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068-130-029
�T AP i John I. Church CHURCH, John 40-69B + 21 Palermo Dr: Oroville 43-69P SPEC. INSPEC.. #27-77 earthquake —TPa damage to residence 4-07-29 01-3075 r� CONTRleOmW.DClinkinV1eard 2195 Ithica St. 068 130-029 ,f, , Oro QLSONMARTHA eV � (remodel kitchen) 21' PALERMO DR;^ORO LE ���.,�, � rCONT: KELLI' RIDGE HEATI�J .ANEW •PELLET, STOV&'� 2 � I _� , F ;068-130029 �'11 - 04'2115' OLSON, LYNN 21 -PALERMO DR, OROVILLE > Conn GEORGE'&'SONS460-F IN: -R OFfir.• -� x T� - _ ___ _ - _� 1_ _ Al 068-130-029 05=1909. u OLSON, MARTHA LYNN 216PALERM0 DR, ORO VILLE'-, Opt:,,C &'N HEATING & AIRFw 68-130'029 t` 05-1941 21 PALER4O'jjR, OROVILLE Con[: HURST, MIKE �_, INRLE �F . `ELEC SERV i a John I. Church CHURCH, John 40-69B + 21 Palermo Dr: Oroville 43-69P SPEC. INSPEC.. #27-77 earthquake —TPa damage to residence 4-07-29 01-3075 r� CONTRleOmW.DClinkinV1eard 2195 Ithica St. 068 130-029 ,f, , Oro QLSONMARTHA eV � (remodel kitchen) 21' PALERMO DR;^ORO LE ���.,�, � rCONT: KELLI' RIDGE HEATI�J .ANEW •PELLET, STOV&'� 2 � I _� , F ;068-130029 �'11 - 04'2115' OLSON, LYNN 21 -PALERMO DR, OROVILLE > Conn GEORGE'&'SONS460-F IN: -R OFfir.• -� x T� - _ ___ _ - _� 1_ _ Al 068-130-029 05=1909. u OLSON, MARTHA LYNN 216PALERM0 DR, ORO VILLE'-, Opt:,,C &'N HEATING & AIRFw 68-130'029 t` 05-1941 21 PALER4O'jjR, OROVILLE Con[: HURST, MIKE �_, INRLE �F . `ELEC SERV i Cts I � � � �- - -_ NOTES Z RESIDENTIAL PERMIT NO, 068-130-029 OLSEN OS -1941 21 PALERMO DR, OROVILLE i Cont: HURST, MIKE r j ELEC SERV SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. - FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER A! C4, OFFICE COPY Address2-1 • RALERm0 Z�2 rLOV LLE GAS Meter By Date ELECTRI�-S�YV�YVIU Meter By �S Date 'Zg Q JOB FINALED (Date) Signature—w�CJI/LO�-� = OK = 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/Meth Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -A. C. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes Closet Light -Shower Ught-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. Fumace-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. Bdnm. Windows or Exiting Doors -Sill HL & 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-Underfir. 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. Elec. 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 -Meth. 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 InstldA)rive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 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: J=OK 0= Not OK . = Not Applicable . =Nat Ready MOBILE HOMES 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 W P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements -Setbacks -Easements Date 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 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 Date PERMANENT END SYSTEM (ONLY) Date 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 I 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 /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 33 5176 7 License Class: C-�O License Nu/tuber: Date: -7-,9/-05 Contractor: //L)!S ,7 L��LL-/ r NC, a 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 Coder 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'pursivant to'the provisions of the Contractor's State License Law (Chapter 9 commencing with Section, . 7000) of Division Sof the Business and Professions Code) or that he or she is exempt therefrom: and the basis.for,the alleged. exemption. Any violation of Section. 7031.6 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„ fpr sale„(Sec,; 7044,,,Business, and.,Prgfrissjons,, 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.). ❑ 1 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: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit . is issued. I have and will maintain 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 re: Carrier: F'n Policy #: ! CO r / ❑ 1 certify that in the performance of the work for which this permit is issued. 1 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 shalf.stibject 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. PERMIT NO. BPO51941 Issued Date: 07/21/2005 APN: 068-130-029-000 Site Address: 21 PALERMO DR ORO Map Index: Description: upgrade elec service Owner: OLSON, MARTHA LYNNE- 21 YNNE21 PALERMO DR OROVILLE, CA 95966 -Applicant:.. HURST, MIKE._,,., ....;.:...........,:.:,. �.,..:.::...........:..,..:.. 15 OAKCREST DRIVE OROVILLE, CA 95966 530-589-5330 MIKE-TERRI@SBCGLOBAL.NET Contractor: HURST, MIKE 15 OAKCREST DRIVE OROVILLE, CA 95966 530-589-5330 MIKE -TER RI@SBCGLOBAL.NET License #: 335967 Architect: Engineer:. Total Square Ft: 0 S. F. . Valuation: $0.00 Census Code: ` �I \1 ,2 Irk CONSTRUCTION LENDING AGENCY This I hereby affirm that there is a construction lending agency for the Rest performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By - Address: PERMIT 6 hereby issued nder the pplice a provisions of the Butte County Cods enrVor - to do coo d' ated ab for w is fees have been paid. Date: �}� PIRES ON: / L �G ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Bvite County. I hereby authorize representatives of Butte ounty to enter upon the above mentioned property for inspection purpos v Print Name: - (-- Signature: / Date: 7�>7 (— O O Owner A 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 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds 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. -33s-F6 7 License Class: C-�o License Number: Date: -%.� �- OS 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 therefrori and the basis- for,the.alleged. exemption. Any violation ofSection 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 owrierof the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended, oc offered fo sale,.(Sec ; 70g j,. Bg§inegs,and Jprgfessions 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.). ❑ 1, as •owner,..of. the-property,-„amAexclusively.,,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 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I haye,and will..maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued ` I have and will ”maintain• Workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which4his permit is issued. My workers' compensation insurance carrier and policy number re: Carrier: Ile �n Policy #: l 2 ❑ 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: — )-(r Applicant: ' WARNING: ' ' Failure to secure workers' compensation coverage is unlawful, and shallsubject 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; interests 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.) Address: PERMIT NO. BP051941 Issued Date: 07/21/2005 APN: 068-130-029-000 Site Address: 21 PALERMO DR ORO Map Index: Description: upgrade elec service Owner: OLSON, MARTHA LYNNE----,' 21 PALERMO DR OROVILLE, CA 95966 .--,.--,,,.-Applicant:- HURST, MIKE,---'---.- - 15 ...:....:mY...,, ::.:.,..�s.,.v.,. 15 OAKCREST DRIVE OROVILLE, CA 95966 530-589-5330 MIKE-TERRI@SBCGLOBAL.NET Contractor: HURST, MIKE 15 OAKCREST DRIVE OROVILLE, CA 95966 530-589-5330 MIKE-TERRI@SBCGLOBAL.NET License #: 335967 Architect: ,.- .Engineer:. Total Square Ft: 0 S. F. Valuation: $0.00 / Census Code: vl Ie- This i This permit ' hereby iss ed rider the Ipplica0fie provisions of the Brrtte County Codp enrUor Resolutio to do wo d` ted ab for w c fees have been paid. By: Date. PERMIT EXPIRES ON: / L / '-'6 t ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of INtle County. thereby authorize representatives nnof Butte ounty to /eynter upon the above mentioned property for inspection purpos Print Name: (�C-{�� / Signature: Date: 13 Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor 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 OFAPPLICA TION .Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER Last NameO�J © ,n i ��/ First dame L. Address e o Q (� City StateClk zir Phone Fax E-mail APPLICANT SIGNATURE X at For office use only: CONTRACTOR Name /� t / ' t e. Flood Zone Address 1 5 QC CreS4- City ©('o vl r q 9e, I No State, Zil - '4 `? Phonesa 0 -1q q3 Map Book Fax E-mail Planner Lic. #3351 6 C�ss�O APPLICANT SIGNATURE X at For office use only: ARCHITECT/ENGINEER Name Flood Zone Address e, City I No State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT SIGNATURE X at For office use only: APPLICANT NAME Name M 1 Ike. Flood Zone Address e, City VState I No Occ. Zip Phone Map Book Fax E-mail Planner APPLICANT SIGNATURE X at For office use only: Zoning Property Addres A rvct (f rot c) t", Flood Zone Cross Street Q r1 d j 6 SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BP (9-5 _/ BIN # LOCATION AP# G J C) -©d (Do 0 Property Addres A rvct (f rot c) t", City ©r%IOl/I Cross Street Q r1 d j 6 WORKER'S COMPENSATION Policy Number Carrier -V�k Fund 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 Page 1 of 2 Description or Scope of Work: A00 S 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: A_ �l /J Receipt #: qr � Amount: J J Bldg z Date: �f (� Other ��*— � Total REV 2-24-05 SUBMITTAL & PERMIT 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. ❑ 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 A/C 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. (I 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. ❑ 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. 