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Home My WebLink About069-200-027Gent C. Eldridge 68 Kokanee Dr., lot 71, KR#3, Oroville ko ntr: Better Builders Const., Oro. it #1626-80B,P,E (new sin le vn J69-200-027 05-2265 �ELDRIDGE, GRANT & JULIA 8 KOKANNEE DR, OROVILLE ont: NINE BROS VINYL INYL SIDING 069-200-027 06-0644 ELDRIDGE, GRANT 68 KOKANEE DR, OROVILLE Cont: MAKIN ROOFING RE ROOF 'rIWA-i— -I t1 1 t M gg Butte County Department of Development Services. o�Tre Ram IN O T E S 7 County Center Drive. Oroville. CA 95965 (530) 538-7601 vnvvv.buttecotintyngVos °ouxt{ I RESIDENTIAL APN: Permit No. Owner. 069-200-027 06-0644 j ELDRIDGE, GRANT Site Address: 68 KOKANEE DR, OROVILLE Cont: MAKIN ROOFING j Contractor. RE ROOF Type of Permit �- -- — --- --� SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOS FINALED: SIGNATURE: 0l OK Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Opth, 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd flr - Tub. Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1•l Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE IMECHANICAL 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 61 AC Ducts Insultn & Support 14 Girders Sills-Anchr Botts J oists-Vnts -Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16. Insulation 64 Furnace -Vent Acc-Comb Air RtrnfVent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic c ° DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 18 Walls Studs -Nailing Spacing & Braces-PlatesSound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-fir-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clmc 72 Elec Trim & Subpnl, Breaker SYs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clmc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking Clmc 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn,• LPG Appince Undr House 3- drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Dmge Planters ElYes❑No °�' s` 87 Stucco Brown -Finish o °�• m 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs DATE JELECTRICAL 90 Wtr Well, Dscnnct, Elec, Plmb 40 Fxtr & Tmsfrmr Clrnc4ns Prtctn 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntitn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Gmd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-D/O to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga Q CU or DAL 98 Address Posted AC Wire Sz 93O CU or O AL 99. Fire Sprinkler 48 Range Circ ga CU or AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral E)Yes ❑No�� o'er 49 Service -Riser Cndctrs & Grnd Main Dscnnct o` o12' m 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector OK Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat Q or LPO Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-CImcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs 0 Foundation Q 14 Exits 1S Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D E C K S'C O V E R S'C A R P O R T S 'GARAGE S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnis s` °` ° oma• DATE IPOOLS 1 Setbacks -Easements 2 Soils; CompactionStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance -GF] 5 Elec Pool Lting; 15 volts-GFI 6 Elec Encisrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w15'-Crcltng Egp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg B6kes-Encisrs=pnlboards4nsultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide o'er �c � 0� Pool Drawing BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. 311Z*1111MILI PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury, that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 03/23/2006 APN: 069-200-027-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: 92 9 7 2 Site Address: 68 KOKANEE DR ORO ? _,O S Contractor: Date:J` Map index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: RE -ROOF (27 SQ) 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: ELDRIDGE GRANT C & JULIA PPT 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 68 KOKANEE DR 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 95966 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: MAKIN ROOFING pp such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 1900 ORODAM BLVD #4 sale. If however, the building or improvements are sold within one OROVILLE, CA year of completion, the owner -builder will have the burden of 95966 proving that he or she did not build or improve for the purpose of sale.). (530) 532-1360 ❑ 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.). Contractor: MAKIN ROOFING 1900 ORODAM BLVD #4OROVILLE, ❑ I am Exempt under Article 3 of the Business and Professions Code CA Date: owner: 95966 (530) 532-1360 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 License #: 828727 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy#: I certify that in the performance of the work for which this permit.is Valuation: $0.