S q-0 D S Proposed Building Use D Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY All items have been submitted . ........................................ Plot plans, 4 sets, signed by preparer of plans. . Complete ansOJ4 sets, signed by preparer of plans i ..................... . Engineered plan and calcs, 3/4 sets, with wet signature on plans . ............. Hazardous Material Form . ........................................... . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings. ...................... . R -/Engineered truss details and layout in duplicate (required prior to plan check). ... . Mobilehome data and rufacturer's installation instructions, 2 sets. ........... Fees of $ . ............................. . 1.• Impact fees as shown on attached schedule-.�ffZ�Q1., .a AIZ. l .......... to 12. California Department of Forestry plan approval/fees. ....................... . CL -Flood elevation letter (100 year flood) byS�alifornia Engineer................... 1 . Sanitation and plot plan approval �� CJ Health Department. ............ 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. . . 20. Pre -inspection for required. ..�s�ild 9 �speauo (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance. .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner )............ r 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ................................................. . 33. -34. Whgn y issue the permit, process as follows: Mail to ower. Mail to contractor. (f Telephone (sand hold for pickup at �_. <J office. Deliver with inspector. Other , Parcel Creation Acreage Applic Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted p for t erm it. . su n e: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Cou a -by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder - Copy - Department of Public Works I BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) School District DVLO U Al Building Department No C A.P'Number 0&./ -T —(9,��jurisdiction 0 'City 4 ®bounty I; Property Owner/� ATC� f_SO w , Property Location/Address 1 Subdivison Lot No. Residential Development 0 ®meq. Footage ' No. of Living MHI Addition (Group R) Units Commercial/Industrial 0 0 NewsAdditio . A •lr� " '(Floor Plans reviewed by School District Personnel) 9 District Identification No. 940005 l�►�.� /cGt c%� School District certifies that fI (Street Address) (City) v - has complied with the requirements of Resolution No. h* o t representing square feet. School"District Representative (State) Sq. Footage, n " (Including Exterior 'Roofed Areas) . Date ' • Vim, �V�'�/' � ���.•.I`/vim �v K i� (Applicant) (Phone Number) (Zip.Code) 9a by payment of $ 6 / -7 9/93 Date Paid by Check Number Remarks: /X " Bank Number mr +. r f pa" id b' y fCash If,;subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEdA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building:departrpi t)% Pink (school district) feeform.Al (4/92) owner: f�-'Jug' ✓j Permit No. 9,3-20 �. 9741 Oro Quin LOCATION ROOF Material Thickness (incites) ENERGY CERTIF ICAT ION 5-e e7 O A. P. No. DESCRIPTION OF INSULATION Brand Name Thermal Resistance (R Value) EXTERIOR WALL Material FIBERGLASS BATTS Brand Name MANVILLE-SCHUL.LER Thermal Resistance(R Value) R13 Thickness (incl�ea) 3 5/8" CEILING Batt or Blanket Type FIBERGLASS BATTS Brand Name MANVILLE -SCHUL ELv R Thickness(inches) 1'2" Thermal Resistance(R Value)R38 Loose Fill Type Brand Name Minimum Thicknesi(Inches) Number of Bags Wt. per bag 35 Lb. Area covered(ft. ) Thermal Resistance(R Value) FLOOR, ELEVATED Material FIBERGLASS BATTS Thickness(inches) O"' FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) Brand Name MANVILLE-SCHULLER Thermal Resistance(R Value) R19_ Brand Name Thermal Resistance(R Value) - Brand Name alue) BrandName Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building in conformance with the State of California Energy Requirements. LOFRKE: INSULATION CO., INC. F i NAME/OWNER SIGNA URE OF INSTAIA TI APPLICATOR 499150 STATE CONTRACTORS LICENSE NO. January 21, 1994 DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. 57 ell 01111 'R (Please print) STATE CONTRACTOR'S LICENSE NO. 0 SIGNATURE OF GENERAL CONTRACTOR OWNER DATE THIS CERTIFICATE: MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL. INSPECTION APPROVAL. AND A COPY SHALL BE POSTED WITHIN THE BUILDING . January 1984 /---+•-- •�--wr •-, -.+�1 --- ".nr-w--s-ry,..-.fie x�W++MS.c•,---..�,viy-+,.,.,.-..',,,:..-.-...a,T.-,..-,.��-�,.r.r•�-^..Cr-'=. COUNTY OF BUTTE BUILDING DIVISION ` DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 c., 7 County Center Dive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307, CORRECTION NOTICE OVVER PERWT 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, pie contact this office immediately. �a 6J Q„zi 44 19 1 / Date / Inspector REV 110/Z SF IL D9 �6 PGL BLDG. PROD, SAC. P. 1/3 PO. BOX 292850 MENTO, CA 95829.2850 BUILDING PRODUCTS A Palmer G. Lewis Company TELECOPIER COVER LETTER PLEASE DELIVER THE FOLLOWING PA6E(5) TO: NAME: �- FROM: r v TOTAL,PAGES ENCLOSED: DATE: -- IF -THERE ARE ANY PAGES MISSINC;'PLEASE NOTIFY, OUR OFFICE IMMEDIATELY AT ONE.OF THE FOLLOWING NUMBERS: (916)- 381-4242 1-800-952-8614 FAX NUMBER ( 916)-381-2834 PGL BUILDING PROOUCTS SACRAMENTO, CA f I J 11 a S Elp -�2 1013:07 PGL BLDG. PROD, SAC. ROSE &W4 ROSBORO LUMBER COMPANY P.O. Sa 20 - Springfield, OR 97477 PHONE: (503) 746-8411 • FAX: (503) 726.8919 i::, Z:3 9 B c:; I I-, v i:i, 1; Iftx; M11t; I I sills )7 7 MARK 4 Q GTY DEP7H FEET :N FRAC T c --oMB, N, E A L F.7T 4 4 0 P61 X �Cl 02 2;60: 240 C A 4 2 4 240 5-512 05%A 12 6C 02 E 5 a 05-iiE 1 i5 6111 v2 5 4 B ocj-! 50 (10 !:)o 02 0 11-112 60 02 (-6-3/4 X 16-1,11 60 02 'd4 2 co 0 F 60 50 60 02 ;4 1 09 60 02 V; 2 k*, FF 60 .i - 9 i 2 X 12 60 02 60 ,BOER ACKNOWLEDGMENY INVOICE TEAMS ANO CONOITIONS Ftertaa $00PPIt 441 Irflor" d6cloGtooeW With orjongj freight bills. A"W"Oun rufae 10 apply On claims of orao, tally & manuiactuto, ROSBORC ',past duearcoLqft will be asaosW & sg,^W 4;h,,g, Of j%% Per mon, (18% CUSTOMER'S ORDER: IS SUBJECT h annum). Cust~ 40m to indemnity Awbm Lumber comgww tar all expenses incurred In tonnWion TO ALL OF INE TERMS AND with Ift 41oakm of amounts due hwourww. inclucaro all tart COM and wwmy�s Ines incufrbd CONDITIONS STATED HEREIN, 141 the trial W*1 and an My appow. I ,All "90" -r"Mng this Oldw 10111 take Owe In Lane County, Of&oon, ar-M in Iffm bo kum be~ &.* ockAwwowtdoo and CAI ftw" purchase • Ord-, this acWftw)adWnwt taWo o..dana& in all P.3/3 z SEP -1&5 '01 09:07 PGL BLDG. PROD, SAC. APAA jw rrvp P.2/3 �,wlll110r!!1!!I Certificate of Conformance Certificate N° 19065, THE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES that the structural wood products identified below and marked with a collective mark of American Wood. Systems (AWS) were man- ufactured in accordance with the specifications indicated below. (9XANSI Standard A190.1-1983, for Structural Glued Laminated Timber M h Job Location SACRAI`EM U. Customer's Order No. 301-32007 nate 9-3-93 _ Mtgr's order No. / PROOF LOADED END JOSS Signature Title Company ROSBORO LUMBER CO. Address QUALITY CONTROL SPRINGFIELD, OREGON 4027-C Date 9-8-93 IT IS HEREBY CERTIFIED that the structural glued laminated timber production of the above-named manufacturer which carries a collective mark of American Wood Systems (AWS) is subject to regular audit by American Wood Systems, such audit consisting of the inspection with reasonable frequency of the manufacturing process, with adequate sampling to verify the quality of glulam construction and the adequacy of glue bond. :4o�a�gr SEAL ��RSNING��� by Michael R. O'Halloran Executive Vice President AMERICAN WOOD SYSTEMS — A RELATED CORPORATION OF AMERICAN PLYWOOD ASSOCIATION elnAoiq booV/ Isli,toulz b -i1 lefit 2Eijir.R30 YS3A3H RNUTORIU tAM 03ME012R.-ECOU BMT -nsm W511: (4XIA) mWayl booW nuoiisr�A to Asm avilool,0o T flliw b9x�.srn bas %voled b-idilnabi �rGleci aft# til+w sonbm "s ni baiuiod'u ZedroiT t)Olsnirr.f.J baul01�-utoutl? iot ,tt4.r-r.MtA bisbttsla 18AAW A - - ZrVI COL CNO Gamw ci :C1b n58'yuj OnweOfi t 3r11'o noitwnolq iodrril bolzfiimsl bauto Imutouve erdl;lSrt1©BRITABO YBBR'H Bt Ti 1SIUM.t of 1.1elduw ai (84A) amrav2 bwW nmiismA to ksm ®vitoo{W c ee mso rtoiriw imulostunsm i �onUt`tpey, 6106roP331 t11.w nPlMiscle"i ar'; to gnilatanoo s+bus nous ,arfistay2 bcoW nsonsmA yd ttbus r bm nodowilanoo msluip to yN.Gup erll yfliev of gmilgrk►tt,! etzupebe rillw ,reOaptq gmiutz&unzm srlf ►o .bnod 2u1g to yosupoba Brit _ S i ns,c:aH'C .A lesdoRA 17.ar,le,119 031V svau:>, -:�; r Rf n:,�ptst��1�QJ.,`, v`,c .I,l est ✓u-`"' C�" �-c� 7 J 1•f 061-54-0-025 92-3582E ATCHISON, Richard 9741 Oro Quincy Rd, Berry Creek (sf/upgrade elec service) OFFICE COPY « Address q7`7� G ate. i ELECTRIC .,Meter BY a y x°.,r�,w,..vtc,.�q""��°�j;,A^r"'.�'I'�ptJ=,:;.c��*";.�;�W''e�1�{�'?!�:;it � :.ip �•�,,�.,..�u:-aF-.:'"�'f4�.., .,.a,>�r' AI COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0. 7 County Center Drive - Oroville, California 95965 - Telephone: 916,538-7541 ? r� ? k2 APPLICATION AND PERMIT �f ..J ASSESSOR PARCEL NUMBER 061-540-025 ZONING U BUILDING PERMIT OWNER RICHARD ATCHISON TELEPHONE 589-1896 ,SQ, FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 9741 ORO QUINCY ROAD BERRY CREEK CONTR ACTOROWNER'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total V&luation is LENDER'S MAILING ADDRESS Filing F=ee $ 155,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING 741 ORO CY ROAD BERRY CREEK Permit tee PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF n 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 ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: PRE INSPECTION & UPGRADE SERVICE _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 18.50 Main service 200A TO IOOOAI CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElNON-RESID 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 1, as the owner, or my employees with wades as their sole compe I- 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.(k\ OR ACDNS. ACC. / _37.50 3.54 sq.ft. NEW CONSTR.LTI.OUT _OU ULET BRANCH CIRCITS @ 5.00 /POWER APPARATUS &) \SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 75rj AL 4R&I FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. 6Virin 9 15.00 PRE !NSP• Permit Fee $ 53.50 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. V1 I shall not employ any person in any manner so as to become subject mac' to the W. C. laws of California. Notice to Applicant: If after making this statement, should you becomesubject 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 liabilit{es, jud ments, costs, and expenses which may in any way accrue against sa a ty in cpF�seg�ence of granting of this permit. C / (,/' - Date �Z .J Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑� An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 53.50 HAz OFEES IMP FLOOD CDF PARCEL PO HD ISSUE This permit is hereby issued under the sions of the Emote p y Code and/or work indi t L for which fees �I TOR OF PUBLIC By /' `' PrRMI- EXPIRES Date 1/, applicable provi- resolutions to do have been paid. WORKS 11 / D to //;'3 ,"`_� ' ! 1 Receipt No. 126206 WHITE-D.P,W., YELLOW- ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE -.DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER - 061-540-025 ZONING U BUILDING PERMIT OWNER RICHARD ATCHISON TELEPHONE 589-1896 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 9741 ORO QUINCY ROAD BERRY CREEK CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILD97Permit ADDRESS41 ORO QUINCY ROAD BERRY CREEK fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 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 ISIG W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: PRF INSPECTION R UPGRADE SERVICE _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑I am licensed under p provisions of Cha t. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification /u1I 1, 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 Main service 200ATO1000A) 37.50 NEW CONST./ DWELLING OCCUP.&\ OR ADDNS. ( ACC. BLDGS. / 3.6Q sq.ft. NEW CONSTR ULT' -OUTLET NO N.RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS &\ SINGLE OUTLET C'R. / Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APPLNS, OR EX. OCCUp. OUTLETS (RESID.) EA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 PRE INSP 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. LQI I shall not employ any person in any manner so as to become subject J� 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 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 ll lia 'es, Jud m_ ents, costs, and expenses which may in any way accrue a' st sal ty c q ence of granting of this permit. ;ag Date �o .-9_ % 1 Signature of ApplTcant — OwnerElContractor❑ Agent El 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 TOTAL FEE $ 53.50 rlAz DFEES IMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under the Bions of the Bj&tte y Code and/or work indi t d for which fees R OF PUBLIC By P R EXPIRES Date G/ applicable provi- resolutions to do have been paid. WORKS D to // 3 Receipt No. 126206 WHITE-D.P-W„ YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916'538-7541 APPLICATION -AND PERMIT ASSESSOR PA C:ZONING —MBER — 2 U% I BUILDING PERMIT O! ER ab _C/ SO/J TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS O - U IA)C)D. %�02(&r CONTRA'CTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRES !??(// Permit tee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFDuplex❑ Mobilehome❑ Other III/ 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 ❑ Remodel [i Utilities ❑q Installation ❑ ( Other � Describe work: ie �✓152�GflClY1 J�[�,C� �Pi/✓tTG�- /_` Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the BUSIneSS and Professions Code and my license is in full force and effect. License No. ClassificationAL 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 Main service 200ATO1000AI .7. Sb— NEW CONST.( DWELLING OCCUP.�\ OR ADONS. ACC. SLOGS. /) 3.6Q sq.ft. NEWCON5TFL ULTI.OUTLCITSE' NON.RE51D BRANCH CIR @ S.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 CID 76d PRA ED APLNS.❑ EX. Occup. OUTLETS P(RESID )REA.) 1 3.00 Temporary service 1 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 XE s Permit Fee $ ST1 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling 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 — Owner[IContractor ❑ Agent ❑ An OSHAwork 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 TOTAL FEES HAz 1)FEES IMP FLOOD CDF PARCEL PO HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or indicated above for which fees DIRECTOR OF PUBLIC -WORKS By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. Date Receipt No. 2 6 2p (p WNITC•D. P. W., YELLOW- ASSES 90R, PINK -INSPECTOR. GOLDENROD -APPLICANT '. n i �vi't4��' 'y�e11 P}y%.:Y moi^ t'a++ ytK ' .%W1)�?4 4 �r i �1" �P}x �"1�A17'iMN'r.,..'hti''�� k�p.,,� !{a'��:vr'SINe'^•�.-,i...r'` i • �.. . COUNTY OF BUTTE�PARTMENT OF PUBLIC WO,F�"' BUILDING DIVISION 7 COUNTY CENTERTT DRIVE - OROVI_L'E, CALIFORNIA 95965 = 'TELEPHONE (916) 538-7541 OWNER /`Tr7L Proposed Building Use PERMIT APPLICATION DATA SHEET C)V\1 A. P. No. 66/ -S7((0 Building Inspector 21z- Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................. 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of$ .......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ........................ 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval . Health Department . ............. 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. . ........... 19. Driveway permit (construction approval required prior to occupancy). .. ........ 20. Pre -ins ectlOn for Pre,Inspection request - p required. . to Bu;Id;ng Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification). ........'�. �... . 22. Certificate of Workmans. Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner Mail to owner ) ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................................... . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ........................................ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan deck list_ .. .............. ........ .. ... :.. . ... . ... 33. t �- e► n S p e.� /`7 34. When you issue the permit, process as follows: Mail to Mail to contract . Telephone and hold for pickup at office. eliver with inspector. Other Parcel Creation /0 Acreage Appli Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works _COUNTY OF BUTTE` Department of Public -Works -7'County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature.. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan -to provide the major labor and materials for construction of the proposed property improvement (yes or no) es 2. I (have/have not)/(; signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name: Address City Phone-' 'Contractors License No: 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise., and provide the major work: _ Name . . Address City Phone Contractors -License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name _ -Address Phone Type of Work Signed: Property Owner Social Securi Number Date -- 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. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 CountylCenter Drive - Oroville. California 95965 - Telephone: 916.538-7541 APPLICATION -AND PERMIT PERMIT NO. ASSESSOR P.4 C MBER — — ?_ ZONING U BUILDING PERMIT O, ER TELEPHONE /� S0. FT. OCC. BUILDING VALUATIONC��h�0�f OWNER'S MAILING ADDRESS - CLC? G U �,tiC D. 0212' rK Ck�_ .... CONTRACTOR'S NAME TELEPHONE CONTRACTCR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN c Total Valuation $ LENDER'S MAILING ADDRESS _ Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRES � "1 Ll C'�� C C' � � (� Permit fee $ .�/SIV PLUMBING PERMIT Filing Fee 1 15.00 Each Trap I 5.001 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEP4RCEL MAP Water piping 7,00 Each qas water heater or vent 7.00 USE OF STRUCTURE SDuplex❑ Mobilehome❑ Other 7� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W 015.00 • TYPE OF WORK New Ii7 ; Addition L1 Remodel ❑ Utilities ❑ Installation[ Other ]- Describe work: 7rE J-4 f d C�L� _��,��(C e_ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLLESS SS 18.50 jC- CONTRACTORS LICENSE LAW - I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) El 1, 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 Main service 200ATO1000AI 37.50 t; NEW CONST./ DWELLING OCCUP.&) OR ADDNS. 1 ACC. BLDGS. 3.6Q sq.ft. NEWCONSTR • ULTI.OUTLET NO N.RESID. BRANCH CIRC ITS @ 5.001 /POER APPARATUS e \SINGWLE OUTLET CIR. ) Ex. OCCUp(OUTLETS OR FIXTURES RAO 7FIXE6d Ex. Occup. OUTLD TS P(RES]0 IREA.) I 3.001 Temporary service 15.00 Home Facilities 15.00 Misc. Wiring 9 15.00 J Permit Fee $ t �' WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. F -u i I have placed on file with the County of Butte Building Department a Certificate of Workmeri's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling 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 - Owner❑ Contractor C Agent CI An OSHA permit Is required For excavations over 5'0" deep and demolition or construct. ion of structures over 3 stories .n height. Mobile Home Installation Fee S Energy Inspection Fee $ 0cc CONST TYPE TOTAL FEES ` =T I HAZ DFEES IMP I FLOOD CDF PARCEL PO HD SSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. I I WORKS Date i Receipt No. ZL, �L� �,; NNITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPL. CANT PRE -INSPECTION OWNER • vg A C DATE LOCATION: ���'%� �J320 �UJi()C �� 6£W7 GK. A. P. # CONTRACTOR: QWY\e(� ZONING ------------------- (J PRE -INSPECTION FOR: Sf(-V (c -e- V, DATE TO INSPECTOR �0 " 9 '9 z ------------------------------------------------------------------------------------ PERMIT HISTORY: NONE AS FOLLOWS: TYPE OF OCCUPANCY S �> FIELD - INFORMATION BUILDING USAGE: TENNANT: 0 OCCUPIED [] HAS ELECTRIC �_] FAS GAS [::] HEATED -COOLED OTHER COMMENTS: ACTION RECOMMENDED: ISSUE Q OTHER: PERSON CONTACTED HOLD FOR [:] HAS SANITATION FACILITIES