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HomeMy WebLinkAbout062-720-001i i WE -.v,. -.`'; )ti. -:,r' .� .---r., -�...a..��.�`'-.�f'�y.�','r�'�1•-tiv-:. S.:!%i;'" ;ter+` -F`... �'„i�r:� w..r'..r� e • 062=726-001 03-3395 MCCOY, DWIGHT SHANE CT, BERRY CREEK Cont: OWNER ELEC FOR WELL 1 / �A- d 5 `A _Gy 'V VV [bLv V 1 OFFICE COPY I Address •�y =-B y � � Data ELECTRIC Meter By Date . I� i (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Ener Plan Checking Fee 9Y 9 $ $ PERMIT FEE _ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 R LES Main Service p A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law f r the following reason: VI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 46.00 NEW CONST. DWELLING OC NG CUP. CCU OR ADDNS. 8 ACC. S. SO 3.5¢FT. NEW SID. MULTI.OUTLET 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. ounEr OR FaTURES 20 @ 1.00 BAL p .5e Ex. Occup. oFIxLITE gFLNSS oR, 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 -- PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation hof one hundred dollars ($100) or less.) O 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 f I should become subject to the workers.' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X �� Date Signature of Applicant - ❑ Owner ❑ Contractor,, ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT 03-3395 ASSESSOR PARCEL NUMBER 069-790-001 ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS P 0 BOX 1404 E1 Dorado CA 95632 CONTRACTOR'S NAME 0WLV�7KR TELEPHONE TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MNUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS SHANE C7, RFR-RY CREEK CA Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDN510NS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: ELECTRIC FOR WELL ONLY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 600VOR UE Main Service .A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law r 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 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation I one hundred dollars ($100) or less.) 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 9 1 should become subject to the worker ' ompensabon provisions of section 3700 of the Labor Code, I shall forth omply w' those provisions. Date I i® S' nat a of pplicant - ❑ Owner ❑ ntrac ❑ Agent An OS A permit is required for excavations er 60" deep and demolition or construction of structures over 3 stories in heightfl, Main Service 200A TO 1000A 46.0D 6.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. BUDS. 3.5¢x' NCµgESID. MULTI -OUTLET @7.50 POWER APPARATUS a SINGLE OUTLET aR. Ex. Occup. OUTLET OR FDTTURES 20Q1'00 BAL @ .SO Ex. Occup. ours Ao °EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 Pre instection 91- 3.00 PERMIT FEE $ 89.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEIE S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEES9. 00 HAZ. I D FEES IMP I FLOOD I CDF I PARCEL PO HD ISSUE This permit is hereby Issued under of the Butte County Code and/or indicated a ve for wh' es have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT • i j COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION v 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ��� ASSESSOR PARCEL NUMBER Proposed Building Use: Counter Technician: Date: Items required in order to apply for a permi6 All boxes MUST be checked OR marked NA in order to ply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or find plans, all in duplicate. ❑ 7. Metal bfdgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................. ❑ 9. Site plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Fire Sprinklers............................................................................................ ❑ 14. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 15. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 16. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... _ ❑ 17. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 18. Sanitation and site plan approval from the Environmental Health Department in _ ❑ 19. City of Chico Plumbing permit........................................................................ _ ❑ 20. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 21. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: _ ❑ 22. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... _ ❑ 23: NPDES Form............................................................................................. _ ❑4. Encroachment Permit for drileway from the�P c Works Dept ................................. _ 25. Pre -Inspection for � required ................ _ ❑ 26. Contractor's license information. (Number, Name Style, Classification) ...................... _ ❑ 27. Worker's Compensation Carrier and Policy Number ............................................. _ ❑ 28. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... _ ❑ 29. Letter of Signature authorization.................................................................... _ ❑ 30. Recorded copy of Agricultural Acknowledgment Statement .................................... _ ❑ 31. Manufactured home utility clearance............................................................... _ ❑ 32. Existing violations and/or expired permits......................................................... _ ❑ 33. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 34. Other: e_ - _ When issued Telephone %and hold for pickup. I have been i0oVed of ffiobove items and requirements for obtaining a building permit. Applicant:fl_�Date:-/ f- -3- ©3 1. Index permit appliddtion forte above items number Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above &tabj ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division CONTRACTOR: C PRE-INSPETION FOR:- DATE OR DATE TO INSPECTOR UPERMTT HLSTORY:( )NONE fi AS BUILDING INSPECTOR'S REPORT Building Description: Electric: Gas: Commercial/Usage: Residential/# of Units: Currently Occupied Abandoned/Vacant Yes No Electric currently On Off Condition of Electric Natural Propane None Obvious Problems: Sanitation: Plumbing Working ZONING: Currently On Off Well Working Potable Water. Obvious ' SewageProblems Comments: ACTION RECOMMENDED: ISSUE: HOLD FOR Inspector. Date Y W Sketch buildings on reverse and indicate location on property. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive Oroville, California 95965 •Telephone (5M30) 538- �5 1 Ci` q�� ��^ (Rev.12/96) PENT NO. • APPLICATION AND PERMIT ZONING BUILDING PERMIT ASSESSOR PARCELNUMBERC)�4� �a �, _ . °N� U U SO. Fr. OCC. BUILDING VALUATION owNIaR . M� \j 0 /5 1-1 G NONE CONTRACTOR'SNAME CONTRACTORS MAILING ADDRESS cOt5TRUcnoN IFN DER Fireplace {ENDERS MAJUNG ADDRESS Total Valuation $ LICENSE N0. Fifin Fee $ 20.00 ARCNSREGT OR ENGINEER Permit Fee ARCWr=t OR ENGwE73:S MAL= ADDRESS Plan Checking Fee Energy Plan Checking Fee $ BuaowGADDRESS G` ^ Tl s C -A PERMIT FEE $ PLUMBING PERMIT Firing Fee 20.00 IDT N0. SUBDNSIDNS NAME 7.00 Each Trap USEOFSTRUCTURE Solar or heat pump water heater 26.00 Water piping 15.00 SF ❑ Duplex ❑ Mobllehome ❑ Other sP7cFy Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 ❑ Other ❑ New ❑ Addition ❑ RelnodU� ❑ r Building sewer 15.00 S i G I W @20.00 . I Mobile Home Describe Work: PERMIT FEE g ELECTRICAL PERMIT FMg Feel 20.00 eDov OR LEM ups 23.0 Mein Service zooA oR �- main *Service —A, To I—A 46.00 NEW CONST. DYVF]J.SdG OCCUP. 3.50FFT. OR=NS a ACC. / U NEW=NST. MULTFOtJTIJTT @7.50 NON.MMCH MMUS PERMIT, FEE PAID $ a Ex. Occup. OunET OR FIXRJRES ew ® sc FD® APPLNS. OR 5.00 Ex. Occu ovn rs m. eA. $Temporary SRA Service 23.00 Mobile Home Facilities 20.00 Mise. Irlrr 2;.E $ c SHERIFF PE MIT MECHANICAL PERMIT Fling Fee 20.00 Heating OTHER $ 0 coon, Hood 6.50 Ventilation $ PERMIT FEE S Mobile Home Installation Fee S $ Energy Inspection Fee $ cac CONST. TYPE TOTAL FEE $ Z_. NAL. 0. FEB IMP R WD CDF PARCEL PD NO AMOUNT RECEIVED $This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work I/ I � indicated above for which fees have been paid. DAVE RECEIVED nab COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET �) OWNER: ho,&2_-,�ASSESSOR PARCEL NUMBER �' v v Proposed Building Use: Counter Technician: Date: Nt1 Q Items required in order to apply for a permit) All boxes MUST be checked OR marked NA in or er o ply. ❑ 1. Site plans, 3 or 4 sets, signed. by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner. ❑ 12. Hazardous Material Form. ❑ 13. Fire Sprinklers ❑ 14. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office ❑ 15. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 16. Fees as shown on the attached Schedule of Fees Due Sheet. ❑ 17. Statement of Intent for Non -heated and A/C Buildings. ❑ 18. Sanitation and site plan approval from the Environmental Health Department in ❑ 19. City of Chico Plumbing permit. ❑ 20. California Department of Forestry plan approval ❑ paid. ❑ 21. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ❑ 22. Contact Land Development about ❑ Improvements, ❑ Drainage. ❑ 23. NPDES Form ❑ dri w Encroachment Permit for ay fro eu 'Works Dept. (construction approval prior to occupancy). 25. Pre -Inspection for C _ t required. ❑ 26. Contractor's license information. (Number, Name Style, Classification). ❑ 27. Worker's Compensation Carrier and Policy Number. ❑ 28. Owner -Builder Verification ( ❑ Given to owner, ❑ Mailed to owner). ❑ 29. Letter of Signature authorization. ❑ 30. Recorded copy of Agricultural Acknowledgment Statement. ❑ 31. Manufactured home utility clearance. ❑ 32. Existing violations and/or expired permits. ❑ 33. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 34. Other: When issued Telephone and hold for pickup. I have been Tied of a bove items and rpguirements for obtaining a building permit. Applicant: Date: r' 13 © -3. IRATION OF APPLICATION Applications for which a permit has not been iss ed w I exph one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will b0Wired. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Original -Applicant