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall I forthwith comply with those provisions. Date: Applicant: WARNING: F ' ure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol io to do work indica ed above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) n2 n (� :_nal B Date: 23'l� I B By Name: EXPIRES ON: c )-2�"O r / Address: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O 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 o any officialfo m or document of Butte County. I hereby authorize representatives of Butte County to ente7ucn the above mentioned property for inspection purpos tj�i1//I Print Name:yCf ►� Signature: o.6 Date: ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIRENIENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BP 0 0 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION BIN N Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" APPLICANT INFORMATION CONTRACTOR OWNER INFORMATION Last Name i "r First Name ', Address S Zip City % V r Fax S State Zip 6 Phone Class C Fax E-mail APPLICANT INFORMATION CONTRACTOR Name / o AddressG 8 U O /o cp11, City 6 fO' //C P LPhone E mail State Zip Phone' 3 3 6 Fax S E-mail ` Planner Lic. #g, 2 Class C APPLICANT INFORMATION ARCHITECT/ENGINEER Name State C'4 Address ` (o City LPhone E mail State Zip Phone Book Fax E mail Planner State License Number APPLICANT INFORMATION Name , G 1! Address City r State C'4 Zip l ` (o Fax LPhone E mail J - APPLICANT SIGNATUREWPA AlIF En For office use only: Zoning Property Address 4e Flood Zone Cross Street 40dg SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PROJECTLOCATION AP# —GUIJ -• VL Property Address 4e / Cross Street 40dg 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: �eroo�:2-75, Sq FT- Living Garage Open Cov ❑ 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: K,G , Amount: �5..� Bldg Receipt #: � 1004 SRA Sheriff 6 SMIP Date: 3, G. /) 3 O Other �•C CO 0 Total C' 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 manual, (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. Building Permit Application Without Required Clearances Form ❑ 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.) ❑ t. 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 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\BIdoADD1SubRamts.doc Paqe 2 bf 2 REV 8-12-05 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP052268 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 08/23/2005 APN: 069-200-027-000 the Business and Professions Code, and my license is in full force and effect. G License Class : License Numb �[ ( Site Address: 68 KOKANEE DR ORO Date: — 23 _0 Contractor: b . Map Index: Description: SIDING, VINYL (24 SQ) OWNER -BUILDER DECLA ATION 1 hereby affirm under penalty of perjury that I am exem 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: ELDRIDGE GRANT C &JULIA PPT 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 68 KOKANEE DR the Contractors State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: NINE BROTHERS VINYL SIDING 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 7744 ORPHEUM WAY year of completion, the owner -builder will have the burden of ANTELOPE, CA proving that he or she did not build or improve for the purpose of 95843 sale.). (916) 752-5252 ❑ 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 eLaw Contractor: NINE BROTHERS VINYL SIDING ❑ I am Exempt under Article 3 of th ine P e io 0 7744 ORPHEUM WAY Date:- owner: ANTELOPE, CA 95843 WORKERS'COMPE SATI D LA_ 1 I hereby affirm under penalty of perjury on oft a follb ing larations: (916) 752-5252 ❑ 1 have and will maintain a certificate of conse t to se f -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit License #: 847142 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 Architect: insurance carrier and policy number are: t � rU"d Engineer: Carrier: Ct 1� nn Policy #: V �� X 2 ID - 0'1 ❑ I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if 1 should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: � O c 00 s' Applicant: ^ 5 ^ S J( 'L/ �U( WARNING: Failure to secure w r rs c m nsation coverage is unlawful, and shall subject an emplo er t ri inal penalties and one hundred thousand dollars ($100,000), in addition to the 2 - O� cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resoluti n to do work indicated above f r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: A K\ By: A� v 1. Date: V 2 L3 - n PERMIT EXPIRES ON: 0 - 2c)- l ILD 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. 13- 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 1 have read this application, that the above information is correct, and that I am the owner ormy au iz ent of the o comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance o n �offic' or r c ment of It ou h reby authorize representatives of Butte County to enter upon the above mentioned property for inspection ' purpos Venl ai7i/Pi� Z,4S- / Print Name: /CH()X--Signature: e Date: OrContractor ❑ 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 INFORMATION Last Name F1 D FGtrcAri4 t Address 6' ora n C_ e D. City ORO V F State CA Zip 05'_06_ I Phone 530 5.89 _ /4fDeax 195 9 y E-mail ,6 CONTRACTOR ARCHITECT/ENGINEER Name i11 rlROT 1tiT= R S (/I Vl s-/' +� Address 7 7 Lt / Pa e Uvh -Vol City A0 t e to I_ State t::::�A Zip I 195 9 y � 16 75 z -5Z 5 Fax 916 '11 FE'o Lic. ? Class D_ APPLICANT INFORMATION ARCHITECT/ENGINEER Name Address 7 7 Address Cityn �7e City Zip gsBk State Zip Phone Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name 0 /I i' a M I Y1 L A S HC H U V Address 7 7 Uy)-, Wif Cityn �7e State �n Zip gsBk Phone 916 7S -SLS Fax g (6,T -726 — SK6 E-mail Book �c��llllllllllllll�t��\r� For office us on y: Zoning Property Address Flood Zone I I SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc 61 PERMIT NO. BIN # PROJECT LOCATION AP#.0 CSR -- - b 2 Property Address City Cross Street WORKER'S COMPENSATION Policy Number 1903 2 n^ 0 Carrier t a e e— F OPW If hiring anyone other than license contractors, a certificate of worker's compensation mustbe shown at the time of permit issuance. LENDING AGENCY Name Address t Description or Scope of Work: /»S Q /A V/ h y "( S Sq FT- Living Garage Open Cov ❑ 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. I I Received by: <� G. Amount: V I I Q, 00 Bldg I I Paqe 1 of 2 SRA io'dReceipt #:�Lbb Sheriff 22) 1(3 SMIP Date: _ 23 ` 105 Other iin-w Total REV 8-12-05 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 AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (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. Building Permit Application Without Required Clearances Form ❑ 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 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 8-12-05 PERMIT NO. 1626-80B,P,E,M PERMIT EXPIRES �/ r I / il Grant C. Eldridge OWNER CONTR. Better Bldrs. Const., Oroville LOCATION (A.P. ' 1L -79-97- 68 79-77 68 Kokanee Dr., lot 71, KR#3, Oroville Temp. Power Pole: Called PG&E Temp. Elec. Serv. Called PG&E Temp. G s Serv. Cally PG&E J 0V/ — E7 FINA LED (DaSO e) 1, (Signature) i COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING ;setback A soli Firewall Sol[ Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor . Footings /, Windows n , 3rd Floor StemwaII Sidino To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for phsically handica ed Conformance of ex. structure Appliances Gas Piping Temp. Gas &Test Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat I Rou h'— Reinf. Steel Final I Fixtures Bond Beam i FIRE SPRINKLERS I Motors Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts -- !�,z ' Underaround Door Closer I Final Final MOBILEHOME UTILITIES - - - - - - - - - - - - - - - - - - Elec. Service Elec" Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION .............. Support Elec. Continuity Water Piping Drainage Gas Piping DATE 41 //—d 0 REMARKS OR CORRECTIONS 406A--T7--- L(�� C?tLp q-1,I;59a 67 otlDT �2Iz1�D w 6 �l�' 6 � Cfl =icy -moo W ivere (NOTE: An entry must be made on this form each time you visit the job site.) RESIDENTIAL ENERGY CONSERVATION STANDARDS f CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT !9A RaRA ujoe (location) BUILDING PERMIT NO. /(12,? G -An 13 A:P. NO.�-.17 THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge.gU Fdn. Walls 4) A Floors A Walls Ceiling/Roof Ducts Circulating Pipes_ APPROVED HEATER APPROVED WTR.HTR. GLAZING: Single Glazed AJ14 Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. WEATHERSTRIPPED DRS. ✓ BACK DAMPERED FANS AM INTERMITTENT IGNITION DEVI�.ES AW CERT. APPLIANCES 1/ I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name Signature of (p a pru Insulation Applicator State ontrg�tors License NO --,/-,15.50;2A General Contractor/Owner Name ,I..Al (please print) Signature of. General Contractor/Owner Date State Contractors License No. 3?sa 1.ri THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WTTTiTN THF. nWF.T.T.TNI:_ UNDERFLOOR e.') Setbacks - asements.J 3--Pfg-Main; Soils - SteelFtg. Depth Above Completed ❑ Exce Job Card Signed �) ate —T - Corrections Completed Job Card Signed Date tg., Garage; Soils - Steel - ❑" Ftg. Depth Ftg., Porches & Decks; Soils - Steel - ❑" Ftg. Depth Stemwalls, Garage; Steol - Slockouts Stemwalls, Garage; Steel - Blockouts . Piers - FiM0WN-f49,4Wel- 9. Drain; Fall - Fittings - 9;4t' Test - 2 way C/O - Sewor Test +0-• Gas Pipe; itize - Test Wr-wateirb?65e: Test - Anghwf egulator Servi est - .