HomeMy WebLinkAbout061-550-0150
I/
61-55-15 92=10.81 B
MIYAHARA,jac hie
216 He -Le' -Ye Rd,, Berry. Creek
new garage -ll
IDELLA'LACEY
APPLICATION I - FOR DETERMINA"T'l ON
8/24/91
61
5
5
f
DEPARTMENT OF PUBLIC WORKS
WILLIAM (Bill) CHEFF, Director -
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965
Telephone: (916) 538-7681
January 17, 1992 RONALD D. McELROY
Deputy Director
Idella Lacey RE: . AP r61 55-15
1472 -Linden Avenue CERTIFICATE OF COMPLIANCE
Long Beach, CA 90813
Dear Ms. Lacey: .
Enclosed please find the Certificate of Compliance which was recorded
by the Butte County Department of Public Works in the office of the
Butte County Recorder on January 7, 1992. The Recorder's Serial
Number is: 92-00651.
If you have any questions regarding this matter, please contact this
office.
Very truly yours,
William Cheff
Director of Public Works
Stuart Edell
Assistant Director
SE/ds ,
attachment
cc: Building Department
Environmental Health Department
Ted Runge, P. 0. Box.2042, Oroville., CA 95965
Vii, -U066 1
92-000651 1 Total
Recorded I
Official Records I
aCounty of 1
Butte I
RETURN TO: Candace J. Grubbs I
Public Works Recorder I
Land Development Section 1:24pm 7 -Jan -92 I PUBL
CERTIFICATE OF COMPLIANCE
Issued to: Idella Lacey
1472 Linden Avenue
Long Beach, CA 90813
This Certificate of Compliance is hereby issued by the County of Butte to
certify that the land division which created the parcel of property
identified below complies with the applicable provisions of the Subdivision
Map Act and of Chapter 20 of the Butte County Code.
1. Property location: on the east side of He-Le-Ve Road
approx. 3000 ft. north of Encina
Grande Road. Bloomer Mountain
area.
2. Assessor's Parcel Number: AP 61-55-15
X
Description : All that certain property located in the County of Butte, State
of California, more particularly described as follows:
COMMENCING at the Southeast corner of the Northwest quarter of the Southeast
quarter of•Section 30, Township 21 North, Range 5 East, M.D.B. & M.; thence
North 1° 21' 30" East along the Easterly boundary line of the Northwest quarter
of the Southeast quarter of said Section 30, 530.00 feet to the true point of
beginning for the parcel herein described; thence from said true point of
beginning North 70° 40' 29" West 331.70 feet to the centerline of an existing
road easement; thence North 27° 18' 40" East along said centerline 445.94
feet; thence North 220 37' 25" East 121.78 feet to the Easterly boundary line
of the Northwest quarter of the Southeast quarter of said Section 30; thence
South 1° 21' 30" West along said centerline 521.78 feet to the true point of
beginning.
TOGETHER WITH rights of way of record recorded in Book 2717 of Butte County
Official Records at Page 596.
Issuance of this Certificate is conditional upon the following conditions
which have been imposed pursuant to the Butte County Code Chapter 20-166 and
Government Code, Section 66499.35 (b), to protect the public health and public
safety:
NONE
County of Butte
Subdivision Violation Committee
END OF DOCUMENT
END OF DOCUMENT
1
FA
Idella Lacey
1472 Linden -Avenue
Long Beach, CA 90813
Dear Ms. Lacey:
butt¢ Co
DEPARTMENT OF PUBLIC WORKS
WILLIAM (Bill) CHEFF, Director
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965
Telephone: (916) 538-7681
RONALD D. McELROY
August 29, 1991 Deputy Director
RE: AP#61577,_,
APP. FOR—DETERMINATION
At the regular meeting of the Butte County Subdivision Violation
Committee meeting held on August 28, 1991, the committee granted a
conditional Certificate of Compliance for the above -referenced
property. The conditions are:
Provide satisfactory evidence that a suitable site for the installa-
tion and replacement of a sewage disposal system fora single family
residence exists on the property..
There is a fifteen -day appeal period before this Certificate can be
recorded unless you sign and return the enclosed waiver waiving your
right to appeal the committee's decision..
If you have any questions regarding this matter, please contact this
office.
Very truly yours,
William Cheff
Director of Public Works
i
t
Jo,H� endonsa
Asdistant Director
JM/ds
attachment
cc: Planning Department
Environmental Health Department
Building Department
Ted Runge, P. 0. Box 2042, Oroville, CA 95965
..
4
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovllle; 6eflfornle 95965 - Telephone: 916,'538-7541 _7_1
APPLICATION AND PERMIT y�v`
ASSESSOR PARCEL NUMBER
061-550-015
ZONING
U
BUILDING PERMIT
OWNER
YACHIE MIYAHARA (408)
TELEPHONE
269-2781
So. FT. oCc. BUILDING VALU ON
OWNER'S MAILING ADDRESS
4404 JARVIS AVE SAN JOSE 95118
600 M 10,800
CONTRACTOR'S NAME
Ou1NER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
10,800
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee
$ 52.50
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Ener Plan Checking
9Y g Fee
$
Penalty
$
BUILDING ADDRESS HE—LE—VE ROAD BERRY CREEK
Permit f
$ 172.50
UMBING PERMIT
Filing Fee 1 15.00
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME
PAR/CEL MAP
�(O `3 y
Water piping
1 7.00
Each pas water heater or vent
7.00
USE OF STRUCTURE
SF ❑ Duplex[] Mobilehome❑ Other DET GARAGE
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 ❑ Uti lities ❑ Installation❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service ESS
200A OR V OR LESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
El 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. Classification
Nq�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 200A TO 1000A)
NEW CONST./ DWELLING OCCUPM
OR ADDNS. l ACC. SLOGS. //
_37.50
3.64 sq.ft.
NEW CON5TIL ULTI-OUTLET
NON-RESICn BRANCH CIRC ITS
@ 5.00
(POWER APPARATUS 6\
SINGLE OUTLET CIR.
Ex.ccu
po O UTLETS OR FIXTURES
20 76d
Ex. Occup. our OUTLETS PIRESID IREA.�
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Iyirin 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
FiIingFee 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.
1 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.
XThis
Date
Si ature of Appl'c — Owner Contractor ❑ Agan
An OSHA permit is required for ex on o er eep and demolition or construct-
ion of structures over 3 stories in
Mobile Home Installation Fee S
Energy Inspection Fee $
cc CONSTxyPE OTAL FEE S 172.50
/V,�'
HAz OFEES IMP FLOOD DF PAflC PD HD Issu
permit is hereby issued under the
cions of the Butte County Code and/or
work indicated above for which fees
I ECT R OF PUBLIC
BY
PE IT EXPIRES Date
applicable provi-
�
resolutions to do
have been'paid.
WORKS
Datq(a, )�
, o fa ��^ +
- r �•.
Receipt No. 1155350'�
WHITE-D.P.W.. YELLOW-ASSCSSOR, PINK-INSP G OR. GOLDENROD -APPLICANT
—_ I
Co .
JUN 2 1 1993
June 18, 1993
TO: Department of Public Works, Planning Dept.
This is an referance to an active garage permit in the
works, expiring in October, 1993•
I like to notify you that we will not be building the
garage after all. This is because we did the foundation and
had the inspector look at it. At first, the inspector wrote
we can build on our own risk. Then the second time, he changed
and wrote that we could not and should have an contractor do
it, which we never had anticipated on an contractor.
Therefore, we decided to quit. Please cancel my permit
and if there is any refund I am entitled to, will be appreciated.
Thank You '
7achie
'
Mi h r ya a a
4404 Jarvis Ave.
San Jose, Ca 95118
Permit #92-1081
t
..RESIDENTIAL
` + 61-55-15
92-1081 B
MIYAHARA, Yachie
216 He-Le-Ve Rd; Berry Creek
new garage
�c J
JOB FINALED (Date) N ��
Signature
J=OK
O = Not OK
=Not Applicable~
Not Ready RESIDENTIAL (;
' =
Date UNDERFLOOR (Plans) OK except If's
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" 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/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. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit),OK except ti's
16. Water Htr.: Vent -Access -Combustion Air -Baffle
----------- -- - --------------------------
17. Water Pipe; Test & Anchor -Nail Protection
18. D.W.V.; Test -Fittings & Anchor -Nail Protection
------- ------------ ------------------
19. Shower Pan: Test, First Floor -Tub Access
20. Test -Tub & Shower. -Second Floor -Tub Access
---------------- ------------------
-- 21. Gas Pipe: Size & Anchors
Date _ Card B-1 -- - Date - - Card BB=1 -
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except ti's
---- -- 22. Fixture & Transformer Clearance -Ins. -Protection -
--------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors
------------- ---------------------------------------------
_- - - 24. Size Boxes & No. of Conductors -Stapled
----------------------------- -------------------------------
- 25. Romex Installed Close to Edge of Studs & C.J.
