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HomeMy WebLinkAbout069-360-035i "I , .69-36-35- PRANCIS WAGNER' . , ' _ MOUNTAIN DEVELOPMENT C0. -277,5-72B P_ tE: - 34•Cle6ess Dr,, roville �- -' �A F , Permit'#1966- 86B(wood stove/ 34 GlenessDr., Lotrl , Oroville (new single 1 03 y • j! • ra �. • � fy 0 i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 638-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 638-7541 PERMIT NO. BPO53126 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: 11/21/2005 APN: 069-360-035-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 34 GLENESS DR ORO Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: RE -ROOF (24 SQ) Contractors' Slate 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: BLIBI ER JASON W & ALLISON J to its issuance, also requires the applicant for such permit to file a 34 GLENESS DR signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95966-9423 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: BUBIER JASON W & ALLISON J owner of property who builds or improves thereon, and who does 34 GLENESS DR such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for OROVILLE, CA sale. If however, the building or improvements are sold within one 95966-9423 year of completion, the owner -builder will have the burden of (530 ) 589-2601 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of t Business and Professions Code Date:.l� 2/ate Owner: License #: WORKERS' COMOMSATION DECLARATION I hereby 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. Architect: ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. PeGoy#: Valuation: $0.00 ❑ 1 certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' ��• compensation provisions of Section 3700 of the Labor Code, I shall VO forthwith comply with those provisions. Date: 1`r 4 75 Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and .one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 -of the.Labor code, interest, and attorney's fees., CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolution to do work Vindicate above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)I� Name: By: I _ ' ' Date: CX PERMIT EXPIRES ON: 11 -21 -OG 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. O Notification in accordance with Section 19827.5 of California Health & Safely 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 fficial form or document of Butte County. 1 hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. . Print Name: 7/7 &Adj �L_ Signature: Date: .Owner O Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 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 OFAPPLICATION Website: ww%v.buttecounty.net/dds "PLEASE PRINT CLEARLYY OWNER INFORMATION Last Name IFirst Name Address City j�%20r/i State iP Zip Phone S Fax E-mail APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X F ffice use only: Zoning Property Address Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BPO .5 3122G BIN # .PROJECT LOCATION AP# o q - 3Cr1� Property Address City Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: 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: K6 Amount: a Bldg Receipt #:W(6-75 SRA Sheriff Other Date: ( I- 2)- Ob Total 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 ori 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.) ❑ 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. regard in 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 KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary. delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [ X] NO [ ]. - 2. I HAVE [ X ] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: S. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated:. NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: ��San cc DATE: NOTE: This Owner -Builder verification is required by Section 19831 -and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION `BUILDING `GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o if you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. 1966-86D FRANCIS WAGNER 34 Gleness br, roville k COUNTY OF BUTTE - DiPARIMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 Ifw APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER r `T 5 ZONING BUILDING PERMIT OWNER ' f /r fa /,� C 15 GL /'�-e�E TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 41 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace �C, G G L C' CONSTRUCTION LENDER �k�t- � UNKNOWN Total Valuation $ FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER i uf�� LICENSE NO.�7 PIan,Chefa: Fee $ Energy'Plan Checking Fee ARCHITECT $ OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS. Permit fee $ 7 k c.� PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 C ,r✓C [ ( Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFE]' Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 10.00ea TYPE OF WORK New Addition❑ Remodel[:)Utilities❑ Installation[] Other Describe work: Ccov e Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 610v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. _ License License No. Classification f� 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.N , New DONS.' ( AUL 13 GS. /22sgft O NON-RESID BRANCH CIRCUITS 2.SOea POWER APPARATUS .