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HomeMy WebLinkAbout063-250-0181. 1 ' " . �:"J- y:61, pi, �j' '10 kN- "re" bb rloo IT for 'Hi o yow t t lee v l N Y a. \ - '- h -_-. _� ��._..-. _......_ .. . --.y...r... :.:n,;�r . _ •►::- .. yr-- ➢,+-w�„�� •.. r,,:�:.;......: ,r-..-_ . - - r r - ., - ��•� ...i�^S•`� .% To San� Y I •/S Village Rd., app.2800'SE of Cr wn, } + Point Rd., 2 mi.E.of Hwy 32, Forest ! I = Ranch - IIIIII � ,•� 1 Permit #2361-79B,P,E(new single family)' Larry Henderson + N/ S-Village Rd, app 2800' SIE of Crown ' point Rd, app 2 mi. E. of Hwy 32,For Ran. I ; Permit # 1414-82B,P,E (add bdrm, bath and 1 office and smoke det SF i�3 k Permit ��13�6=83B add open i (c p deck & cov r I - 4 r deck/SF)r141 63-25-18 r Permit#1423-85B(install woodburning ` ` stove/SF) j�� ���(��CM0^ f063 + 95-116T B s }• i � LACY- Rachel ' 4 i*4725 'Village Drive; Forest, Ranch s its{reroof/SF)-Ely,Roo�fing;' t B07-,1304 r 063-250-018 MISCELLANEOUS 066iric Panel':' i REPLACE ELECTRICAL! PANEL '- 4725 VILLAGEDRIVE GaZALES, BRETT 1 l 1 } N • i 1 1 { ' BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 4725 VILLAGE DRIVE Owner: Permit No: B07-1304 APN: 063-250-018 GONZALES, BRETT Issued Date: 6/13/2007 By GLB Permit type: MISCELLANEOUS P O BOX 4037 Subtype: Electric Panel CHICO, CA 95927 Expiration Date: 6/12/2008 Description: REPLACE ELECTRICAL PANEL (530) 892-8429 Occupancy: Zoning: TM20 Contractor Applicant: Square Footage: GONZALES, BRETT Building Garage Remdl/Addn P O BOX 4037 CHICO, CA 95927 Other Porch/Patio Total (530)892-8429 , FEE INFORMATION . DBE Single Phase Service-Resid - $58.00 1 , LICENSED_ CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires 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. X 6/13/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I 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 WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My Workers' Compensation insurance carrier and policy number are; total t-nargea: $58,00 tees rata: $58.00 Balance Due: $0.00 Receipt No: B3507 OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License �. Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or . improve for the purpose of sale.). I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: , (This section need not be competed if the permitis oror on�ed dollars ($100) or less. �� ❑ I AM EXEMPT under Section B. & P.C. for this reason: j�/TI CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Owner's Signature X�,e6/13/2007 Signature ` _ Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING.AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip 6/13/2007 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the.. use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property�am autho 'z o ad a property awne half. 6/13/2007 Owner ❑ Contractor OR; Agent for Owner. ElAgent for Contractor FILE COPY t a �13TrBUTTE COUNTY �o o DEPARTMENT OF DEVELOPMENT SERVICES o o BUILDING PERMIT APPLICATION o o OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o = = . "�" o A FEE WILL BE REQUIRED AT T11VE OF APPLICATION C Website: www.buttecounty.net/dds 01i **PLEASE PRINT CLEARLY** OWNER INFORMATION Las . Name �QS F ame Mairpcfe O Y�� City C t Co StaCA ZipGy 7 l Phone _ Fax �— E-mail APPLICANT INFORMATION CONTRACTOR Name City ICO Address Zipgs City Fax State Zip Phone Fax E-mail Open Cov Lic.# I Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City ICO Address Zipgs City Fax State Zip Phone Fax E-mail Open Cov State License Number APPLICANT INFORMATION Name 30K a�eS Address O S/D `? City ICO State f �( Cf !`� Zipgs Phone f5 /02 ^ Q�,J� OO 77 Fax E-mail APPLICANT SIGNATURE I PERMIT' NO. W� It %\-1A BIN # . PROJECT LOCATION AP#/./ Property Address �2S V, !l . City �o G C� WORKER'S COMPENSATION Policy Number Carder If hiring anyone other than license contractors, a certificate of worker s compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: �e l ccOak V Flood Zone SRA I ves I No Occ. Type Const. I i Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): el Iff VP For office use only: Zoning Flood Zone SRA I ves I No Occ. Type Const. I i Butte- County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. G If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal G income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). 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) Ye, 6 2. I (HAVE/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. Ye 5 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 THE 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 Description: REPLACE ELECTRICAL PANEL Reference Number: B07-1304 Applicant Name: GONZALES, BRETT Owner's Name: GONZALES, BRETT 01 AP # : 063-250-018 Signature of Property Owner. Date: �Z" " COUNTY OF BUTTE f� BUILDING DIVISION l ~ 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 1 CORRECTION NOTICE R_f /u. / 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. /0tr Date "' Inspector REV 10192 r . j:063_25_ .- 0 Rachel e' 95t-11B4725Vll6 age Driv018Foesf/SF)Ely. Roofing W~ d r •' , kr- .' - Vis; • ,� ,� � ._ � � K - ' COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT NO. APPLICATION AND PERMIT; 4k ASSESSORPC0.NUM8E� bJ-2�U-Ult� zoNING BUILDING PERMIT OWNER Lacy TELEPHONE 0918 SO.. FT. OCC. BUILDING VALUATION ALUATION 18U0 08 OW4ER'SLA�LINGrDZSS /M%lage Dr Forest Ranch CA 95942 CONTRACTOR'S NAME tly Hoofing Inc TELEPHONE CONTRACTOR'S MAILING ADDRESS 13291 Contractors Dr Chico CA 95926 Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 27.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 4725 Village Ur - Forest Aanaa PERMITFEE $ �nz ,.� .,.+.. r . =; •;:a: c x: sr 4t s-;.:.. �4;a cw: a lilt • ., .e . sc•> ..� Y PLUMBINGPERMIT Filing Fee 20.00 tt tEef i*TrAp " awr , . , 71ig Oti I LOT NO. SUBDNIS ION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 ` USEOFI(T_RUCTURE SF E Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK v New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: remove & replace roacin>z W/ 25 yr comp — 18 sgs Mobile Home S G W 920.00 PERMITFEE $ 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 " 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 jis in full force and effect. /. q License Class C_ 1 4, G- 3 9 LIC. No. 6 U 7 3 6 U OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contraciors License Law for the following reason: ''' ❑ ],as owner of the property, or my employees with wages as their sole`cornpensation, 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. ❑ 'Tam exemot uhder Sec.- '; Business'•and Professioris'Code, for this reason NEW CONST. DWELLING OCCUP.sO. OR ADDNs. ( a ACC. BUDS. ) 3.52 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) d SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES ) SAL20 Q 1.0050 FIXED APPLNS. OR Ex. Occup. (OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE s Contactor - WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: L] I 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 SCate ;r'uria MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation f PERMITFEE $ Contractor Policy Number 3-140 -- (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, I shall forthwith comply with those provisions. :9G / —cR� ) ~ X %l 2�-� _Date 5-31-1 Signatur of Applicant - ❑ Owner UContractor ❑ Agent OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 47.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSUE 1-00 This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work in indicated above for which fees have been paid. PAn BY �' Date i v , / PERMITEXPIRESON- I , (ate) ` , ReceiptNo. 1 r-71 �L./!4/ WHITE-D.D.S.-Y.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) 538-754 PERMIT NO. APPLICATION AND PERMIT AS OL7U-S OR P�RpV-�1 7 8p ZONING BUILDING PERMIT OWNER acne! Lacy TELEPHONE 894-0913 SO. FT. OCC. BUILDING VALUATION 1800 1080 OW NG ADDRESS �+E% �UVillage Dr Forest Ranch Cti 95942 CONTRACTOR'S NAME ;ply stooling Inc TELEPHONE CONTRACTORS MAILING ADDRESS 13291 Co-�itractors Dr Chico CA 95026 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAIUNG ADDRESS Filing Fee $ 20.00 Permit Fee $ 27.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 4725 Village Dr - 2 oLosi-_ aanch PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF 11 Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 0 Describe Work: remove & replace roofing w/ 25 yr comp - 13 s q s Mobile Home I S I GI W 1 @20.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filing Fee 20.'00 • •.. Main OOOV OR LESS Service 00A OR LESS ) 23.00 ( 2 (. ) _.46,D0 Mall?"Service .-200A-TO 'T600A' " -. _. ...... _ - ._ . ... .... ". a :.. ., . ,.. .I. .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-14 , Q —19 9 Lic. No. 607385 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. ) SFtO. OR ADDNS..: a ACC. BUDS. 3.5 2 NEW CONST: MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIA. Ex. Occup. (OUTLET OR FIXTURES ) 20 @ 1.00 �'L Ex. Occup. (OUTLETS (RES D.�EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I 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 State Fund MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 538-148 (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, I shall forthwith comply with t s provisions. X _ Date 5-31-95 Signaturof Applicant - ❑ Owner IQ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 47.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSUE This permit is hereby issued under ttie applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. B67 / Date OF IF 01 -905-V [p PERMITEXPIRESON (D111A� IF I (D..) ir Receipt No. WHITE•D.D.S.-B.D. ANARY•A ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 4 t&17 v Y6 1414-82B P E PERMIT NO. � _i PERMIT EXPIRES OWNER Larry Henderson G.. CONTR. Owner 4- ASSESSOR PARCEL 63-01-113 LOCATIONN/Side Village Rd, app 2800' S/E.of Crown Point, app 2 miles E. of -Hwy 32, For Rand s. `f . Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E V JOB FINALED (Date)✓CT �� Signature /.0 J = OK . O = 45otJK ` - = Nbt Applicable = #Not -Ready - t RESIDENTIAL (Single and Duplex) Date UNDER OOR Plans OK except #'s Date FRAMING (Continued) oning requirements-SepwAtS�%asesAefits penings. g., Main; Soils-SUie1-E4eQ_RWnd.- / js/" Ftg. Depth xt. Doors -One 3'-Gheeic'Paaracje- d -e ecy�2esEits —J•. ,/" Ftg. Depth- e -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth Iy� Roof Overhang-AttiS_)4ents-Ra4eF-9alttiggers temwalls, Main; Steel -BI uts-W d- ding -N • ' g -V.& e 6* Gtem,nalle, lockouts=Wrapped-Slab - n er r. ccess 7. Piors-Fireplace Ft .-S el &jA, PTaaftng�Area-Gla.3 Protection-Skylights-P46eNc- -Fitt' - w ew g -Bolts rs er r It -Material -Support -Ins. tts-Joists- Vent s -Cripples Card -BI Date Card -BI Date Card -BI Datg&Card-BI Date Card -BI Date Card -BI Date Card -BI Dat L Card -BI Date Date FIN Plans) OK except k's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's Ex teps-Door & Sidelight Protection -Landings 7 moke Detector _ 1 it. W. ion Air - nce-Comb. Air-Connector- Mage; Above Floor -Ducts -Meeh. Protection ater Pipe; T AAc,,&s-Nail Eratei6fion V.; est -Fit Amcbors-Na' ection m Exiting `• First Floor & Bath Fixtures & Tub Access 19. Tmsf-T-vb-B-Stmw€r"2nT71oor-Tub Access 11T. Elec. Trim & Subpanel; Breaker Sizes -Labels N33:-�ss�P a Size"T-ichors 6 nces-Hearth 4.let. Outlets at Wood Panel; Int. &Ext. Card -BI Dat - L Card -BI Datepp tante; rnd.-Air Gap -Cooking Clearance Card -BI Date-7�. yJ Card -BI Date 67 u e s s at Kit. Counter - anding-Closer Date ELECTRICAL Permit OK except q's 6 e earance-Ins. Protection - arance- omb.,Air-Connector-P.R.V.- In Garage; Above Floor -Meth. Protection - le ecep Spacing -Lights BiSw•+•tclles(A.Dedrs 7 ec .Listed for Location 2 tz Boxes & No. of Conductors-Sta 71 p ac es in arage; (G.F.I.)-Romex P ec. 2 om x Installed Close to Edge of Studs & C.J. quip. Ground made up w(A4eeh.Fasteners-,B�,-lBdater 72. 1 nsujat ion -Foam- Looked in Attic s lichen &Conductor Size uard Rails & Deck Construction -Post Caps _ ubfeed Wire Size ga. Cu o&*W A r Al 7 n s rr-Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes . 2f: Idnge Al, E id 7.9. 7 Following instld.: Drive e -s ❑ No; Walks es ❑ No; Planters ❑Yes ❑No o; rown-Finish 2 & Ground -Main Disconnect 29. -Motors-Meeh. Equip. 77• onnect- rotes-Brkr. & Cond. Size -115V Outlet _— 3 tght-Shower Light 7 . Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 7 lectrical, Plumbing 80. ec. Trim; G, .I. Receptacle -Underground Card B-1 YCk> Date _Card -BI Date 9.r.-Venti!,ation throughout House Card B -I Date Card -BI Date 8 Date MECHANICAL (Permit) OK except q's Corrections from Previous Inspections _ d; Gas -Electric 3 _or er Sewer Connected -C/O to Grade -HD Approval 327-YInsulation 86, ergy Compliance Certificate -Other Certificates ow; Size & Grade - _ 3 s -Comb. Air -Return Air Vent -115V outlet 35. Iatform if Furnace in Attic --- ---- Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI — _ Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except p's CoInments inal:3 at Final-._.,0o­ ills Proper Material & Anchors 39,-Sills' _ __ ____ alts; Studs -Nailing, Spacing & Bracing-Plates-9er>Ad __ wing Walls over Girders & Floor Nailing- 3 r ft Stop in Walls (rat proof) p/7 _ it tops; Frorfea-6silings-SLaic�6gesE -T / )/! Bader & Beam -Size & Bearing gen a-PMt Baps -Anchors -Connectors Cl�t-R•F_h;-dies-Qirlin_,Rot>i-�rac.tyHfq. Rf --_ _I IeS UT _I ype A F lue-Ftr ace Throat - _ t ' ccess; Size _. Bdrm. Windows or Exiting Doors -Sill H t imensions - 4% 6ac.ge F'r I2t miming (NOTE: An entry must be made each time youvisit jobsite) V = 'O K' 0 = Not OK Not Applicable MOBILEHOMES = Not Ready MISCELLAN EOI t. Date MOBILEHOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #' 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch _ 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/O -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 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors - 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -61 Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1, Zoning Requirements -Setbacks -Easements Card -BI Date _ Date Card -BI Date _ POOLS (Plans) OK except #'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/O 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 v 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 RFCTT V.MTTAT. ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITHURRENT ENERGY REGULATIONS AT fnreS-f- krtK-R-k �VtllCote_ D,�ONSERVATION (location)' u BU ILD ING PERMIT NO. j j�y -$ 2 Q , p. k—=, A;P. NO. (23 -61 -113 THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge Fdn. Walls Floors Walls v R- lq Ceiling/Roof Ducts_ N Circulati g Pipes IJ APPROVED HEATER APPROVED WTR.HTR. GLAZING: Single Glazed . WA Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. m]A— WEATHERSTRIPPED DRS. ✓` BACK DAMPERED FANS oIA- INTEMAITTENT IGNITION DEVICES CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND.AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name Signature of' (please print) Insulation Applicator State Contractors License No. General Contractor/Owner Name ka.rru_ Signature of (please print) General Contractor/Owner Date State Contractors License No. t THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. COUNTY OF BUTTE t o DEPARTMENT OF PUBLIC WORKS �y 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter or need additional explanation, please contact this office immediately. 9 PJO D Inspector ` Date >7" ' z COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS,., -- Y 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. 129 Inspector /i�J��%�CGr/% Date COUNTY OF BUTTE-'DEPAATMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, gali,orrria•95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT ASSESS R PARCEL NUMBER ZONING BUILDING PERRhI OWNER SO TELEPHONE SO. FT. OCC. BUILDING VALUATION Oa OWNE 'S MAIL( ADDRESS C TRACTO NAME 7E<ILEPHONE O T CTO 'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER �R'S UNKNOWN Total Valuation $ O� O Filing Fee $ 10.00 MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER Al�� LICENSE NO. Plan Checking Fee $ r Oi) Penalt y $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ � (� Bu1LD} A;7; /� /(/ s PLUMBING PERMIT Filin Fee 10.00 9 Each Trap 3 2.00 r Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each pas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SFRD plex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ P Addition - Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work:� Permit Fee $ 0 Li Contractor ° N,L 1 ELECTRICAL'PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONSDWELING OR ADDNST ACCLBLDG al)g sq ft 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. (cense No. Classification 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 CON5TR I.OUTLET 2.50 ea NO N.RESIb BRANCH CIRC ITS NEWCONSTR.POWER APPARATUS 61 NON .RESID. / (SINGLE OUTLET CIR. / Ex. OCCUp(OUTLETS OR FIXTURES 50@� ' BAL@1 EX. OCCU IXED APPLNS. OR j p•�OUTLETS (RESID.) EA.) 2.00 Temporary service 1.0.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor � ;fp 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. cirI 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 FiIIng Fee 10.00 Heating r ni d Cooling Hood 3.00 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue againt s id Co ty i• conseq ence of the granting of this permit. X Date Z Sign re ofBicant — Owner ��ontroctor ❑ Agent An SHA peis required for excavations over 5'0" deep and demolition or construct- ion of structures ovve/er 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ G �Q occOP, GROUP /` 3 T^O; /V/COAST. ✓ PRCE PD HD SSu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC By PER EXPIRES Date_ the applicable provi- resolutions to do fees have been paid. WORKS / Date ✓, _ Receipt No.— 1;>91%91 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT NO. �= 1326-83B PERMIT EXPIRES 5/6/84 OWNER LARRY HENDERSON CONTR.-Owner ASSESSOR PARCEL 63-01-113 LOCATION_ N/S Village Rd, SE Crown Point, FR Temp. Power Pole_ Called PG&E Temp. Elec. Service_ Called PG&E_ Temp. Gas Service _ Cal led PG&E JOB FINALE( Signature J = QK 0 = Not OK — = Not Applicable = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's Date DEC , COVERS, CARPORTS, ETC. (PI OK except N's 1. Zoning Requirements—Setbacks—Easements '1ZZpning qequiremiacks asements 2. Soils; Special MH Support—Sketch 3. Sewer; Location—Test—Fall-C/0—Concrete ooting ; Siz — e — ing—Connectors f . D ck e d Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4, d P s—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete C lumns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft.i /"LPG 6. Car ts; Windows—Doors 7. Utility Clearance 7. le Card -BI Date Card -BI Date Card -13100 Date Card -BI Date Card -BI Date Card -BI Date Card -BI _ N Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements 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/O 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-1 Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable RESIDENTIAL (Single -and Duplex) = Not Ready Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear 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 Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. 59. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Bedroom Exiting 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except #'s 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights & Switches at Doors 70. 71. Plb., Elec. & Mech. Equip. Listed for Location Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 22. Size Boxes & No. of Conductors -Stapled 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72, Insulation -Foam -Looked in Attic ❑Yes 73. Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes El No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. 29. Service -Riser Conductors & Ground -Main Disconnect Equip. Clearances; Panels-Motors-Mech. Equip. 76. Stucco; Brown -Finish 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Card B -I Date Card -BI Date Date Card -BI Date 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Permit) OK except q's 31. A.C. Ducts; Insulation & Support 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval _ _ 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86. Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic --- Card -BI Date Card -BI Date Card -BI _- _Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except H's 36. Sills; Proper Material & Anchors Comments at Final: 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38 Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub A -41. 42. 43. 44. Header & Beam -_Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-ShthnQ.-Ring. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) w � COUNTY QF BUTTE - DcPAR-(HENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N / t ASSES; Or PARCEL NUMBER ZO TNG V BUILDING PERMIT O WNE TELEPHONE SQ. FT. OCC. BUILDING VAL TI OW MAIL[ G ADDRESS l�oX P �F ��r/G Sr v o CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Penalty $ ARCHITECT OR ENGIN-EER'S MAILING ADDRESS Permit fee $ ' -- Z> Bul, I G A DRE PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 / TYPE OF WORK New ❑ Addition [?J"'Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADO'L 100 AMP 2.50 NEW CONST DWELINGOR ADDNS. ACCLBLDGS.CCUP N1 / 22 sgft 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 No. Classification 1�r—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 CONSTR. I.OUTLET NO N.RESID BRANCH CIRC TS 2,50 ea NEW CONSTR (POWER APPARATUS S1 NON.RESID. SINGLE OUTLET CIR. / 50@aia Ex. Occup OUTLETS OR FIXTURES BAL@10S EX. Occup.(OUTLETS IXED P(RESID )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penVy of perjury (check one): F? 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 shal I be deemed revoked. Heating Cooling Hood 3.00 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgm nts, costs, and expenses which may in any way accrue ag 'nst aid Co ty conse uence of the granting of this peri" t X Date Z_ re of liCanr — Owner Contractor ❑ Agent ❑ SigfSuH AnA prm' is required for excavations over 5'0" deep and demolition or construct- of struct s over 3 stories in height. Mobile Home Installation Fee $ _ TOTAL PERMIT FEE $ , 0o Occup. GROUP �_ I TYPE OF Co ST. PARCEL t/ PD HD S This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO O PUBLIC BY PE EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS � 6 Date S—y��L�3 ,ion Receipt No. 711 V�/ WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT Owner: ' X, wl,/ ,, 1 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT re AJ A.P. # Address: %{ e9, .. �0 /,fp le cl, Date of Inspection'' Tenant: t9ex,14J fi2 Inspector 7e—� O� " Building Location: Type of Inspection requested: -T7 1. Hou ing. /7.2. Financing 77 3. Change ' of Occupancy to 4. Other (specify) lflo�" GJ,'�� '. Present use. of building: A. Sanitation (Housing) .1. Water closet: 2. Lavatory: 3. Bathtub or shower: ' 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating' facilities: . 7. Natural light and ventilation: 8.' -Rom and space requirements: ' 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connectior.-to sewage disposal: 12. Connection to water•supply: 13. Rubbish and garbage facilities: 14. .Comments: ' B. Structural 1. Piers and footings: 2. Floor construction: 3: Wall construction: 4. Ceiling and'roof construction: 5. Fireplaces:' 6. Comments: C. Electrical, 1.. Service and ground: 2. Receptac' es: ' 3. Fusing: 4. Comment s D. Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4... Comments E. Other 1. Maintenance and repair: 2. Fire hazards _ 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 66' Corinents • . c F.: Ccmmiercial Buildings 1. Roof covering: 2. Disnince to property lines: 3. Physically handicapped: 4. Rest-oom floors and walls: 5. Exits: 6-."" Improvements• .� 7. Zoning:_ 8. Comerit : - G. Field Prohl.ei:is or Viclatior,s 1. Problem or lolation (give complete description): 1. What acti 3o Wf,:it action r.ecomnenaea: 7-7 A. -Infgmation only / Hold for ten (10) days, then wri!�e letter. / / C. Write letter. 77D. Other: 'ile No. BUTTE CCUNTY (For Action 1, 2, 3) Public Works Dept. (For Information ✓) Director Dep. Dir. Sec. Rd. & Br. Mtce. Shop & Yards Bldg. Insp. Admin. D&C / Tra'fic Const. Rd. Des. Br. Des. Sur. & Loc. Transp, R/W Mapping Land Dev. Ref. Disp. Drng. / S. I. Sub. & Pcl. Maps Permits Larry Henderson P. 0. Box 8 Forest Ranch, CA 95942 Dear Mr. Henderson: BEAUTY v�-T %,r O 1 L_COCrlrlr, vHWLtU[ 7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965 Teleohone: (916) 534-4541 Wi11iam(Bi11) Che ff 7�3C291L{]AIfGAQ?D July 20, 1982 Deputy Director RE: Building Permit A.P. # 63-01-113 With reference to the above subject, we have been advised by one of our building inspectors that you have not obtained the required permits and inspections from this office for the work you are doing as follows: Constructed an open deck and a covered deck on your property located off Village Drive, Forest Ranch. Since permits and inspections are required. by both State and County laws, please contact this office within ten (10) days of the date of this letter, submit two (2) complete sets of plans, apply for the required permits, and pay the appropriate fees'4y' including penalties. All work must stop until you obtain these permits and are authorized by our field inspector to proceed. This field authorization cannot be made until the existing work is inspected and approved. Your cooperation in resolving this matter would certainly be appreciated. Should you have any questions concerning this matter, please contact this office. JFG:dd cc:uild soq. Inspector - Chico ssess Yours very truly, Clay Castleberry Director of Public Works J.F. Glander Chief Building Inspector This form supplied by Longfellow Lumber. THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Street Lot Number Tract No. Exterior Walls Manufacture hick ness/Type R Value Ceilin ` .fie• Manufacturer Thickness R Value Blown: Manufacturer Thickness Ho. Bags Wt./Bag Sq. Ft. Covered R Value loors Manufacturer Thickness/Type R Value Slab on Grade Manufacturer Thickness/Type R Value Width of Insulation Inches Foundation Walls Manufacturer Thickness/Type R Value GEN L NTRACTOj �� �4� AL LICENSE NUMBEK/j/ � BY TI TL DATE DATE2— INSULATION CONTRA OR LICE LICENSE NUMBER BY TITLE DATE ,P�L�FIiMIT NO. 2361-79B,P,E' PERMIT EXPIRES ;;OWNER Tony Santos CONTR. owner 63-01-113 'LOCATION (A.P. ) NIS Village Rd., app.2800'SE of Crown Pt. Rd., 2 mi.E.of Hwy 32, Forest Ranch or lay • r Temp. Power Pole j'. ` Called PG&E �rElec. Serv. /Called PG&E Temp. Gas Serv. YCalled PG&E OB J FINALED ze Patel "loll (Sig to ) ti COUNTY OF BUTT — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING IBUILDING (Cont'd) I PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor — 7✓,,-- Main Bfdg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwalI Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwa I I Insulation 5el 7 Heaters Slab Prov. for ph sic Appliances Carport handicapped Conformance of ex. Gas Piping &Test Footings structure Temp. Gas Slab Final _ ' `^ 4 Sanitation Patio FIREPLACE Final Footings Footing Ok E CT CAL Masonry Walls ThroatRou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framin Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown ------ Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer I Final i o Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec" Pedestal Water Piping Sewer Gas Piping 816EHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE W)ARJW,� ... W�-ff L�si�2 r (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARIVENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 ? el epgon e: 534-4541 /7 :Z6 / — :% APPLICATION AND PERMIT A autnorize representatives the county above-mentione propert or inspectio `'C X ignature of Permit or A ent tsutte to enter upon the Date Receipt No. I White-D.P.W. - Yello Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above f�which fees have been paid. DIAECTOA OF PUBLIC WORKS 1, _ m ff Date — - F Building permit expires DateA BUILDING Owner p.�Q SQ. FT. OCC. BUILDING VALUATION Mailing Addressl ,c (a . en Telephone No. C Contractor 9 J `i'� Mai I i ng Address Fireplace , O•� Total ValuationDo lJ Telephone No. Permit Fee ,,,0 p Building Address ' �� L, Plan Checking Fee Vor Penalty Permit Fee W66 ts0 ab l S z O G✓16"-y`�A0C1J1Azr PLUMBING No. @ FEE N r 2 PERMIT FILING FEE $3.00 010 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. �r Ofd �b Go a^^ g Water -piping 1.50 �'� y Each gas water heater or vent 1.50 FW I kr Sa ion Fire Dept. Fire Zone Use PerAt Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvemen s Each additional outlet .30 Building sewer 5.00 Bldg. P s Recd ff Porc roval Plans Approval Lawn sprinkler system 2.00 p y NEW JR ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ ds $ o ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5•�� Single Family twDuplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADO'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADO'L 100 AMP 1.00 NEW CONST. DW 4 CCUP. OR ADDNS. AC G 20sgft t5 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name st le of: y NEW CONSTR BRANCH IR T 1 NON.CONS � BRANCH CIRCUITS/ 2.50ea NEW CONSTR. (POWER APPARATUS 9 NON-RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTURES BAL9; Ex. Occu FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 Gtr ys am exempt from the Contractors License Laws of the State of California. Permit Fee $ .(5�0 $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this mit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation F2.00 Hood Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ �( TOTAL PERMIT FEE $ l autnorize representatives the county above-mentione propert or inspectio `'C X ignature of Permit or A ent tsutte to enter upon the Date Receipt No. I White-D.P.W. - Yello Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above f�which fees have been paid. DIAECTOA OF PUBLIC WORKS 1, _ m ff Date — - F Building permit expires DateA f BUTTE COUNTY (For Action 1, 2,3) Public Works Dept. (For Information J) Director Dep. Dir. Sec. Rd. & Br. Mtce. Shop & Yards Bldg. Insp. Admin. D&C / Traffic Const. Rd. Des. Br. Des. Sur: & Loc. Transp. R/W Mapping Land Dev. Ref. Disp. Orng. / s. I. Sub. & P Maps Permits 1 f I r' t G , July 209 1979 Tony Santos RE: Building Permits P.O. Box 119 02360-79 and -23 Forest Ranch, CA.. 95942 (AP 63-01-111 6.63-01-119 Dear Sir: With reference to the above subject and your nater maintenance agreement for Lots 9, 11, and 14 on parcel map recorded Book 67, Page 3, l do not see how you can enter Into an agreement with yourself. Until such time as we receive a recorded easement for the water lines and well as well as a maintenance agreement, we cannot give final approval. Please note we do not -consider easements and agrements valid unless they are granted to and between separate parties. Should you have any questions concerning this, please contact me. Yours very truly, Clay Castleberry Director of Public Works J.F. Glander JFG:dd Chief Building Inspector cc: Chico Office 011 � .;7<A,�Y r � N 1.., ; an` -i? -'J" - , v �, a�.r::-��. ,., `.".