-. YIer�AY 6 UIj�,YjGleer�prer-^ rvia�y. ray — �uya�, „a. 1 Girders - Sills - Anchor Bolts - Joists - Vents -Cripples Above Completed - ❑ Except: Job Card Signed J 2eL,-i Date - o a Corrections Completed Job Card Signed Date PLUMBING - ABOVE FLOOR 45:- Water Htr.-iFbRt--.-Assees - Conabi afinn Air ater Pipe - Test & Anchors - Nail Protection 1Q/6in Pipe - Test - Fttngs & Anchors - Nail Prot. - 42" Test IK 6heweF4n - Test, -First -Flee` Tub Access ,14—. Test Tub & Shower, 2nd floor - Tub Access te— Gas Pipe - Size & Anchors Above Completed - ❑ Except: Job Card Signed Date " Corrections Completed Job Card Signed Date ELECTRICAL - ABOVE FLOOR �learance & Insulation Prot. at Flush Light Fixtures _�. Receptacles Spacing - Lights & Switches at Doors Sixe Boxes & No. of Conductors - Stapled - Romex Installed Close to Edge of Studs & C.J. equip. Ground made up w/Meeh. Fasteners 2 Appliance Circuits In Kitchen & Conductor Size - A.C.-Wire Size/ Range Circ.❑ ga. Cu or At - Oven Circ. ❑ga. Cu or Al, Insulated Neutral ❑Yes ❑No Service - 144sr_�V3 & Ground Uepd-hes-& Water Pipes Clothes Closet Light - Shower Light Above Completed - ❑ Except: Job Card Signed Date Corrections Completed Job Card Signed Date Cu or AL MECHANICAL - ABOVE FLOOR I .32-- A.C. Ducts - Insulation & Support '_�/ent Fan - Exhaust above Insulation i 9+^ Condensate Drain & Overflow - size & Grade -26sFurnace - Vent - Acces-Corrlb. Air -- Return Air Vent -- 115V outlet 34--<ttic Access & -1 Above Completed - ❑ Except: Job Card Signed Corrections Completed Job Card Signed Date 4-/A-R-0 Date FRAMING 36/Wal s. - Studs - Nailing &pacing & Bracing - Plates Baring Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops - Furred Ceilings - Stairs - Chases - Tub Header & Beam - Size & Bearing IC Hangers - Post Caps - Anchors - Connectors K A109- Truss-Shlring,Rfng. ��r Type A Flue - Fire�Areet 47�.Attic AocessSize & Bdrnt. Windows or Exiting Doors - Sill Hgt. & Dimensions Garage Fire Protection Framing _ ti69- Alea Separation Walls - 1 hr. Fire - 2 hr. Fire -Ext. Doors - one 3' - Check Garage _ �-5E--Stairs -- Width-Headroom-Ris&-Run-Landing-Fire Prote tion _ - Attic Vents - Rafter Outriggers Siding - Nailing-Alenees- i _ Stucco Mesh, Drip Screed & Fdn. Vents & Underflr. Access -gS:—Glass Protection if required �_ hear Walls Above Completed - ❑ Except: ---- Job Card Signedat-PIA Date (p _10 v Corrections Completed Job Card Signed Date FINAL P!Ops Ext. Steps, Door & Sidelight Protection - Landings _ mok or 61 rnace -- Vents-Cirnces-Comb. Air -Connector- In Garage-Hgt. & Mech. Protection @9, -Exiting G_. F. I-& Bath Fixtures & Tub Access Ie2T & Subpanel - Breaker Sizes - Labels 6/�1tai its irece or Stove - Clearances -Hearth I tlets at Wood Panel - Int. & Ext. ix Appliances in Kit. - Grnded - Air Gap - Ckng. Cirnce 6 , lec. Outlets & Receptacles at Kit. Counter Zge'llarage Fire Door - Swing & Landing -Closer -4U- Arris. Duct in Garage- Damper 7 r. Htr - Vents-Clrnces-Comb. Air-P.R.V.-Connector - In Garage- Hgt. & Mech Protection ZA_-r4rejyAI1s & Openings - Area Separation Walls _I . eceptacles in Garage (G.F.I.) Romex Protec. Insul n - Foam - Looked in Attic / /Yes 7 uard s & Deck Construction dn. Vents & Crawl hole d rainage & Wood -Earth Clrnces- L -under floor I , es Following instld: Drive ❑No; Walks ❑No; Planters ❑Yes 1; A CCreating Drng. Problems ❑Yes 0"6-- - j=o; Brown -Finish �'r'ZCGG 0 A.C. Unit-Disconnect-CImces-Brkr & Cond. Size - 115V Outlet ail Brits Above Roof - Plbg.-Appliances-Firepl. -- Clrnce to Opngs .--�V Well - Disconnect, Electrical, Plumbing _ Exterior Elec. Trim & G.F.I. Receptacle entilation throughout House Lection orrections from Previous Inspections 187 --Gas Test - Meters Tagged -Gas & Electric 7- Supply & Sewage Connected - Cleanout to Grade Energy Compliance Certilicate Above Completed L'• Fxcept: Job Card Sign Date - _-X Corrections Completed Job Card Signed Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OroviIle, California 95965PERMIT /� �-- Telephone: 534-4541 n 40 CCCCJJJJ . APPLICATION AND authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Xv 1i� Date Signature of Permitee or Agent Receipt No. � (ac / oho 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. DIRE ,C-T_OR OFfUBLIC WORKS - Building permit expires Date BUILDING Owner 2�``� C. < SQ. FT. I OCC. BUILDING VALUATION 72 9 60 Mailing Address GID M 0 Telephone No. t`OL✓, Q Contractor Mailing Address Fireplace®r ASD Total Valuation L Azo L;1 1 �; J�6 elephone j le c_ Permit Fee Bb Building AddressPI an Checki ng Fee Vor Penal ty [j Permit Fee PLUMBING No. FEE PERMIT FILING FEE $3.00 Each Trap (� 3 4a -' Q VLL e3 Repair drainage or vent piping 1.50 A. P. No. (�-_ 7 i;Z — ning &Planning Water piping QO Each gas water heater or vent 1.50 FWT;;C��J SaoAn I Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 D Bldg. s Recd Parcel Approval Plans Aof*p'rovaI Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $a4 60 194 16c ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 OC:, Main service 600v OR LESS 100 AMP OR LESS 5.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 100 25.00 100 AMP OR LESS Main service EA. AOD•L 100 AMP 1.00 NEW OR ADDNST AWC. L CUP. 4\ 2¢sgft I 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 le of: NEW NON-RESIESID. U TI -OU LET CON D. ( BRANCH CIRCUITS 2.50ea NEW CONSTR. (POWER APPARATUS a 1 NON-RESID. SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES) IB L�; FIXED APPLNS ORst Ex. Occup. OUTLETS (RESID) EA) 2.00 Temporary service 10.00 , Mobile Home Facilities 15.00 License No. 32,3 as Classification %� Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability forWor men's Compensation. have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. lecertify 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. 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 MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating 1W 4,T-- 44, 41� v Cooling41 Ventilation Hood 2.00 C?C� Permit Fee $ 011CS Land Development Fee $ � $ TOTAL PERMIT FEE $ (di authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Xv 1i� Date Signature of Permitee or Agent Receipt No. � (ac / oho 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. DIRE ,C-T_OR OFfUBLIC WORKS - Building permit expires Date \ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS — BUILDING DIVISION 7 County Center Drive — 0roville, California 95965 — Telephone 534-4541 PERMIT APPLICATION DATA SHEET Other Applicant,-,' Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Plans checked by_ Plans approved by OTHER: Coov/DPW Telephone Mail Other Date )ate Date may' Permit No. OWNER _ �,-„t'.r- -? ` C'. X b/0 d� 1t A. P. No. 4.1 Proposed Building Use �ci /= Permit fee based upon: Complete Contract Price ! - DPW Valuation i Atherf(explain) Building Inspector 41 ' ' 4r ` .. Date S7 (f) At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: - DATE RECEIVED APPROVED y' 1. All items have been submitted................................................................... 2. Plot plans in duplicate/triplicate............................................................... 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and calcs..................................................... 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. 9. Letter of signature authorization............................................................. 10. Sanitation approval from Health Dept.... 11. Planning approval for ............. 12. Certificate of Workmen's Compensation Insurance ........................ 13. Contractors License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec. request to bldg.inspector (date) 16. Other i When you issue the permit, process as follows: Mail to owner Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspection. Other Applicant,-,' Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Plans checked by_ Plans approved by OTHER: Coov/DPW Telephone Mail Other Date )ate Date may' f North Burbank Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95965 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS Telephone 533-2000 This verification form must be submitted to the Butte County Department of Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North Burbank Public Utility District, must be submitted to Butte County. 1139 Applicant: GRA:.T C. LLDRIDGL (� Applicant Address: 22 3oY,%L 0AXS DMri:, O:OVILLw., Applicant Phone No.: 539-1,W3 n Property Location(s): 08 K0:�0 Zi, D'd �;, OROVILLL, C < IMLLY RID=. :5 T1 "S �-:IT 3 T A. P. No. (s): n "-,1-72-0-M-0 Fees Paid: SCOR FACILITY CT L�:G, i]LT_ . ��,c(OU°0 Application for service approved: North Burbank &PRIL 1, 1980 Public Utility District Inspection(s) made and successful test(s) observed: Location: Y___.,r7 / '—�� ^ Date: By: North Burbank Public Utility District release to close permit: Date: J-�/9-� ? By: )%,ao _,J/ 1139