&) SINGLE OUTLET CIR. / .20050C EX. Occup\OUT ETS OR FIXTURES 20960! FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.Y 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. a I shall not employ any person in -any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date / Si nature of A PPlicont — Owner ❑ Contractor ❑ Agent ❑ 9 An OSHA permit is required for excavations over 5'0" deep and demolition Or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ r TOTAL PERMIT FEE $ OCCUP. CONST.T71 I FLOOD PARCEL I PD ND 39UE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS "d �"I B ",' a '� F D / e. � A PERMIT EIla _ � XPIRES" bate Receipt No. 1 l G WNITE-D.P.W.. YELL0W-^96!79011, PINK -INSPECTOR. GOLDENROD -APPLICANT _ COUNTY OF BUTTE e% • DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. !✓��.�LIEZAII) b `1� I cI C X X P-4 COUNTY OF BUTTE - DEPaRTMF.NT OF PUBLIC WORKS PER IT NO. 7 County Center Drive - Oroville, C�lifornia 95965 - Telephone 916/534-4541 70 APPLICATION AND PERMIT ASSESSOR PARC NUMBERZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC, BUILDING VALUATION OWNEFf5S5 AI LING A30�A/DDR ESSD t//J Q e4 CONTRACTOR'S NAM /E� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace 0 60 O CONSTRUCTION LENDFF37 UNKNOWN Total Valuation $ , Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGI(747�R,__,__,— LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee n $ " ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING OyDDRESy. Permit fee $ ,2 , v PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 049 (/f Ulf� Solar or heat pump water heater ' 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5.00 Each qas water heater or vent -5.00 USE OF STRUCTURE SFS Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW I 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: A/eB j) &46S70 UL Penult Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) •,--�_ I, as the owner, am exclusively contracting with licensed contract- `moors. (Sec. 7044) 1 am exempt under Sec.�� Business and Professions Code for this reason - 1Q,�/i CJS i/Ll �1.U�c NEW CONST. DWELLING OCCUP.eI , OR ADDN5. (ACC. BLDGS. /z ¢sq ft NEW CON5TRESID. BRA NCH2,50 ea NO N.R ESID BRANCH CIRC ITS POWER APPARATUS h (SINGLE OUTLET CIA, Ex. Occup(OUTLETS OR FIXTURES DAL2 eALO30 FIXED Ex. OCCUp- OUTLETS P(RESID )KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Iyirin g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Penult Fee .. $ '~ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue LXagainst aid County in con quence of the granting of this permit. Date Signature of Applicant — wnontractor ❑ Agent ❑ An OSHA permit is required for eA�vatioCns over 5'0" deep and demolition or construct- ion of structures over 3 stories in Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 2 S' u occup. CONST.TYPe IFLOODIPARCE11 PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indi ted above for which DII PUB By PERMI XPIRES Date the applicable provi- resolutions to do fees have been aid. p C ORKS Dae Receipt No. �f� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD-APPL'ICANT i F, 1 Butte County Department of Development Services. "T%f N ® T E S 7 County Center Drive, Oroville, CA 95965 (530) 538-7601 www.buttecounty netrdds �J RESIDENTIAL APN: 069-360-035 05-3126 Owner- BUBIER, JASON & ALLISON 34 GLENESS DRIVE, OROVILLE Site Address: Cont: RE -ROOF Contractor. Type of Permit: ; ^ 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 JOB FINALED: 1 SIGNATURE: .. /�� CHECKED BY n r }i 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 JOB FINALED: 1 SIGNATURE: .. /�� CHECKED BY +=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION 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 0 or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test -Crossovers -Breakers -Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID E C K S`C O V E R S•C A R P O R T S'GARAGES 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-C nn ctrs-S hthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls DATE IPOOLS 1 Setbacks -Easements 2 Soils; CompactionStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFl 6 Elec Encisrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bdxes-Enclsrs-pniboards4nsultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Encisr; Fencing -Alarms 13 Bonding, Diving board or Slide a� 0`41* a 0s Pool Drawing = OK 0 = Not OK RESIDENTIAL (Single. & Duplex) DATE 1UNDERFLOOR I DATE IPLUMBING , 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgrnd 13 Plenums & Ducts; Clrnc-MaterialSupport-insultn 14 Girders Sills-Anchr Bolts -Joists -Vnts-Cripples 15 Acc & Vntltn 16 Insulation S` c o'`° DATE IFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & flr Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frpic Ties or Type A Flue-Frplc Throat Clrnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrflr Acc 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnis 38 Insulin -Walls -Ceilings 39 Infiltration-Walls-Wndws DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or ❑AL AC Wire Sz ga CU or AL 48 Range Circ ga []CU or ❑AL Oven Circ ga QCU or ❑ AL Insulated Neutral QYes QNo 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o'er a o'`° 0� 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Prtctn 56 Shwr Pan; Tess, First flr-Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub, Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping DATE MECHANICAL 61 AC Ducts Insulin & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn[Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic o�•c DATE IFINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Sis & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clmc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters Q Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler