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HomeMy WebLinkAbout066-470-005Yr"-: - S=,y� y ',•';;:.,I.�.�..�,, ..,.-,. �,y;*s r�.Uf,,• ,ar��.,Y �,r..r'..w.-. r,�y,•4 i�', C" vi.;..`"'.;:tri�i'iw.` �Y^ +' . r •y ..ti.....�,--^'.-.., .....+_ - .. -. ._ ..'i"r '.'. '... -Al'��,,,� -- ' 05 t E/S Skyway,300' S -o onto en Maga. -. i contr': R &A Builders, Paradise 'Permi't #2925-76B,P,E,M(new 3 unit ; --- - apartment) R `Y, 66-47-5 wall/3 uni n_ + : apt.bldg.) 17 7 - .- ._ -OZ470051v PERMIT#97=2214, r:#. W-p11y �i/-,ni,r.`•�g� tRPermir 'tDe#].45;:28-7�6.'�B-�(re. li•.Z ata 137 01 �Skyway;.,Magalia Cont 1 Sierra'.;Refrigeraton 4Gas' Ser ,& Htrs/Triplex,` ?r, 066-470-005. :05-1877 Y KOZLOWSKI, MARTIN . `r 4IF-3Y 13790 SKYWAY; MAGALIA' INALED • CONT: CONRADS PLUMBI t` WTR BTR(ELEC) �< A: Al 1 f • L W , iy i �cfli 7^cfli 7 et � �1, ��i4� "�'PK.�4,`'„'..�1' -'�1L ,'..,�- . ''i�''��.i3 '�'Ffi`Fid:.+5+'i}�'K'.xYi,'L'M.'Wp!'N'-�%'2'yK.r++:�rr1+�•' -•7��.:PKiyi',"��r,.s"v'�f2��"w".'"'x9'1�5+�',.bird'�i:'rC^k�,�i�5s"r'E+i'K-x'7ir'°9;rY? 066=470-005 PERMIT#97-2214 RUPP, 'Del' 13790 "..Old, Skyway, Magalia Conti Sierra Refrigeration' & A/" t Gas Ser &.Htrs/Triplex.. /7670 COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDIN IVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916)-7541t� � E71; NO• (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUIP 14WX47 5 I ZONING1iI UILDINGPERMIT OWNER DEL%RUPP TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADTj)90�YS7KYWAi MAGALIA CONTRACTOR'SNE NAMESIERRA REFRIGERATION & A/C T$%7-0022 CONTRACTOR'S MAIUtJsa„f\QDP % CLARK RD PARADS19 CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 13790 OLD SKYWAY Energy Plan Checking Fee $ TRI PM $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome S Other TRIPLEX SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other [ Describe work: NEW SERVICE AND DIRECT VENT HEATERS � j Gas i in system 1- 5 outlets 1 5.00 15.00 Buildin sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE ELECTRICAL PERMIT Fling Fee 20.00 L Main Service ZooAORLEss 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 C — ,2 D Lic. No. N �� � � � 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 I000A 46.00 NEW CONST. OwELLIup. NG Occso OR ADDNS. ( a ACC. B.S. 3.52FT. N NST. NON -R S.ANCULT'HO �CETS @7.50 OWER APPARATUS R SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAS O I SO NS Ex. Occup. ouTELETS R S D.oEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE _ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' 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' co, pe sation insurance carrier and policy number are: Carrier !� t_..t./YY0 Policy Number (-",y„.� -k .?'71 M/Ar,t e7002 z 7 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. �✓� X �/� • �r f�,�.,pr Date�(���� _ Signature of ApplicantO Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60” deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating S 15 75.00 Coolingcompensation, Hood 6.50 Ventilation PERMIT FEE $ 95.00 Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE 120.00 TOTAL FEE $ HAZ. D. FES IMP FLOOD 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. �p r v0/0g.' By """ - —D'a`te PERMIT EXPIRES ON Oa?e Receipt No. 1 L 14V Ci/ - -A WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENRODPPLICANT "MI"i TI COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street, Chicp, CA - (916) 891-2751, 7 County Center Drive, Oroville, CA - (916) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining tothis ma -iter, or need additional explanation, pleqse contact this office immediatiWy. 33 Date 6-1/ Inspector REV 10/92 COUNTY OF BUTTE- DEPARTMENT OF r)EVk. OPMENT SERVICES - BUILDIN (VISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 8-7541E�o. (Rev. 12/96) APPLICATION AND PERMIT oc ASSESSOR PARCEL NUMBER XN&XXXXNNXX 066-47-005 ZONINGBUILDING ARMHI PERMIT OWNER DEL RUPP TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 13790 SKYWAY MAGALIA CONTRACTOR'S NAME SIERRA REFRIGERATION & A/C TELEPHONE ' 877-0022 CONTRACTOR'S MAILING ADDRESS 6899 B CLARK RD PARADISE CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS ' Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 13790 OLD SKYWAY Energy Plan Checking Fee $ $ TRI PLEX PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome It Other TRIPLEX SPECIFY Each Trap 7.00 Solar or heat'pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other EX Describe Work: NEW_ SFRVTC'.F, AND DTRFC:T VENT HFATFRS Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ 25.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200AORLE 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class 4r—ZO Lic. No. � Ja 3 24 s 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' co a sati In i ante carrier and policy number are: CarrierPERMIT Policy Numberil�v � 0007 2 (The above sections need rvbt be completed if the perwA is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X �. Date _ Signature of an - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excava ons over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46.00So WEE200A CCU000A NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. BIDS. 3.5¢FT; NEW CONS. NON -RES DT MULTI-CIRCUT 97,50 POWER APPARATUS TLET CIR. OUTLET OR FIXTURES 20 Q 1.00 OUTLET OR FIXTURES Ex. Occup.BAL p .so Ex. Occup. ourLEEDTs RESSID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 2000. Misc. Wiring23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating 5 15 75.00 Cooling Hood 6.50 Ventilation FEE S95-00 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 120.00 HAZ. D. FEES IMP FLOOD CDF PARCEL Pp HD UE 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 _Da a �g PERMIT EXPIRES ON e Receipt No. 'Z Z ��� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Calif4nia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER6 _ L/ O �� ZD" ��1 BUILDING PERMIT OWNER AJ TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 's �n /� ^a VG ' V / CONTRALTO 'S NAM TELEPHONE � i.'�li o2L CONfRACTOq'SILI_/(,v`NO ADDRESS ^ ^p� �.LJ CONSTRUCTION LENDER Fire lace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 2 0.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS p �� ©�� c.5- � Energy Plan Checking Fee $ $ nR f jOhx PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other •f SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installati n ❑ Other* Describe Work: Cr.f �' 1�/G Pi p/nC� r �%r n1�1��11f5 Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service 2o0A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law 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.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X 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. Main Service TO 46.00 NEW CONST. DWELLIWEE NG OUP. SO CC OR ADONS. ( & ACC. BLDS. 3.5¢FT, NEW REBID. MULTI.OUTLET @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. OUTLET RES Ex. Occup. BAS I:w IM Ex. Occup. o xi1TlPDTS REESID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating S Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 1Z O HA2. I D. FEES IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date _ Date Receipt No. WHITE-D.D.S.-S.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT PERMIT NO. 4528-76B PERMIT EXPIRES r OWNER L. R. Douglas CONTR. owned' LOCATION .(A.P. 1 66-47-5 ) E/S Skyway, 300'S.of Coutolenc Rd., Magalia Temp. Power -Pole Called PG&E I Temp. Elea Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date) (Signatur { i COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) Setback Firewall Forms Parapets Main Bldg. Restroom Finish Footings Windows Stemwal I Sidin Slab Roof Sheathing Piers Roofing Garage Fdn. Vents Footings Garage Vents Stemwal l Insulation Slab Carport Footings Prov. for physically handicapedy Conformance of ex. structure Slab Final Patio FIREPLACE Footings Footing Masonry Walls Throat Reinf. Steel Final Bond Beam FIRE SPRINKLERS Soil Piping 1st Floor 2nd Floor 3rd Floor Topout Water Pipin< Sewer Fixtures Water Htr. PLUMBING Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS ��- 1 �/ i 0 (NOTE: An entry must be made on this form each time you visit the job site.) ELECTRICAL This form supplied by Longfellow Lumber: THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Street Lot Number Tract No. Exterior Walls Manufacturer Thickness/Type R Value Ceil�inr ss . l/ Batts: Manufacturer (:::f)—(:::f)— (::n Thickness ri / R Value `' Blown: Manufacturer Thickness Ho. Bags Wt./Bag . Sq. Ft. Covered R Value Manufacturer Thickness/Type R Value Slab on Grade ;C Manufacturer Thickness/Type R Value +. ! r , Width of Insulation Inches Foundation Walls Manufacturer Thickness/Type R Value"K GENERAL CONTRACTOR ! LICENSE NUMBER��G`. BY_ TITLE DATE`�� INSULATION CONTRACTOR /,j LICENSE NUMBER BY .Po TITLE �i� h7 �� • DATE ,• .5 /7-' { C 3� COUNTY OF BUTTE .,DEQAJ TMEN„T OFI_PUBLIC WORKS • et 7 County Ct?nter Drive — Uroville, California 95965 « Telephone: 534-4541 APPLICATION AND PERMIT P,61 Sign ature'o ermitee r gent jai/,P,? p�� j �y��� l' BY Date (j O 9� Receipt No. y �il �7 White-D.P.W. — Yellow -Assessor — D Pink -inspector — Goldenrod -Applicant wilding permit expires ate BUILDIN Owner L _ R . L?oU&Z_A S SQ. FT. OCC. BUILDING VALUATION t . Qom � Mailing Address ce; 6 y/.� K �� , Telephone No. ,1,77� Fireplace Contractor Total Valuation 17 Mailing Address b Permit Fee Plan Checking Fee /or Penalty -00 � Oa Telephone No. Permit Fee $ 3 6, oO O �+� Building Address C�tG (/I/��, d� c.�VTOLL�i�i PLUMBING No. @ FEE PERMIT FILING FEE $3.00 ,04�,Ilv 64L ,i Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 6 G _ f� 7 . Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe � Ssai-pe4ietr I FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. Plans Rec'd Parcel Appr of •, Plons prowl Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP OROR LESS5.00 Main service EA. ADD•L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others OV Main service 1100EAMP OR LESS 25.00 Main service EA. ADD•L too AMP 1.00 NEW CONST. DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. ) 20 sq ft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 12,50ea NEW CONSTR. POWER APPARATUS & NON.RESID. (SINGLE OUTLET CIR. 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: Ex. Occup(OUTLETS OR FIXTURES)50 @25a 109 Ex. Occu FIXED APP LN S. OR P• 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. certify that in the performance of the work for which this D-ermit is issued I shall not employ any person in any manner ' p so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ I FEEPERMIT FILING FEE J$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 authorize representatives of the County of Butte to enter upon the above-mentioned erty for inspection purposes. TOTAL PERMIT FEE $ Q 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 aid. DIRECTOR OF P JBLIC WORKS Sign ature'o ermitee r gent jai/,P,? p�� j �y��� l' BY Date (j O 9� Receipt No. y �il �7 White-D.P.W. — Yellow -Assessor — D Pink -inspector — Goldenrod -Applicant wilding permit expires ate RESIDENTIAL ' .PERMIT NO. _066-T-70-005 � 05-1877'"" KOZLOWSKI, MARTIN ' 13790 SKYWAY, MAGALIA CONT: CONRADS PLUMBING' ` WTR HTR(ELEC) T • i • � r t r c t SPECIAL CONDITIONS' �I CHECKED - BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER = is •._ , � r ° , , . }! ' • . * - . • • ' ` � t . •. ' JOB FINALED (Date) 5 Signature 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.netWds PERMIT NO. BPO51877 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: 07/15/2005 APN: 066-470-005-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 13790 SKYWAY MAG License Class: License Number: Map Index: Date: Contractor: Description: NEW ELECTRIC WATER HEATER 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 Owner: KOZLOWSKI MARTIN G ETAL permit to construct, alter, improve, demolish, or repair any structure, prior KEGG JACK W &MARTIN BRENDA L; 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 PO BOX 1 159 the Contractor's StateLicense Law (Chapter 9 commencing with Section MAGALIA, CA 95954 7000) of Divisiori 3 of •tt(e 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 Applicant: KOZLOWS,KI„MARTLN, 0.ETAL.. Code: The Contractors' State License Law does not apply to an KEGG JACK W & MARTIN BRENDA L owner of property who builds or improves thereon, and who does PO BOX 1159 such work himself or herself or through his or her own employees, provided that such improvements are not.intended or offered for MAGALIA, CA 95954 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 Contractor: CONRADS PLUMBING 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.). 954 E LASSEN AVE CHICO, CA 95973 ❑ I am Exempt.oder Article 3 Busin ss nd Professions Code (530) 893-1124 Dater ��' downer: CONRADSPLBG@SBCGLOBAL.NET. License #: 670692 WORKERS'COMPdWSATION 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 Architect: Labor Code, for the performance of the work for which this permit is issued. Engineer: . ❑ 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 is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S.F. Valuation: $0.00 Policy #: 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 r -- provisions. (— Date. Applicant: J 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 Brrtte County C.odR ?nrvor 1 hereby affirm that there is a construction lending agency for the Resolutions to o work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)( C Name: - 05 By Date: J I -Is- PERMIT EXPIRES ON: Date Address: ❑ • 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 an icial form or d ument of Butte County. thereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos Print Name: Signature: Date:'7.- .- �. S� — �S 14110- A�wwner 0 Contractor ❑ Agent for Owner ❑ Agent for Contractor = OK =Not OK = Not 4plicable MOBILE HOMES = Not Readyeady 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 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ftJ P LPG 7. Well Clearance 8. Disconnect 8. Utility Clearance 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-Connecto? 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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings .12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (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-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=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. Gmd.