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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P RMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 ����
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
63-25-043
ZONING
IM -10
BUILDING PERMIT
OWNER ,
Robert Terrill
TELEPHON1E
345-0962
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
847 W. 9th St., Chico 95928
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 'J.00
LENDER'S MAILING ADDRESS
PermiI F-ce _
$
ARCH!TFCT OR L, ',INE -ER
LICE`iSE r, o.
Plan Che :Ing Fee
$
Energy Plan Checking Fee
n
$__
ARCHITECT OR ENGINEER'S MAILING ADDRESS
_
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Balckberry Rd., Forest Ranch
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each gas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other Electric
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I G JW I J
110-00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ® Installation ❑ Other ❑
Describe work: New Meter f t � 1 '1
!"l (-lel aic P/21V,4T1' (ATA pvt' �-
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 8011 OR LESS 100 10.00 10 QQ
100 AMP OR LESS
Main service EA. ADD'L 100 AMP
2.50
_
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
,t
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification,
,
1, as the owner, or my employees with\wages as their sole compen-
sation, will do the work,and the stru—cture is not intended or offered
for sale. (Sec. 7044) A
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.B ,
OR ADDNS. ( ACC. BLDGS. ) hQsgft
NEW CONSTR. MULT I -OUTLET
NON-RESI D BRANCH CIRC ITS 2.50 ea
POWER APPARATUS &)
(SINGLE OUTLET CIR. )
Ex. Occup(OUTLETS OR FIXTURES 2AL030
1.20
ALO 90
FIXED APPLNS. OR
Ex. — -_ OUTLETS IRESID,) EA.) 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring
g 1 15.00 15.00
Pre -Inspection 1 15.00 15.00
Permit Fee $ 50.00
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.
NXI shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
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, judgment ; costs, and ex ses which may in any way accrue
sa'd County in onsequence-of e;granting of this permit.
X �4 -- al (
Date
Signature of Applicant — Owner 0 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 $
Energy Inspection Fee $
occ
CONST TYPE
-
TOTAL FEE $50.00
E
Az
cuA
PARK
SCHL
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PAR0
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ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated abo) for which fees have been paid.
Of EC OR OF PU IC WORKS
By l J Date
PERMIT EXPIRES Efeate �,'
Receipt No. 88931
WHITE-O.P.W., YELLOW-ASBE330R, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY,OF BUTTE
DEPARTMENT rOF PUBLIC WORKS °
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541'
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
ER PERMIT NO.
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.
ii e
-t,-"- J.1,
V /f'/— 74% O Ila— �d n t/r G -�'-P P i9 A.- 8L1 ie
�i�/L%�Gt C_S�o•�
..Y"oK r'9 U r " `t /Jl/l / Y I _J..4 -
Date Inspector
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PfERMITT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION' AND PERMIT
ASSESSOR PARCEL NUMBER
63-25-043
ZONING
TM -10
BUILDING PERMIT
OWNER ,
Robert Terrill
TELEI;rHONE
345-0962
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
847 W. 9th St., Chico 95928
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ •.0,00
LENDER'S MAILING ADDRESS
Perak! Fce
$
ARCHI : ECT OR L -v (NEER
LICENSE NO.
Plan Che_,ang Fee
$
Energy Plan Checking Fee
n
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Ralrkhprry Rd-, Forest Ranch
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
51
SUBDIVISION NAME
PARCEL MAP
/e 3—o?
Water piping
5.00
ach qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other F1 Prtri r
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G W
10.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ❑X Installation[] Other ❑
Describe work: New Meter _
X-ota- a-L&da c P(LtuATE (iA%&_ oGy
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
a)
Main service 100V OR LESS
100 AMP OR LESS
10.00
1 10,00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification.
I, as the owner, or my employees with wages as their SOIe COmpen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUR.&
OR ADDNS. ACC. BLDGS.
, /20sgit
NEW CONSTR. U TI.OUTLET
NON•RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS d
(SINGLE OUTLET CIR.
Ex. OccupOUTLETS OR FIXTURES
20050e
eAL030
FIXED APPLES. OR
EX. Occup. OUTLETS (REBID,) EA.�
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. bYirin 9
1 15.00 15.00
Pre -Ins ection
11 k5.00 15.00
Permit Fee
$ 50.00
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.
IC7f I shall not employ any person in any manner so as to become subject
VA' to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed.revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
g
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, judgmen , costs, and ex ses which may in any way accrue
agai t s 'd County in onsequen a granting of this permit.
X Date �
Signature of Applicant — Ow,rae Contractor E]Agent Elwork
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 $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $50.00
Az.
CUA
PARK
SCHL
I FAD
I COF
I PAR PE�f HD
ISSUE
iiz
This permit is hereby issued under
sions Of the Butte County. Code and/or
indicated abov9I for which
DII C R OF U
By
PE MIT EXPIRES ate
the applicable provi-
resolutions to do
fees have been paid.
IC WORKS
Date
—
Receipt NO. 88931
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
-I
VAI
'A
^
' .COUNTY OF,BUTTE - DEPARTMIEN�T_PF PUBLIC WORKS BUILDING DIVISION
7 COUNTY CENTER DRIVE - ORZ5VILLE,;CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICAT[bfi DATA SHEET
Permit No.
OWNER
Proposed Building Use ir
'Building Inspector Date
At time of permit applicati6n, I was advised the following data must be submitted prior to permit processing and/or issuance:
------ 2. Plot plans "'""p"^"='"'p"^a`e.signed uyp/:pu,e' of plans ........
-----_ 3. Complete plans in duplicate/triplicate, signed by prepararof plans . .
-----_ 4. Co |ete engineered plans and oo/ca, with we�oignutun*on-plans ..
-----_ 5. Hazardous Material Fonn..�............�....�...............
_----- Ei Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings . .. ...... .....
---_-- Fi Engineered truss details and layout induplicate (required prior bup check)
_----- 8. PWobi|ehomeinstallation data including manufacturer's installation
^ .
instructions .......................................................
-_---_ 10. Fees of ...... .. ................ '
---_-_11. Chico Urban Area fees paid .......................................
---_-- 12. Park fees paid .............. .. ........ .. ............ .... .. .. ; . .. .. ���---
------ 13. School District fees paid....... .... ... �
------ 14. Sanitation approval from Health Department
' �-__--15. City ofChico plumbing ponnit.....................................
-_----16 Plot plan and business license approval fronn City of
(see City for other requirements)
--_--_ 17. Planning approval for (A) Uoe:-----_--(B) Parking: . ......
` -_---- 18. Improvements may be required. Contact Land Development Section DPW
_----- 19. Driveway permit (construction prior to occupancy)
-_���- 20. Pre -Inspection for ~ ALLG'required . . . p�'m«n»«. requestn
' Building Inspector
oma)
� _---_- 21. Contractor's license information (No, Nome Style, Classification) ..
' -__--- 22. Certificate of VVorkmano Compensation Insurance .. .... .. .. .. .. .. ..
--__-- 23 Owner -Builder Verification (Given to owner o. Mail to owner o).....
_-_--_ 24. Reporded copy of Agricultural Acknowledgment Statement .........
-_----25. Letter cfoi ihaduneauthorizadon ...................................
. -____2G
27
When you issue the parmit, process as follows: Mai| to owner. ------__Mbi| to contractor.
Telephone and hold for pickup at _--_-___uffioo' ----____De|iverw/inapeotor.
Other
Applicant DateCopy of H.az-Mat form sent —Health Dept. —Fire Dept. ----Air Pollution Date
-
Copy o{p|anasent _-----Hoa|thOapt. ----_-FiroOopL _--__Other_--__-_ Date By
^+.
,~^Th6following data must be submitted prior to permit issuance: (qircle new item '-. checked_ .~~,./.
l. Index permit for above items No. '
2. Additional items required:
./
Contractor,ovo/nner, owner, was advised mabove required data uv---nhvne_-- rnailby—..date
oontmrtm, designer, owner, was au"/aeu o, above venu/,eu data uv_--onvne---ma//---voun by— date
�
Pla,ns checked by Date Plans approved by Date
Sets of plans on hold in —File cabinet _AP folder
Copy -DPW
�
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovi!le% CalSfornia 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSESS P CEL NUMBER_
ZO
BUILDING PERMIT
✓,_ !
i/T
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
JOWNEWo-
AI N DORESS
f}.'S�jMErTELEPHONE
TOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee $ ;0,00
LENDER'S MAILING ADDRESS
o •^7i a $
ARCH!7ECT OR L.. ,INEE.P.
LICENSE NO.
Plan Che. -,:;ng Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Permit fee $
PLUMBING PERMIT Filing Fee 10.00
Each Trap
2.00
V�yy-
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE �
SF ❑ Duplex❑ Mobilehome❑ Other �if/l/y
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G W
0.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities Installation El Other ❑
Describe work:
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
I600V
OR LESS
Main service 100 AMP OR LESS
10.00 D
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
'
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BuSInesS
and Professions Code and my license IS In full force and effect.
License No. 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 Prof essions.Code
for this reason
NEW CONST. DWELLING OCCUP.N
DR ACDNS. (ACC. BLDGS.
, /z¢sgft
NEW
N0N.RESID CONSTR. BRANCH CIRCUITS
2.50 ea
POWER APPARATUS tr
(SINGLE OUTLET CIR. I
Ex. Occup( OUTLETS OR FIXTURES
zoeeoc
eAL030
FIXED APPLNSOR
EX. Occup. OUTLETSS (R(RESESID.1 EJ
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
JV
Permit Fee
$
Contractor
r
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.
II s of em to ny person in any manner so as to become subject
o the W. C. laws ot uaii1ornia.
_ -.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
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
penult Fee ----- --- -
$
Contractor
1 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 $
Energy Inspection Fee $
OcC
CONST TYPE
TOTAL FEE $ ��' oa
HAL.
I CUA
PARK
I SCHL
FLD
CDF
PAR
PD
) HD.
ISSUE
This permit is hereby issued unaer the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
PFRUIT FXPIAFq nntP
Receipt No.
_
COUNTY OF BUTTE-yDeoartment of Public Works .
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 '
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will. be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no)
2. I (have/have not) 'fA_U< signed an application for a- building permit
for the proposed work.
-'3. -I have contracted with the following person (firm) to provide the proposed
construction:-.
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate,. supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. :I will provide some of the work but I have contracted (hired) the following
persons to -provide the work indicated:
Name Address Phone Type 'of Work
Signed:
Property Owner
Social Security Number S-60(,-.5 2-
__Date-.. _. _- 22
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
(1
PRE -INSPECTION
OWNER: r I�rri 1 I DATE��aa'C(
LOCATION: hP _��, JJ _ I VOYp_sA-
ir
CONTRACTOR_of2 )n `PlK ZONING
PRE -INSPECTION FOR: _ QVe� —
? -;
DATE TO INSPECTOR T� f g�
PERMIT HISTORY: i NONE �( AS OLLOWS: -
TYPE OF OCCUPANCY
-BUILDING USAGE:
FIE - --D,, FORMATION
ACTION RECO114MEVDED :
ISSUE HOLD FOR
v '
OTHER: ,
BY DATE '5_0 3 -91
Dov -c,
Yov I�ci ve
4o pend ak-'
BIo-c Hoec�- y
—+-o
ioc�- qo-4-� .
,IV y , proO evn ,�
O -r-
3 -LAS -sem -
C, ule
IV o -S iO I*&k'ls o e -v If3 d
E obey rt -e r v-', I I