HomeMy WebLinkAbout068-160-107FRANK WALKER /6/L�/„
2840 Quincy Rd., 02�v�ille
>contr: M.H. Electric, Oroville
Permih #3148-77E (serv. change)
028-160-107 PERMIT #97-2669
WALKER, VERONA
2840 ORO QUINCY HWY
CONT: RON HOLAND 'o'lowL /•
REROOF W/COMP, EXT HT OF SER MAST
` (0 V — 1(oO 10-7
--
/:" W(kl WOWM
2610 qvwcy
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
T"County Center Drive — Orovi Ile, California 95965
Telephone: 534-4541
APPLICATION AWD PERMIT
autnorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
) "t i
r �I
X ! Date
Signature of Permitee or Agent
Rer,pint Ain
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 PUBLIC WORKS
By
Building permit expires Date
Date
BUILDING
�-
Owner i ) ; .. r%r • l
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor �` j�r r r r
Total Valuation
Mai Iin Address
g �' �' �� ' �`
Permit Fee
PI an Checki ng Fee &/or Penalty
'
Telephone No.
'Permit Fee $
Building Address �1 i A
n �'� ''_ y't �� I
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
t /
Each Trap 1.50
Ir
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W. C.
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma p
60' R/W
Improvements
p
Lawn sprinkler system 2.00
Bldg. Plans Recd I
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Ji
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 .'
rr
06r7 r , r
Main service 100 AMP OR11V OR SLESS 5.00 t r
`�
Main service EA. AOD•L too AMP 2.50
Single Family ❑'� Duplex ❑ Mobil Home ❑ Others ❑
OVER 600V
Main service 100 AMP OR LESS 25.00
Main service EA. ADD'L too AMP 1.00
NEW CONST. DWELING
OR ADONS. ( ACCLBLDGOCCUP. &) 22sgft
NEW CONSTR. MULTI -OUTLET
NON-RESID. (BRANCH CIRCUITS) 2.50ea
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: 1 1%
1 .-/f
Ex. Occup(OUTLETS OR FIXTURES) BAL@@t
FIXED ALNS.
Ex. Occup. ( OUTLETS P(RESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
:�
License No. d / Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ T, r/�
$ • r 7,
MECHANICAL No. @ 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.
'have placed on file with the County of Butte a certificate of
❑ Workmen's Compensation Insurance.
F-1 I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
autnorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
) "t i
r �I
X ! Date
Signature of Permitee or Agent
Rer,pint Ain
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 PUBLIC WORKS
By
Building permit expires Date
Date
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION MID PERMIT
Wonu
,3-i178-7 7
..0
BUILDING
Owner Lv
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address 9 / �.�. r+ r
Permit Fee
Plan Checking Fee &/or Penalty
Tele ho a No.
U ,�
Permit Fee $
Building Address;
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
fle
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. _
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fee rrW.
ire Dept.
FireZone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
s ec
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE J$3.00 sf�
5 c
Main service 100 AMOR S
P ORLESS 5.00 ! V b
u
h
Main service EA. ADD'L 100 AMP 2.50&W
Single Family Duplex ❑ Mobil l4ome ❑ Others ❑
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADO'L 100 AMP 1.00
NEW CONST. OR ADDNS. ( ACCLBLDGDWELING OCCUP. &) 20sgft
NEW CONSTR. MULTI -OUTLET
NON.RESID. ( BRANCH CIRCUITS)2.50ea
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: �/ ",
j C(�_�� �_
Ex. Occup(OUTLETS OR FIXTURES) BAL@@1
FIXED APPLNS. OR
Ex. Occup. (OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
rr•
Mobile Home Facilities 15.00'
License No. S' �� Classification CIO
Misc. Wiring 6.25
❑ I 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.
v I certify that in the performance of the work for which this
permit is Issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
(J//ill
X
TOTAL PERMIT FEE
$ .:
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.
DIREC OF PLALIC WORKS
—I Date d
Signature of Permitee or Agent
-✓"� BY Date
Receipt No. '.=7
White-D.P.W. — ellow-Assessor — Pink -Inspector — Goldenrod -Applicant B permit expires Date
se ,
,:028 150—lot PERIT#97=2669
WALKER, VERONA
4
2846 OROQUINCY HWY
' CONT :. `RON HOLLAND !
REROOF, EXT HT OF SER MAST'
(Rev. 12/96)
COUNTY OF BUTTE- DEPARTMENAG- DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541
APPLICATION AND PERMIT
PERMIT NO, t
AssEssOVUt3a1C)BL;407
ZONING1X
BUILDING PERMIT
OWNER VE / NTA WAt YM
�� vv 111
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
ILI
OWNER'S MAILI ADDRESS
�a unu QUI, 1'�,Ty, 0 , OVILLE, 95956
6-1 .% 6 • 00
cow"'ACTOR.'Y Nr
Rud s LJL�L A3D
T,EIFPHONE
»t�� X210
CONTRAcVM AWA '0V E, OROVILLE, 95965
CONSTRUCTION LENDER
LENDER'S MAIUNG ADDRESS
Fireplace
Total Valuation $ Jbu.
ARCHITECT OR ENGINEER
LICENSE NO.
Filen Fee $ 20.00
Permit Fee $ 15.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING,2 FESS
LoA►U OP.QQUI�CY mry
Energy Plan Checking Fee $
OROVIU E
$
PERMIT FEE S
LOT NO.SUBDNISIONS
NAME
PARCEL MAP
]I
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex ❑ Mobilehome ❑ Other
SPECIE-`/
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 f
New O Addition O Remodel O Utilities ❑ Installation O Other a
Describe Work: RLTZ00F 1` 1711 =Ti , Y!XM;D TIEIG17 01 SI�F`VIC
1,r
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S G W 920.00
PERMIT FEE S
ELECTRICAL PERMIT Filing Fee 20.00
COOV OR LESS
Main Service Zoon oR Less 23.00 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 irAlull force and effect.
License Class Lic. No. S/� lA O
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
O I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service ( 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( 8 ACC. BLDS. 3.52FT.
� -RESI.T MULTI -O TLE
BRANCH 13CUITS @7,50
POWER APPARATUS
a SINGLE OUTLET CIA.
Ex. Occup. OUTLET OR FIXTURES BAL@ .0
Ex. Occup. OUTLETSRAPPES u.DEw 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
L4
PERMIT FEE $
WORKERS' COMPENSATION DECLARATION
i Ke eby affirm under penalty of perjury one of the following declarations:
O- 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
M I 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' comp nsation I suranc carrier and policy number are:
Carrier / 4, ":
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Policy Number / n h Y 0 et S"- 9 `/
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
O 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to 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
o W th cc P y ith ose prows4ons.
X, __ Date �2 ! 2Z ��
Sigrtat re of AlSplicant - O Owner Contractor O Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 78•00
HAZ.
D. FEES IMP
FLOOD
COF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated,atiove for which fees have been paid.
By
v
PERMIT EXPIRES ON
Date
Receipt No. `J1�►��►
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERM No.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOFd6§ELrgfJi107
�VERONA
ZONING._
BUILDINGPERMIT '!
OWNER
WALKER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
6 0 3 60.00
GW"ER5 fyl�I�c'Rb QUINCY HWY, OROVILLE, 95966
coNrRAc�Ltb5�4NUA�VtLLAND
T Y4 7210
CO"TRACT6br1JV11 Msft, OROVILLE, 95965
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
'
Total Valuation $ 360.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filin Fee $
20.00
Permit Fee $
15.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING fjQr,F6 OROQUINCY HWY
Energy Plan Checking Fee. $
OROVILLE
PERMIT FEE $
35.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 1
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 ❑ Installation ❑ Other IR
Describe Work: REROOF WITH COMP, EXTEND HEIGHT OF SERVIC
MAST
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home IS I GI W1
920.00
PERMIT FEE S
ELECTRICAL PERMIT
Filing Fee 20.00
"OOVMain Service 20.A OR LESS
23.00 23.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that 1 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 ull force and effect. -11POWER
License Class Lic. No. -6 t 0
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
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' c p �n�ys,�af ion i uranc carrier and policy number are:
Carrier s4W rP t4 h4
Mein Service ( To I
46.00
NEW CONST. DWELLING OCCUP.
WE U
OR ADDNS. ( a Acc. BLDs.
SO
3.5��:
NEWCONST. MULTI -OUTLET
NON-RESID. C CIRCUITS
@7.50
APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
B4� p 1.0100
UNS
Ex. Occup. ouTLEEDrs RES D.OEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE $
43.00
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEt $
Policy Number / 6 O y O 0S— q7
(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
or th Cory ith Those Prov' ' ns.
_ �. --
Date /2 0Z_- l /
Si at re of A plicant - ❑ Owner. Contractor ❑ Agent
An OSHA permit is required for excava ions over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 78 00
=HAD.
FEES IMP
FLOOD
CDF
PARCEL PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Res utions to do work
indicate ove for whit fees ha b n paid.
ByM Date 1
4 g I rA ,Imhp
PERMIT EXPIRES ON Id c
Date
ReceiptNo. 231454 -
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
(Fie,.12/96)
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
,OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
aIg Oro 0ru0'4l `l5`7(06
CONTRA'S NAME TELEPHONE '
Al a� L 9210
CONTRACTORS MAILING AQDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
'
Total Valuation $
p
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$15,O -t:;)
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
O v
Energy Plan Checking Fee
$
.vL
$
PERMIT FEE
S i
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 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 ❑ Installation ❑ Other
Describe Work: "-7
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
$
��
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200A OR LEss
23.00 8
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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
Main Service YOGA TO 1000A
46.00NEW
CONST. DWELLING OCCUR
OR ADDNS. ( & ACC. S.
s0
3.50FT_
No RES DT MULTI -OUTLET
97,50
APPARATUS
8 SINGLE OUTLET CR.
EX. OCCU OUTLET OR FIXTURES
SAL @':0050
Ex. Occup. ofli xiTLEeDrs A=.oEw
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
$ ^
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
S
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP
FLOOD
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
Dale
Receipt No. 3
WHITE.D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
• .4 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: lL��� lL-- ��1-0 ASSESSOR PARCEL NUMBER: ��%,� /) — -7
Proposed Building Use: Building Inspector:Date: 2 — -2 �-- 12
At time of permit applica on, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All items have been submitted .-------------------------------------------------------------------------------------
❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------
03. Complete plans, 3/4 sets, signed by the preparer of plans. -----------------------------------------------------
04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. --------
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
06. Energy Design Compliance and supporting documentation. ----------------------------------------------------
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------
❑9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------
❑ 10. Fees of $ -------------------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. ----------------------------------------------------------------
❑ 12. California Department of Forestry plan approval/fees. --------------------------------------------------------
❑ 13. Flood elevation certificate.----------------------------------------------------------------------------------------
❑ 14. Sanitation and plot plan approval Health Department. -------------------
❑ 15. City of Chico plumbing permit. -----------------------------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------
1117.
---------------------
❑17. Planning approval for (A) Use: (B) Parking: -
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.
❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). ---.
❑20. Pre -inspection for required Request to Building Inspector on
❑21 ontractor's license information. (Number, Name Style, Classification). ----------------------=------
Q/ 2. Workers' Compensation carrier and policy number. ----------------------------------------------------
1123. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------
❑ 24. Letter of signature authorization. -------------------------------
❑ 25 . Recorded copy of Agricultural Acknowledgment Statement. .
❑26. Letter of intent on building use. ----------------------------------
❑ 27. Manufactured Home utility clearance. --------------------------
028. Existing violations and/or expired permits. ---------------------
0 29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
❑30.Other:
When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor.
❑ Telephone / and hold for pickup at with inspector.
Applica;iFolluotion4Date:
Date:
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, o By:.
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
(Date)
/z-- z - ? 7
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items required: _
Contractor, designer, owner, was advised of the above required data by o phone, ❑ mail, o Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, o mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, o mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note trdnsfer by: Date:
Yellow Copy - Department of Development Services, Building Division.