HomeMy WebLinkAbout062-190-028i(
062-190-028 PERMIT#95-1628
HEATHORN
314 Lakeside Way, Lake Madrone
Cont; DASL
New HVAC/SF,,,�.9'/�
r
Bill Heathorn _
E/S Lakesi'Hb,Way, app.75"S9 of Old Mill
Rd., lot 49,'Spring Valley, Lake Madrae
contr:Mountain Development, Oroville
Per it #4644-8 ;P E add r
• 'e
? r PERMIT NO. 4644-80B,P,E
PERMIT EXPIRES_ !qhs
^ OWNER Bill Heathobn
• r
�. CONTR. Mountain Development, Oroville
ASSESSOR PARCEL 62-19-22
' 1
LOCATION E/S Lakeside Way, app.75'S.of Old
Mill Rd., lot 49, Spring Valley,Laki! Madrone
• ft
i
j�
1
a
s
Temp. Power Pole
Called PG&E
— r
r Temp. Elec. Service
Called PG&E
Temp. Gas Service
4
Cal led PG&E
JOB FIN ED (Date) S �� E
i Signature
.a
J = OK
0 = Not OK '
- = Not Applicable RESIDENTIAL (Single and Duplex)
* = Not Ready
Date
UNDE LOOK Plans OK exce t#'s
Date FRAMING (Continued)
oning requirements—Setbacks—Easements
-4V--Wqp2rty Line Firewall & Openings
!7t: f, ., ain; Is—S el—Elec. Grnd.— / . /'' Ftg. Depth
xt. Doors—One 3'—Check Garage -3rd story, 2 exits
F ., G e; S ' s.S3oaI_ / /" Ftg. Depth
Stairs; Width—Headroom—Rise—Run—Landing—Fire Protection
_6.—Ftg., Porches & Decks; Soils—Steel— / /" Ftg. Depth
•A4—PI wood on Roof Overhang—Attic Vents—Rafter Outriggers
-_',. emwalls, Main; Steel—Blockouts—Wrapped—Slab
Siding—Nailing—Veneer
temwalls, G e; Steel —18fovkoals*revWdc
7. Piers—Fireplace Ftg.—Steel
317—Stucco Mesh—Drip Screed—Fdn. Vents—Underflr. Access
t=- Mazing Area—Glass Protection—Skylights—Plastic
8. D.W.V.: Fall—Fittings—Test-2 way C/O—Sewer Test
ear Walls; Nailing—Bolts
9. Gas Pipe; Size—Anchors
10. Water Pipe; Test—Anchors—Regulator—Service Test
11. Electric; Underground
12. Plenums & Ducts; Clearance—Material—Support—Ins.
13. Girders—Sills—Anchor Bolts—Joists—Vents—Cripples
Card -BI to — S'0 Card -BI Date
Card -BI Date Card -BI Date
42.0
Card -BI Date Card -BI Date
Card -BI
Date rd -BI Date
Date FINtans) OK except N's
Card -BI Date Card -BI Date
Date
PLUMBING (Permit) OK except q's
r Ht.; Vent -Access -Combustion Air
. Ext. Steps -Door & Sidelight Protection -Landings
^5T."Smoke Detector
Vents -Clearance -Comb. Air -
In Garage; Above Floor-Ducts-Mech. Protection
Connector -* -Ater Pipe; Test & Anchors -Nail Protection
D.W.V.; Test-Fttngs & Anchors -Nail Protection
--57-1reTroom Exiting
ath Fixtures & Tub Access
Siower Pan; Test, First Floor -Tub Access
e}8�Test Tub & Shower, 2nd Floor -Tub Access
Elec. Trim & Subpanel; Breaker Sizes -Labels
X49 --Gas Pipe; Size & Anchors
92: '64e#s & Rails
trey ace or Stove; Clearances -Hearth
.64U-C4eewjQuUets at Wood Panel; Int. & Ext.
Card -BI
Date( -tor kO Card -BI Date
it. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
nr_ffreC_Cholets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except #'s-@&.-
ftg�75rage Fire Door; Swing -Landing -Closer
- -A-C-uc in Garage -Damper
20. Fixture & Transformer Clearance -Ins. Protection
y1.-�lec. Receptacles Spacing -Lights &Switches at Doors
tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
8 Mech. Equip. Listed for Location
tze Boxes & No. of Conductors -Stapled
Owoolftec. Receptacles in Garage; (G.F.I.)-Romex Protec.
@@--IRSDfation-Foam-Looked in Attic E] Yes
aa,.'-Qpmex Installed Close to Edge of Studs & C.J.
2* -Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
.,ails & Deck Construction -Post Caps
ppliance Circuits in Kitchen &Conductor Size
n. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
_ Subfeed Wire Size / k1 ga. r AI- r AI
wLW. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu o[ Al,
Insulated Neutral []Yes ED No
o o ng instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes ❑No
service -Riser Conductors & Ground -Main Disconnect
ucc rown-Finish
Sr-
--@9r-Equip. Clearances; Panels-Motors-Mech. Equip.
7 .C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30. Clothes Closet Light -Shower Light
78r•40errts Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
Card 3 I
Card B -I
Datq(0 -L Card -BI Date
Date Card -BI Date
er Well; Disconnect, Electrical, Plumbing
error e . Trim; G.F.I. Receptacle -Underground
84v--}.. tiltionthroughout House
g&.-eftysProtection
Date
MECHANICAL (Permit) OK except M's
_
83__Cerrceliene-4rom Previous Inspections
84r-9aSTest-Meters Tagged; Gas -Electric
_
A.C. ucts; Insulation & Supp rP
- 32.
32. Vent n; Exhaust above ulation
33. Condensa Drain & _ rilow; Size &Grade
gCr-WaTsT"dr Sewer Connected -C/O to Grade -HD Approval
aaCompliance Certificate -Other Certificates
Card -BI
Card -BI
34. Furnace -Vent ss -Comb. Air -Return Air Vent -115V outlet
35. Attic Access Iatfo f Furnace in Attic
a Card-BIe
Date Card -BI �te
Card-61/1-37)ate Card -BI Date
Card- Date Card -BI Date
Card -BI Date Card -BI Date
Comments at Final:
Date FRA Plans) OK except p's
_ S
§.LUs, Proper Material & Anchors
Walls: Studs -Nailing, Spacing _& Bracing -Plates_ -Sound
'11" Bearing Walls over Girders & Floor Nailing_ _
raft Stop in Walls (,at proof)_ _
Mire Stops; Furred Ceilings -Stairs -Chases -Tub
_
Wider & Beam -Size & Bearing _
X42-44angers-Post Caps -Anchors -Connectors
43. - 75v�s-S h t apQ •-H
roil. fireplace Ties or Type A Flue -Fireplace Throat
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
-TO-Sdrm. Windows or Exiting Doors -Sill Hpt. & Dimensions
�7.�arage Fire Protection Framing
_
_
(NOTE: An entry must be made each time you visit jobsite)
J =GK
0 = •Not OK
= Not Applicable MOBI'LEHOMES
* = Not Ready
MISCELLANEOUS
'Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
_
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts- Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
_
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Location -Test -Wrap:/ '/"L"ft./ P'Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
Card -BI
Date + Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except q's
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except N's
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
4. Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/0 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
COUNTY OF BUTTE - DEPARTME NIS OF PUBLIC WORKS PERM T �"o A
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541/V,�
(J
APPLICATION AND PERMIT
ASSES OR Pt EL UMBER
�p 1—/�-Z7
G
%
`14%
FILIA)f BUILD 4 PERMIT
Ol?
t/.� �>�qw-m 1
N
2POWNER'S
TELEPHONE
SO. FT. OCC. BUILDING VALUAT ON
-
`•O�
MAILING ADDRESS
C Vb, !/V•MECVftV#0M&tfr
TE.
�L5EP`9
I0D(%C.o%Y8`--��;V �s"
[Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
f , Oc
LENDER'S MAILING ADDRESS
Permit Fee
$ go,pp
ARCHITECT OR EN GI
LICENSE NO.