�"�'l"` -�--�r: :"'�,aL- � 'yam; �=m.--e> -ten.- .� .., ,.,- F ; ,. . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 ; APPLICAtION AND PERMIT ASSESSOR PARCEL NUMBER �/y �. ` ZONING BUILDING PERMIT OWNER ) �•'. �.', Y T- (i 'Pw d U 1 n b� TELEPHONE SO. FT. OCC.1 BUILDING VALUATION OWNER.'S MAILING ADDRESS ..- '- ` I CONTRACTOR'S NAME - +yam` 7i1..11�ti' TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER A , UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ /� •�( ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS /�5 �j, ' � %Yl)P 'moi � A:.,-...1.�t,%'! ��_� 1�: PLUMBING PERMIT Fee Filin Fee 10.00 Filing �1 iEach Trap 2.00 Solar Water Heater 20.00 t Water piping 5.00 LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE ' SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑ 1RemodeI ❑ Utilities ❑ Installation ❑ Other �' Describe work: ,,r.i. N j 11 �17,r-i k, )Y V� • rite 1yF'_ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUR.& OR ADDNS. ACC. BLDGS. 2I/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F-1NONRES 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 Q 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 CONSTR ULTI-OUTLET 2.50 ea NON."ESID BRANCH CIRC ITS NEW -CONSTIR ( POWER APPARATUS . / D. SINGLE OUTLET CIR &) ExOccu zoesoe . P�OUTLETS OR FIXTURES 5AL®300 FIXED ALNS Ex. OCCUp. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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. a` -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. Heating Cooling Hood 3.00 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. 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 $ TOTAL PERMIT FEE $ (J V OCCUP. GROUP I TYPE OF CONST. I PARCEL PD - ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC / By ` PERMIT EXPIRES Dater the applicable provi- resolutions to do fees have been paid. WORKS Date's r t ' �7 -11 Receipt No.. i�, WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION ANI' PERMIT PERM NO. / rJ ASSESSOR P RCEL NUMBER =BUILDING ZONING PERMIT OWNER- r TELEPHONE ,SQ. FT. OCC.1 BUILDING VALUATION OWN AILIN ADDRESS Fb r CONTRACTOR'S NAME TE HONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Q Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ �r ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT ORiN ENGINEER'S MAILING ADDR SS Permit fee $ BUILDIN A DRE � 11 _ /S PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 1 -.%*S Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition ❑ emodel ❑ Utilities ❑ Installation Eln Other Describe work: r Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000V OR 0 AMP ORSLESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. I DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2I/20sgft 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 dl, 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 COO D NSTR' BRANCH CIRCTITS 2.50 ea NEW CONSTR. POWER APPARATUS & NON RES I.D. SINGLE OUTLET CIR. Ex. Occu / 20@SOa P\o OR FIXTURES eALmaom FIXED FIXED APPLNS. OR A Ex. Occup. OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor 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. / U ' 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 10.00 Heating Cooling Hood 3.00 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 Countyof 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 liabil'ties, judg ents, costs, and expenses which may in any way accrue against aid Coun y n consequence of the granting of this permit. Qr XIV'Kvu�Date 1 S Sin Dra of cant — Owner ❑ Contractor ❑ Agent ❑ s required for excavations over 5'0" deep and demolition or construct- A SHA pe(e,�'))ver of sructu 3 stories in height. Mobile Home Installation Fee' $ TOTAL PERMIT FEE $ OCCuP. GROUP I TYPE OF CONST. PARCEL PD FHD I 1550E This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which TO F PUBLIC BY PERMIT EXPIRES Dat " the applicable provi- resolutions to do fees have been paid. WORKS Date — I K— \l i0 Receipt No. WHITE-D.P.W., YELLOW -ASS& SSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT