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HomeMy WebLinkAbout064-570-00564-57-5 _ M. Courtney `2� 5 Racine Cir., lot 104, PP#10, Maga. contr: Malcolm Hall, M.Wlia Permit #5593-78B,P,E,M(new single family) AAQI 5/i2/7? `^ 64-577-5 V ontr: Malcolm Hall, Magalia %grmit #6 76-7 B add d ,�C�/SF) 64=5 5 114199 Racine Circle, Magali mitt .1818.8.2B., P,., E.(add. _fami rm, _.ba woodburning stove)SF q contr R & A Bldrs , Paradises -/2- � �6 v 064-57-0-00593-'2832 MILTON 93-2832 B 14199 RACINE CR, MAGALIA /0 CONTR: GILMORE CONST ADD WINDOW TO STORAGE AREA 064-57-0-005 "93-3365.E-�T REESE, Milton 1. 14 1la 14199 Racine`Circle, Magalia /Oy/ /�' (add circuit for 220)SF 064-570-005 PERMIT'#95-0157 REESE, Milton H. 14199 Racine Circle, Magalia Cont; Waterworks Unlimtd op 9 relocate pellet stove & new woodstove 064-570-005 PERMIT#98-0605 REESE,. Milton F/A4-1--9-Z5 -69 14199 Racine Circle, Magalia Cont: Tri -Flame Propane ' Gas Line to Log Lighter/SF 064-570-005 04-0562 REESE, MILTON & DOROTHY 14199 RACINE CIRCLE, MAGALIA CONT: JESSEE HTG & AIR INSTALL PROPANE HVAC 064-570-005 04-0584 REESE, MILTON & DOROTHY 14199 RACINE CIR, MAGALIA I CONT: JESSEE HTG & AIR REPLACE HVAC t4 O6 607 0: a REESE, MILTON 14199 RACINE CIR, MAGALI Cont: ADVANCED ELEC. C!iNALEIUPGRADE ELEC (HOT TUB) B07-1541' •+• - 064-570-005 MISCELLANEOUS Re -Roof REROOF WITH COMP 14199 RACINE CIR REESE, REVOCABLE INTER VIVO 5 ii■ cfli l,�'i uO row 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: 14199 RACINE CIR Owner: Permit No: B07-1541 APN: 064-570-005 REESE, REVOCABLE INTER VI Issued Date: 7/17/2007 By GLB Permit type: MISCELLANEOUS PO BOX 382 Subtype: Re -Roof MAGALIA, CA 95954 Expiration Date: 7/16/2008 Description: REROOF WITH COMP (530) 876-6586 Occupancy: Zoning: RTI Contractor Applicant: Square Footage: GREENE & SON ROOFING GREENE & SON ROOFING Building Garage Remdl/Addn -P O BOX 2467 P O BOX 2467 PARADISE, CA 95969 PARADISE, CA 95969 (530) 873-3940 (530) 873-3940 Other Porch/Patio Total FEE INFORMATION DBMSC Re -Roofing $173.00 Total Charged: $173.00 Fees Paid: $173.00 Balance Due: $0.00 Receipt No: B3907 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License GREENE & SON ROOFING 275057 / C-39 / 5/31/2007 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 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 pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) s in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 7/17/2007 penalty [$500]; Please check one of the following: Contractor's S gnature Date E]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 WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND the work himself or herself or through his or her own employees, provided that such improvements WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR 11I are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and The Contractor's License Law dows not apply to an owner of the property who builds or improves policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: STATE FUND policy Number: 1753692 Exp. Dale:10/112007 Contractor's License Law.). (This section nee not a competed if the permit is or one hundred dollars ($100) or less.) IAM EXEMPT under Section B. 8 P.C. for this reason: ❑ ❑I 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 7/17/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 7/17/2007 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 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 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, injury, including death, and property damage caused by, arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of a sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the a mentioned property for inspection purposes. I hereby certify that I am the property owneror W authorized to act on I a roperty owner's behalf. Q 7/17/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner Contractor OR Agent for Owner ❑Agent for Contractor FILE COPY Lenders Address City State Zip I 07 rF BUTTE COUNTY 0 o DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION 0 0 OFFICE #: (5_30)538-754I FAX #: (530) 538-2140 o-�,J�"' o A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: w. w.buttecounty.net/dds Y DUN'S **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name First Name AJ Mailing Address City i t� e/lePhone City + EFaO E-mail APP CANT SIGNATURE X � PERMIT NO. ` BIN # PROJECT LOCATION API Ift j5-2 Property Addre wv9la City WORKER'S COMPENSATION Policy Number 53lo9Z- Carrier 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: CONTRACTOR Name P S n`, J� Address p Q ,� b City I No State Zi SgZ7 Phone 873-39 (� Fax E-mail �- State License Number Lic. # `0 f� 5assC-3 9 APP CANT SIGNATURE X � PERMIT NO. ` BIN # PROJECT LOCATION API Ift j5-2 Property Addre wv9la City WORKER'S COMPENSATION Policy Number 53lo9Z- Carrier 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: ARCHITECT/ENGINEER Name 51` Address 30 '� City I No State Zip Phone Fax E-mail Open co State License Number APP CANT SIGNATURE X � PERMIT NO. ` BIN # PROJECT LOCATION API Ift j5-2 Property Addre wv9la City WORKER'S COMPENSATION Policy Number 53lo9Z- Carrier 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: APPLICANT INFORMATION Name 51` Address 30 '� City I No State Zip Phone Fax E-mail Open co APP CANT SIGNATURE X � PERMIT NO. ` BIN # PROJECT LOCATION API Ift j5-2 Property Addre wv9la City WORKER'S COMPENSATION Policy Number 53lo9Z- Carrier 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: Zoning Flood Zone 30 '� I Yes I No Occ. Type Const. Sq FT- Living Garage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): Open co For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Tb f7^nom0-r 30 /J/70 / I ,CA/!G✓lCAm, . %3T7" BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES ° BUILDING PERMIT BP041123 0 u 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) o .,i r. o. c OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: wwwbuttecounty.netldds cOU N'1y LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penally of pedury that I am licensed under provisions of Chapter 0 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and Issued Date: 04/22/2004 APN• 064-570-005-000 effect. License Class: License Number.. Site Address: 14199 RACINE CIR MAG Date: Contractor. Map Index' ' OWNER -BUILDER DECLARATION I hereby elfirm under penally of perjury Ihai I am exempt from (he Description: up -grade elect. service for hot tub Contractors' State License Law for the following reason (Sec. 7031.6 Buslness and Professions Code: Any city or county which requires a permit to construct. alter, Improve, demolish; orrepair any structure, prior Owner: REESE MILTON HILMER & DOROTHY 10 Its issuance, also requires the applicant for such permit to file a GERARD signed statement that he or she Is licensed pursuant to the provisions of the Contractors Slate License Law (Chapter 0 commencing wllh Section 14199 RACINE CIR 7000) of Division 3 of the Business and Professions Code) or that he or Is MAGALIA, CA she exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the . 95954 applicant to a civil penally of not more than Uve hundred dollars ($500).): ❑ 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 (Sea 7044, Buslness and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who bullds of Improves [hereon, and who does Applicant: REESE MILTON HILMER & DOROTHY such work himself or herself or through his or her own employees. provided that such Improvements are not Intended or offered for GERARD sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving (hat 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 Professions Code. The Contractors' Stale License Lew does not apply to an owner of property who bullds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ADVANCED ELECTRIC & SOUND ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner. 3881 G BENATAR WAY CHICO,CA 95928 WORKERS' COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following dedareUons: ❑ 1 have and will maintain a coAiOcate of consent to self -Insure for 530-891-7597 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit License fF: 623540 Is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is Issued. My workers' compensation Insurance carrier and policy number are: Architect ; Carder.Engineer: , Total Square Ft: 0 S. F. Policy M 64 1 certify that In the performance of the work for which this permll le 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' Q Valuation: $0.00 compensation provisions of Section 3700 of the Labor Code, I shall Census Code: forthwith comply with those provisions. Dale: 4/2�/mr1 el -P -83354-1i 17 Arftorrf �>ecewL-cl : 5,5. e� Applicant:. ' WARNING: Failure to secure workers' compensation coverage -Is /j (� y unlawful, and shall subject an employer to criminal penalties and one �p 9 hundred thousand dollars ($100.000). In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit Is hereby Issued under th ppiicahis provisions of (he Butte County Code and/or I hereby affirm that there Is a construction lending agency for (he ResotuUons)o do work Indicated a ve or which lees have been paid. performance of the work for which this permit Is Issued (Sec 3097 CN.) Name: PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify (hat the use of IhIs facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage. handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.6 of California Health & Safely Code Is not applicable to the scheduled construction of Ws project. O Attached are copies of the required E.P.A. notigcallon forms. I hereby certify that I have reed (his application, that the above Information Is correct, and that I em the owner or the duly authorized agent of (he owner. I agree to comply wilh all countyand state laws relating to building construction. I acknowledge It Is unlawful to eller the substance of any official torm or eumant of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection p "a. 1 Print Name: M \k--"!