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 within 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 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. BPO51909 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that + am licensed under Issued Date: 07/19/2005 APN: 068-130-029-000 provisions of Chapter 9 (commencing with Section, 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class: 2 U Lice Numbber: i6,0sl k Site Address: 21 PALERMO DR ORO �se Date: -1. d Contractor. 5 I N 14&L. "l'TC.-+w-> Map Index: Description: REPLACE HVAC/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 Owner: OLSON, MARTHA LYNN Business and Professions Code: Any -city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior 21 PALERMO DRIVE to its issuance, also requires the applicant for such permit to file a OROVILLE, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 95966 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 Applicant: C & N HEATING & AIR intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an and. owner of property who builds or improves thereon, and who does 2210 BIRD STREET such work himself or herself or through his or her own OROVILLE, CA 95965 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 530-534-9419 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 Contractor: C & N HEATING &AIR 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 2210 BIRD STREET pursuant to the Contractors' State License Law.). OROVILLE, CA 95965 ❑ I am Exempt under Article 3 of the Business and Professions Code 530-534-9419 Date: Owner: License #: 700568 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent.to self -insure for workers' compensation, as provided for by Section 3700 of the Architect: Labor Code, for the performance of the work for which this permit Engineer: is issued. ❑ 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: Total Square Ft: 0 S.F. Carrier: Valuation: $0.00 Policy r1: Census Code: �1 I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the 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, 1 shall n forthwith comply with those provisions. �� (//•/ v Date: _ i — - Applicant: WARNING: Failure to secure w rkers' 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 Bnfte County CMR_ anrUor I hereby affirm that there is a construction lending agency for the io do work i ' ated v for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) �/ -' �V-Swl Name: Date: 6 Address: RMIT EXPIRES ON: P Dat of ❑ 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 1 am the owner or the duly authorized agent of the owner. 1 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 docu e t of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos Print Name: 17 N I t ���1 AU 3 Signature: _ w"" ( Date: ❑ Owner 0 Contractor 13 Agent for Owner 0 Agent for Contractor 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 OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER Last N UL f' t Name Address 21 n Cityk ILO State ' Zip (^ J (� Phone Fax E-mail APPLICANT NAME CONTRACTOR Name Name e Address Zip 7s-< < 6S City Fax S 3 9' State Address `,�--Z, Phone Map Book City V l�Q E-mail State Zip s��— Phone s 3 c-1 _ 9 Fax S 3 Cr _ (-/ Z J- E -mail E-mail Lic. # 00 (.8 C 'ass C-- 2D APPLICANT NAME 'ARCHITECT/ENGINEER Name City Address Zip 7s-< < 6S City Fax S 3 9' State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City Sta ( Zip 7s-< < 6S Phone �/ y �/ Fax S 3 9' E-mail APPL-ICA N i IGNATURE X For office use only: Zoning Property Address Flood Zone Cross Street SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BIN # LOCATION AP#b�� _ )3o - o-2-ci Property Address 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 Page 1 of 2 Description or Scope of Work - 0, t,— . , � P i� S .Footage , U ❑ 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 required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: Bldg SRA Receipt #: Sheriff SMIP Other Date: Total REV 2-24-05 SUBMITTAL & PERMIT 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. ❑ 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 A/C 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. ❑ 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 within 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 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP042115 LICENSED CONTRACTORS DECLARATION 1 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' 07/16/2004 APN'' 068-130-029-000 the Business and Professions Code, and my license is in full force and effect. License Class: L'_3 License Number:44g--g Site Address: 21 PALERMO DR ORO ( Date: 7—Mg—OV -O Contractor: k4* Map Index: Description: RE -ROOF (20 SQ) 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: OLSON, LYNN 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 P O BOX 775 7000) of Division 3 of the Business and Professions Code) or that he or PALERMO, CA 95968 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 Applicant: GEORGE &SONS ROOFING owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 1090 HURLETON ROAD provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one OROVILLE, CA 95966 year of completion, the owner -builder will have the burden of 530-589-4443 proving that he or she did not build or improve for the purpose of sale.). ❑ 1, 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, Contractor: GEORGE & SONS ROOFING and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1090 HURLETON ROAD ❑ I am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 530-5894443 Date: Owner: License #: 682274 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 Architect' ' is issued. I have and will maintain workers' compensation insurance, as Engineer: squired 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: Carier,_.ct✓i Total Square Ft: 0 S. F. Policy #: 077a —��l -� � - Valuation: $0.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' mpensation 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 interest, fees. 40&lalrr_l '— code, and attorney's CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code ?nrVor I hereby affirm that there is a construction lending agency for the Resolutions t do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) i LLQ,, 7. 16. 4 Name: By: Date: PERMIT PIRES ON: % • 1 4o -OS Address: Date ❑ 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 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:///,_O,/ CL Signatur Date: 2�� - , j Ell Owner CI Contractor f d ,&ent for Owner 13 Agent for Contractor r BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION APPLICANT SIGNATURE X S i ayTr�gent r George Ro fimg For office use only: OWNER Name Lynne Olson Address P.O. Box 775 City Palermo State CA Zip 95968 Phone 530-589-5662 Fax E-mail Lic.# APPLICANT SIGNATURE X S i ayTr�gent r George Ro fimg For office use only: CONTRACTOR Name GEORGE ROOFING Address 6810 Lincoln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax (530)533-0287 E-mail dan@abcgc.com Lic.# Class dan@abcgc.com 452266 1 C39 APPLICANT SIGNATURE X S i ayTr�gent r George Ro fimg For office use only: ARCHITECT/ENGINEER Name N/A Address 6810 Linocln Blvd City Oroville State CA Zip Phone (530)533-6393 Fax E-mail dan@abcgc.com State License Number APPLICANT SIGNATURE X S i ayTr�gent r George Ro fimg For office use only: APPLICANT NAME Name GEORGE ROOFING Address 6810 Linocln Blvd City Oroville State CA Zip 95966 Phone (530)533-6393 Fax (530)533-0287 E-mail dan@abcgc.com APPLICANT SIGNATURE X S i ayTr�gent r George Ro fimg For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. NO. LOCATION AP# Qc.B, 130 • 0�-9 Property Address 21 Palermo Dr. Cross Street BPa¢z115 BIN # WORKER'S COMPENSATION Policy Number 272-596-02 Carrier STATE FUND If hiring anyone other than license contractors, a certificate of workers compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work Reroof Sq. Footage 20 Squares ❑ 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 required. 2UEST FOR REFUNDS rods can only be made upon written request by the person who paid the The request must be made prior to the expiration of the permit and no truction work has been done. Filing fees, plan check fees for work plan ked and other department costs are not refundable. Received by: !?l Amount: 110._ Bldg Receipt #: 40& 1B 69 Date: 7.1(0.04 SRA Sheriff SMIP Other 110 Total REV: George Roofing COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 01075 ASSESSOR PARCEL NUMBER r nn ZONING - BUILDING PERMIT p a.� J TELEPHONE SO. FT. OCC. BUILDING VALUATION oiv NG ' s C OR'S E TELEPHONE -' CONT O .sD S t r co rp cno NOER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ f) ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 21 T' • , GRWRLE Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing F6e 20.00 USEOFSTRUCTURE SF �p Duplex ❑ Mobilehome ❑ Other 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 EX Installation ❑ Other ❑ Describe Work: I&STEL PM XT STS Gas piping system 1 - 5 outlets 15.00 sewer 15.00 —Building Mobile Home S G W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service ".A.0.'.:: 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.POWER License Class Lic. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. +� ® I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) .. ! I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. rf X lI Ii+• _t,yU1 �, ! ,L '.Q_ ►*. Date t — , ,' �� _ Signature of Applickht - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service YOGA TO 46.00so NEW CONST. DWELLING OCCUP. SO CCU OR ADDNS. ( ; NON-REOSID. MULTI -OUTLET 97.50 APPARATUS 6 SINGLE OIJILtT CIA. EX. OCCU OUTLET OR FIXTURES SAL ® 1.300 FIXED Ex. Occu , ourrs Ro �eA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEEc$� HAZ. I D. FEES IMP FLOOD CDF PARCEL Po HD ISSU 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 Date PERMIT EXPIRES ON" /A /.Jr/I % Dite Receipt No. 337337 / �55.W WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 0 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT 01-307-5 ASSESSOR PARCEL NUMBER 130 029O ZONING BUILDING PERMIT TELEPHONE r O— P.Q. Bc)y 7759 RALMM9 Q4 9-59-62- SO. FT. OCC. BUILDING VALUATION CONTRACTOR'S NAME KEITY RIDGE HEATING TELEPHONE CONTRACTORS MAILING ADDRESS I =NOW 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 $ BUILDINGADDRESS DRIVE,21 PALERM9 OROV!I$ Energy Plan Checking Fee $ PERMIT FEE _ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF )J Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities EX Installation ❑ Other ❑ Describe Work: ] NSTAT T . POLET STOP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W Q20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service a00v OR LESS 200" 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: ❑ 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. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLDS. SO 3.50FT. N CONS ' MULTI -OUTLET @7,50 POWER APPARATus 8 SINGLE OLmiT CIR. Ex. Occup. OUTLET OR FD=REs 20@'.00 BA.00 Ex. Occup.. DF"LUT>Frs AD°en 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Policy Number (The above sections need not be completed 9 the permit is for work of a valuation of one hundred dollars ($100) or less.) —9 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. ��/� 0' X / r1GVW Date Ids �� i _ Signatuite of Applicant- ¢3 Owner ❑ Contractor ❑ Agent — I An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST.TYPE TOTAL FE HAZ. D. FEES IMP FLOOD COF p" E&EI PD HD _ ISSU 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 Jr D2- Ito rReceiptNo.337337 / $55.00 E-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive -7541 Oroville, California 95965 • Telephone (530) 538 IRev.12/9a) � PERMIT N0. AS SE390R PAACAPPLICATION AND PERMIT Q rAJ1eER OWNER 6 $ 3 O `— 0 20N1M0 BUILDING PERMIT WI c, r.+� . 0 ( g;,j 10 cc: FT. . OCC. BUILDIN ow �o AOO$%n2 p G� S &, /jd -775 A I��..v,� ( ? G VALUATION C� 75/ COMgACTppy �MA� 1 1 r 1 TCLlAON! ll \ �C .•.�e �� '� r COMAACTORI MAAJNO ORElB .N lam. ✓t/U t� .i✓ CAMS TAUCnO#d LENDER LENDER S MNUrq ADORltB Fireplace ARCNrtECTORENOINEEA LICENSE No. Total Valuation $ S �O c►o AACNrtECT OR ENOMCtA9 YAa1NO ADOIIESB Filing Fee S 20.00 Permit Fee OUIDINO ADORESS Plan Checking Fee Energy S Plan Checking Fee E J S or MO fUa01NDDN7NAME P E AP PERMIT FEE PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE Each Trap 7.00 SF M--pupleX ❑ M{obilehome O ether Solar or heat um water heater 23.00 OPEc Water 2iping 15.00 TYPE OF WORK Each gas water heater or vent 15.00 New ❑ Addition ❑ Remodel ❑ UD6ties ❑ lnftleticn/ �' Ofh� ❑ Gas piping stem 1 - 5 outlets. 15.00 Describe Work: N 5 -�� 1 (s Buildingsewer Mobile Home SIG W 15.00 @20.00 PERMIT FEE S ELECTRICAL PERMIT Flin Fee 20.00 Main Service 800V OR LESS 200AA OR LESS 23.00 Main Service 200A TO 1000A 48.�� NEW CONST. ( OWENI OCCUP . OR ADONS. a AOC. OLDS. 3.5¢R. NON•RESIO. MULTI -OUTLET @7.50 POWER APPAAATU8 a WILE OUTLET cut Ex. Occu OURF►OR rLmlREB Io 0 1.00 .90 FI)SAL Ex. Occup.oVrunEOE91SI oR tT9 E0. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ *PERMXT FEE PA1b s �S MECHANICAL PERMIT Heating Fling Fee 20.00 SRA Cooling SHEFFURI # Hood Ventilation 6.50 OTHER s PERMIT FEt S Mobile Home Installation Fee S Energy Inspectlon Fee S OCc CONST. TYPE TOTAL FEE $ W AJKOimRE�EX"� NZ• 0. refs IMP 0 COP PARCEL PO NO 6UE 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. NVM%m 3--5-73 3 7 A TO 0E K f MW COM IM By Date PERMIT EXPIRES ON tat"n OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES ❑ NO Q 2. I HAVE 13 HAVE NOT ❑ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: e i lv4 �y�,-- 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: I2' �d 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 SIGNED: PROPERTYOWNER: SOCIAL SECURITY NUMBER: DATE: 0 NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office 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 parry of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you 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, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A- frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. I+Micel /�1 Vi ira, C.B.O. ,uilding Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER FILE NO. BUTTE COUNTY (For Action 1, 2, 3) Public Works Dept. (For Information/) Director Dep. Dir. Sec. Rd. & Br. Mtce. Shop Equip. & Yards Ref. Disp. Bldgs. & Grds. Bldg. Insp. Admin. D & C/Traffic Const. Rd. Des. Br. Des. Sur. & Loc. Mapping Drng./Permits Sub. Checking Right of Woy n 11 •'. August 31, • 1977 John I. Church .` RE: .Special Inspection 427-77 21 Palermo'Dr. (AP 34-07-29) ' Oroville, CA. 95965 ¢ r Dear Mr,.Church: With references to the above subject and your request for inspection of earthquake " damage to your dwelling located at 21 Palermo Drive in Oroville, the requested inspection was made•on August 30,,.1977: The'inspection�revealed that the house has typical cosmetic type damage --. plastered ceilings and walls in most rooms are cracked.. The garage has large cracks in the concrete slab and the building•is leaning up hill to an 'extent that it should be corrected at -the earliest possible time.to avoid further damage. Should you -have any questions concerning this, please contact us. Yours very'+truly, Clay Castleberry Director of -Public Works • J.F. Glandes 4 ; JFG:dd Assistant Director Owner r a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS' 7 County Center Drive - Oroville, California 95965 J Telephone: 534-4541 APPLICATION FOR SPECIAL INSPECTION A. P. No. 341— " 0 / Mailing Address /0,V PY i1`1D %�, Telephone No. :)licant I n h l+ D. ("' A tAVC h Telephone No. -7- 3 - 3Y1.3 Mailing Address Building Location �! /-G 149 )_ M O �i /11 ,D/II --I fV u , /"-k-. w_r, irj.,a"*,\ hereby request a special inspection of the following building: / / 1. Dwelling (if only a portion, specify) / / 2. Apartment House (if only a portion, specify) / / 3. Commercial (specify present occupancy) / / 4. Other (specify) am requesting a special inspection for the purpose of: 1. Moving the building. 2. Financing (specify agency) / / 3. Change of occupancy to Other (specify) Case No. I hereby certify that I will obtain the necessary permits and make any necessary corrections, alterations, or repairs required by the County of Butte, as a result of this inspection, to comply with building and housing code requirements. I also certify that prior to the use or occupancy of this building, I will complete the above required corrections, alterations, or repairs, or, if the building is presently occupied, I will complete the above required corrections, alterations, or repairs within thirty (30) days. I certify that I have read this application and state the above information is correct and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. r ;trf.? %.iii t Date Signature of Owner Fee/paid $ Receipt No. 1st -DPW - 2nd -Inspector - 3rd -Applicant J R% 5 l~, r 45.� c4 L �s f j J R% 5 l~, r m r t �, fi `Owner • _ Address: Tenant: BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT A. P. # 3 q- 0 7 02' S' Date of Inspeq io Inspector Building Location: ;PL/ Type of Inspection requested:. r _ 1. Housing / / 2. Financing / / 4. Other (specify) " 3. Change of Occupancy to ,a,-- 'Cr Present use of building: A. 'Sanitation (Housing)' 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating facilities: 7. Natural light and. ventilation: 8. 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: B. Structural - j e,F,��A�C 'A - 1. Piers and footings:' p�;,r,/!,y /Cl �r^y,,r,� y�,� C y, 2. Floor construction:-�� ���. U ,� L ZL 3. Wall construction: /,j 0i, 1 „� 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: C. Electrical 1. Service and ground: .2. Receptacles: 3. Fusing: 4. Comments:- D. omments• D. Plumb in 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: (continued on back) E. Other 1." Maintenance and repair: 2. F ire ' hazards : 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Comments: F. Commercial Buildings 1 I. 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: A. Information only - file. / / B. Hold for tent (10) days, then write letter. / / C. Write letter. D. Other-