26. Equip. Ground made up w/Meth.- -Gas-,Fastners-Bond a &- Water
----- ---- --------------------------- -- ---- ---------------
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
------------------------------------------ -'-------------------------
28. Subfeed Wire Size / ga. Cu or AI-A.C. Wire Size ! ! ga.
_Cu or AI
29. Range Circ / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
----------- ------------------------------------------------------------------
30. Service -Riser Conductors & Ground -Main Disconnect
---------- - - ------------------------- ----------------
31. Equip Clearances Panels-Motors-Mech. Equip.
---------------------------------------------------------------------------
32. Clothes Closet Light -Shower Light -Spa Light
------- ---------------------------
-
----------
---------------------
33. Smoke Detector
-----------------------------------------------------------------------------------
Date Card B-1 Date Card B-1
--------------------------------------------------------------------------------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except ti's
------------
34.-A.C.- Ducts Insulation - Support
---------------------& --------------------------------------------
35. Vent Fan: Exhaust above insulation
-------- -- ----------------------------------------------------------
36. Condensate Drain & Overflow; Size & Grade
------------------------------------------- - _--- ----
_ 37 Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet
-------- ----------------------------------------------------------
38. Attic -Access-&- Platform ii Furnance in Attic
------------------------------------ -------------------------------------------
Date
Card -8- t Date Card-B-1-------
Date
ard B-1
---------------------------------------------------- --------------------------
Date Card B-1 Date Card -B- 1
Date FRAMING (Plans) OK except ti's
39. Sils. Proper Material & Anchors
-
----------------------------------------------------------------------------
40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
------ --- ----------------------------- ---------------------
42. Draft Stop in Walls (rat proof)
- - - -------------------------------------- ----- --- ---------------
43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
'infgle & Duplex)
Date FRAMING (Continued)
_ 45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50._Garage Fire Protection Framing
51. Property Line Firewall & Openings
------- __ 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. _Stairs: Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
----------------- - -
______ 55. -Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls: Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration- Walls -Windows
-----------------
-Date
------------
-------
Date Card B-1 Date Card B-1
-- - ------------
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except ti's
61. Ext. Steps -Door & Sidelight Protection -Landings
__ 62. Smoke Detector
63. Furnace: Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor -Ducts -Meth. Protection
----------------
64. Bedroom Exiting
--------------------------- ----
65. G.F.L & Bath Fixtures & Tub Access -Spa
66. Elec_ Trim -& Subpanel_Breaker Sizes & Labels
-----------------
67. Stairs & Rails
68. Fireplace or Stove: Clbarances-Hearth
69. Elec. Outlets at Wood Panel: Int. & Ext.
70. Kit Fixt_& Appliance_Grnd_Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
•--------------------------------- g_--- -----
72. Garage Fire Door, Swing Landing Closer
---------------- - - ----- ----- --
73.- A.C.-Duct in -Garage -Damper
--------------------------------------- -
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor-Mech. Protection
---------------------------------- _
75. Plb__Elec. & Mech. Equip. Listed for Location
------------------
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
----------------
77. Insulation -Foam -Looked in Attic ❑ Yes
--------------------------
78.
- - 78. Guard Rails & Deck Construction -Post Caps
-------------------------- ---------- ----- -
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
--- - ------------------------------------ -
80. Following instld.; Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
------------------------------------------
81.
-----------81. Stucco: Brown -Finish
--------- --------------------------- --- -
82. A.C. Unit: Disconnect. Electrical, Plumbing
83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings
--------------
84. Water Well; Disconnect, Electrical, Plumbing
-------------- -------------------- -- -
85. Exterior Elec. Trim_G.F.I. Recep tacle-Underg round
86. Ventilation Throughout House
--------------------------------- ------
-----------------
87. Glass Protection
- -- - ---------
88. Corrections from Previous Inspections
------------------------------
- ------------- -----_-----
89. Gas -Test- Meters Tagged: Gas -Electric
-------------------------- ------------------
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
--------------------------- ---------------- -
Date Card B-1 Date Card B-1
•-------------------------------------- -- - -
Date -------------- Card_B-t----------- __Date _ Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
4 O
O = Not OK
Not = Not R(ldyable 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 -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / /" L" ft.
/ /"Nat. or/ /" L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card 8-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
i
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
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.; Columns -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 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, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
_ Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
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
COUNTY OF BUTTE
BUILDING DIVISION
' DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
c� 7 Z ;
WNERPERMIT 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., s;
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately. I
Date 2-1114 Z Inspector ,l-/ ✓t'
REV 10/92
�—�+,..r+� ��,`. � •"iTx""yyf '".``+....lir �+ 7i•°Fru•�.�y`1.a". `-. .�r`. -,. , __ • -r - - - ' � .- '..�• , �' �-.r� !,
COUNTY OF BUTTE
' DEPARTMENT OF PUBLIC WORKS
1469 Humboldt Road, Chicq, CA - (916) 891-2751
7 County Center Drive, Oroville,.CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
z
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work ,
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
of
t.
• � `Ae
Date / /.�9 Inspector
REV 11/91
r
NOTE.—All Materials & Workmanship Shall Be in
Accordance with Recognized Good Practices and
of a quality prescribed for the Specified use in the
Uniform Building, Plumbing & Mechanical Codes and
the National Electrical Code.
3°
A setback of 5 t. from the
property lines and a setback
of 50 ft. from the road
centerline shall be clear of
structures or equipment except
for a 2 ft. eave overhang. -�-
C
s
This set of plans and spe
kept on the job at all times
make any charges or al►,ter.
written permission #ro the
Works, County'of Bette.
el
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N ;
ations `IIU?T ' e
,t is unla°3!�# t tC
on sari wn, 0ut
)artmeA of Public
Location of structures &
equipment shalt be as shown
^i r m all (easements.
& „ea •.
APPROVED .
Butte County
Environmental Health
E COUN
®EPAR,rMENT
IR v E D
ivironmentai Health
�PR 0 9 1992
Iroville, California
Date
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Provide approved flashing U ail exterior
openings, typic&:!.
Codr� ic/y s
BUTTE COUNTY .
BUILDING DEPARTMENT
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COUNTY OF BUTTE - DEPARTMENT OF 'PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER G //(G / �( Pe A. P. No.
c
Proposed Building Use Building Inspector Date YL
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted.
�2. Plot plans in duplicate/triplic gn by preparer of plans ........ 4 �6
3. Complete plans in duplicate ate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans .. '
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions
( 10. Fees of$�L�......................................
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13• School Distr'ct fees paid ..............
14. Sanitation approval from �bmlIt (e Health Department 9 q2
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name'Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ...................................
26.
27.
When you issue the permit, process ag/follows: Mail to owner. Mail to contractor.
_ Telephone 40&-7- 01- �%and hold for pickup at office. Deliver w/inspector.
Other Col/ec+-
Applicant .Date ),r/9 -z_
Copy of ! Idz-Mat form sent Health Dept. Fire Dept. v Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submittedp 'or o permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional, items required:
Contractor, designer, ow& -r was advised of above required data by�one_mail—counter ba__.date
Contractor, designer, owner, was advised of above required data by—phone—mall
counter by date
Plans checked by Date Plans approved by _Date r Z
Sets of plans on hold in File cabinet AP folder
Copy—DPW
To Buildina Department
FROM: Environmental Health \
SUBJECT: Sanitation Clearance
4
'1 U-e-
yy ) Rt P --,L,P a 61=5 -61:5:
Owndr Location AP#
Plan Approved for: Sewage Disposal Water Supply
Fold final for: Water Supply
Final clearance O.R. for: Water Supply
Clearance for be bi ome. Other O�
.`MOTE �
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4k
Sanitarian Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovil.le; California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMB"
(/Q50 - v��
ZONING
BUILDING PERMIT
OWNER P/' /^� �/-j�� L Ce
ATE/LpEPHONEe
SO. FT. OCC. BUILDING VALUATION
L/ L/
OWNER'SZAAILING ADDRESS
1 DY SEtr ✓� s AYESAAIT 5; ' MA 91180
CONTRACTOR'S NA E TELEPHONE
00ilex-
'
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$ oa
ARCHITECT /OR ENGINEER
LICENSE NO.
Plan Checking Fee
g
Energy .Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS h I�
- G E- V
Permit fee
$ �7 Z.
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
1 5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
7.00
Each pas water heater or vent
7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other o9e 9,"- Gfl
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G W
@ 15.00
TYPE OF WORK
New Addition _ Remodel LI Utilities ❑ Installation❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200A OOR LESS
18.50
Main service 200A TO 1000AI
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
1 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. Classification
Lj 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.&1
OR ADDNS. l ACC. SLOGS. II
3.5Q sq.ft.
NEW CONST R. tiULTI-0UTLET
NON -RE SI D. BRANCH CIRC 'ITS
@ 5.0�
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. OOCUp(OUTLETS OR FIXTURES
20 75d
FIXED APPLINS
EX. Occup. OUTLETS (RESID )REA.�
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
9
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
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
FiIingFee 1 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 — 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 5
Energy Inspection Fee $
occ I CONST TYPE
I
TOTAL FEE $ J`7� s -
HA2
0FEES IMP
1
I FLO�O
CDF
PAii
PD 1 110SSUE
11
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.
WORKS
Date
Receipt No. 1555
WNITE-O.P.W.. YELLOW -ASSES SOP, PINK -INSPECTOR. GOLDENROD -APPLICANT
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)
2. I (have/have not) � u¢i 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 T 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 FwA&_1
Social Security NZmber
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832- of -thea California..Heal.th and Safety Code.
This verification must be,completed and returned to our office before we are per-
mitted to issue the permit.