HomeMy WebLinkAbout066-400-01166-40-11
ROY TRU ITT /42� K�z
13741 -South Sugar Pine Rd, /agalia
Contr: Golden Empir6Const, CItrus Hts-
Permitj#253-82B(repair storm damage/SF)
t 066-400-011 .93-0053P , M .
.SMITH, Dan CONTR: Franks Refrid.
13741 Sugar Pine, Magalia t
(sf/.new 'forced air furn.) r'' 1171f /i
066-400-011 04-1478
SMITH, DANIEL
13741 SUGAR PINE DR, MAGALIA
Cont: N/A
DETACHED GARAGE
OS
nrf-.zeal-f�! 1 04-33-41
SMITH, DANI.E'1-
1 ?741 SUGAR PINE DR, MAG
Cent: MrOLFE ELECTRIC ��
1:1.FC K-, CHANGE ,�
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NOTES RESIDENTIAL
066-400-011 X04--1478
SMITH, DANIEL
13741 SUGAR PINE DR, MAGALIA
Cont: N/A
DETACHED GARAGE
i
f
SPECIAL CONDITIONS
CHECKED
BY
SRA
r 1 FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
' SPECIAL INSPECTION ITEMS
VERIFY
}! USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
♦
r JOB FINALED (Date) Ik /10�
Si ature
V= OK
0 = Not OK
- = Not Applicable MOBILE HOMES
= Not Ready
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O -Concrete
LOL
Date DECKS, COVERSA-ARPORJrS GARAGES (Plofis) OK except #'s
j 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
&.,Woo Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Frg-Bracing
,.,5.-Afam"AWt1.; Columns -Connections -Splice -Decal -Enclosures
Za►earptTf's Wirlows opors-
r7 lectric
1. ; Sills-Ahchors-Studs-Rftrs-Trusses
1g-�&i�Nailing-Veneer-Stucco-Mesh
110_ , S g --Roofing
1 . ; Steps -Doors -Landings
12►13raeed-Wall Panels
Date
Date
4.
Water; Location -Test -Easement Needed (Sketch)
FINAL (Plans) OK except #'s
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
2.
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / /"L"ft./ PLPG
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
7.
Well Clearance & Disconnect
5.
8.
Utility Clearance
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 -Pane lboards-Ins. to Main in Conduit
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
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 Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
12.
Permanent Foundation Only; License Decal
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
LOL
Date DECKS, COVERSA-ARPORJrS GARAGES (Plofis) OK except #'s
j 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
&.,Woo Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Frg-Bracing
,.,5.-Afam"AWt1.; Columns -Connections -Splice -Decal -Enclosures
Za►earptTf's Wirlows opors-
r7 lectric
1. ; Sills-Ahchors-Studs-Rftrs-Trusses
1g-�&i�Nailing-Veneer-Stucco-Mesh
110_ , S g --Roofing
1 . ; Steps -Doors -Landings
12►13raeed-Wall Panels
Date
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-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 -Pane lboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
V = OK
0 = Not OK
- = Not Applicable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date
Underfloor (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main, Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ P' 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 -Anchors -Regulator -Service Test
12.
Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15.
Access & Ventilation
16.
Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17.
Water Htr.; Vent -Access -Combustion Air Battle
18.
Water Pipe; Test & Anchor -Nail Protection
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
69.
Stairs & Rails
Date
70.
Card B-1 Date Card B-1
Date
71.
Card B -t Date Card B-1
Date
72.
ELECTRICAL (Permit) OK except #'s
23.
Fixture & Transformer Clearance -Ins. Protection
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
25.
Size Boxes & No. of Conductors Stapled
26.
Romex Installed Close to Edge of Studs & C.J.
27.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or At
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral ❑ Yes ❑ No
31.
Service -Riser Conductors & Ground Main Disconnect
32.
Equip. Clearances Panels-Motors-Mech. Equip.
33.
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
84.
A.C. Unit Disconnect, Electrical -Plumbing
Date
85.
Card B-1 Date Card B-1
Date
86.
Card B-1 Date Card B-1
Date
87.
MECHANICAL (Permit) OK except #'s
35.
A.C. Ducts Insulation & Support
36.
Vent Fan, Exhaust above insulation
37.
Condensate Drain & Overflow, Size & Grade
38.
Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet
39.
Attic Access & Platform if Furnace in Attic
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
40.
Sills Proper Materials & Anchors
41.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
42.
Bearing Walls over Girders & Floor Nailing
43.
Draft Stop in Walls (rat proof)
44.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45.
Headers & Beams -Size & Bearing
Date
FRAMING 6Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties-Purlin-Roff Brac.-Truss-Shting.-Ring.
48.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Battles
50.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58.
Glazing Area -Glass Protection -Skylights -Plastic
59.
Shear Walls; Nailing -Bolts
60.
Brace Interior/Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext. Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
66.
Bedroom Exiting
67.
G.F.I. & Bath Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70.
Fireplace or Stove, Clearance -Hearth
71.
Elec. Outlets at Wood Panel, Int. & Ext.
72.
Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance
73.
Elec. Outlets & Receptacles at Kit. Counter
74.
Garage Fire Door; Swing -Landing -Closure
75.
A.C. Duct in Garage -Damper
76.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
77.
Plb., Elec. & Mech. Equip. Listed for Location
78.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
79.
Insulation -Foam -Looked in Attic
80.
Guard Rails & Deck Construction -Post Caps
81.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
82.
Following Instld./Drive J Yes J No/Walks J Yes J No/Planters J Yes J No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical -Plumbing
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throughout House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92.
Water & Sewer Connected -C/O to Grade -HD Approval
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date b
Date
Card K1 Date Card B-1
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
DEPARTMENT -OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE M (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netldds
PERMIT NO.
BP041478
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' 08/05/2004 APN• 066-400-011-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 13741 SUGAR PINE DR MAG
Date: Contractor:
Map Index:
GAR(768)
'
OWNER -BUILDER DECLARATIONDeSCrlptlon'
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason'r(Sec. 7031.5
Business and Professions Code: Any city or county, which requires a
Owner: SMITH DANIEL JOSEPH
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
13741 SUGARPINE
signed statement that he or she is licensed pursuant to the provisions of
MAGALIA CA
the Contractor's State License Law (Chapter 9 commencing with Section
,
7000) of Division 3 of the Business and Professions Code) or that he or
95954
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
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
Applicant: SMITH DANIEL JOSEPH
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
13741 SUGARPINE
such work himself or herself or through his or her own employees,
MAGALIA, CA
provided that such improvements are not intended or offered for
95954
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have tie 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
Contractor:•
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' State License Law.).
❑ 1 am Exempt under Article 3 of the B and Professions Code
�iness
Date: Owner:
License #:
WORKERS' COMPE ATION DECLARATION •
I hereby affirm under penalty of perjury one of the followin4eclarations:
❑ 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
Architect:
is issued.
Engineer:
❑ 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:
Carver:
Total Square Ft: 768 S. F.
Policy#:
Valuation: $18,432.00
Census Code:
C�27 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'
compensation provisions of Section 3700 of the Labor'Code, I shall
forthwith comply with those provisions.
Date: O -
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
damages for in Section 3706 the Labor
((
compensation, as provided of
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is here y issued under the applicable provisions of the Butte County Code ?nrvor
I hereby affirm that there is a construction lending agency for the
Resolutions to do ftirk indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
�M— 8 • V ' 4
Name:
BY / • ate:
PERMIT EX44 ON: ' O�
Address:
Da te
(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 alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: DAJi L:1 Signature: Z6���
Date: l I
�Qwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
is
j�3v1 q. 5 0
BUTTE COUNTY
' DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
OWNER
Name i k L C —1-K
Address ty S - NL
City L U
State
Zip
Phone -31 W
Fax
E-mail
APPLI ANT SIGNATURE
X
For office use only:
CONTRACTOR
Name
Al
Address
City
I Yes
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
Lic. #
Class 71
APPLI ANT SIGNATURE
X
For office use only:
ARCHITECT/ENGINEER
Name
Address
City
I Yes
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
State License Number
APPLI ANT SIGNATURE
X
For office use only:
APPLICANT NAME
Name
Address
City
I Yes
State
Zip
Phone
Type Const.
Fax
E-mail
Map Book
APPLI ANT SIGNATURE
X
For office use only:
Zoning
Flood Zone
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
oil _ lq��
BP
BIN #
LOCATION
Property Address _5 Oil
N �
Cross Street LA b
WORKER'S COMPENSATION
Policy Number
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:
Sq. Footage
❑ 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 fee will be
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.
Received by: mount: 2_7 -I ' �Y'Bldg
SRA
Receipt #: r 7 �� Sheriff
A4 2 c) -2,z .9S SMTP
8r5�oq-
Date: = �i.[ -(�1.� /J Other
Total
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 4-30-04
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!)..
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ a6 Sanitation and site plan approval from the Environmental Health Department.
❑ 7=: 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation (if required).
❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Statement of Intent for Non -heated and A/C (if required).
❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
❑ 9. Letter of intent.
❑ 10. Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2
REV 4-30-04
2T i
'f
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 Gounty Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER:Sm ��"' 1 ASSESSOR PARCEL NU R 0 ' '1 OD
Proposed Building Use: Counter Technician: Date: �' 2`"t0 L/
It required in order to apply for a permit. All boxes MUST be checked OR marked NA in order o apply.
�/ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
'� .
2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
-O' 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and.signed calculations.
VA 4. Engineered truss details and layouts in duplicate. No faxes!
..a 5. Letter from Engineer or Architect for truss design review.
.®- 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate. .
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate
❑ 11. Site plan and business license approval from the City of Biggs
❑_ 12. Letter of intent for non-residential buildings
.9N 13. Detached Accessory Building Form filled out by the owner
❑ 14. Hazardous Material Form
15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. Ir
O 16. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 17. Fire Sprinklers............................................................................................
❑ 18. Agricultural Buffer clr and,site,plan apr from the Ag Commissioner Sent by
❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........
20. Erosion Control Plan Required.............`.......................................................... ........
21. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
iV22. City of Chico Plumbing"permit................................ ................
23. California Department of Forestry plan approva paid. Sent by: 5
24. Planning approval (A) Use: &(B)Parking: (C) Parcel Check: -a P
25. Contact Land Development about _ Improvements, _ Drainage .........................
26. NPDES Form.............................................................................................
27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Pre -Inspection for required.......
❑ 29. Contractor's license information. (Number, Name Style, Classification) ...................
0 30. Worker's Compensation Carrier and Policy Number ..........................................
31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
❑ 32. Letter of Signature authorization ...................................... :.............................
❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................ •................
El 34. Manufactured home utility clearance ................ :............................ ..............................................
❑ 35. Existing violations and/or expired permits..........'..............................................
❑ 36. Deed Res6iction..........................................................................................
i/ 37. ❑ Grant Deed, ❑ M.H. Title/Aatement of Facts, ❑ Letter from Legal Owner, ❑.Check to H.C.D. $
38. Other: %� rd S c } (-u►r GIS Sf SSo2S_ �kri►�o C%um
❑ 39. Other: e .
When issued Telephone and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: Date:
SO- V//
1. Index permit application or the b e : Plan Ch ck Letter
2. Additional items r
Contractor, design , owner, as a . e of thea ata b one, mail, ❑ counter, by qffia Date:
Contractor, designe , was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: _Date: Plans approved by: Date
Structural reviewed by: Date: tructural approved by: Date:
Note transfer by: Date:
V041 f Yellow: Building Division
E.H. USE ONLY
z Rol Plan AttecMd /
Floor Mn Anactiod \
Qam to G.D. •!
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
� Sno� �l
Owner o�ation AP#
Plan Approved for: Se osal Water Supply: Public Private Well
Clearance for _„d ellipg. Other
Hold final for:
Final clearance O.K. for:
NOTE:
8/96
M0,
I COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541
SCHEDULE OF RECEIPT OF FEES
OWNER 1111 �/) BVI A.P. #A � - Q00-0
PROPROS -D BUILDING USE,L?.t-J U' � DATE 6'Z�
RECEIPT # DATE REC.
1. BUILDING PERMIT FEES
--- Balance Due ..................... $ I I
--- Additional Fees Due........... $
--- Revised Plan Checking Fee.... $
2. SCHOOL DISTRICT FEES
(paid at School District Office) (form available after Plan Check)
3. SHERIFF FEES (paid at Building Division)
Residential............ X $360.00 =$ _
Units
Commercial (sq. ftg.)..... X $0.03 = $ _
Sq.Ftg.
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit)..... X —=$
_
# Units Amt.
Commercial (Sq. Ftg.).... X = $
Sq. Fig. Amt.
5. RECREATION DISTRICT FEES
(paid at Recreation District Office) (form available after Plan Check)
6. THERMALITO DRAINAGE DISTRICT FEES
510.00 (paid at Building Division)
7. SRA FIRE INSPECTION AND PLAN CHECK FEE
IS" (paid at Building Division)
I 5'2 -9 b
8. WATER TENDER FEES BATTALION #
$200.00 (paid at Building Division)
9. NORTH CHICO SPECIFIC PLAN (paid at Building Division)
Residential Zone X_=$
Zone # Units Amt.
Commercial (sq. ftg.) ......... X = $
Sq. Ftg. Amt.
10. OTHER
u0`1-Lq 5-�q-L�,_/
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed durine the elan checkins process.
APPLICANT
DATE
Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You
have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a
protest are specified in Government Code Section 66020(a). -
Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003)
O.B.- I
OWNER-BTJII.,DER VERIFICATION
Attention Property Owner.
An "owner-buildee' 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
I personally plan to provide th or labor and materials for construction of the proposed
property ovement : YES NO 1
2. I SAVE HAVE NOT 13 signed an application for a building permit for the proposed work.
. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS: CITY:
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
SIGTNED:
PROPERTYOWNER.:
NOTE: This Owner -Builder Venfication is required by Section 19831 and 19832 of the
California Health and Safety Code. This verykAul on must be completed and
returned to our ofjke before we are permitted to issue the permit.
OVER
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 of record on such
a permit Building permits are not required to fie signed by property owners unless they are personally performing their
own work If your work is being pmlbr red by someone other than yourself, you may protect yourself from possible
liability if that person applies far 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
Homme from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own wow 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 famrly, and the work (Including materials
and other costs) is 1300 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then yon may be an employer.
♦ 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,
woticers competetion insurance, disability inw ance costs, grid unemployment compensation coniributions.
♦ TbM may be financial risks for you if yon do not carry out dme, obligations, and these risks are especially serious
with respect to wor'icer's compensation insurance.
♦ For more specific infinmation about your obligations under Federal Law, contract the Kemal Revenne Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Dept of Benefit Payments and the Division of Industrial Accidents.
If file stivcdre is intended for sale, property owners who are not licensed contractors are allowed to per their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be cofactors is to secure an "owner builder" building
per, eaonWWIY imps that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
In€armatioa about licensed contractors may be obtained by contracting the Contmctors State License Board in your
commtmity 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 confirm did you
are aware of fl= matters. The budding permit will not be issued until the verification is returned.
ffear,P&WOld
CV' ira, CB.O.
ing Inspection
NOTE= 77W Own— Bur7der f.Pr, fornrmfon is requfred by Section 19830 ofice Cafifornk Health and Safety Code
OVER
Jan 28 04 08:40a
p.2
Department of Development Services
Building Division
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 (530) 538-2140 FAX
DETACHED ACCESSORY BUILDING
OWNER'S STATEMENT OF USE
Plan review will not be started until this form is completed, signed by the property owner, and
returned to the Butte County Building Division. Attached Accessory Buildings and Additions
will be checked for residential use. Exception: Garages and Carports.
Owner: 2 t L C- ,� SPA Phone: � 7 3 7 q
Mailing Address�R-
`� f
Site Address: UGA RL t� �
Assessor's Parcel Number: Deo '— — 01 J Zone:
Please answer questions 1-16, and ecplain any yes answers for questions 2-14 in the space provided on page 2 of
this form
GENERAL WFORNLATION:
1. Is there a primary dwelling on the property?
Yes G -No ❑
2. • Is the structure already built, under construction, or under notice of code violation?
Yes [] No 9-11
3. Will items produced in this building be offered for sale?
Yes ❑ No
4. Will the public have access to this building?
Yes ❑ No
5. Will any advertising. on or off site, be associated with the use of this building?
Yes ❑ No Q --
SITE CONDITIONS:
6. Is the structure foundation within 5' of septic tank or 10' of leach lines?
Yes ❑ No
7. Is any portion of the structure located closer than 20' to your front property line?
Yes ❑ No
S. Do you plan to add a driveway or modify existing access to a county maintained road?
Yes ❑ No Q,-
9. Will the proposed structure encroach within any recorded easement?
Yes ❑ No E;-
;CONSTRUCTION
CONSTRUCTIONFEATURES:
10. Will this building have insulated floor, walls, or ceiling?
Yes ❑ No 0-
11. Will this building be heated or cooled?
Yes ❑ No G�-
12. Will this building have a water closet/toilet?
Yes ❑ No 9-
13. Will this building have a sink?
Yes ❑ No E'
14. Will this building have a water heater?
Yes ❑ No 9-
15. What type of floor covering gill the building have?
16. What type of wall covering will the building have? S )r �t ;-J
OVER
1 of
Jan 28 04 08:41a
p. 3.
PROPOSED USE: (check only one box)
1. ❑ Residential Storage Shed — I will be storing in this building and it will
not be ed for any other purpose (no bathroom and no heating or cooling).
2. rivate Garage — "A building or a portion of a building not more that 1,000 square feet (3,000 by
exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are
stored or kept." A garage door is reouired..
3. ❑ Residential Carport — A covered structure intended for parking of vehicles. Two or more sides must be
entirety open.
4. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport
If you checked #4, please check the uses below which best fit this building.
❑ GuestHouse ❑ Pool House. ❑ Studio Apartment ❑ In-law quarters
❑ Recreation Room ❑ Game Room ❑ Study ❑ Library
❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio
❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Sewing Roam
❑ Canning Kitcben ❑ Music Room ❑ Family Room ❑ Sun Room
❑ Private Office ❑ Workshop' ❑ Home Occupancy 2 ❑ Other—Use=
I. Describe type or Wat"
&brat be spptoved by the Bu- Cetuay planning Division
Explanations: This area is for explanation of any "yes" answers on questions 2-14. Please indicate the question
number before the explanation.
Additional Information:
Plan review will not be started until this fom is completed and received. A Plans Examiner will contact the
owner with specific requirements per the use indicated.
I hearty affirm under penalty of pequry that the above information is true and correct. I understand that any changes
to the use, or character of use, of this building will require permits from the permitting authority. I understand that
Real Estate Disclosure laws require disclosure of this information if or when the property is offered for sale.
Owner's Name: Please Print
Owner's Signature: Date:
2 of 2
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
PERMIT NO.
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
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Date: Contractor.
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
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
�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
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
pursuant to the Contractors' State Licens Law.).
❑ lam xem t rider Article 3 of the Busi ss d Prof so ns Code
Date: wrier:
WO KERS' COMPENSA ION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ 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:
Carrier:
Policy :
-the
I certify that in the performance of 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'
compensation rovisions of Section 3700 of the Labor Code, I shall
forthwith co I with th isprovisi
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
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutions to do work indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
BY Date:
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 alter the substance of any offi ial form or document of Butte County. I hereby
authorize representatives of Butte County to enter ugon the above mentioned property for inspection purposes.
Print Name: Signature:
Date: KIAAllo
❑
caner ❑ Contractor ❑ Agent for Owner Agent for Contractor
Department
J. Michael Crump, Director
Public
f B u t
Works
LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI
Project Description:-�L�=Z--�
Project Location and/or Parcel Number:
L
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit
from the State of California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Signed:
Title:
Date:
U
Less than 1 Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program
Revised 5/12/04
w
SITE PLAN REVIEW APPLICATION
Date: 0L1 AP# goc) _ of I
Permit Number (if applicable) Q I '1 % 7?
APPLICANT INFORMATION Parcel Size: ,
Owners Name: L��i�heX
Owners Address: �! �yy' Com' "''� U C4+ ` S
Telephone No.: D/Y !37 7`7
Situs Address:
/�—
Proposed Use:
Residential
❑ New Single Family Residential
❑ Single Family Addition ❑ Single Family Remodel
❑ Mobile Home
M Residential Accessory 0,�,fa �o(j
Permanent Second Dwelli
❑ g
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Septic
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
❑ Commercial Remodel
❑ Industrial Remodel
❑ Well
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
❑ Site Plan Stamped Approved
By04 Date 71,2q LOL�
AarrP 1 of G
R
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Snow Load Area:
❑Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
F] Nitrate
Action Plan (See Environmental Health for standards)
Watershed Protection Overlay Zone (See attached standards and requirements)
Expansive Soils (Test for expansive soils and if verified proper foundation design required)
(� SRA - (CDF to determine specific requirements)
100 -Year Flood Plain: (See attached)
• Flood Zone: )
• Flood Panel No.: (��0�%C (jtf DSC✓ Index Date:
❑ Sacramento River Reclamation District (Approval must be obtained from the Calif rnia Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit
❑ Administrative Permit
❑ Minor Variance ❑ Variance
-------------------------------------------------------------------------------------
-----------------------
❑ Detached Building Use Form ❑ Encroachment Permit
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning:
Applicable Building Setbacks:
Front
Zoning Code
90
Streets & Highways
Fire Prevention
Subdivision Map
Side
s
Side Street
Rear
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Pana I n•F C
Applicable Development Fees:
Standard Fees
❑ Fire
❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Impact
❑ Other
--------------------------------------
Subdivision Map Special Fees
❑
Water Tender
❑
Road Improvement
❑
North Oroville Area
❑
Other (per map)
Amount Formula
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
Parcel Created By
❑ Deeds:
Date of Creation: Legal Access Provided:, ❑ No
Deed of Reference: Legal Access Required ❑ No
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation: F-1 No ❑ Yes
Comments: fhvtR o al ,e a, Af-i Irl D�a� ( 00011)NN P,a;1iAA,- -("A
❑ Yes
❑ Yes
A] Parcel Deemed to be legal
❑ Verify Legal Parcel '❑ Verify Legal Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
JO Subdivision Map/Parcel Mai:
Map Date of Recording:
Lot:
Book: Page: 3 78-14-4
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
Parcel Map/Subdivision Map/Use Permit Conditions
❑ Comply with the following Conditions of Approval:
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified ' professional and be
submitted to and approved by the Department of Public Works.
❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate
Battalion Water Tender Fund may be required.
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development.. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
❑ Property owners responsible for roa
0
u
n___ a _re'
Summary of Specific Requirements:
This information provided in this summary is based on the application information and on the best available data at the time
of review.
CALarrysTuildina Pennit Site Plan Reviewl.doc
Paaa S of S
J
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.net\dds
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally 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 : —/�_ License Number: Z 7
Date: 11 -ZZ --0'1 Contractor: &T i -7'rZ/ t
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
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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
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
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Cl I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
yG I 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 ip issued. My workers' compensation
insurance carrier and policy number are:
Carrier: /
Policy M. /jam
O 1 certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to 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.
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
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
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.)
PERMIT NO.
BP043341
Issued Date: 11/22/2004 APN: 066-400-011-000
Site Address: 13741 SUGAR PINE DR MAG
Map Index:
Description: ELE SER CHANGE/SF
Owner: SMITH DANIEL JOSEPH
13741 SUGARPINE
MAGALIA, CA
95954
Applicant: WOLFE ELECTRIC
1300 PARK AVE
CHICO, CA 9928
(530) 345-2800
Contractor: WOLFE ELECTRIC
1300 PARK AVE
CHICO, CA 9928
(530) 345-2800
j License #: 844427
1 ... =
Architect:
Engineer:
Total Square Ft:
Valuation -
Census Code:
OFFICE PY n
2,� I ���✓
Address 1yu
�� ,�--
GAS
Meter BDate
ELEC R (
Meter By Date
+41
41-A J
14
This permit is hereby issued under the applicable provisions of the Butte CouNy :oda an(Vor`"--
Res�ntork :Wr which fees have been paid. l
g .I I Date:
PERMIT EXPIRES ON: II C9
Address: I (D e)
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the Califomia Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
O 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 any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes
Print Name:- Signature
Date: �-zZ
❑ Owner Contractor ❑ Agent for Owner
❑ 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 FAM (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP043341
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of pedury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 11/22/2004 APN: 066-400-011-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : �;—�� License Number: Z 7
Site Address: 13741 SUGAR PINE DR MAG
Date: -ZZ-o Contractor. 4UI6k
Map Index:
Description: ELE SER CHANGE/SF
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: SMITH DANIEL JOSEPH
to its issuance, also requires the applicant for such permit to file a
13741 SUGARPINE
signed statement that he or she is licensed pursuant to the provisions of
MAGALIA, CA
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
95954
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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
Applicant: WOLFE ELECTRIC
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
1300 PARK AVE
provided that such improvements are not intended or offered for
CHICO CA 9928
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
(530) 345-2800
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
Contractor:. WOLFE ELECTRIC
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' State License Law.).
1300 PARK AVE
❑ 1 am Exempt under Article 3 of the Business and Professions Code
CHICO, CA 9928
(530) 345-2800
Date: Owner:
License #: 844427
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of pedury 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
Architect:
is issued.
have and will maintain workers' compensation insurance, as
Engineer:
14I
, 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: 41&/�
Total Square Ft: 0 S. F.
Policy #:
Valuation: $0.00
Census Code:
❑ 1 certify that in the performance of the work for which this permit is
issued. I shall not employ any person in any manner so as to
become subject to 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'.
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
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Pdp anfVor'
I hereby affirm that there is a construction lending agency for the
Resoluti n to do work indi ted a e r which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
(�
Name:
1301"A . Date:
PERMIT EXPIRES ON: I
Address:
(D*e)
O I 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 alter the substance of any official forth or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name:%�.Q�r✓ ��04f(� Signature:
Date:
❑ Owner Contractor ❑ Agent for Owner 0 Agent for Contractor
r!
1�
066-400-011 93--M, 3P,*
SMITH, Dan CONTR: Franks Refrid..'
13741 Sugar Pine, Magalia'A
(sf/new forced Air furn.)
ti-1Cl
{. r ..... �` �- _• -moi ^'FjT i"wo� 4..�r•r',.'� w'. . ,^,�T'-: Si. IF•N� .� C�!, :?�S yF� i 4
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
j� r 7 County Center Drive - Oroville, a,lifgrnia 95965 - Telephone: 916/538-7541
/� • �r" APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
066-400-011
ZONING
RT -1
gWLDING PERMIT
OWNER
nR .�'a1+1 t
TELEPHONE
877»4702
S0. FT. JCFQC-5J BUILDING VALUATION
KIK
OWNER'S MAILING ADDRESS
13741 Sugar Pine. Ma alis 95954
CONTRACTOR'S NAME_
'e
FranICs Refriger
TELEPHONE
8774881
CONTRACTOR'S MAILING ADDRESS
5655 Almond St.. Paradise 95969
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
'
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
i �71a at M a i
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.
403A
SUBDIVISION NAME
Magalia
PARCEL MAP
Water piping
1 7.00
Each qas water heater or vent
1 7.00
USE OF STRUCTURE
SF Dt, Duplex[] Mobilehome❑ Other %
SPECIFY
Gas piping system 1 - 5 outlets
1 5.00 :).
Building sewer
1 15.00
Mob le Home I S G W
@ 15.00
TYPE OF WORK
New Addition ❑ Remodel❑ Utilities❑ Installation❑ Other®
Describe work: Forced Air Fumee
Permit Fee
$ 20.
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600v OR LESS
200A OR LESS
18.50
Main service 20GA.TO 1000A)
_
37.50
CONTRACTORS LICENSE LAW
[-declare under penalty of perjury (check one):
~
®'fi am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$
and Professions Code an my license Is In full force and effect.
License No:.��41� Classification CF. "`c'�
❑ 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)
El I,
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.&\
OR ADDNS. ( ACC. BLDGS. /
3.6dsq.f[. `
NEW CONSTR. TL ET
NON•RESID BRANCH CIRC ITS
5•�0
POWER APPARATUS &
(SINGLE OUTLET CIR.
Ex. Occup(OUTLE4s OR FIXTURES
20 20 760
FIXED P(RESID )LNS REA.)
Ex. Occup. OUTLETS
I 3.00
Temporary service
15.00
Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
F-1- I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
1 19,001 9.00
Forced Air
Cooling
Hood
6.50
Ventilation
Permit Fee
a .(�
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County'Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments costs, and expenses which may in any way accrue
,against said,County� in consequence of the granting of this permit.
/
X %n �" ,+ A' Date / "`
Signature of Applicant — Owner❑ Contractor ❑ Agent �~
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures ove43,st0 4ies in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE $ 44 .00
HAz
DFEES
IMP
FLOOD
CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the
sions of the BLktte ounty Code and/or
�
Work Indio ted 1OVeyfOr which fees
DI ECT' R OF PUBLIC
By .1/ �+
PERMIT EXPIRES Date / —
applicable provi
resolutions to do
have been paid.
WORKS
Date %�• 93
• 9j�
x r
Receipt No.
WHITE -D. P.W„ YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
A
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road., Paradise— Phone: 872-6307
CORRECTION NOTICE
OWNER PERMIT NO.
i; 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.
co-rvfFt2
77
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMITAllV
ASSESSOR PARCEL NUMBER
066-400-011
ZON\ ,IG
RT -1
BUILDINd ERMIT
OWNER
-
TELEPHONEDan 877-4702
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
13741 Pine, lia 95954
CONTRACTOR'S ME
TELEPHONE
877-8881
CONTRACTOR'S MAILIN ADDRESS
5655 Almond St., Paradise 95969
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $
13741 Sugar Pine, Magalia
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
403A
SUBDIVISION NAME PARCEL MAP
Ma alia
Water piping 7.00
Each pas water heater or vent 7.00
USE OF STRUCTURE
SF [I Duplex Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 1 1 5.00 5.00
Building sewer 15.00
Mobile Home S I G I W @ 15.00
TYPE OF WORK
New F-1 Addition❑ Remodel❑ Utilities❑ Installation❑ Other ®
Describe work: Fnrrpd Ai r Furnace
Permit Fee $ 20,00
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200A OR LESS 18.50
Main service 200A TO IOOOA) 37.50
CONTRACTORS LICENSE LAW
I declare nder penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions, Code an my license is in full -L force and effect.
License N��9� ( s�p4
Classification _
1,
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
OCCUP.&1 3.6dsq.ft.
NEW CONST. DWELLING OR ADDNS. ACC. BLDGS. II
NEW CONSTR ULT' -OUTLET
NON•RESID, BRANCH CIRC., TS @ 5.00
POWER APPARATUS .&)
SINGLE OUTLET CIR.
EX, Occup( OR FIXTURES 20 76
A
Ex. Occup. OUTLETS PNS
I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring '15.00
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
�J 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.
F] 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.
Contractor
MECHANICAL PERMIT Filing Fee 15.00
Heating .00
Forrpd Air
Cooling
g
Hood 6.50
Ventilation
Permit Fee $ 24.00
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judg COSt S, and expenses which may In any Way aCCfUe
again�sadnt in con equence of the granting of this permit.
X Date 1 -- �— 9.�
Signature of Applicant - owner
g pp ❑ Contractor ❑ Agent
An OSHA over 5'0" deep and demolition or construct-
ion of structurestover r39stories inheight.
Mobile Home Installation Fee S
Ener Inspection Fee $
Energy P
OCC
CONST TYPE
TOTAL FEE $ 44.00
HAZ
DFEES
IMP
FLOOD
CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issu d under thea applicable rovi-
P Y � PP P
sions of the tte oun Code and/or resolutions to do
work indi ted ov or which fees have been paid.
EC R OF PUBLIC WORKS
By .lam Date —8'�
P R IT EXPIRES Date
129
Receipt No.
WHITE-D.P. W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
-COUNTY OF BUTTE,111
7 COUNTY CENTER DRIVE
_PAMBNXM.- R IBLIC W6*IF WNW
_ BUILDING DIVISION
fit
OROVI�,�dLIFORNIA`.95 65,;.�TELE;�WdN� (9146138-7541
APPLICATION DATA SHEET
OWNER S /Y1 / V
400 6 --4-011
Proposed Building Use j9A / Building InspectorDate J / // 6491A
``tet
At time E -application, I was advised the following data must be submitted prior -to permit processing and/or issuance:
DATE RECEIVED BY
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
All items have been submitted.
Plot plans, 3/4 sets, signed by preparer of plans . ..........................
Complete plans, 3/4 sets, signed by preparer of plans : ..................... .
Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
Hazardous Material Form . ..................... ................... . .
Energy Design Compliance and supporting documentation . ..................
Statement of Intent for Non=Heated and A/C Buildings. t .....................
Engineered itruss details and layout in duplicate (required prior to plan check). ... .
Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
Feesof$ .........................................
Impact fees as shown on attached schedule . ..............................
California Department of Forestry plan approval/fees. ....................... .
Flood elevation letter (100 year flood) by California Engineer . ................. .
Sanitation and plot plan approval Health Department . .............
City of Chico plumbing permit . ........................................ .
Plot plan and business license approval from City of Biggs/Gridley. .............
Planning approval for (A) Use: (B) Parking: . ........
Contact Land Development about (A) Improvements (B) Drainage. .......... .
Driveway permit (construction approval required prior to occupancy). Fre-I swot! -ion reque�Ts
Pre -inspection for required. . to Building Inspector (Date)
Contractor's license information. (No., Name Style, Classification) . ..............
Certificate of Workmans Compensation Insurance . ......................... .
Owner -Builder Verification (Given to owner i, , Mail to owner ............
Recorded copy of Agricultural Acknowledgement Statement . ..................
Letter of signature authorization . ....................................... .
Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
Letter of intent on building use . .........................................
Mobilehome utility clearance . ......................................... .
Documentation of legal access . ........................................
Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
Existing violations/expired permits . ......................................
Plan check list . .....................................................
When you issue the permit, process as follows: Mail to owner.y" Mail to contractor.
Telephone and hold for pickup at Affce. Deliver with inspector.
Other
Parcel Creation / ! >
Acreage Applicant Date /
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 Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
PERMIT NO. 253-82B
PERMIT EXPIRES 215/83 _.
OWNER ROY TRUITT
CONTR. Golden Empire Const Co, CItrus_Hts
ASSESSOR PARCEL 66-40-11
LOCATION 13741 South Sugar Pine Rd., Magalia
{ Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
Temp. Gas Service
Cal led PG&E
JOB FINALE[
Signature
= OK
= Not OK
= Not Applicable MOBILEHOMES MISCELLANEOUS
= Not Ready 1, . I
Date
MOBILEHOME UTILITIES (Plans) OK except f's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORT$, ETC. fPlans) i,,, except f .
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns-Connections-Splice-Decal-Enc�os,res
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
7. Utility Clearance
6. Carports; Windows -Doors
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 f's
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
_
Date Card -BI Date _
POOLS (Plans) OK except f'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. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B-1
Date Card -BI Date
Card -BI
Date Card -BI Date
= OK
= Not OK
= Not Applicable RESIDENTIAL (Si gle and Duplex)
= Not Ready
Date
UNDERFLOOR Plans -OK except #'s
Date
FRAMING (Continued)
1.
Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
2.
Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
4.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
50.
51.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52..
Siding -Nailing -Veneer
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
P' rs-Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8.
D W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. G s Pipe; Size -Anchors
10.
W ter Pipe; Test -Anchors -Regulator -Service Test
11.
EI ctric; Underground
12.
PI nums & Ducts; Clearance -Material -Support -Ins.
13.
Gir ers-Sills-Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Dae Card -BI Date
Date
FINAL (Plans) OK except q's
Card -BI Da Card -BI Date
Date
PLUMBING (Permit) OK except q's
56.
Ext. Steps -Door & Sidelight Protection -Landings
57.
Smoke Detector
14.
Water t.; Vent -Access -Combustion Air
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water P pe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower an; Test, First Floor -Tub Access
60.
G.F.I. &Bath Fixtures & Tub Access
18.
Test TuJ& Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL rrnit OK except q's
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.
Fixture & TrAnsformer Clearance 'Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21.
Elec. Recept les Spacing -Lights &Switches at Doors
70.
Plb., Elec. &Mech. Equip. Listed for Location
22.
Size Boxes & o. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23. Romex Install Close to Edge of Studs & C.J.
24.
Equip. Ground ade up w/Mech. Fasteners -Bond Gas & Water
72.
Insulation -Foam -Looked in Attic ❑Yes
73.
Guard Rails & Deck Construction -Post Caps
25. 2 Appliance Circuits in Kitchen &Conductor Size
_
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size ; / ga. Cu or Al
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes 0 N
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes ❑No
28.
Service-Riser.Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.,
Equip. Clearances; Panels-Motors-Mech. Equip.
77,
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
--
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
82.
Ventilation throughout House
Glass Protection
Card B -I Date Card -BI Date
Date
MECHANICAL (Permit) OK except N's
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
31.
A.C. Ducts; Insulation & Support
85.
86.
Water & Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
_
_
32_
33.
Vent Fan; Exhaust above Insulation
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
Date Card -BI Date
Card -BI
_
Date -_ Card -BI Date.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING(Plans) OK except k's
Comment at Final:
36.
Sills; Proper Material & Anchors
_
_
37.
38.
39.
4
2.
43.
4
_
Walls; Studs -Nailing, Spacin
Bearing _W_a11 ov _Girders &
Draft St I t p of
Fir ,tAl rred Ceili s S ases Tu
_ & Beam -Si e & g
Hang s -P - s c rs-k£ctfSFs - - -- -
Cing. of f r. Tie P oof Brac.-Truss-Shthnq.-Ring.
_T e Ties Ty Flue -Fireplace Throat
c Access: Size &_ Romex Protection -Draft Stop -Ins. Baffles
46.
47,
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Garage Fire Protection Framing
(NOTE: Anentry must be made each time you visit job site)
COUNTY OF BUTTE - DEPARTMEN•T OF PUBLIC WORKS PERMIT N0.
7 County Center Drive - Oroville, California95965 - Telephone 916/534-45 do
APPLICATIN AND PERMIT ,i►
ASSESSO/-Ry^P/P_ RCE NUMBER
✓ —//
wW
ZONING
BUILDING PERMIT
OWN RD�/ //a/-
"p//
TELEPHONE
SQ.FT. OCC. BUILDING VALUATION
rti•-•
`vv ep
OWNER'S MAILING ADDRESS
RA
TPCTO 'Sr% E/p�/Y�
sCO
% / /n`%/�"���/O
S/0
{YOWXQA T O r�/ If/r/ R I✓`IV P.lo
Fireplace 114/
25-00,00
CONSTRUCTION LENDER
UmKKNOWN
Total Valuation $
Osvo.,o
Filing Fee
$ 10.00
LENDER'S MAILING A DRESS
Permit Fee
$ 159. o
ARCHITECT OR ENGINLICENSE
NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ , Stj
B U I L. DJy,G AD R SS �.0a� �•/, n� �� ��_
Z3 !/( /T�-
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
MA6 &114—
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities stat do her
Describe work: AY P1gM��
�SN71�� C/V6 5D4 4,4/3L�
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP ORSLESS
5.00
,L'EF3U/LD MJ¢SaN G�/MN�Y /�t/jC�1Di2 7jrL;�u/fL
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.y)
OR ADDNS. ACC. BLDGS.
2� sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
�l am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. 0 a 7 '3Classification `
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTFL -OUTLET 2,50 ea
NON•RESID BRANCH CIRCUITS)
NEW CONSTR. ( POWER APPARATUS 61
NON.RESID. SINGLE OUTLET CIR. /
EX. OCCUp OUTLETS OR FIXTURES_ BAL@1
FIXED APPLNS. OR
Ex. Occup. (OUTLETS (RESID•) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
�. I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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
again Bounty i c sequence f the granting of this permit.
^�_��
X Date
Signature of Applicant - Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST,
I PARCEL
PT.[7
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTO ROF P LIC
el
By c
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. 67 O
WHITE-D.P.W.. YELLOW -ASSESSOR, INK -INSPECTOR, GOLDENROD -APPLICANT
Owner:
BUTTE COUNTY DEPAR&NT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
i
A. P. # 6,�' (a ` 0-1(
Date of Inspection -2-
j6LV,-" -
Inspector zle h�k _
Address: /3%L{ (. S. Su s,A-R ?t t.) 6 'P-cA HA64U[Pr.
Tenant:
Building Location: ( 3 7 LI ( Sc>be4R (�ivt Ind ,
Type of Inspection requested:
T71. Housing 2. Financing
4. Other (specify) 1?P"1gGF
Present use of build
3. ,Change of Occupancy to
'A. Sanitation Housing)
1. Water closet:
2. Lavatory:
3. Bathtub or shower: t
4. Kitchen sink:
5. Hot and cold water to fixtures: '
6. Heating facilities:
7. Natural light and. ventilation: 5
8. Room and space requirements:
9. Bedroom window or door for second exit:
10. Infestation of insects, vermin, or rodents:
11. Connection to sewage disposal:
'12. Connection to water supply: '
13. Rubbish and garbage facilities:
14. Comments:
i
B. Structural
1. Piers and footings: f
2. Floor construction:
3. Wall construction:
4. Ceiling and roof construction:
5. Fireplaces:
6. Comments:
C. Electrical
1. Service and ground
2. Receptacles:
3. Fusing.
4. Comments:-
D.D. Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4. C- ents
(continued on back)
E. Other `• .
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Comments:
F. Commercial Buildings
1. Roof covering:
2. Distance to property lines:
3. Physically handicapped:
4. Restroom floors and walls:
5. Exits:
6. Improvements:
7. Zoning:
8. Comments:
G. Field Problems or Violations
1. Problem or violation (give complete description) -
2. What action taken (give complete description):
3. What action recommended:
T% A. Information only - file.
Hold for.tea (10) days, then write letter.
C. Write letter.
77D.. Other: