HomeMy WebLinkAbout069-340-022...............
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-
- 113-71P
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i 44.Hillcrest Ave., 0 ovill
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NOTES
PERMIT NO
9
RESIDENTIAL
069-340-022
HARRIS, SARA 05-0467-
452 HILLCREST AVE, OROVILLE
Cont: COMMUNITY ACTION I
C/O WATER HEATER
SPECIAL CONDITIONS
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
c13
JOB FINALED (Date)
Signature U
CHECKED
BY
J=OK
0 = Not OK
NotNo Readyable
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
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-Grnd-/ /Amp -Concrete
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / /" L "ft./ P LPG
7.
Well Clearance & Disconnect
8.
Utility Clearance
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
Date
12.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Card B-1 Date Card B-1
1.
Zoning Requirements -Setbacks -Easements
Card B-1 Date Card B-1
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
Date
12.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Card B-1 Date Card B-1
1.
Zoning Requirements -Setbacks -Easements
Card B-1 Date Card B-1
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Panelboards-Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J=OK
0 = Not OK
= Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" 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- Bloc kouts-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
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
12.
Electric Underground
Glazing Area -Glass Protection -Skylights -Plastic
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
Shear Walls; Nailing -Bolts
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
Brace Interior/Exterior Wall Panels
15.
Access & Ventilation
Insulation -Walls -Ceilings
16.
Insulation
Infiltration -Walls -Windows
Date
Date
Date
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Ext. Steps -Door & Sidelight Protection -Landings
17.
Water Htr.; Vent -Access -Combustion Air Baffle
Smoke Detector
18.
Water Pipe; Test & Anchor -Nail Protection
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
Bedroom Exiting
20.
Shower Pan; Test, First Floor -Tub Access
G.F.I. & Bath Fixtures & Tub Access -Spa
21.
Test Tub & Shower, Second Floor -Tub Access
Elec. Trim & Subpanel, Breaker Sizes & Labels
22.
Gas Pipe; Sixe & Anchors
Stairs & Rails
23.
Fire Sprinkler; Test
Fireplace or Stove, Clearance -Hearth
72.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
75.
24.
Fixture & Transformer Clearance -Ins. Protection
76.
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
77.
26.
Size Boxes & No. of Conductors Stapled
78.
27.
Romex Installed Close to Edge of Studs & C.J.
79.
28.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
80.
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
81.
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
82.
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral 0 Yes O No
32.
Service -Riser Conductors & Ground Main Disconnect
83.
33.
Equip. Clearances Panels-Motors-Mech. Equip.
84.
34.
Clothes Closet Light -Shower Light -Spa Light
85.
35.
Smoke Detector
86.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
Date
Water Well, Disconnect, Electrical, Plumbing
Card B-1 Date Card B-1
Date
Exterior Elec. Trim, G.F.I. Receptacle -Underground
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36.
A.C. Ducts Insulation & Support
37.
Vent Fan, Exhaust above insulation
38.
Condensate Drain & Overflow, Size & Grade
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40.
Attic Access & Platform if Furnace in Attic
Date
95.
Card B-1 Date Card B-1
Date
96.
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Card B-1 Date Card B-1
41.
Sills Proper Materials & Anchors
Card B-1 Date Card B-1
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
Card B-1 Date Card B-1
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 A Flue -Fireplace Throat Clearance
50.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57.
Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59.
Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64.
Ext. Steps -Door & Sidelight Protection -Landings
65.
Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68.
G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70.
Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72.
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-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83.
Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters O 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:
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BPO50467
B. C. Building Permit 01-16-04 pp 1
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: 02/17/2005 APN: 069-340-022-000
the Business and Professions Code, and my license is in full force and
effect.
License class : _ ' r C) icense Number: i,p�
Site Address: 452 HILLCREST AVE ORO
Date: • /% contractor: r' o >� (y
Map Index:
Description: change h2o heater
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: HARRIS SARA L SS
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
425 HILLCREST AVE
signed statement that he or she is licensed pursuant to the provisions of
OROVILLE, CA
the Contractor's Slate 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
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: COMMUNITY ACTION AGENCY OF BUTTE
Code: The Contractors' Slate License Law does not apply to an
COUNTY INC.
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
2640 SOUTH 5TH AVENUE
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
OROVILLE, CA 95965
proving that he or she did not build or improve for the purpose of
(530)538-7559
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
Contractor: COMMUNITY ACTION AGENCY OF BUTTE
pursuant to the Contractors' State License Law.).
COUNTY INC.
❑ I am Exempt under Article 3 of the Business and Professions Code
2640 SOUTH 5TH AVENUE
Date: Owner:
OROVILLE, CA 95965
(530)538-7559
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 #: 617201
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
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier: ly -y j/Y�
Total Square Ft: 0 S. F.
Policy #: IiJ �d�
—r
❑ 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�'r—
forthwith comply with those provisions.
J
Date: -' .' <7
Applicant:_t���
/ U,
WARNING: Failure to- secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is h by issued under the applic le provisions of the Butte County Code and/or
eve been
I hereby affirm that there is a construction lending agency for the
of the work for which this is issued (Sec 3097 Civ.)
Resolutions do work indicated f v�hich s have paid.
2— O
performance permit
BY Date:
Name:
PERMI XPIRES ON:
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 8 Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: rr `Y�Cc� f'r-� Signature:
Date:
❑ Owner ❑ Contractor ❑ Agent for Owner Agent for Contractor
B. C. Building Permit 01-16-04 pp 1
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.
BP050467
B. C. Building Permit 01-16-04 pq 1
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: 02/17/2005 APN: 069-340-022-000
the Business and Professions Code, and my license is in full force and
effect
: r L)_-�
License Class icense Number:
Site Address: 452 HILLCREST AVE ORO
Date: Z- /7--!25contractor: ( c i�
Map Index:
Description: change h2o heater
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: HARRIS SARA L SS
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
425 HILLCREST AVE
signed statement that he or she is licensed pursuant to the provisions of
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business. and Professions Code) or that he or
95966
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: COMMUNITY ACTION AGENCY OF BUTTE
Code: The Contractors' State License Law does not apply to an
COUNTY INC.
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
2640 SOUTH 5TH AVENUE
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
OROVILLE, CA 95965
proving that he or she did not build or improve for the purpose of
(530)538-7559
sale.).
O 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
Contractor: COMMUNITY ACTION AGENCY OF BUTTE
pursuant to the Contractors' State License Law.).
COUNTY INC.
❑ I am Exempt under Article 3 of the Business and Professions Code
2640 SOUTH 5TH AVENUE
Date: Owner:
OROVILLE, CA 95965
(530)538-7559
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
License #: 617201
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
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier: lty�'r �� �rY4
Policy #:
Total Square Ft: 0 S. F.
O 1 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
Ci�7
forthwith comply with those provisions.
Date: -' 6Z — 0
Applicant:��
WARNING: Failure to- secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
/
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is h y issue under the applic le provisions of the Butte County Code and/or
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.)
Resolutions do work)ndicate ve f which s have been paid.
2-- ��—O
By: Date:
Name:
PERMI XPIRES ON: _� /7-06
Address:
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any 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: i, -�� Signature:
�. Z - D
Date:
O Owner ❑ Contractor ❑ Agent for Owner Agent for Contractor
B. C. Building Permit 01-16-04 pq 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
CONTRACTOR
Name C A A a �P &Va
OWNER
Last Name �
irsstt Nam,t
Address
T 17(
c����
� � �
City (0
Planner
State
Zip S
Phone
State License Number
Fax
E-mail
CONTRACTOR
Name C A A a �P &Va
Address =5 �_Q7��
City C5" v/ ��
StateC
Z'P?5_ 6
Phone
Fax Gi 7 2D/
E-mail
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Planner
Fax
E-mail
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
or office use only:
Zoning
Flood Zone
Cityc��
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.
BPoSO L/6
BIN #
LOCATION
AP# /
Property A!;- 2 /`i7 L -I—
Cityc��
Cross Street
WORKER'S COMPENSATION
Policy Number JS Q
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:
20
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
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
SMTP
Other
Date: n Ci Total
REV 7-27-04
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. (Note: Not required for additions to
mobile or modular homes.)
❑
5.
Statement of Intent for Non -heated and A/C for Non -Residential Buildings. .
❑
6.
Manufactured homes: (A) Data sheets and 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).
❑
13.
Sanitation and site plan approval from the Environmental Health Department.
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 itemst)
❑
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, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application 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
KIFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04
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02,-0763.
a; 069-040-022
� , .
CREST, CRCVILLE
1'452
HILL
< ARTIC AIRS
_ I, • . _ � CAL HEATERS " `. � ...