Plan Checking Fee
$ A0.00
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ Q 0
BUIL G ADDRESS
E � �/Cs/%�C !.(J/� iaorp, IV7�s_
PLUMBING PERMIT
Filing Fee®.00
Each Trap
2.00 Z-0-0
Repair drainage or vent piping
2.00
Water piping
Jar co
LOT N00
su E „�
PARCEL MAP
Eaco qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
2.00
,-,� TYPE OF WORK
New F-1AdditionI� Remodel ❑ Uti lities ❑ Installation ❑ Other ❑
Describe work: �C{ —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee /0.00
Main service 100 AMP OROR LE SLESS
5.00
Main service EA. ADD'L too AMP
2.50
NEW CONST. DWELLING OC�+
OR ADDNS. ( ACC. BLOGS. (Q
2P Sq ft �s•3CJ
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 for c and effect.
a71 —
License No. j1� Classification
�
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and. Professions Code
for this reason
NEW 1_01ID R BRANCH MULTI -OUTLET
ITS 2.50 ea
NEW CONSTR.POWER APPARATUS 11\
NON-RESID, (SINGLE OUTLET CIR. 1
Ex 50 @ 25c
. Occup(o Ts OR FIXTURES BAL@10¢
FIXED
Ex. Occup.(OUT ETS (RESID,)REA.1 2.00
Temporary service 10.00
Mobile Home Facilities
15.00
Misc. Wiring 6.25
Permit Fee $ 2;g7, 3
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
/ of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiIingFee 3.00
Heating
Cooling
Hood
2.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
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 C n in sequence of the granting of this permit.
t- Date
Signature of Applicant — Owner ❑ Contractors 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 $
Land Development Fee $
TOTAL PERMIT FEE $
OCCUP. GROUP
r
I TYPE DF C.N.I.
✓
PARCEL
t
PD
Z
ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DI TOR OF UBLIC
/ =$
By/'\�
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
y/�t _
Date L '�
Receipt No. !�
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
w
t,
i
y
yr�
elf}
_-
OFFICE COPY
Address
GAS Date
Meter By
ELECTRIC pate
Meter By
4
y
t COUNTY OF BUTTE=DEPARTMENT OF DEVELOPMENT SERVICES= BUILDING DIVISION
F 7 County Center Drive - Oroville,, CAlif6rnia•95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT'
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
HEATMRN
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
CONTRACTOR'S NAME TELEPHONE
DASL
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER -
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS i
f
Penalty
$
BUILDINGADDRESS
114 LATERIDE. WAY
PERMITFEE
$
LAID? MADIRM
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISION'S NAME
PAR. L MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF [X Duplex ❑ Mobilehome ❑ Other
sPECIF,
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00 js.pp
Building sewer
15.00
TYPE OF WORK
Newry❑ Addition ❑ `ERemodel ❑ U ilities ❑ Installation D Other
Describe Work: NWHVAC
Mobile Home I S I G W r
920.00
PERMITFEE
$ 35.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.'00
'
Main Service a00V OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class ' Lic. No. -A-5.3
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason: I
D 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 sae.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason t
NEW CONST. DWELLING OCCUR
OR ACDNS. ( 8 ACC. BLDS. )
SO.
3.50 FT.
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
( & POWER APPARATUS )
SINGLE OUTLET CIR.
Ex. Occup. (OUTLET OR FURORES )
20 Q 1.00
SAL so
Ex. Occup. ( OUTLETS RES D.)EA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$ 43.00
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations)
D 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compens tion �osurance carrier and policy number are:
Carrier 77 �/ -v3 %7 /G7 /l9 ?Y�r /�► �y
MECHANICAL PERMIT
Filing Fee 20.00
Heating MO(W BM1
15.00
CoolingrJ
(�
Hood
6.50
Ventilation
PERMITFEE
$ •LAJ
Contractor
Policy Number— U Z5 or,Mobile
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.) f
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
fo hwith com ly with those provisions.
X ,,u _ 1zt Date
Si nature o Applicant - ❑ Ow er D Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Home Installation Fee
Is
Energy Inspection Fee Is
OCC
CONST. TYPE
TOTAL FEE $ 128.00
HAZ. I
D. FEES
I IMP I FLOOD
CDF
PARCEL
PD I HD
ISSU
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
s have been paid.
indicateAL:
471 y/��-�
BY Date /
PERMITEXPIRESON % % � fiv
(Date)
ReceiptNo. 180704
I
WHITE-D.D.S.-G.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
- - ' 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 062-190-028
ZONING
BUILDING PERMIT
OWNER
HFATHORN
TELEPHONE
SO, Fr, OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
314 LAKESIDE WAY BERRY CREF4
CONTRACTOR'S NAME
DASL
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
-
Permit Fee
$
ARCHITECT OR ENGINEER - -
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$ '
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDINGADDRESS
314 LAKESIDE WAY
PERMITFEE
$
LAKE M-A-DR.ONE
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
1 7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar Or heat pump water heater
23.00
USEOFSTRUCTURE
SF CX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00 15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ]
Describe Work: NEW HVAC
Mobile Home IS I GI W
@20.00
PERMITFEE
$ 35.00
Contractor
ELECTRICAL PERMIT
Filinq Fee 20:00
Main Service / eoov OR LESS
200A OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class C �� Lic. No.�53
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BUDS. )
SO.
3.52 F7.
NEW CONST.MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES)
20 Q 1.00
BAS -So
Ex. Occup. OUTLEEDTS (REs o.)ea
( )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
g
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compens tion�l0suranc� carrier eyed p Icy number are:
Carrier % f7I �'!7 %a 7-,- 1
MECHANICAL PERMIT
Filing Fee 20.00
Heating 000 T 1
Cooling
TON
15-00
19.00
Hood
6.50
Ventilation
PERMITFEE
S 5
Contractor
Policy Number O
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, l shall
fo hwith cc ly with those provisions.
a
X� Date "—�
S gna ure o pplicant - ❑ O er Contractor ❑ Agent
An OSHA rmit is required for excavations over 50" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 128.00
HA2.
I D. FEES
IMP
I FLOOD
I COF
PARCEL I PD I HD
ISSU
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated v wh ch fees have been paid.
By /u/" Date /
?ZIA�
PERMITEXPIRESON -71f W
(pate)
ReceiptNo. 180704
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE -
BUILDING DIVISION'
DEPARTMENT OF DEVELOOMIk 4ERVICES
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
I
CORRECTION NOTICE }
CA 4,'-
-�
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.
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Date Inspector
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. C�OUN�VQa BUTTE - DEPARTMENTOFDEVELOPMENT SERVICES -BUILDING DIVISION
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7COUNTY CENTER jDRIVE -OROVILLE, CALIFORNIA95965-TELEPHONE (916)538-75411%�w•
�., PERI IT APPLICATION DATA SHEET
OWNER t? -Y� 6 V` t� ,A A. P. No. n Iva _/ go --Q.�!/
Proposed Building Use
Building Inspector
Date
At time of p it 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, 3j4 sets, signed by preparer of plans . .......................... t..
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. ...........
"s 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 . ........... .
i °
'{ 15. City of Chico plumbing permit. .......................:: �.
16. Plottplan 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). .. -
l5n; ;sped60n request ^.
20. Pre -inspection for required. . to Building inspector (bate)
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.......................I................. .
30. Documentation of 50% subdivision developed or (A) Road improvements completed
f and (B) Parcel meets zoning area and frontage requirements. .................
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
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When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. -1 -1e -liver with inspector.
Other
Parcel Creation
Acreage Applicant
Date
Copy of Haz-Mat form sent o Health Dept. Fire°Dept. Air Pollution Date
Copy of plans sent Health Dept. �y 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,*,. V., Counter by _'Date
Contractor, designer, owner, was advised of above required data by _ phone _ m it c'Tcoynier by _ Date
Plans checked by Date Plans approved by ' ',T' ,42 f"""' ; Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works