—aN �} - \LL,C C, Signature:t 1 Dale: ` 1st'l ay Owner 0 Contractor 0 Agent for Owner 0 Agent for Contractor 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.netldds PERMIT NO. BP041123 LICENSED CONTRACTORS 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 Issued Date• - 04/22/2004 APN: 064-570-005-000 the Business and Professions Code, and my license Is in full force and effect. License Class: License Number: Site Address: 14199 RACINE CIR MAG Date: Contractor. Map Index: Description: up -grade elect. service for hot tub OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior Owner: REESE MILTON HILMER & DOROTHY to its Issuance, also requires the applicant for such permit to file a GERARD signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 14199 RACINE CIR 7000) of Division 3 of the Business and Professions Code) or that he or MAGALIA, CA she is exempt therefrom and the basis for the alleged exemption. Any 95954 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than rive hundred dollars ($500).): ❑ 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: REESE MILTON HILMER & DOROTHY such work himself or herself or through his or her own employees, GERARD provided that such improvements are not intended or offered for sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving 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 Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Slate License Law.). Contractor: ADVANCED ELECTRIC & SOUND ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner. 3881 G BENATAR WAY CHICO,CA 95928 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 530-891-%597 O 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 License #: 623540 is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is Issued. My workers' compensation Insurance are: +lrchitec�: carrier and policy number Engineer: Carrier. Policy #: J4 1 certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. Issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall Census Code: forthwith comply with those provisions. Date: ti 2t°�l(J%#- �L 17 Applicant: /l in(A)r? (we C& 1PC� . V S. mac, WARNING: Failure to secure workers' compensation coverage is�")[�����y unlawful, and shall subject an employer to criminal penalties and one I/ i�- 9 C) ("C' hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under th pplicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is issued (Sec 3097 Clv.) Resolutions do work Indicated a ve or which fees have been paid. BY Date: Name: n PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to eller the substance of any official form or d cument of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspectionp o S. 1 Print Name: M �'�—'TnN {r} _ \��CS G Signature: Date: �"�l2t1O`1 100'r1wrier 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP a,qlia 9 DATE: _ APN: ^ �` ZONING: / OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE! STREET ADDRESS: .rte r ,/y Py 1- 1�► /�1 �Mi �r `I (� �e `rte FAX �� CITY, ZIP: AA AA � E-MAIL: SITE ADDRESS: , CITY. ZIP: A Eta NEAREST CROSS STREET: w4c6aVI: MAC 04 TRACTILOT P. APPL CANT NAME -PHONE: Tk �eF , STREETADDRESS: FAX CITY, ZIP: MAW" 1,6 A ITArkrIl E-MAUmm CONTRACTOR NAME: PHONE: V 4 '" 2\ 5 STREET ADDRESS:FAX: t Afr WA CrrY, IP: G4 I E-MAIL: -- LICENSE NUMBER 90 LICENSE TYPE: ARCH ITEC /ENGINEER NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: b jj -14 i ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: Application Received by..� Date.. Receipt number: `��j Amount Received: �v J [ 5' & rJ 7 0y n (3 '! � Master application 3-4-04 0 ol, oS7gq S-70 d-oos- ;�ee Ro, ,o,4 Jed FIIJA)ed 3J1i® 4 I 00 103 BUTTE COUNTY 0 0 PER Ill NO. - ' `' DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT o 0 BP040584 E- �\,`; 24 HOUR INSPECTION #: 530 ) () ( 538-7636 OROVILLE 530 891-2834 (CHICO) 0 OFFICE #: (530) 538-7541 rn,'(„-7 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 issued Date: 03/01/2004 APN: 064-570-005-000 the Business and Professions Code, and my license is in full force and ' effect. ucense Class: L`.ts�Y">, License I�rm r. Site Address: 14199 RACINE CIR MAG Dater Contractor. ( Map Index: Description: CHANGEOUT HVAC OWNER -BUILDER D LARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a (OWner' REESE MILTON HILMER &DOROTHY permit to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a GERARD signed statement that he or she is licensed pursuant to the provisions of 14199 RACINE CIR the Contractors State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or MAGALIA, CA she is exempt therefrom and the basis for the alleged exemption. Any 95954 ' 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).): ❑ 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 Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: JESSEE HEATING 8r AIR ' such 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 improvements are sold within one 3025 SOUTHGATE LANE year of completion, the owner -builder will have the burden of CHICO, CA 95928-7427 proving that he or she did not build or Improve for the purpose of 530-8914926 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professlons Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: LESSEE HEATING &AIR r pursuant to the Contractors' State License Law.). t { ❑ I am Exempt under Article 3 of the Business and Professions Code r 3025 SOUTHGATE LANE CHICO, CA 95928-7427 Date: owner. 530-891-4926 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 405424 ❑ 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. fad I have and will maintain workers' compensation Insurance, as . A; Chiket• c - " t: required by Section 3700 the Labor Code• for the performance of Engineer the work for which this permit is issued. My workers' compens=9un insurance carder p6licy number are:/� �and Total Square Ft: 0 S. F. Valuation: $0.00 Policy n: irk - ❑ I certify that in the performance of the work for which this permit is Census Code: 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �'1 Dat•Cl 55 -0 0 Date: �' Applicant: 3 i Ise r� tf��' � 39 N CI, -1 � WARNING: ailu a to secure workers' comp allon coverage is unlawful, and 1 subject an employer to criminal penalties and one hundred thousand dollars ($100,000). In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the is h eby Issued unpeee��f'''���he ap icable provisions of the Butte County Code and/or t de Indidat d performance of the work for which this permit Is Issued (Sec 3097 Civ.) LResokdionsafJ ve fof rich fees have been paid. ✓ f —N Name: Date: 1 2 ' Address: XPIRES ON: v Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505. 25533• and 25534 of the California Health and Solely Code, which regulate the storage, handling and use of hazardous materials. 1 ❑ Notification In accordance with Section 19927.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. 1 hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge It is unlawful to alter the substance of a officl If r document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pure se r Print Nem.: Q Signature: Date: ❑ Owner (Q Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01.16.04 pg 1 0 3) jO� I COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 .7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates tliat the following violations of butte county Ordinances exist at the aboveaddress and should be corrected. Please notice 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. Date / u Inspector REV 10/92 F h I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP040562 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 02/27/2004 APN• 064-570-005-000 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. Site Address: 14199 RACINE CIR MAG License Class : License Number. Map Index: Date: Contractor: Description: INSTALL NEW PROPANE HEATING & AIR OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the UNIT Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner•' REESE MILTON HILMER & DOROTHY to its issuance, also requires the applicant for such permit to file a GERARD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 14199 RACINE CIR 7000) of Division 3. of the Business and Professions Code) or that he or MAGALIA CA 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 95954 applicant to a civil penalty of not more than five hundred dollars ($500).): 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: JESSEE HEATING & AIR such 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 improvements are sold within one year of completion, the owner -builder will have the burden of proving 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 Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed COntraCtOi• JESSEE HEATING &AIR pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Bu ii and Professions Code 3025 SOUTHGATE LANE Z? [J`iOwner zlQJL ' CHICO, CA 95928-7427 Dat- 530-891-4926 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: 405424 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and p6licy number are: Carrier: Total Square Ft: 0 S. F. Policy#: I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to Census Code' become subject to the workers' compensation laws of California, ia, 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. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor JJJ / / D code, interest, and attorney's fees. -`-�' --� CONSTRUCTION LENDING AGENCY -- --- - - •This it i her y issue un err a applicable provisions of the Butte County Code and/ori I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Vuno Res d w fl c t d v f r H ich fee have been paid. 0� lal Name: BY: D`a�te. / Address: PERMIT EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to lhe'scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official forth or document of Butte County. I hereby authorize representatives of Butte County two enter upon the above mentioned property for inspection s. L7� Print Name: M ��-^TDa W % ` EsS.- Signature: �'-'•-� Date: 2l L? �� y Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 I V BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO P�0& DATE: 2 l L7 toy —7 APN: C --S?io — o — oto ZONING: NEAREST CROSS STREET: -AC\,NE N �. l FF Vt`cw/+►�'i C ^' 'fON TRACT/LOT#: SITE ADDRESS: i � t � � ,��� � a -►c c `rc cue CITY, ZIP: C—A IRIS' R5 OWNER NAME: PHONE: 4]r^ n�v� cc�"Z. S-30. X7.3. STREET ADDRESS: 1 `k t� Ci -1 IZ f� c C vac •� FAX: �--- CITY, ZIP: E-MAIL: APPLICANT NAME: PHONE: STREET ADDRESS: FAX C "— CITY, ZIP: E -MAIL: ---- CONTRACTOR AME:PHONE: A/c E.3a.891.Ligzr. STREET ADDRESS: FAX: CITY, IP: CH -"CQ 1S" 9 i 4 i E-MAIL' LICENSE NUMBER. leta-5-`4Z LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS FAX CIN, ZIP: LICENSE NUMBER E-MAIL: DESCRIPTION OR SCOPE OF WORK. Pr GGGC-s C. Qa �e E lbw -ma c - wc>�- A C:eAt4VIP. n42 a ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: 7 Application Received by: Date: Receipt number: �j Amount Received: % B. C. Buildino Permit 01-23-04 no 2 V O.B.-1 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. 0I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES ❑ NO 9 HAVE A HAVE NOT ❑ 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: PHONE: CONTRACTOR'S 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: CONTRACTOR'S 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 cDATE:` NOTE: This Owner -Builder Verijkation is required by Section 19831 and 19832 of the California Health and Safety Coda This verification must be completed and returned to our office before we are permitted to issue the permit. OVER I OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party ofrecord on such a Permit Building Permits are not required to be signed by property owners unless they are personally performing their own works. 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 tb put their license number on all permits for which they apply. - If you plan to do your own worm 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 $300' or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal 'income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Intemal 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 allowedto perform their conditions. work personally or through their own employees, without a licensed contractor or subcontractor, only tinder limited A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building Permit, erroneously implying that the property owner is providing his or her own labor and material personally. enmity are not p rally. Building p required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirmthat you are aware of these matters. The building permit will not be issued until the verification is returned. relY' Mi 1 C. Vi ira, C:3.0. r Mer, Building Inspection NOTE. YNs Owner Builderinfonnadon is required by Section 19830 of the California Health and Safety Code OVER 5-11 0_4 0 y County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Jessee Heating and Air ADDRESS: 3025 Southgate Lane CITY & STATE: Chico, CA 95928 nATF ()F CI AIM- 04/99/fl4 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 064-570-005 Plerl—lift No.:04 050M � PAiD RETAINED I REFUND Development Services $ 55.00 $ - $ 55.00 SRA $ - $ - $ - Sheriff $ _ $ - $ Other: $ $ $ TOTAL $ 55.00 $ - $ 55.00 .................. ........ X. ::BREAi +Q WN ::::::::::::::: BUDGET`.:::: ........ ACCOUNT::::AM0LTrq.T:: .............. .............. Development Services 440-001 4210500 $ 55.00 SRA 0100 4617240 $ Sheriff 280 1011811 $ - Other $ _ TOTAL$ 55.00 $ 55.00 1, 1110 U11Ue1b1y[1UU, ueclale unuer penalty ui perjury cnai ine services or amcies ciaimea nave been perto d or delive etT,-an at this claim is true and correct as stated. Dated this day of, 2004, at l I C (/ Calif. a-4 igna I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles spec a above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of 2004, at Oroville Calif. Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE -AUDITOR'S USE ONLY EPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. ~� �,DISPLAY REVENUE STATUS O`-�� YEAR |=""G=' »'`I' pEKIOD *CCuum/ TRANS CODE 211 �TRANS DATE � ' | . .DATE ENTERED05/19/04 CASH *CCuom/ DUE DATE 05/19/04 vEnuux . INVOICE DATE RECEIVABLE pCc/ DISCOUNT AMT .DISBURSE FUND 1505 C3 WARRANTS CLRNG F 1505 CHECK NUMBER 665293 / 'CHECK DATE 05/19/04 i 3 E muMuEx :PARTIAL/FINAL INVOICE/RECEIPT '1Oyy � AMOUNT ' CLEARED { � SALES/USE TAX 0. 001VOID DESCRIPTION ` | CONTROL NO ' j ENTERED BY BANK CODE � WARRANT NONOTE� IN � ') CLICK 'OK' TO CONTINT: REFUND CALCULATION SHEET CLAIMANT: Jessee Heating and Air ADDRESS: 3025 Southgate Lane CITY & STATE: Chico, CA 95928 DATE OF CLAIM: 04/26/04 APN: 056-3 4 nO RECEIPT INFORMATION -`- NUMBER: 394040 DATE: 03/01/2004 ISSUED TO: Jessee Heating and Air CHECK #: 10569 AMOUNT: $55.00 PERMIT #: 04-0584 Yes No Yes I No j Yes No PRIOR REFUNDS: X FEES VERIFIED X REFUND BREAKDOWN BLDG SRA SHERIFF DETAIL PAID RETAIN REFUND 440-001 4210500 0100 4617240 280 1011811 BLDG FILING FEES Building Plumbing Electric Mechanical PLAN CHECK Plan Check Ener INSPECTION Ener SRA -BLDG Building $46 PERMIT FEES Building Plumbing Electric Mechanical OTHER BLDG Overcharge 55.00 55.00 55.00 .............. :::::::::::::::::::::::::::::::::: :.:.:::.::::.::.::::::::::::::::::::::.........:::::::: .............. .......................... .......................... REFUND PROCESS FEE BUILDING TOTAL 55.00 55.00 55.00 SRA - FIRE SRA -FIRE Fire $43 .......................... SHERIFF - $360 :: SHERIFF Sheriff OTHER NON -BLDG OTHER $ 55.00 $ - $ 55.00 $ 55.00 BLDG $ - SRA $ - $ - SHERIFF 440-001 0100 280 4210500 4617240 1011811 CHECK: $55.00 DIFFERENCE: (Should be blank) APPROVAL Date Reviewed 4/27/2 Michael Vieira Building Manager BUTTE COUNTY Butte County Department of Development Services MAR 10 2004 DEVELOPMENT Building Division SERVICES 7 County Center Drive Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on t he receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit is for permits issued - if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Develo ment Services for payment processing. CLAIMANT'S NAME: MAILING ADDRESS: MIKE S. GRAY JESSEE HEATING & AIR / 3025 SOUTHGATE LANE, CHICO, CA. 95928 ( 530)8.91_ PHONE: ASSESSOR'S PARCEL NO.: 0 6 4— — 5? 0 — — o 05 — [Please use one claim form per permit] BLDG PERMIT NO.: 04. — _0584 _ Receipt No. 1 Receipt No. 2 Receipt No. 3 RECEIPT NO.`394040 RECEIPT DATE: 03 / 01 / 04 RECEIPT AMOUNT: $8 [P ✓:1C REASON FOR REFUND RE UEST: PERMIT ALREADY ISSUED FOR ABOVE PARCEL NO. Check those fees which you wish to have considered for refund: [Building Permit Fees [Sheriff Fees SRA Fees (CDF Fire Planning) Other (specify): CHANGE OUT HVAC Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may ick them up prior to that time. Signiture I Date K:/Ft:7 fund pplication 082203 i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP040584 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 Issued Date: 03/01/2004 APN: 064-570-005-000 the Business and Professions Code, and my license is in full force and effect. License Class Site Address: 14199 RACINE CIR MAG : License ,_ m r.. Date:. Contractor: Map Index: 1 Description: CHANGEOUT HVAC OWNER -BUILDER D LARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: REESE MILTON HILMER &DOROTHY permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a GERARD signed statement that he or she is licensed pursuant to the provisions of 14199 RACINE CIR the Contractor's State License Law (Chapter 9 commencing with Section MAGALIA CA 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 95954 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).): ❑ 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 Contractors' State License Law does not apply to an Applicant: JESSEE HEATING &AIR owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 3025 3025 S S OUTHGATE LANE sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of CA 95928-7427 proving that he or she did not build or improve for the purpose of 530-891-4926 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: JESSEE HEATING &AIR pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code 3025 SOUTHGATE LANE CHICO, CA 95928-7427 Date: owner: 530-891-4926 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 405424 ❑ 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. Ur Architect: I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: � Carrier: T�1.y% Total Square Ft: 0 S. F. Valuation: $0.00 Policy#: 2 Irl — ❑ I certify that in the performance of the work for which this permit is Census Code: 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ^ I r/ id S 0 C) Date: 1 Applicant: 39 7 t4 CL -1 WARNING: ailu a to secure workers' comp sation coverage is unlawful, and flal subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY rl ereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) This permit is h reby issued unfleryhie ap icable provisions of the Butte County Code and/or 0 Resolutions t d indidat d ve f ich fees have been paid. - j . - I Name: By: Da/tee. PERMIT 10S S Address: EXPIRES ON: t) Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and -that I am the owner or the duly authorized agent of the.owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of a offic' If nn r document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pure ses. Print Name: T \ Gi SA fSSi. kS= _ ��. Signature: Date: -� ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538.7541 PERMIT NO. C5 611 B. C. Building Permit 01-23-04 pg 2 DATE: r t- 6 ± I' APN: / J (O V u ZONING: NEAREST CROSS STREET: TRACT/LOT#: SITE ADDRESS: ( 41 LF I � ` f CITY, ZIP: �C OWNER NAME: PHONE: STREET ADDRESS: � PAC t t -tyJ/� FAX CITY, ZIP: E-MAIL, APPLICANT NAME: PHONE STREET ADDRESS: FAX . CITY, ZIP: E-MAIL 2 CONTRACTOR NAME: PHONE ( I� STREETADDRESS: { JQ FAX CITY, ZIP E - MAIL LICENSE NUMBER LICENSE 'TYPE. - YPE:ARCHITECT/ENGINEER ARCH ITECT/EN GINEENAME: PHONE STREET ADDRESS: FAX: CITY, ZIP LICENSE NUMBER: E -MAIL - DESCRIPTION OR SCOPE OF WORK: c ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: Application Received — 0�4 by: Date: Receipt number: 156 CAD D Amount Received: 1 B. C. Building Permit 01-23-04 pg 2 064-570-005 PERMIT#98-0605. REESE, Milton 14199 Racine Circle, Magalia Cont: Tri -Flame Propane Gas Line to Log Lighter/SF//9/� OFFICE COPY Address GAS Meter By Date ELECTRIC Meter By . Date' COUNTY OF BUTTE -DEPARTMENT QF DEVELOPMENT SERVICES-BUILDINGDIVISION 7 County Center Drive - Oroville, Calif6rnia 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT d� a� ASSESSOR PARCEL NUMBER 064-510-005 ZONING RT-1BUILDING PERMIT -" OWNER MI11rQI\4 ESE TE�E�MONE_��586 tf SO. FT. OCC. BUILDING VALUATION S OWNERMAI�IJsi/,1Q.pftES INE CIRCLE, MAGkIA 95954 . CONTRACTORI ffE PROPANE T 73=4102 CONTRACTOR ILgbfOTY34 MAGALIA 95954 OTY34 CONSTRUCTION LENDER [Fireplace LENDER'S MAILING ADDRESS otal Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checkin6 Fee $ BUILDING ADDRESS 14199 RACINE CIRCLE Energy Plan Checking Fee $ MAGALIA PERMIT FEE $ LOT NO. SUSDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF)P, Duplex ❑ Mobilehome ❑ Other SPECIFY j Each Trap 7.00 Solar or het um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other .14] Describe Work: PROPANE GAS LINE TO LOG LIGUIR Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ 35, ELECTRICAL PERMIT Fling Fee 20.00 Main Service 23.00 LICENSED CONTRACTOR'S DECLARATION I 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 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 \ 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 of one hundred dollars ($100) or less.) I 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. �''"`� X ..... fid. + Date 9 Ct � 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. Main Service To 46.00so CCU000A NEW CONST. DWELLING OCCUP. WEE OR AODNS. ( .ACC. B.S. SO 3.52 FT. NEW NON -.E tIDT MULTI.OU CLET Qa 7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occu OUTLET OR FIXTURES�0 "1 1.0 Ex. Occup. ountDrsRESI6.oFRa 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ 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 $ 35.00 HAZ. D. FEES IMP I FLOOD I CDF PARCEL PO 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 19 1 Dafe Receipt No. Z319f}% r U' - 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, Califovhia ' 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION -AND PERMIT �V b�, d �� ASSESSOR PARCEL NUMBER 064-570-005 ZONING RT -1 BUILDING PERMIT OWNER MILTON REESE 7873.6586 SO. FT. OCC. BUILDING VALUATION owNER'S MAIr+1WACINE CIRCLE, MAGALIA 95954 CONTRACTORfJJAI E FLAME PROPANE TELEPHONE 73 411 CONTRACTORP6„IWBNbXD 1134 MAGALIA 95954 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS ' Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Film Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 14199 RACINE CIRCLE Energy Plan Checking Fee $ MAGALIA $ PERMIT FEE 5 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF)R Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ LNilities ❑ Installation ❑ Other Il Describe Work: PROPANE GAS LINE TO LOG LIGHTER Gas piping system i - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ 35.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Serviceeoov DR LEss 200A 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.P License Class LIC. NO. OWNER-BUILDER DECLARATION I 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR OR ADDNS. ( & ACC. BLDS. SO 3.52 FT, NEW NON -R S11DT ANCS.I CIRCETS @7.50 OWER APPARATUS a SINGLE OUTLET CR. Ex. OCCu OUTLET OR FIXTURES B20 Q I: Q Ex. Occup. ouTEiFrs P.,6.OE. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 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 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I 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. -� X(o.—= !ems- 2Datey� Signature of Applicant -,Owner ❑ Contractor ❑ Agent— gent An 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 $ occ CONST. TYPE TOTAL FEE $ HAZ, I D. FES IMP I FLOOD I COF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By PERMIT EXPIRES ON 4�h"'7 Dere —1 Receipt No. 55•®8 WHITE-D.D.S.-B.D. CANARY -ASS SSOR PINK -INSPECTOR GOLDENROD -APPLICANT PERMIT#95-0157 REESE, Milton H. 14199 Racine Circle, Magalia Cont; Waterworks Unlimtd relocate pellet stove & new woodstove �wr COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive ' Oroville, California 95965 - Telephone (916) 53 541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 064-570-05 ZONING R BUI DING PERMIT OWNER TELEPHONE873-6586 SQ. FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 14199 CONTRACTOR'S NAME WATEIR TELEPHONE CONTRACTOR'S MAILING ADDRESS F. CHICO 95926 Fireplace 2 LOW CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 54.00 ARCHITECT OR ENGINEER / - LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 14199 RACINE CR MAGALIA PERMIT FEE $ 74.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME _ PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF fl Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ OtherL Describework: PELLET STOVE RELOCATE AND INSTALL PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 NEW WOODSTOVE Main Service ( 2001 OR LE1111 OR SS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. OLDS. ) S0, 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ 1 am a licensed under provisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON -RESOD. ( BRANCH CIRCUITS ) @7.50 ( POW ER APPARATUS ) &SINGLE OUTLET COR. Ex. Occup. ( OUTLET OR FIXTURES ) - BA20 L. @ 1.00 50 Ex. Occup.FIXEDAPPWS.OR ( OUTLETS IRESID.I EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in^ consequence ofthe granting of this permit. X • 0,s Date (-- 3 1 — g"' Signature of Applicant -A Owner O Contractor ❑ Agent An 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 $ 74.00 HAZ. D. FEES IMP FLOOD COF PARCEL PO HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. Bv` /r Date PERMIT EXPIRES ON /Dere/ 17116$ Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING IVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 53 541. PERMIT NO. APPLICATION ANa PERMIT qS - ©I.�T ASSESSOR PARCEL NUMBER 064-570-005 ZONING RI BUI DING PERMIT OWNER MTT,TON H. REESE TELEPHONE 873-6586 SO. FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 14129 RACINE CR, MAGALIA 95994 CONTRACTOR'S NAME WATERWORKS TINT.MTT)- TELEPHONE 893-4961 CONTRACTOR'S MAILING ADDRESS 135 W 8TH AVE, CHIM 95996 Fireplace 1 2 3,000 CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 51L no ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 14199 RACINE CR MAGALIA PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PAflCEL MAP Water piping 15,00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF Y Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel 1:1Utilities ❑ Installation ❑ Other Describework: PELLET STOVE RELOCATE AND INSTALL NEW WOODSTOVE PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service I200AORLESS 600V OR LESS ) 23.00 Main Service I 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. I & ACC. BLDS. ) SD, 3.50 FT. CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044) EII am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON -REBID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIN. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. .50 Ex. Occup.FIXED APPLNS. OR ( OUTLETS IflESID.I EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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 against said County in consequenceofthe granting of this permit. X ��`-�f7 - Date Signature of Applicant Owner ❑ Contractor ❑ Agent An 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 $ 74.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. ey Date //-?J kc PERMIT EXPIRES ON IDatel Receipt No. 171168 I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN R00 -APPLICANT RtMDENTIAL a' 93-2832 B 064-57-0-005 REESE, MILTON MAGALIA 14199 RACINE CR CONST J CONTR: GILMORE STORAGE AREA Y ADD WINDOW TO 91�� lR li u I JOB FINALED (Date) 10— -7 y Signature V=OK O = Not OK =NotApplicable MOBILE HOMES Date/Initials MOBILE HOME UTILITIES (Plana) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Teat -Fall -C/O Concrete 4. Water; Location -Teat -Easement Needed (Sketch) S. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Teat -Wrap: / /" L"ft. / /"Net. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect. 8. Utility Clearance Date/Initials MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3.. Gas; MH Test -Demand -Valve -Connector .4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Tent -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy MISCELLANEOUS Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs: Connectors Shthg -Rfg: Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric S. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Lendings Date/Initials POOLS (Plans) OK except #'a 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date/Initials UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3.Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Materiel -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date/Initials PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nasi Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'a 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Meth. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels -Motors -Mach. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date/Initials MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date/Initials FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Wells over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin=roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection-Skyllghts-Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Date/Initials FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. • Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door, Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection 75. Pib., Elec. & Mach. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Fireplace -Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES U ING DIVISION ,j 7 County Center Drive - Oroville,,Califorpia 95965 - Telephone 1 ) 8-7541 PERMIT NO. APPLICATION AND PERMIT �-3 a-- 8 ASSESSOR PARCEL NUMBER 06457-005 ZONING RT -1 BUILDING PERMIT OWNER Milton Reese TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 14199 Ra Cine Circle, Magalia 95954 Est, 410.00 CONTRACTOR'S NAME Gilmore Construction I TELEPHONE 872-3473 CONTRACTOR'S MAILING ADDRE9662 Ishi Dr. , Magalia 59954 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 410.00 Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 23.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE $ 58.00 14199 Ral%ne Circle Magalia PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF 10Duplex O Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W EJ!E20 TYPE OF WORK New ❑ Addition ❑ Remodel D Utilities ❑ Installation ❑ Other CK Describe Work: Add Window to Storage PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 211" OR LESS ) 200A OR LESS 23.00 Main Service , 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCC P. OR ADONIS. 1 & ACC. BLOS. ) SD, 3.50 FT. CONTRACTORS LICENSE LAW I decI under penalty of perjury (check one) !ram a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and m license is in full force an ffect. y License No. 4!1q 5-3 y Classification ❑ I, as the owner, 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) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) El am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON,RESID. / BRANCH CIRCUITS ) @7.50 , POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BAL. @x.50 Ex. Occup. FIXED APPLNS. OR p• ( OUTLETS IRESID.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a certificate of Consent to Self -insure. shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, ju gments, cos s, and expenses which may in any way accrue against said Coun n c nseque the granting of this permit. X / Date R `� Signa a of Applicant - ❑ Owner Contractor ❑ Agent An QJHA permit is required for excavations over 5"0" deep and demolition or cons uction of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee Is ocC CONST. TYPE TOTAL FEE $ 58.00 HAZ. I D. FEES I IMPF100D "� CDF PAflCEL PD HD ISSU This permit is hereby issued under the applicable provisions of the Butte my Code and/or Resolutions to do work indicated ove for which fees have been paid. ECJrOR OF PU I ORKS By Date 9� R _9 ` PERMIT EXPIRES ON `l (Date) Receipt 14£i21 n .D. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENT O V.,F,.LOPMENTSERVI- UILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE (916) 538-7541 OWNER PERMIT APPLICATLON DATA SHEET A. P. No" 0 `f Proposed Building Use d L2I2 li//////� d G(/ Building Inspector Date DlJ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: ✓/ DATE RECENED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form. I .............................................. . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California aDDepartment of Forestry plan approval/fees......................... 13. Flood elevation letter (100 year flood) by California Engineer ................... 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ........................................ 16. Plot plan and business license approval from City of Biggs/Gridley. . ........... 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .......Pm4nspe�o� Bqu- 2020. Pre -inspection for required. .. to B.,17 . Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification). .............. 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road......' 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . ..................:...................... . 29. Documentation of legal access . ....................................... . 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan4checklist..................................................... 33. .34. When you issue the permit, process as follows: Mail to owner. ail to contractor. Telephone - - ----'and hold for pickup at office. Deliver with inspector. Other j q Parcel Creation Acreage Applicant Date D Copy of Haz-Mat form sent Health Dept. Fire Dept.Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other_ Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by 42 Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works JEC F- x + \A !; IN STALLDVAL- (EKISTINO) F-NVRr-,Y- FIF'FICI rb 3° 1r✓IrJDoW 5L.A8 I EmSTING WINO W I'MMINCY D iR,- Cil Y I A iiovc 1 1 1 : 10 J0-1-s- l4c4D P.T. ?,Iq i r." 51-oii VVIA i +..xw,.e;:;cx✓ .�:w:r. Z �-; : `,'A �-a5.'<"prr,`..�M4�.".':i''r{SN'.1FN�lrr.�.�K �'�:ti.%��.s`v't'�"_I1-^"�..7d..'r�=f'+r:.t`iYriw.y;rs,�yf�,•`''�,,,t}.�'�eF�f.-.:�r."re..Y'� ::i`-. rt_w_ raw;. _..�"siKa�,i`�'-�v.T �-� -3 tCI (oci- s7-OoS 14 q SwF, iia ,124 ,g 3 ., 6_14ldd _ -•� 4 rr t ,124 ,g 3 ., 6_14ldd _ r COUNTY OF BUTTE - DEPARTMENT OF..DEVEL0PME4T SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION' AND PERMIT 95, -3�n' ASSESSOR PARCEL NUMBER 0�. f �7VRnJ5 (� ZONIN BUILDING PERMIT OWNER Hilton Reese TELEPHONE 873-6586 SQ, FT, OCC. BUILDING VALUATION OWNEWS MAILING ADDRESS 14199'Ratine Circle Ma alis CONTRACTOR'S NAME Freedle Electric 307746 TELEPHONE 872-0381 CONTRACTOR'S MAILING ADDRESS 5567 Desante Lane Paradise 95969 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE $ 14199 Racine Circle, Magalia PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF C71, Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel O Utilities ❑ Installation ❑ Other)b ' Add Circuit for 220 Describe Work: PERMIT FEE $ contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 23.00 200A OR LESS Main Service ( 200A TO 1000A ) 46.00 �y NEW CONST. ( DWELLING OCCUP. Sp OR ADONS. & ACC. BLOS. ) 3.50 FT.. NEW CONST. MULTI -OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 _� E;ONTRACTORS LICENSE LAW( I declare under penalty of perjury (check one) El am a licensed under provisions of Chapter 9, Division 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 compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) 14A the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason POW ER APPARATUS ) 8 SINGLE OUTLET Clfl. 20 Ex. Occup. ( OUTLET OR FIXTURES ) BAL. @1.50 Ex. Occup.FIXED APPS. OR (OUWTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 1 23.00 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. Ashall not employ any person in any manner sous to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 43,00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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 against said County iin�n�consequence ' V �off the granting of this permit. q•�X ��6J�. . Date /C) — I,—,y Signature of Applicant -) Owner ❑ Contractor ❑ Agent An 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 $ 43.00 HAZ. I D. FEES IMP I FLOOD COF I PARCEL I PO HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have bee pFaid. `OIREC�OR -0F U�Bi,L,IC WORKS By �► �/ri% n /,;�h+l/f� Date ^' PERMIT EXPIRES ON //1/ JVZ "7"' IDerel ' �� Receipt No. 153205 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PIN -I SPECTOR GOLDENROD -APPLICANT COUNTY, OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION J 7,:ounty Center Drive - Oroville, California 9_5965 - Telephone (916) 538-7541 PERMIT NO. - APPLICATI,ON AND PERMIT=� ASSESSOR PARCEL NUMBER 064-570-005 ZONING RT -1 BUILDING PERMIT OWNER Milton Reese TELEPHONE 873-6586 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 14199 Racine Circle Ma alfa CONTRACTOR'S NAME Freedle Electric 307746 TELEPHONE 872-0381 CONTRACTOR'S MAILING ADDRESS 5567 Desante Lane Paradise 95969 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee S ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE $ 14199 IRqrinp Circle, Magalia PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15,00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF O( Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ElRemodel ❑ Utilities ❑ Installation ❑ Other)Q Describework: Add Circuit for 220 PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS )23.00 200A OR LESS �✓ Main Service ( 200A TO 1000A I 46.00 NEW OCC�� OR ADONS.T ( D ELLINa ACCGBLOSUP I 3.5C F . CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-flEslD. ( BRANCH CIRCUITS I @7.50 ( POWER APPARATUS I & SINGLE OUTLET CIN. Ex. Occup. ( OUTLET OR FIXTURES I @ 100 B20AL. . Ex. Occu FIXED APPLNS. OR p' ( OUTLETS (RESID.) EA. I 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a XCertificate of Consent to Self -insure. I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 43.00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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 against said County in consequence of the granting of this permit. X � uh`�� ( � (J �re7=8 Date 3 Signature of Applicant -:9 Owner ❑ Contractor ❑ Agent An 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 8 ocC CONST. TYPE TOTAL FEES 43.00 HAZ. I D. FEES I IMP FLOOD I I CDF PARCEL PD ND ISSUE 14Z This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions IRECT F BLICS indicated a ve for which fee have be—ate BY PERMIT EXPIRES ON (Dare) provisions to do work d. 9 "f- Receipt No. 153205 Z -' Q . 00 WHITE-D.D.S.-B.O. CANARY -ASSESSOR PIN -I SPECTOR GOLDENROD -APPLICANT .-..-.s,�i,+1'1�.,,Ati�.r14- w�`ryCsr"1Sy`i,f'„y.�•.'..�F'..r t•/7�w�e�*Ty.r"'"�is����l�"'CT�ittik,r'1`"•v."ry,-ly.tC``i,1i...n� �-- r� •'TT. COUNTYOF BUTTE - DEPARTMENTOF DEV,ELgPMENTSER CES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE%ALIIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET OWNER ' C� A. P. o. Proposed Building Use Cf, Building Inspector Date At time =permit cation, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY .items have been submitted . ....................................... . 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Forma ........................................... . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... R. Engineered truss details and layout in duplicate (required prior to plan check). .... Mobilehome data and manufacturer's installation instructions, 2 sets. . 0. Fees of $ an - 00 :................................. !o 3 1 Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer. ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit. .............. . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). . . 20. Pre -inspection for required. .. ;B. clo e4d�T (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ......................... 23. Owner -Builder Verification (Given to owner , Mail to owner,). .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to.a public road. .... . 27. Letter of intent on building use . ........................................ . 28. Mobilehome utility clearance. ................... 29. Documentation of legal access . ....................................... . 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ............................................... ... . 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage p licant%��c.Date �3 Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works a' uERWT NO. 6976-78B 4t PERMIT EXPIRES OWNER M. L. Courtney Malcolm Hall, Magalia CONTR. Mm 64-57-5 (-OCATION (A.P. ) 265 Racine Cir., lot 104, PP#10, Magalia �r F, 5 G i Il i Temp. Poer Pole Called PG&E a 1 Temp. Elea Serv. R" Called PG&E J iJO . Gas Serv. n alled PG&E . f F I N A L E D (Date) (Sign re) t Setback Forms Main Bldg. Footings Stemwa I I Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab . COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTiON'RE-CORD BUILDING BUILDING (Cont'd) Firewall Soil Parapets 1. PLUMBING Restroom Finish 2nd Floor Windows 3rd Floor Siding To out Roof Sheathing Water Piping Roofing Sewer Fdn. Vents Fixtures Garage Vents Insulation Water Htr. Heaters Prov. for ph sically handicaped Conformance of e structure Appliances Gas PipingTest m . Gas Final Sanitation FIR PLACE Final 15P — % uS/ Q ZR, -I Footing I ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door:Closer Final Final MOBILEHOME UTILITIES ------------------.Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OBm� E INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping 5 DATE REMARKS OR CORRECTIONS a 7f (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS + 7 County Center Drive ,,_.,OrctviIIe, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X_ Date o -7 Signature of Permitee or gent Receipt No. ! E q 7 `f White-D.P.W. - Yellow -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 for which fees ha d. DIRECT R OF/PU11LIC WORKS By Iz'�'7P B tlding permit expires Date BUILDING OwnerSQ. ` FT. OCC. BUILDING VALUATI Mailing Address Telephone No. Contractor G'D.C.gJ Mailing Address �� ,L/�Q,� �� e� FireplaceTotal Valuation Telephone No. 3 _ 1 d Permit Fee , 60 ® Building Address �itJ� G/.t2G,L,�,' Plan Checking Fee &/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 ,p Repair drainage or vent piping 1.50 A. P. No. ��'IS 7" �� Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 fomes� Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel eclaration Parcel Map 60' R/W Improv ents Each additional outlet .30 Building sewer 5.00 Bldg. PI s Recd Parcel A royal PI s Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION M UTILITIES ❑ OTHER ❑ Permit Fee $ is da -93-79'111%M- ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family XT Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 NEW OR A.D.S. ( ACCLBLDGSLING CCUP. �) •ZPSgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professi ns Code under the name style o r k11A ! 00 ( 6" / NEW RES,.,CO BRANCH CIRCUITS) NON-RESID. (BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS d NON-RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTURES B L@; Ex. Occup ( FIXED APPLNS. OR • OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No 31-fClassification 31 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I 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 I Workmen's Compensation Insurance. /1 I 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 Land Development Fee is TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X_ Date o -7 Signature of Permitee or gent Receipt No. ! E q 7 `f White-D.P.W. - Yellow -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 for which fees ha d. DIRECT R OF/PU11LIC WORKS By Iz'�'7P B tlding permit expires Date �.. r.. APE•7MIT NO. 5593-78B,P,E,M J /I PERMIT EXPIRES !4 ,/ OWNER M. L. Courtney, Malcolm Hall Magalia CONTR. L, 64-57-5 LOCATION (A.P. ) t 265 Racine Cir., lot 104, PP#10, Maga. Temp. Power Pole Called PG&E Temp. Elea Serv. Called PG&E Temp. Gas Sen '- / Called PG&E F _ / JOB r {{V// FINALED 2� 7 t (Date (Signatur ) a, ,0/ 0 17P T down/ Y/IS- iN % a oaed >c x1l'a Cl e d s;�?�,/J 11/1 r -Cs cG,T % F slip eE ,� rlo ?low /ole 7'�s 31;t 0,,t/ A/e � 0 ew/i:vy FA ,� V (NOTE: An entry must be made on this form each time you visit tie job site.) D, I �rl`-' D/L Com Gfa ��� G4i Lrc Zo //o vs S g V COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ' ' BUILDING INSPECTION RECORD BUILDING BUI DI)NG (Cont'd) PLUMBING `V Setback 6_ Firewall Soil Piping Forms '/g2 - /,e - Parapets 1st Floor `LZ Main Bldg. Restroom Finish 91 it -v-()W"2nd Floor Footings /0—/?- Windows 11-14;- %8' 3rd Floor Siding QM/ To out - Af q09 Slab Roof Sheathing / �/ %7� !tet Water Piping//-//- % Piers 10-1,7- Roofing Sewer Garage Fdn. Vents _ Fixtures Footings /b/Z-' Garage Vents Water Htr. l6 y rj Stemwall 16 - Z- rf ® Insulation No Heaters �----- Slab - / - Prov. for physical y Appliances B Carport handica ed Gas Piping & Test Conformance of ex. Footings structure i Temp. Gas Slab Final Sanitation Patio dIREPLACE Final Footings FootinLECTRICAL Masonry Walls Throat / / ' �' Rough s 1711 AP -1) Reinf. Steel Final fl Fixtures 411117q--4 Q Bond BeaM FIRE SPRINKLERS Motors Framing I I / 761/16 Test > Water Htr. Stucco c� Mesh Final Subpanels MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Coollno Temp. Pole Finish Ducts O Under round, Interior Lath I I Ventilation // 4ti Permanent Door Closer -,A Final 1 w Final MOBILEHOME TILITIES --• Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping WMOBILE140ME INS A ATI • ............ • Support Elec. Continuit A Water Piping Drainage Gas Piping ,R' �`�C} DATE REMARKS OR CORRECTIONS 7 ie,044 � o �.r✓�s � // Ot" � x /xc 7D/4 1i�' (Vo t../ f, /.P 2i// �G o S�e&i GIGS' /0 -/"5r -7,P ,0/ 0 17P T down/ Y/IS- iN % a oaed >c x1l'a Cl e d s;�?�,/J 11/1 r -Cs cG,T % F slip eE ,� rlo ?low /ole 7'�s 31;t 0,,t/ A/e � 0 ew/i:vy FA ,� V (NOTE: An entry must be made on this form each time you visit tie job site.) D, I �rl`-' D/L Com Gfa ��� G4i Lrc Zo //o vs S g V A, bb l� I RES IDENT IAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN ONFORMANCE WITH CURRE ENERGY CONSERVATION REGULATIONS AT i Y 2z C (location) BUILDING PERMIT NO. A;P. NO. 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 Ceiling/Roof /Z- 19' Ducts Circulating Pipes APPROVED HEATER APPROVED WTR.HTR. GLAZING: Single Glazed Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. WEATHERSTRIPPED DRS. BACK DAMPERED FANS INTERMITTENT IGNITION DEV3CES' 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 Nam Signature of (please print) Insulation Applicator State Contractors License No. 3 1� General Contractor/Owner Name c%'-/-- �c (please print) Signature of General Contractor/Owner—,;7Date State Contractors License -No. 3' --/ %r3 THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. r ✓ 9r7aith Y ,.'7Ze jzr�,reeat!ajt - eatime LICENSED HEATING & AIR CONDITIONING CONTRACTOR 10 PEARSON ROAD - PARADISE, CALIFORNIA 95969 PHONE 877.8881 j March 26, 1979 Butte-County Building Department Oroville, California Res Heat Pump clearance under Deck. To whom it may concern, The vertical clearance for a Payne, Carrier or Westinghouse Heat Pump evaporator fan hole in deck must be equal to diameter -of 'fan. blade or deck must be 8'f above unit. Respectfully,. Robert A. Mangrum, Manager RAM/mld COUNTY OF BUTTE — DEt ARTMENT OF PUBLIC WORKS t 7 County Center Drive — Oroville, California 95965 Tel eph,pnf: 53t-4541 APPLICATION AND PERMIT A 71 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X /I Date/001 Signature of Permitee or Agent Receipt No. 17/ -/ lee) - White-D.P.W. - Yellow -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 for which fees have been paid. DIRECTOR OF,,4PUBLIC WORKS By Date v / Building permit expires Date Ay, --g BUILDING OwnerSQ. FT. OCC. BUILDING VALUATI .4L- O f Mailing Address g` Nr X l �% Telephone No. Contractor L Mailing Address - — � Fireplace do, UQ Total Valuation .3 ' ..3 fT�elephoneeNo. Permit Fee Building Addr �,� �T Plan Checking Fee&/or Penalty Permit Fee QO PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 70 O Each TraD 1.50 Z�4A!!t9 �[lficai}ion 9a(j�� Repair drainage or vent piping 1.50 / _P A. P. No. �P S % •, ' _ T- Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F44 S Fire Dept. Fire Zone I Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration '4 60' R/W Im rove ents p Each additional outlet .30 Building sewer 5.00 Bldg. ns Recd Par ,oval 01 Plan Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ �/� �aL Permit Fee $ 17,20 is ELECTRICAL No. @FEE , PERMIT FILING FEE $3.00 3 Ott 800V OR LESS Main service 100 AMP OR LESS CJ 00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( OW E UP. •r'' 20sq ft37,'0 OR ADDNS. AC 5 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 style of: Alm [� t� ��� I NEW CONSTR. MUL I.OUTL T NON.RESID. % BRANCH CIRCUITS 2.50ea dl. A , NEW CONST R. POWER APPARATUS BT NON.RESID. (SINGLE OUTLET CIR.@ Ex. OCCUD(OUTLETS OR FIXTIIRES BpL@e1C4 Ex. Occup. ( FIXED A OUTLETS P(RESID )LNS,REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 G� License No -3!y% 8�i Classification ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ Q $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE I 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 �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 permit is issued I shall not employ any person in any manner ' so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating u Cooling I VLelv, 1 5�_6a Ventilation Hood 2.00 C D 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 $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X /I Date/001 Signature of Permitee or Agent Receipt No. 17/ -/ lee) - White-D.P.W. - Yellow -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 for which fees have been paid. DIRECTOR OF,,4PUBLIC WORKS By Date v / Building permit expires Date Ay, --g r " COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS + k 7 County Center Drive - Oroville, California 95965 Tel epiiont,: 534-4541 APPLICATION AND PERMIT auhrunce representatives or the County of Butte to enter upon the above-mentioned property for inspection purposes. 9b X _ '/r, Date Signature of Permitee or Agent Receipt No. 1�7.� a4 White-D.P.W. - Yellow -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 for which fees have been paid. ,,-MIRECTOR OF PUBLIC WORKS By A�-� - Date /e-3/- 7Y Building permit expires Date fV G -7 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor Mailing Address 3' ,C„r/v1� ��� G' Y Fireplace Total Valuation �,Ll� Tele hN Eone o. Permit Fee Building Address 0, G 2 c� is r' C x ec-w6 Plan Checking Fee &/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE J$3.00 Je�� Each Trap 1.50 j () �Z" I b X1 Repair drainage or vent piping 1.50 _, �.�_ j A. P. NO. �% QT j Zonin &Planning Water piping 1.50 Each gas water heater or vent 1.50 Fksl WO.CC_ I -Sellitati'on I Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking I Plans ParcelEach I Declaration I Parcel Map 60' R/W Improvements additional outlet .30 Building sewer 5.00 Bldg. Plans Rec Parcel A rovol I Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ 4.5-6 $ D0'i ,4M,*fB1 .�6 p e dr�eIsTiwG ELECTRICAL No.1 @ FEE p fes,-�y3 , 7� $ M PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Sin Single Family Duplex Mobil Home 9 y p ❑ ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER. 100 AMP60ov 2500 OR LESS � Main service EA. ADD•L 100 AMP 1.00 NEW CONSDWELING O OR ADONST ( ACCLBLDGS.CCUP. 7i� 20sgft 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 style of: NEW MULTI -OUTLET NON-RESIESID, 1 BRANCH CIRCUITSI 12.50ea NEW CONSTR. POWER APPARATUS a NON -RESID. SINGLE OUTLET CIR. Ex. OCCUO(OUTLETS OR FIXTURES 1 50@250 BAL@1 Ex. QCCU p•FIXED APPLNS. OR (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ 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. l/ I certify that in the performance of the work for which this y�V permit 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 Hood 2.00 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 $ 3 auhrunce representatives or the County of Butte to enter upon the above-mentioned property for inspection purposes. 9b X _ '/r, Date Signature of Permitee or Agent Receipt No. 1�7.� a4 White-D.P.W. - Yellow -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 for which fees have been paid. ,,-MIRECTOR OF PUBLIC WORKS By A�-� - Date /e-3/- 7Y Building permit expires Date fV G -7 i f PERMIT NO. 1818-82B3p,E PERMIT EXPIRES - Ila I I OWNER 0--4L. COURTNEY �{ 14199 Racine Circle CONTR. ASSESSOR PARCEL 64-57-5 LOCATION R & A Bldrs � (Al U V.- Temp. Power Pole_ Called PG&E _ Temp. Elec. Service Called PG&E _ Temp. Gas Service _ Cal led PG�� JOB FINALE[ r Signature . 3 i f PERMIT NO. 1818-82B3p,E PERMIT EXPIRES - Ila I I OWNER 0--4L. COURTNEY �{ 14199 Racine Circle CONTR. ASSESSOR PARCEL 64-57-5 LOCATION R & A Bldrs � (Al U V.- Temp. Power Pole_ Called PG&E _ Temp. Elec. Service Called PG&E _ Temp. Gas Service _ Cal led PG�� JOB FINALE[ r Signature i .. i f PERMIT NO. 1818-82B3p,E PERMIT EXPIRES - Ila I I OWNER 0--4L. COURTNEY �{ 14199 Racine Circle CONTR. ASSESSOR PARCEL 64-57-5 LOCATION R & A Bldrs � (Al U V.- Temp. Power Pole_ Called PG&E _ Temp. Elec. Service Called PG&E _ Temp. Gas Service _ Cal led PG�� JOB FINALE[ r Signature V = OK O = Not OK - = Not Applicable MOBIL EHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) O,.:;xcept # 1. Zoning Requirements -Setbacks -Easements �^ 2.. Soils; Special MH Support -Sketch 2. Footings'; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 4. Wood Awn.; Posts- Beams-Rftrs.-Connec.-Shthg.-Rfg. Bracing__ 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enc.:;>„,es 6. Gas; Location ­Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card - BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 'Card -BI Date _ Date Card -BI Date _ POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances _ 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/0 to Grade -HD Approval 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 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. Health Department Approval 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Card -BI 10. Plumb; Cir. Test -Water Supply Test Date Card -BI Date Card B-1 Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date V = OK ';' 0 - pfat OK _£ Not Applicable SIE Not Ready RESIDENTIAL J'S;ngle and Duplex) Date UNDER OOR Plans OK except hi's Date FRAMI Continued 64,'2o"requirements-Setbacks-Easements ro erty Line irewall & Openings g., Main; Soils-Steel-Elec. Grnd.- / Ftg. Depth 4 xt. Door One 3' -Check Garage-3rdti,story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Fig. Depth idth-Headroom-Rise-Run- Land ing-Fire Protection 4. Fig., Porches & Decks; Soils -Steel- / /'' Ftg. Depth ood on Roof Overhang -Attic Vents -Rafter Outriggers Stemwalls, Main; Steel- Blockouts-Wrapped-fil,�iding-Ndiling-Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab sh-Drip Screed-Fdn. Vents-Underfir. Access 7. rs-Fireplace Ftg.-Steel Area -Glass Protection -Skylights -Plastic D.W.V.: ,ia11_way C/O -Se est 55.--6hear4le44s ailing -Bolts 9. Pipe; Size -Anchors 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 Card -BI Date and -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date` Card -BI Date Date FIVA Plans) OK except q's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 5 Ext. Steps -Door & Sidelight Protection -Landings &7 Smnkp neleca,,. ent-Access-Combustion Air Watw-Pipe; Test & Anchors -Nail Protection 58. Euuuwe Vents -Clearance -Comb. Air-Connector- In Garage; Above Floor-Ducts-Mech. Protection 16!6.W .; Test Flings & Anchors -Nail Protection 58.-8edrgr­Exiti ng 1 First Floor -Tub Access 60. 1§e.r._1,8rtath Fixtures & Tub Access Test Tub & Shower, 2nd Floor -Tub Access' 61.4-rec. Trim & Subpanel; Breaker Sizes -Labels _ & Anchors tairs_e�kails 63. 4'rrjpI,,fce or Stove; Clearances -Hearth 6 ec. Outlets at Wood Panel; Int. & Ext. Card -BI Date and -BI Date _ _ 6 ppliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date e s eceptacles at Kit. Counter Date ELECTRICAL Permit OK except N's 6 ire Door; Swing -Landing -Closer 68.. . uct in Garage -Damper Fixt & Transformer Clearance -Ins. Protection 69. Wtr. H ce-Comb. Air-Connector-P.R.V.- I rage; Above Floor-Mech, Protection 2 ec. R cep Spacing -Lights &Switches at Doors 2 xes & No. No. of Conductors -Stapled 70. Ib., Elec. & Mech. Equip. Listed for Location ees in Garage; (G.F.I.)-Romex Protec. 2 om nstalled Close to Edge of Studs & C.J. quip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72• Insulation - - ooked in Attic 12rs 2 A &Conductor Size 73.-fnaW-Raits & Deck Construction -Post Caps - 26 ire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74.- nts & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked un r Floor ❑ Yes 2 ga. or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Fd'?Niwjag instld.: ve ❑ Yes ❑ No; Walks [:1 Yes ❑ No; Planters Yes 0 N & Ground -Main Disconnect co; roJn-Finish 2 ances; Pa Is-Motors-Mech. Equip. ; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet oset Light -Shower Light 7 ents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 9. isconnect, Electrical, Plumbing 80. terior Elec. Trim; G.F.I. Receptacle -Underground Card B- Date Card -BI Date 81 roughout House Card B -I Date Card -BI Date ass Protection Date M HANICAL (Perrr.it) OK except N's , _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 1. A.C. Ducts; Insulation & Support er & Sewer Connected -C/0 to Grade -HD Approval _ 32. Vent Fan; Exhaust above Insulation orgy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade _ 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Card -BI a -BI Date Date Card -BI Date --------- Card -BI _ Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Z - 0 Card -BI Date Date FRA G(Plans) OK except q's Comments at Final: Proper Material & Anchors - _ __-- IIs Studs -Nailing, Spacing & Bracing -Plates -Sound p6aring Walls over Girders & floor Nailing _ . Draft Stop n Walls (rat ) vw�z _ / _ o s;Fur d ilio s -Stairs -Chases -Tub 41. eader & Bea -Size Bearing 4Zs-ler "--Pest -Anchors-Connectors -t 4 Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 44. Fireplace Ties or Type A Flue -Fireplace Throat oa - PrR1C7teeess- Size &_ Romex Protection -Draft Stop -Ins. Baffles _ _ ndows or Exiting Doors -Sill Hgt. & Dimensions rage Protection Framing (NOTE: Anentry must be made each time you visit job site) _ COUNTY OF BUTTE A, DEPARTMENT OF PUBLIC WORKS 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 ADD SS 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. a 'I COUNTY OF BUTTE •DEPARTMENT OF PUBLIC WORKS 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 CORRECTIO OTICE BUILDING ORP 0PERTY 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 correctitionn. ork is completed. If you have any question pertaining to this mayiflrf oyhe�fJ additional explanation, please contact this office immediately. Inspector + -�'! Date_ % �.� UNIFORM BUILDING CODE, 1973 EDITION - Loose Leaf $16.00 - 1976 Edition - Loose Leaf $22.00 Soft Cover $14.00 Soft Cover $19.80 or DWELLING HOUSE CONSTRUCTION PAMPHLET, 1973 Edition 1976 Edition - $3.30 per copy $2.75 per copy Send to: International Conference of Building Officials 5360 South Workman Mill Road Whittier, CA. 90601 - UNIFORM MECHANICAL CODE, 1973 Edition - $8.00 per copy 1976 Edition - $10.80 per copy Send to: International Conference of Building Officials 5360 South Workman Mill Road Whittier, CA. 90601 or same address as shown for Uniform Plumbing Code UNIFORM PLUMBING CODE, 1973 Edition - $8.00 per copy 1976 Edition - Loose Leaf $12.30 Send to: International Association of Plumbing & Mechanical Officials Soft Cover $10.80 5082 Alhambra Avenue Los Angeles, CA. 90032 or same address as shown for Uniform Building Code NATIONAL ELECTRICAL CODE, 1975 Edition - $5.50 per copy Send to: Stacey's Technical Store, 581 Market Street, San Francisco, CA. 94104 or National Fire Protection Association, 470 Atlantic Avenue, Boston, Mass. 02210 1978 Edition available for $6.25 per copy at: International Conference of Building Officials 5360 South Workman Mill Road, Whittier, CA. 90601 Y COUNTY OF BUTTE , DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phoney 534-4541 t Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 COR CTION 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 co t t this office immediately. i qL M ".A vn A , __ _ / �iiar —:= Inspector Date F0_3D_ c _Zf uwi I CL,.if�sPehlre- E N E R G Y'%C E-B�T IF ICAT ION 0,41a,4 ls-& P/ n/E S _ eL iV � /0 J_ v /O it (o LOCATION f,ejC/ q cJ /1j 4 (r fJ c t'4 /a ye/,vE CT//e 1 A:. P. No. OoJ' o 0 DESCRIPTION OF INSULATION ` ROOF Material 2: -? ' Brand Name Thickness(inches) i= S Thermal Resistance (R Value) ,� -Z EXTERIOR WALL Material f�irir� Thickness(inches) CEILING Brand Name �2 Thermal Resistance (R,Value _'& -`�/ Batt or Blanket Type.' Brand Name ,@ Thickness(inches) 8 Thermal Resistance(R Value) Loose Fill Type Brand Name Minimum Thickness(Inches)Number of Bags wt./ per ba'g lb. Area covered(ft.2) _ Thermal Resistance(RiValue) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material ly,¢ Thickness(inches) Width(inches) FOUNDATION WALL Material Ay 14Z _ Thickness(inches) S _ Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R'Value) Brand Name Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building in conformance with the State of California Energy Requirements. -09 FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. SIG E OF INSTALLATION APPLICATOR DATE I hereby certify the above insulation and all required items..as shown on the Building Department approved plans and attachments have been installed .as required by the State of California Energy Requirements. All equipment,.devices and materials are of the quality prescribed or are specifically approved by the State of California. FIRM 04JNER(.lease pr'nt) STATE CONTRACTOR'S LICENSE N0. SIG RE OF GENERAL CONTRACTOR/OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SNAIL BE POSTED WITHIN THE BUILDING. January 1984 (-Il r i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ERMIT NO. 7 County Center Drive - Oroville, Calijgrnia 9+365 - Telephone 916/534-4541 �� -- �� i r APPLICATION AND PERMIT _A ASSES6g PAS L UMBER (.( ZONING BUILDING PERMIT OWN;U-15 O WNE TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONT CT R'S AME ELEPHONE 2/ COR CT R'S M ING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee 9,3"40+. ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRIESS If Permit fee Zr W BUILDING ADD E 11 II—�' - PLUMBING PERMIT FiIingFee 10.00 Each Trap 2.00 ,0 Repair drainage or vent piping 5.00 I Water piping TO LOT NO. p !I SUBDIVISION NAME I VTARCEL MAP ['J3k-11 Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE �� SF L7 Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer ^, Lawn sprinkler system 5.00 � TYPE OF WORK New El,—, Addition L� Remodel ❑ Utilities ❑ Installaion❑ Other ❑ Describe work:—.11 U Rwm^ B 3 p h� V Permit Fee $ i Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (DWELLI •@� OR ADDNS. ACC. B - 2 qft CONTRACTORS LICENSE LAW I declare der penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code an license is in full fo a 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason R BRANCH cTLE ITs 2.50 ea NEW CO IDRF NEw CON ST . POWER APPARATUS 6\ . . NON- R RESID, (SINGLE OUTLET CIR, / 50@250 Ex. Occup OUTLETS OR FIXTURES BAL@1 00 (FIXED APP LNS. OR Ex. Occup. OUTLETS. (RESID•) EA.1 2.00 . Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit 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 Ii ies, judgments, costs expe ses which may in any way accrue ag st sa C my in copse of th granting of this permit. %� Date Sign re of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excav tions over 5'0" deep and demol' ion or construct- ion of structures over 3%stories in heig 't. Mobile Home Installation Fee $ TOTAL PERMIT FEE (p, , OCCUP, GROUP , 3 TYP of CONST '– PARCEL PD D ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. ry �• /� WHITE-D.P.W., YELLOW -ASSESSOR, PIN -INSPECTOR,LDEN ROD-.PPLI ANT OWNER %4 (` •.✓ wZr.:n r7.. ", .,`�,i.'�'"'-��-�`.. ..--`ra-r, - �'7's.c . A+. y(; s .. :moi' . COUNTY.OF BUTTE - DEPARTMENT OF'PUBL'IC WORKS - BUILDING DIVISION. - 7 COUNTY CENTER DRIVE..- OROVILLE,,CA4tAIF_O�it1A_ 95965 - TELEPHONE: 916/534�541 PERMIT APPI-ICATIOfV DATA SHEET Permit No. A. P. No. `'T ,D�-r Proposed Building Use Permit Fee Based Upon Building Inspector Complete Contract Price LDPW Valuation )th r Explain) p, Date At time of permit application, I was advised the following data must be submitted prior to permit processing andand/arice: DATE RECEIVED APPROVED . All items have been submitted. . . . . . . . . . . 2. Plot plans in duplicate./triplicate. . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . , 4. Complete engineered plans and calcs. . . . . . . . .� 5. Plans with Energy Design Compliance Statement. .. . . . . 6. State Energy Forms No. 7 -Statement of I5ent for Non -Heated and AC Buildings. _114018 Fees of $ A'/G ze— . . . . . •. 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. ., 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . Pre-Inspec. requ. . t to es 17. Pre -Inspection for Required. Building Inspector 18. Other _ (Date) When you issue the permit, process as follows: Mail to owner. A:fMail to contractor. , Telephone and hold for pickup at office. Deliver w/inspector."' Other Applicant A&__ rn-��5/.Y��Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be ubmitted prior to permit issuance. (For required items not checked above at ti application, circle item.) 1. Index permit for above Items No. 2. Additional items required: ontractor esigner, Owner) was advised of above required data by Telephone Mail Other Plans Plans Other Copy—DPW I/I To: Building Department From: Environmental Health Subject: -Sanitation Clearance C� - U11 ✓ Owner *%"?'_.r �C(we (21 V- �o Cf 52 S Location AP � cf - Plans approved for: Sewage Disposal' _ Water Supply• Hold final for: Water Supply Final Clearance O.K. for: Water Supply - Clearance for bedroom mobile home. Other 1 Clearance for addition of %� X.1 4 Q v'` � "� ��'' ��uOn Dy Note" Sanitarian Date J; I