V of r((�
�6
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION -
y �<
7{County Center Drive • Oroville, California 95965 • Telephone (530) 538 -7r -Al ���P,fMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT �j
MBER
iLy.Gry
ZONING
BUILDING PERMIT
OW¢SPS
NER
HARRIS SARA
TELEPHONE
589-3787
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAIUNG ADDRESS
452 HII3ZWr MVIME CA 95%6
CONTRACTOR'S NAME
AMC AIRF
TELEPHONE
89S-3485
CONTRACTORS MAIUNG ADDRESS '
2350 PARK AVE. CHICb CA 95928 !
CONSTRUCTION LENDER i
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
PermWFee $
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee $
BUILDING ADDRESS i
4S2 HIilC = ORAVIII.E CA 95%6
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF FI Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK I
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Q
Describe Work: REF'iACE 2 EX WAIL. HEATERS
EXISrm QS I'm
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI GI W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
600V LE
Main Service 200" OR LESS
23.00
i
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.apOWiE.R
License Class Lic. No.C.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason: 4
❑ 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.
❑ I am exempt under Sec. Business and Professions Code for this
reason I
Main Service 20011 TO lOooA
46.
NEW CONST. DWELLING UP.
OR ADDNS. ( DVT
ACC. BLDS.
SO
so
3.5¢FT.
RO,pT MULTI-OUTLETI RC
97.50
A Pvi USf
EX. Occup OUTLET OR FDCTURES
20 p 1.00
BAL @ .50
FI APPLNS.. OR
Ex. Occup. ovnFrs RESIDEA
S.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. %�,
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 Carrieand policy number are:
Carrier .� �'
MECHANICAL PERMIT
Fling Fee 20.00
Nesting 2
1 • •
Cooling'
Hood
6.50
Ventilation
PERMIT FEE $
50.00
%�
Policy Number 1
(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 f I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with #1cse provisions.
a
X Date Q — «i' W
Signature of Applicant - ❑ Owner ❑ Contractor Q,rAgent
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
CDNST. TYPE
-*�«
TOTAL,FEE $ '_ft"AA
HAZ.
D. FEES
IMP FLOOD CDF PARCEL PD HD
IS E
IP
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.
, /
L�� i�.
By _ LA L{ Date ✓
.ff ✓✓//
PERMIT EXPIRES ON
Date
Receipt No. 343703/50.00
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 (530) 538-41 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
M - 0-7
ASSESSOR PARCEL NUMBER
069-340-022
ZONING
BUILDING PERMIT
OWNER
HARRIS SARA
TELEPHONE
589-3787
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
452 HILLCREST OROVILLE CA 95966
CONTRACTOR'S NAME
ARTIC AIRF
TELEPHONE
895-3485
CONTRACTORS MAILING ADDRESS
2350 PARK AVE. CHICO CA 95928
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE No.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
452 HILLCREST OROVILLE CA 95966
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF 11 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 IX
Describe Work: REPLACE 2 EX WALL HEATERS
EXISTING GAS LINE
Gas piping stem 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE S
ELECTRICAL PERMIT
Filing Fee 20.00
800V OR LESS
Main Service zoOA 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.POWEPPARATUS
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.
❑ 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 2o0A TO
46.00
CCU000A
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. BLDS.
SO
3.50FT.
NONRE ID. MULTI-OUTLE
@7.50
8 SINGLER AOUTLET CR.
Ex. Occup. OUTLET OR FIXTURES
20 Q 1.00
SAL @ .so
Ex. Occup. oFF EEDTs ASID.°�
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE $
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
vrformance of the work for which this permit is issued.
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 carriej and policy number are:
Carrier es -A-- -,1,f;
MECHANICAL PERMIT
Filing Fee 20.00
Heating 2
115.00 30.00
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
50.00
Policy Number ;J 2.I - )
(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 f I should become subject to the,
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith with �osse provisions.
1
X _ �� Date�N _' QOcj--
Signature of Applicant - ❑ Owner ❑ Contractor gent
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
COT TYPE_
TOTAL FEE $'"�
HAZ.�D.FEES
IMP FLOODCDF PARCEL Po HD
IS%E
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicatZor wbich fees have been paid.
By y Date
PERMIT EXPIRES ON / —:3—
Date
Receipt No. 34=/50.00
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT