HomeMy WebLinkAbout071-400-025a
N
TOM ODEKIRK 71-40- 2 5
app 14 mi. off E/S Quincy Rd; app
1
mi. above the T i:dwe-11 Bar -Br-idy
Oroville
Permit #3241-76E(temp pow pole)
for p mp & future const.
71-08-54
» Tom Odekirk 1 mi.
App -14 mij,.off WS Quincy Rd.,app-
above Bidwell Bar Bridge, Oroville .
Permit #2486-77B,P,E,M (new single
family) 00' r-----�
- 71-08-54 '
ermit #4375-78B(lst renewal)SF
4
71-08-54
ntr: Liberty Const.,; Oroville ,,
Permit #123-79B(addcovered dec. SF L
Q
71-08-54
Permit#1679-80B(2nd renewal/
2486-77) SF
071-400-025 PERMIT#95-0324,
ODEKIRK,'=Thomas,
-`
623 Simmons Rd. 'Orov.ille.
Ele Wal!,er
.Heat/SF 7 7.
+ �3
0
H
V
PERMIT NO. P, E,M
PERMIT EXPIRES
OWNER
Tom Odekirk
CONTR.
owner
LOCATION (A.p. 71-08-54
App.lk mi.off E/S Quincy Rd.,app.1 mi". above
Bidwell Bar Bri4, Oroville
/Vgo pj
/� 0 'P, 0
Temp POW
Pole
Called PG&E
Templea Serv.
91 lied PG&E
Te p. Gas Serv.
Called PG&E
71
0 E3
/0
FINALED
(D to
r.
(Signature)
6 +
COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS'.
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback Firewall Soil Piping
Forms Parapets 1st Floor l 61,2
Main Bldg. Restroom Finish 2nd Floor
---
Footings Windows =7 E 44 3rd Floor
Stemwal I Siding To out -z -y / - `%
Slab Roof Sheathing er Pi In /�- 3e 7id, 1 `
Piers S 7 _rte Roofing Sewer
Garage Fdn. Vents - ,0^ D J Fixtures
Footings Garage Vents Water Htr./®-
Stemwal I Insulation Heaters
Slab Prov. for phslcally Appliances >
Carport handicapped
Conformance of ex. V Gas Piping & Test
Footings structure Tem . Gas
Slab Final Sanitation
Patio FIREPLACE Final
Footings Footing ELECTRICAL
Masonry Walls Throat Rou h
Relnf. Steel Final V 2 Fixtures
Bond Beam FIRE SPRINKLERS Motors
Framin Z -I Test Water Htr. —//--
Stucco Final Subpanels
Mesh MECHANICAL Grd. Fault Prot.
Scratch Heating Service
Brown Cooling Temp. Pole • )
Finish Ducts Underground
Interior Lath Ventilation Permanent t t
Door Closer Final Final �®
MOBILEHOME UTI ITIES ' Elec. Pedestal
------------------ Elec. Service
Water Piping Sewer Gas Piping t
OBILEHOMEINSTALLATI N --------------Support Elec. Continuity --
Water Piping Drainage Gas Piping
DATEREMARKS OR CORRECTIONS
b/< Tv 5Cf F(06
ol
' wf
/10
47
(NOTE: An entry must be ma on this form each time you vislt the job site.)
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00
w/, 3 i467- "xP
j
Feu4wtuvc, o"
4 54,11- (46 Bo"
4
Ej
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION RE LATIONS
AT
J3
ATAl.,S, a' C S"77,wo"s /Zl / ��� "F�F ' 4 ...c �/
(location)
BUILDING PERMIT N0. ZS/M-7-7 !3, p; zF A.P. N0.
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge.-
Fdn. Walls.. �//�
Floors
Walls
Ceiling/Roof /'_7,
Ducts / `'
Circulating Pipe s_&-4—
APPROVED HEATER_
APPROVED WTR.HTR.
GLAZING:
Single Glazed _11L1,4
Special (Insulated)
CERT.•& LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS.
BACK DAMPERED FANS/j/-
INTERMITTENT IGNITION DEVICES
CERT. APPLIANCES !/
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
9 IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name
Signature of ease print)
Insulation Applicator
State ss'�V
ntractor
Licensee NoNo..
'General Contractor/Owner Namepig 0Inc f,,41
Signature of (please print)
General Contractor/Owner�06&1,Z_ Date % el
State Contractors
License No. ---
THIS CERTIFICATE MUST BE ON FILE WITH H THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive OroVille, California 95965 //1 �c
T,elephone: 534-4541 /-
APPLICATION AND PERMIT a (J
BY Date 3
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Uilding permit 2pires
BUILDING
Owner 9
O Le
SQ. FT. OCC. BUILDING VALUATION
Mailing Address /� L
�^ !
Telephone No.�j�
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee ,p'O
Building Address � ✓�q�
Plan Checking ee&/or Penalty
Permit Fee
`-A
PLUMBING No. @ FEE
.
PERMIT FILING FEE $3.00
Each Trap 1.50
&( <z
Repair drainage or vent piping 1.50
A. P. No.
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F6e<
W-C,r
S
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
BI ans ec d
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
ELECTRICAL No. @ FEE
17��tka
PERMIT FILING FEE $3.00
600V OR LESS
Main service 100 AMP OR LESS 5.00
Single Family=LOW Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER e00V 25.00
100 AMP OR LESS
Main service// EA. ADD'L 100 AMP 1.00
NEW CONS.OR ADDNST l ACCLBLDGSDWELING �CUP- !:) 22sgft
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
st le of:
Y
NEW CONSTR MULTI -OUTLET
NON.RESI D. BRANCH CIRCUITS) 12.50ea
NEW CONSTR. POWER APPARATUS 6
NON- (
RESID. (SINGLE OUTLET CIR.
250
Ex. Occup(OUTLETS OR FIXTURES) a �@
FIXED APPLNS. OR
Ex. QCCUp2.00
• OUTLETS (RESID.) EA)
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
'I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
is
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
ermit is issued I shall not employ any person in any manner
so s to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspecti purposes.
X Date
Land Development Fee
$
TOTAL PERMIT FEE
$
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been pa' ..
OF,PUBLIC WORKS
BY Date 3
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Uilding permit 2pires
41
u to ount
LAND OF NATURAL WEALTH AND BEAUTY
DEPARTMENTf OF PUBLIC WORKS
CLAY CASTLEBERRY, Director
7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965
Telephone: (916) 534-4541
• H. W. McDONALD
Deputy Director
March 19, 1980
Tom Odekirk RE: Building Permit #W6-77 & lot
8311 Merrimac;Star Route A.P. #71-08-54 ",,.MM AL #4375-78
Oroville, OA., 95965
Dear Mr..Odekirkz,
With reference to the above subject, we have been advised by one of our building
inspectors that there are items requiring corrections for the work which you have
done as follows:.
1. Renu permit (e—m-1-red 7/26/79). 2. Label breaker. 3. Install air gap on
dishwasher. 4. Install smoke detector. 5. Install plate over J box at water heater.
6. Install light in closet. 7. Install t -straps for post 6 beam. 8. Finish stairs.
9. Finish grade around house., 10. Install flex at pump house wiring. 11. Install
proper outside,lights. 12. Furnish certificate. of insulation.
Since these items must.be corrected before.'we can final the job or'issue the required
Certificate of Occupancy, please make the above corrections and contact this office
within ten (10) days of the date of this letter and request final inspection.
Your cooperation in resolving these items in a timely manner will certainly be
appreciated. Should you have any questions.concerning this matter, please contact
this office.
Yours very truly,
Clay Castleberry
Director of Publ' rks
.F`. Glander
JFG:dd/-,/Assistant Director
cc:' Building Inspector - Jerry Stilwell
f
r
F
AP 71-08-54 f
!
RECEIPT FOR CERTIFIED MAIL --300 (plus
postage)
�� '• Tom Odekirk POSTMARK
'? OR DATE
+ :....
. STREET AND N0. ... , < - .., .�.��-. �.,.-
f :,,8311 MerrilnacStar, R yatxy '� °� r;� liz3/L20/80
.I oute r,)'
P.O., STATE AND ZIP'CODE
Tv
Orovill:
CD
e, .'=''L u t9 £uR_L;wL'-" ou
N +
.,,OPTIONAL SERVICES .FOR ADDITIONAL FEES, t "th=h'
YI '
X10RETURN
'
t- Shows to whom and tlate delivered ..:..:.
RECEIPT I . With delivery to addressee only ............ 65¢
+ Y. Shows to whom,
.O 1
date and where delivered .: 95¢. 0,,,_� V_• ;��
DELIVER_T *r •. _ With delivery to addressee only.....:...:
DELIVER 70 ADDRESSEE ONLY ...:.....:............................................ 60¢ Ju OI 4, r 1
rSPECIAL
DELIVERY.(extro fee " —
required)...... .............................. ..t., .. f..,.,. ....�- .
PS Form
"NO. COVERAGE PROVIDED-.
Apr. 1971 ''
3-
(See'other side) 4
NOT FOR INTERNATIONAL MAIL
�. -
a GPO: 1972 O - 460-749
0 SENDER: Complete items I, 2, and 3.
Add your address in the "RETURN TO" space on
reverse.
I. T following service is requested (check one).
Show to whom and date delivered ..........
F] Show to whom, date, and address of delivery.'._¢
RESTRICTED DELIVERY
Show to whom and date delivered ..........
RESTRICTED DELIVERY.
Show to whom, date, and address of delivery.$_
(CONSULT POSTMASTER FOR FEES)
2. ARTICLE ADDRESSED TO:
Tom Odekirk
8311 Merrimac Star Route
Oroville, CA. 95965
3. ARTICLE DESCRIPTION:
REGISTERED NO. CERTIFIED NO. INSURED NO.,
532040
I I
I (Always obtain signature of addressee or agent)
I have received the article described above.
SIGNATURE❑ Addressee C] Authorized agent
p
4.
0 - E OF DELIVERY
T�Aftl(>t�
0851
5. ADDRESS (Complete only if requested)
y4"" V w
6. UNABLE TO DELIVER BECAUSE:
LE('
I/ 4d K
* opo: 6te �z-3ez
�.1
UNITED STATES POSTAL SERVICE
OFFICIAL BUSINESS
SENDER INSTRUCTIO PE ALI Q:TO
USE TO
Print your name, address, and ZIP Code in pace beM. OF
• Complete items 1, 2, and 3 on th QersNA R 211
• Attach to front of article if space p mits.IMI". ise
affix to back of article.
Endorse article "Return Receipt Requ ed?,9 8F:)
cent to number.
RETURN
TO
OFPT OVH%Y
OF , Yog Gurrr
4"..
(Name of Sender)
County of Butte A� l�igR
Dept. of Public Works
C-101,9�r4j�`r P. '
17 County Center Drive I49/z
Oroville, California 12,a/ �+
95(city. State. and ZIP co e
LAND OF NATURAL WEALTH AND BEAUTY
DEPARTMENT OF PUBLIC WORKS
CLAY CASTLEBERRY, Director
7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965
Telephone: (916) 534-4541
H. W. McDONALD
Deputy Director
January 30, 1980
Tom Odekirk RE: Building Permit No. 2486-77 & let RENEWAL
353 Skyline Blvd. Expired 7/26/79 #4375.78
Oroville, CA. 9596.5 (A.P. No. 71-08-54)
With reference to the above subject, our records indicate that your building permit
has expired. Building permits are valid for one year and should construction not be -
completed at the expiration date of the permit, the permit shall be renewed for 1/2
the original fee.
Kindly contact this office within ten (10) days to renew your permit. Should our
records be in error or should your construction be completed, please advise this
office immediately.
Thank you in advance for your prompt.attention concerning this matter.
Yours very truly,
Clay Castleberry
Director of Public Works
F. G1 nder
4Feidd Chief Building Inspector
P.S. For your convenience, we are attaching a renewal application form which may
be completed and signed by you where indicated and returned to this office
together with the fee shown.
cc: _Building Inspector - Jerry Stilwell
cc: PnjYqTM& luabccyoL
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DEbVMINEll-'l 0!1- brIFIFIC
C0U01i 'OF'BI9TT-E — DEP'AR•TMENT OF PUBLIC WORKS
7 County Center Drive Orovi Ile, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT 77q"j
authorize representatives of the County of Butte to enter upon the
above -men 'oned property for inspect n purposes.
X DateL— 2, — �7
Signature of Permitee or Agent
Receipt No.��++��.."
White-D.P.W. — Ye��
w,o ^in -In spec or — G denrod-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.
DR OR Q LIC WORKS
By Date '
Building permit expires Date -7—A6 7�
BUILDING,
Owner /� Q E x g-
SO. FT. OCC. BUILDING VALUATION
6 670
Mai I i ng Address 3 L Q 4 '
JFireplace
�LL�,
Tile hone No.
s
Contractor Q LS{'L_°
Total Valuation 910
Mailing Address
Permit Fee
_
P I an Checki ng Fee &/or Penalty
Telephone No.
Permit Fee
Building Address Ano/Y41 M 7n S`1
PLUMBING No.1 @ I FEE
PERMIT FILING FEE $3.00 -
0
If/"C ,Bb 116- 1
Each Trap Ul 1.50 —
Repair drainage or vent piping 1.50
Water piping 1.50
®,Q(� V I L L Ca'' Zoning Verificatian QWJ
Each gas water heater or vent 1.50
A P. No. 7 l �pG
-s
Zoning & Planning
Gas piping system 1 - 5 outlets 1.5U
Each additional outlet .30
to
SI n�*L.A
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EGA
Parking
Plans
Parcel
Declaration
Parcel M
60' R/W
Improvements
P
Lawn sprinkler system 2.00
Bldg. I e
Parc pproval
Plans 4rpproval
Permit Fee $< 1--
1-3
NEW ADDITION UTILITIES ❑ OTHER [:]ELECTRICAL
No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR 100 AMP ORLESS5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family Duplex Mobil Home Others
❑ ❑ ❑
Main service OVER 600V
100 AMP OR LESS 25.00
0 AM 1.00 �a o
Main service EA. ADD•L 1LING
0 WE
OR ADDNSNEW T (ACCLBLDGS &) 20sgft 7
-
NEW CONSTR. MULTI.OUTL
NON•RESID. BRANCH CIRCUITS) 2.50ea�
NEW CONSTR. (POWER APPARATUS &)
NON•RESI D. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
{7
Ex. Occup(OUTLETS OR FIXTURES) BA�L21
Ex. OCCU FIXED APPLNS. OR
P• OUTLETS (RESI D.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$ .�
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
L14 o® -DEL) ` Ft:,e
TOTAL PERMIT FEE
authorize representatives of the County of Butte to enter upon the
above -men 'oned property for inspect n purposes.
X DateL— 2, — �7
Signature of Permitee or Agent
Receipt No.��++��.."
White-D.P.W. — Ye��
w,o ^in -In spec or — G denrod-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.
DR OR Q LIC WORKS
By Date '
Building permit expires Date -7—A6 7�
• r
COUNTY.OF BUTTE = It EPA,RTMEN T OF PUBLIC WORKS
t' 7 County Center Dri�q �— OroviIIe, California 95965
Tztephone: 534-4541
APPLICAYION AND PERMIT
-2 7,--2 -2,
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.
DIRPUBLIC WORKS
By ECT OF Date
11
ilding permit expires Date
7— o
BUILDING
Owner 7'b ��� %/L
SQ. FT. OCC. I BUILDING VAL ON
0 0
Mailing Address
Telephone No.
Contractor
Mailing Address RIOpy ��� $T
Fireplace' l
Total Valuation
1/1 LL 4::X '9K5;6?
Tele hon^"
js3
Permit Fee
Building Addressf% ®� Q!J/11%�
'
Plan Checking Fee&/or Penalty
Permit Fee
/� Dl
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
®� Q
Repair drainage or vent piping 1.50
A. P. No. /— Qg — -5-14
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F
S i 'on
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel M
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
��
Bldg. P nl. Recd
Parcel A caval
Plans App o
Lawn sprinkler system 2.00
NEW ❑ ADDITION Q�UTILITIES [:]--OTHER ❑
Permit Fee $
$
A O jar"
ELECTRICAL No. @ FEE
6912. 43 f(ra,.2
PERMIT FILING FEE $3.00
Main service 600V OR LESS
10o AMPLESS 5.00
Single Family Q1Duplex E] Mobil Home ❑ Others ❑
Main service E4. ADD'L 100 AMP 2.50
Main service OVER 600 25.00
100 AMP OR LESS
'
EA. ADD'L 100 AMP 1.00
Main serviceNEW
CONST./ NG
OR ADDNS. C ACCLBLDGS.CCUP, 4� 22sgft
CONTRACTORS LICENSE LAW
1 am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
st le of:
y
Zw-�
NEW CONSTRES,., -OUTLET
NON.RESID BRANCH CIRCUITS) 2.50ea
NEWCONSTR./POWER APPARATUS 9
NON .RESID. (SINGLE OUTLET CIR,
Ex. OCCUp(OUTLETS OR FIXTURES 50 @250
BAL@1
Ex. OCCU FIXED APPLNS. OR
p• OUTLETS (RESID,) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
_
License No. Classification 41S
Misc. Wiring 6.25
❑ 1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
hI hlave placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
❑I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
Land Development Fee
$
TOTAL PERMIT FEE
$ i
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.
DIRPUBLIC WORKS
By ECT OF Date
11
ilding permit expires Date
7— o
COUNTY OF BUTTE — D-EPARTMENT OF PUBLIC WORKS
7 County Center Drive — 5 e, California 95965
Telephone: 534-434-45441
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above -menti Oed property for inspectio purposes.
X c� Date
Signature of Permiteeee or Agent
Receipt No./ -2/3 24;1 2
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.
D E*expires
OF PU IC WORKS
BY7VIDate 7�
Building permit Date 7 02
BUILDING
Owner (? O '
SO. FT. OCC. BUILDING VALUATION
Mailing Address
r ,
Telephone No.
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee �C1
Building Address ' r
e
Plan Checking Fee&/or Penalty
Permit Fee D
Ip c — 0 L
PLUMBING No. @ FEE
�+✓O
O
PERMIT FILING FEE $3.00
Each Trap 1.50
,
V[ 1,L
Repair drainage or vent piping 1.50
_
A. P. No.
Zoning &Planning
Water piping 1.50
Each gas water heater or vent 1.50
F&5s'
Sarl*t-Oion
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EOA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. R5 -a ssRRec'd
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
EW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$
teL &--'7,7
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
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 e O 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW OR ADDNS//% CONST.DWEACCLBLDGS.LING CCUP. Y� 20sq ft
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
st le of:
%(
NEW RESID.CONSTBRANCHMULTI-OCIRCUITS)
NON.RE51 D. BRANCH CIRCUITS 2.50ea
NEWCONSTR. POWER APPARATUS 6
NON .RESID. (SINGLE OUTLET CIR.
Ex. Occup{OUTLETS OR FIXTIIRES g L2;
Ex. OCCU FIXED APPLNS. OR
Occup.(RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
2�ram exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ 'w have placed on file with the County.of Butte a certificate of
orkmen's Compensation Insurance.
�I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above -menti Oed property for inspectio purposes.
X c� Date
Signature of Permiteeee or Agent
Receipt No./ -2/3 24;1 2
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.
D E*expires
OF PU IC WORKS
BY7VIDate 7�
Building permit Date 7 02
t7
10
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Uroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
aU II IUIILV IC111C0CIIIGlIVCS UI UIU Luunly UI inulle to enter upon ine
above-mentioned property for inspection purposes.
X Date'
Signature of Permitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
BuHd4ft permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Y f..
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
r r
Building Address `, t( Ir. = -
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
( MSI }JrI "� ;'i ,))
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
Gas piping system 1 - 5 outlets 1.50
A. P. No. ` v
Zoning 8 Planning
Each additional outlet .30
Fees
C.
'Sa on
'Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking"'
Plans
-parcel
Declaration
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Bldg. Plans Recd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
T; ,
01V 01 LES
Main service 100 AMP ORS
SLESS 5.00
• r A
Main service EA. ADO'L 100 AMP 2.50
-
Single Family EJ Duplex EJMobil Home ❑ Others �
OVER 600V
Main service 100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
_
NEW
OR LING O
ADDNST ( ACCLBLDGS.CCUP. & 22sgft
NEW CONSTR. (MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS) 2.50ea
(
NEW CONSTR. (POWER APPARATUS &)
NON-RESID. (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES) �Dq
Ex. OCCU FIXED APPLNS. OR
p• OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
[3'1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $ -�
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
* I certify that in the performance of the work for which this
t' permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
aU II IUIILV IC111C0CIIIGlIVCS UI UIU Luunly UI inulle to enter upon ine
above-mentioned property for inspection purposes.
X Date'
Signature of Permitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
BuHd4ft permit expires Date
COUNTY OF BUTTE — DEFrARTMtNT OF PUBLIC WORKS
7 County Center Drive — OroviIle, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
,,• •- F ac i.v.G L e vvunry vI DUlle w unrer upon me
above -me ioned property for ins ection purposes. //
X Date 6 `l L
Signature of fermiteeee or Agents
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date 6
^Beifdtwg.permit expires Date
BUILDING
Owner G K ®a/� Y
SQ. FT. OCC. BUILDING VALUATION
Mailing Address 3 9 J^' A4 L Ld A L G A v z
Qv -a u e L L. t,
Telephone No.
5 33 —9S o S
Fireplace
Contractor
Total Valuation
Mai I i ng Address @—
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address APPftXI --
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
U l Pr, t (A .
Each Trap 1.50
d
Repair drainage or vent piping 1.50
Water piping 1.50
((((
l i
Each gas water heater or vent 1.50
A. P. No.
oning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
C.
t
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parkinl
Plan s
Declaration
I Parcel Map
60' R/W
I Improvements
Lawn sprinkler system 2.00
Bldg. Plans Recd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00 dD
OR LES
Main service 10000 AMP ORLESS5.00
r
Main service EA. ADD'L 100 AMP 2.50
_
Single Family ❑ Duplex ❑ Mobil Home ❑ Others 7
OVER 600V
Main service 100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONST. DWELLING OCCUR. &
OR ADDNS. ACC. BLDGS. ) 20sgft
NEW CONST-. (MULTI -OUTLET
N.N.RESID. BRANCH CIRCUITS) 2.50ea
NEWC ON ST R. POWER APPARATUS &
NON .RESID. (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES)@SQ
BALCA02I
FIXED APLNS.
Ex. Occup. (OUTLETSP(RESID)REA) 2.00
Temporary service 10.00 (j
—
Mobile Home Facilities 15.00
License No.Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ 13 av
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
Mcertify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No.1 @ FEEPERMIT
FILING FEE 1$3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
fr n
TOTAL PERMIT FEE
$ OZ3
,,• •- F ac i.v.G L e vvunry vI DUlle w unrer upon me
above -me ioned property for ins ection purposes. //
X Date 6 `l L
Signature of fermiteeee or Agents
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date 6
^Beifdtwg.permit expires Date
Owner: /:-o ,�4 �Q
Address k
A6o ve
Tenant: i��
Building Location:
Type of Inspection requested:
G <'-
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
A. P. #
F: F
e if i9' -z Tz' To 6 e
,1Housing / / 2. Financing
Tlt'-- . other (specify)
Present use of building:
Date of Ins�peect/ion
Inspector_/
3. Change of Occupancy to
A. Sanitation (Housing)
1. Water closet:
2. Lavatory:
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating facilities:
7. Natural light and ventilation:
8. Room and space requirements:
9. Bedroom window or door for second exit:
10. Infestation of ,insects, vermin, or rodents:
11. Connection to sewage disposal:
12. Connection to water supply:
13. Rubbish and garbage facilities:
14. Comments•
B. Structural
1. Piers and footings:
2. Floor construction:
3. Wall 'construction:
4. Ceiling and roof construction:
5. Fireplaces:
6. Comments•
C. Electrical
1. Se a and ground:
eceptacles-
3.
4.
D. Plumb in
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4. Comments:
(continued on back)
:.
E. Other t
1. Maintenance and repair: j
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Comments•
F. Commercial Buildings
1. Roof covering:_
2. Distance to property lines:
3. Physically handicapped:
4. Restroom floors and walls:
5. Exits:
6...
7.
8.
Improvements:
Zoning:
Comments:
G. Field Problems or Violations
1. Problem or violation (give complete description):
2. What action taken (give complete description):
3. What action recommended:'
A. Information only - file.
B. Hold for ten (10) days, then write letter.
C. Write letter.
D. Other: a rC 74 15s '� ,�i��-•�.�
s
x.
F
071-400-025 PERMIT#95-0324.'
ODEKIRK, Thomas
;e 623 Simmons Rd.., Oroville
Ele Wall Heater/SF
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroviller, Calif fnia 95965 - Telephone (916) 538-7541 PERMIT NO,
APPLICATION AND PERMIT' 0
ASSESSOR PARCEL NUMBER 071-400-025ZONING
BUILDINd PERMIT
OWNER THOMAS ODEKIRK
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAIUNG ADDRESS 623 SDMNS RD OROVIUE, 95966
CONTRACTOR'S NAME INNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER NONE
UNKNOWN
Total Valuation Is
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
°
Permit Fee $
ARCHITECT OR ENGINEER NONE
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty $
BUILDINGADDRESS
423 SIMMQNS RD
PERMITFEE $
ROVIUE
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
Solar Or heat pump water heater
23,00
USEOFSTRUCTURE
SF 9 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities EX Installation ❑ Other ❑
Describe Work: EI+EMIC WALL ITER
—
�}
Mobile Home IS I GI W1
920.00
PERMITFEE $
Contractor
ELECTRICAL PERMIT Filing Fee 20.00
Main Service EOOV OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO I000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am"exempt from the Contractors License
Law for the following reason: a ,.I L.
I, as owner of the property; or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR
OR ADDNS. ( & ACC. BUDS. )
s0.
3.50 FT.
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATOUTLETUS )
8 SINGLE CMR.
Ex. Occup. (OUTLET OR FIXTURES )
2U o I.00
BAL .50
Ex. Occup. (oUILETsAPLNs (RE IS RA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00.
PERMITFEE _
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed 0 the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
�
forthwith comply with th a provisions.-- ---- —_
Xt _ __ Date Z -Z3 -9S'
Signat ire of Applicant - l Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PER MIT Filing Fee 20.00
Heating 15.00
Cooling
Hood
6.50
Ventilation
PERMITFEE $ 35.00
Contractor
Mobile Home Installation Fee $
Energy Inspection Fee Is
OCC
CONST. TYPE
TOTAL FEE $ 35.00
HAZ.
I D. FEES
I IMP
I FLOOD
CDF
pgRCEL
PD HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated ove for which fees have b n paid.
!
7 /
BY Q Date
/
PERMITEXPIRESON iI (�
(Date)
-3
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISIO
7 County Center Drive - Oroville,-Calife,onia 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 03�
ASSESSOR PARCEL NUMBER 071-400-025
-ZONING
� UILDI G PERMIT
OWNER THOMAS ODEKIRK
TELEPHONE
SO, FT, OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS 623 SIMMONS RD OROVILLE, 95966
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER NONE
UNIDJOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Fling Fee $ 20,00
Permit Fee $
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
'
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty $
BUILDING ADDRESS
623 SIMMONS RD
PERMITFEE $
OROVILLE
PLUM BINGPERMIT Filing Fee 20.00
Each Trap 7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater 23.00
USEOFSTRUCTURE
SF 1� Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping 15.00
Each gas water heater or vent 15.00
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities IX Installation ❑ Other ❑
Describe Work: ELECTRIC WALL HEATER
Mobile Home S I G I W @20.00
PERMITFEE $
Contractor
ELECTRICAL PERMIT Filinq Fee 2 0:0 0
Main Service EOOV OR LESS
( zooA OR mss ) 23.00
Main Service ( 200A TO I000A ) 46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class IL No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
Q� I, as owner of the property, army 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
NEW CONST. DWELLING OCCUR s0.
OR ( 8 ACC. ) 3.S¢ FT.
NEW CCNS.
ONST. MULTI-OUUTLETLE T
NON-RESID. ( BRANCH CIRCUITS ) 97.50
( POWER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. (OUTLET OR FIXTURES) 20 O +•50
BAL 50
Ex. Occup. OUTLETS (RESID.j FEE
( ) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMITFEE $
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT Filing Fee 20.00
Heating 15.00
Cooling
Hood 6.50
Ventilation
PERMITFEE $
-35.00
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
f rthwith comply with th 'se provisions.
Date _�'�3=)
Signa re of Applicant - Owner ❑ Contractor ❑ Agent
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 Is
Energy Inspection Fee Is
OCC
CONST. TYPE
I
TOTAL FEE $ 35.00
HAZ.
I D. FEES
I IMP I FLOOD
CDF PARCEL I PO I HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated ove for which fees have be n paid.
n
BY Date 7
PERMITEXPIRESON
(Date)
Receipt No. 175363
WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE
Department of Development Services
Building bivision
Oroville:, 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541
Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and
issuing your building permit. No building permit will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement
(yes or no) E'5
2. Iave/ ave not)
3.
signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction:
Name
Address City
Phone Contractor's License No.
4. I plan to provide portions of this work, but I have hired the followipg person to coordinate, supervise, and
provide the major work:
Name
Address City
Phone Contractor's License No.
5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated:
Name Address Phone Type of Work
Signed: -�
Property Owner
Social Security Number sxjc— ? - '3 ($v
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 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.