-/ /" 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 -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 Baffle 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 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -KC. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ_ / /ga Cu or AI Insulated Neutral O Yes O No Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac: Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. 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 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elm Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive D Yes O No/Walks O Yes O No/Planters O Yes D No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac: Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. 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 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elm Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive D Yes O No/Walks O Yes O No/Planters O Yes D No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: r 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. BP051877 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjuryS I licensed under ctio 00 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 07/15/2005 APN: 066-470-005-000 the Business and Professions Code, and my license is in full force and effect. Site Add e ress13790 SKYWAY MAG License Class: License Number: Map Index: Date: Contractor: Description: NEW ELECTRIC WATER HEATER 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 Owner: KOZLOWSKI MARTIN G ETAL - >._.•,.- permit to construct, alter, improve, demolish, or repair any structure, prior KEGG JACK W & MARTIN BREN.DA'.L',1 ; to its issoarie€raleo requires the applicant for such permit to file a signed statement or she is licensed pursuant to the provisions of PO BOX 1159' _ the'Contractor's Staie`License Law (Chapter 9 commencing with Section MAGALIA, CA 95954 " 7000) of Division 3 of,tKe Business and Professions Code) or that he or t 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).):. ❑ 1, 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 IMA I N - Appkic nt:.KOZLOWS,K ,..,,.._..RT:..., „ETAL....... . Code: The Contractors' State License Law does not apply to an KEGG JACK W & MARTIN BRENDA L owner of property who -builds or improves thereon, and.who does PO BOX 1159 such work himself or herself or, through his or her own employees, provided that. such.improvements are not -intended or offered for MAGALIA, CA 95954 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 Contractor: CONRADS PLUMBING 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.). 954 E LASSEN AVE " CHICO, CA 95.973 ❑ l 1 am Exempt.under Article 3 Busin -nd Professions Code (530) 893-1124 Dater �� �O'wner:' - CON RADSPLBG@SBCGLOBAL.NET . License #: 670692 WORKERS"COMP SATION 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 Architect: Labor Code, for the performance of the work for which this permit is issued. Engineer:._. ❑ 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 is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Valuation: $0.00 Policy#: ... . ,,. ... Census Code: ❑ 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 00 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 Code ?nrtlor I hereby affirm that there. is a construction lending agency for the Resolutions to o 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: 7 -15 U5 PERMIT EXPIRES ON: r7 -15-OG Date Address: ❑ 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. 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 an icial form or d ument of Butte County. thereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos Print Name: `J ( Signature: •� Date: / — wrier 0 Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERM•Iffl,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 OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** ep OWNER Last Name / C ' S iv Fi Address 0 Ci City S�t� Zip Phone .53o b�7 7 &0 Fax -7oC E-mail . /L457 ep CONTRACTOR Nam ' S iv Address Address 0 Ci en S�t� Zip Phone ZiRKE9, Fax E-mail Planner Li?#�6Gq Class APPLIC T SIGNATURE X 1__j cg q_ For off ic a only: ARCHITECT/ENGINEER Name Flood Zone Address Address 0 City No State Zip Phone ZiRKE9, Fax E-mail Planner State License Number APPLIC T SIGNATURE X 1__j cg q_ For off ic a only: APPLICANT NAME Name Flood Zone . Address 0 % No City Type Const. Stat . ZiRKE9, Phn O 7003Fax Planner E-mail APPLIC T SIGNATURE X 1__j cg q_ For off ic a only: Zoning Property Address /U1 Flood Zone . SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # LOCATION AP# Orr -�� Q- "6 5 Property Address /U1 City Cross Street 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 0 Structure Built without Permits O 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. co Received by:K 6 Amount: �To • Bldg11 Receipt #:� M S / 11 Date:—'S-O�j — other I Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05 c , SUBMITTAL & PERMIT REQUIREMENTS M 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. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. 01 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6: Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required): ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made vdthin two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 COUh 770FT9UTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This building has been constructed and completed in accordance with the requirements of the Uniform Building Code under permit number 2925-76 for the following: Use Classification 3 -unit apartment Address or Location E/S Skyway, 300' S. of Coutolenc,Magali Group H occupancy; Type V -N construction. It is hereby certified for the occupancy described above and may be occupied. Director of Public Works Date Aug, 3, 1977 B POST IN A CONSPICUOUS PLA (Over) NOTICE A new Certificate of Occupancy is required if the use or occupancy of this building changes. This Certificate of Occupancy shall be posted In a conspicuous-piace and is not to be removed by other than the Building Inspector. 2925-4768 PEM "• / ERMIT NO. '.' ' • PERMIT EXPIRESL,���/ / ._OWNER L. R. Douglas CONTR. R & A Builders, Paradise •LOCATION (A.P. 66-47-5 E/S Skyay, 300'S.of Coutolenc Rd., Eagalia l 4V,, Temp. Power Pole Called PG&E Temp: Elea Serv. +, CAIled PG&E =2 /-2—F'/-7(, Temp. Gas Serv. Called PG&E JOB `7 '% 3 - 7 7 FINALED (Date) J G (Signature) r I COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd)' PLUMBING Setback Firewall Soil Piping Stucco Forms Parapets 1st Floor M HANICAL Main Bldg. Restroom Finish 2nd Floor Gl Footin s Stemwall Windows Siding 3rd Floor To out Rinish `' Slab Roof Sheathing Water PI In % Piers Roofing Sewer Final Garage Fdn. Vents Fixtures Footings - Stemwall Garage Vents Insulation / Water Htr. Heaters Slab yoProv. Carport Footings `- for physl lyA handicapped Conformance of ex. structure [lances Gas Piping at Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures J Bond Beam//_ i / FIRE SPRINKLERS Motors rraming L C/ Test Water Htr. .. ' Stucco Final Subpanels Mesh M HANICAL Grd. Fault Prot. ! Scratch Heating ServiceVhK % Brown Cooling Temp. Pole Rinish `' Ducts Underground Interior Lath Ventilation Permanent .�� Door Closer I Final Final DATE / REMARKS OR CORRECTIONS W007.1 - (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 Qrive r:: Uroville, California 95965 �� Telephone: 534-4541 APPLICATION AND PERMIT /-I-- ouuluncC ICIJICSCnIGUVCS of the Lounty or butte to enter upon the above-mentioned property for inspec n purposes. X Date nature of Permitee or Agent Receipt No. / 7 (v S 79, 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 BLIC WORKS BY . Date 45�-/J ilding permit expires Date BUILDING efl Owner ' Oce L 3� SQ. FT. OCC. BUILDING VALUATION ro / O Mailing Address �(o Telephone No. Fireplace Contractor 2 • i �� S , Total Valuation On ,� / Mailing Address • �� �i ten/ Permit e / -- PlanChecor Penalty ps—•- kin Fee / 11 6711-S lep�^e��`Z Permit Fee $ Building Address PLUMBING No. @ ,FEE PERMIT FILING FEE $3.00 f O-,=) 'moo �1iy Each Trap 1.50 r� Uv OLf/Y Repair drainage or vent piping 1.50 Water piping 1.50. Each gas water heater or vent 1.50 A. P. No. —O S • i i^9 Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F a Ion FireDept. Fire Zone Use Permit Building sewer 5.00 EQA 'Parcel Declaration Parcel aP 60' R/W Im Lawn sprinkler system 2.00P ds Rec' <ZE Parce Approval Plans proval Permit Fee $ — $ 7727 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3 Main service 100 AMP ORV OR LESS5.00 Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 J(A17�= NEW CONST. DWELLING O OR ADONS. ACC, GSCjyp. 20sq ft 70 NEW CONSTR. MULTI-OET NON•R ESI D, (BRANCHU CIRCUITS)2.50ea OCC. �' ConS NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. r CONTRACTO S 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: Ex. Occup(OUTLETS OR FIXTURES)50 @250 104 Ex. Occup. FIXED APPLNS, OR OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 o� Mobile Home Facilities 15.00 - �7 0 License No._ag Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 73 $ 737pz WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this 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 v? " Heating Cooling Ventilation Hood 1 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 TOTAL PERMIT FEE $3Q >S ouuluncC ICIJICSCnIGUVCS of the Lounty or butte to enter upon the above-mentioned property for inspec n purposes. X Date nature of Permitee or Agent Receipt No. / 7 (v S 79, 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 BLIC WORKS BY . Date 45�-/J ilding permit expires Date