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071-400-028
71-40-28 CRAIG HILL - - /S Mayberry,--app-600' -E Simmons• -Rd------ Berry Creek area }ine t %I.S/s • Permit#3672-82B,P,E,M(new•single family) �' Ate. ''uhI V* 71-40-28 Permit#4138-83B(add open deck/SF) /1-4U-28- HILL, Craig �' 953-90E 59'May6err'y Road, broville (new 200 amp elec ser)SF iJIJ 9 " 07; -400-02804-3195 WRIGHT, BRANDON :)9 MAYBER.RY RD. GROVILLE'"', Cont: GREEN= ROOF1TlG REP ELEC BOX ON POLE. 071-400-028' „ 06=0189- 14ILL, CRAIG & KIMBRLY • • 1 59 MAYBERRY RD, BERRY CREEK Cont:,WV ALTON INC' . CHANGE OUT HVAC HEAT, PUMP w 0 Fm COUNTY OF BUTTE - DEPARTMENT 01'OPUBLIC WORKS `7,.'>• `,.. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR I^AR,ONUMBBER zo"' G r BUILDING PERMIT OWNE ' ( TELEPHONES0, r . - FT. OCC. BUILDING VALUATION OWNER'S MAILIN D ESS CONTI CT R'S NAME TE PHONE CONTRACTOR'S MAILING ADDRESS Fireplace ' � 00D CONSTRUCTION LENDER UNKNOWN Total Valuation $ 0 - Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER Al LICENSE NO. Plan Checking Fee $ DiD Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ , BUILDIN DDRESS t t- PLUMBING PERMIT Filing Fee 10.00 Each Trap g 2.00 % P Solar Water Heater 20.00 2 Q�f r G-enek Water piping 5.00 �;� " LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 - USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home I S G W1 10-00e + TYPE OF WORK New 2-' ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: Permit Fee s $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS10.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 IQ 1 NEW CONST. I/ DWELLINC OR ADDNS. % ACC. BL G . I 2h0sq it OL 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 m license is in full force and effect. y License No. Classification ® 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) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONSTR. MULTI -O T ET 2,50 ea NON.RESID, BRANCH CIRCUITS)' IRC ITS NEW CONSTR ( POWER APPARATUS &) NON -RES,D. SINGLE OUTLET CIR. Ex. Occu ( 20@50a P\o Ts XOR FIXTURES SAL®300 FIXEDD APP LHS, OR EX. OCCUp- OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 ' ` Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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. Heating et Cooling IV a lb 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 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 against said County in consepuence of the granting of this permit. X �D Q 'r�`c Date Signature o Applicant — Owner Contractor ❑ Agent ❑ a Ions over 5'0" deep and demolition or construct- An OSHA permit is required for exca11y, ion of structures over 3 stories in heig Mobile Home Installation Fee $ TOTAL PERMIT FEE $ occu P. GROUP r 3 TYPE OF CONST. r PAR PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the BI, e County Co nd/or resolutions to do work indicad bove for is fees have been paid. I CTOR UBLIC WORKS ` �\ ^ By s _(lam �— Date a�I PERMIT PIKES ate .— D Receipt No. WHITE-D.P. W., Y LO - 55 PI K-INSP OR, GOLDENROD -APPLICANT ICI?S kDI'. r IL I' CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE .THIS IS TO CERTIFY THA"; ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT Simmon & Mayberry Rd (location). �.,�/ BUII.DINC PERMIT NO. e,� 72--82— A.P. 140. 2 . L10 �--d" THE FOLLOWING HAVE BEEN I14STALLED AS PER APPROVED PLANS: (Chuck each item or w;-ite -N/A if not applicable) i,Ns .AT ION: Slab Edge.- Fdn. Walls ►4, Floors 41_� Walls L/ Ceiling/Roof -22 R-30 Ducts P, f== Circulating Pipes APPROVED BEATER t/ APPROVED IJTR. [ITR. I/ ` G,uz IIr� : Single Glazed Y1 /p_ _ Special (Insulated) CE (T; & LABELED WDS. & SLIDING DRS. (/ _ WE.ITHERSTRZIPPL:D BACK DAMPERLD FANS_�� _ INrl:RMIT'TENT IGNITION DEVICES_ CERT. APPLIANCES J/ I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE RAVE BEEN INSTALLED IN ACCOKDAWCE WLTH THE ENERGY CONSERVATION REQUIREMENTS AND ACREF TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name Hawks Signature of (pleases nt) Insulation Applicator State UUutracLL)rl. License No. 378407 General Contractor/(timer Name C'f2� rG X41- pie, se print) Signature of _ General Contractor/Ouner Date State Contractors Li.censc No. THIS CERTIFICATE MU':;TQH ON FILE WITH THE BUILDING DL' PA RTMENI' PRIOR TO HQUES'tINC 1 -'MAL INSPECTION AND SRRALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. "_ 1, q00.- 0)y WL CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 5 of 8) CF -4R Project Address Builder Name 1 A Builder Contact Telephone Plan Number RS Rater Telehone Sample Group Number capacity indicated on the Performance's CF -IR and RF -.i. If the cooling capacities of installed systems are > than maximum ✓ ❑ Yes ❑ No 5 Ce 1 g Signature Date Sample House Number `p C 42, HF�t Provider -P i2.S et Addrs: A ty/State/Zip: 'opies to: BUILDER- . PRnvu 1WIN IMT lrr nTPUA' nnnA .,. ... �, _ H RS mF fl^ - ! riLkCJ HATER COMPLIANCE STATEMENT The house was: ✓ Nested ✓ ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form. d he installer has provided a copy of CF -6R (Installation Certificate) yk` ADEQUATE AIRFLOW VERIFICATION Procedures /or field verification and diagnostic testing o Method For Airflow Measurement O Yes 0 No Duct design exists on plans 0 RE4.1.1 Diagnostic Fan Flow Usin 0 RVA .1.2 Dia ostic Fan Flow Using 0 RE4.1.3 Diagnostic Fan Flow Using are Flow Capture Hood Plenum Pressure Marchi Measured Airflow: Rated Tons: ❑ Yes ❑ No Measured airflow is greater than the criteria in Table RE -2 Yes is a pass in RA CM, Appendix RE4.1. Total CFM cfm/ton ❑ ❑ Pass Fail ✓ ❑ MAXIMUM COOLING CAPACITY )cedures or determining maximum coolin load capacity are available in RACM, Appendix RF3. 1 ✓ ❑ Yes 0 No Adequate airflow verified (see adequate airflow credit) ✓ 0 Ycs ❑ No Refrigerant charge or TXV ✓ ❑ Yes ❑ No Duct leakage reduction credit verified ✓ ❑ Yes ❑ No Cooling capacities of Installed systems are:5 to maximum cooling 2 3 4 capacity indicated on the Performance's CF -IR and RF -.i. If the cooling capacities of installed systems are > than maximum ✓ ❑ Yes ❑ No 5 cooling capacity in the CF -1R, then the electrical input for the installed systems must be S to electrical input in the CF -1R. ❑ ❑ Yes to 1, 2, and 3; and Yes to either 4 or 5 is a ass Pass Fail ✓ IY1 HIGH EER AIR CONDITIONER •w.s�is ire aVai[ame to KACM. A e—ndis RL ✓ es ❑ No EER values of installed systems match the CF -IR ✓CO Yes O No For splits stem, indoor coil is matched to outdoor coil 199 0 No Time Delay Relay Verified (IfRequired) Yes to I and 2: and 3 if Re aired is a ass Residential Compliance Forms April 2005 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3 of 8) CF -4R Project Address Builder Name Outdoor Unit Model /� Ok ` Builder Contact Telephone Plan Number HERS Rater Telephone Sam le Group Number Com fiance Method (Prescriptive) Climate Zone Certifyink Signature Date Sample House Number FirmtS Provider Q — \ C' V\-QQ iZS Street Address: C ky/State/Zip: AQ\YJ a C Copies to: BUILDER, HERS PROVEDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was: V'0 Tested ✓ ❑ Approved as part of sample testing, but was not tested As the HERS rater pro � ding diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form ✓ WThe installer has provided a copy of CF -6R (Installation Certificate). ✓ THERMOSTATIC EXPANSION VALVE ODM Proce or field verification of thermostatic expansion valves are available in RA CM, Appendix RI. ✓ ❑ REFRIGERANT CHARGE MEASUREMENT t Verification for Required Refrigerant Charge for Split System Space Cooling Systems without Thermostatic Expansion Valves' Unit Serial # rtdoor ocation utdoor Unit Make Outdoor Unit Model Cooling Capacity Bir Date of Verification Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration Access is provided for inspection. The procedure shall consist of ✓ `Yes (( E3 No visual verification that the TXV is installed on the system and tX ❑ installation. of the specific equipment shall be verified. Yes is a pass Pass Fail ✓ ❑ REFRIGERANT CHARGE MEASUREMENT t Verification for Required Refrigerant Charge for Split System Space Cooling Systems without Thermostatic Expansion Valves' Unit Serial # rtdoor ocation utdoor Unit Make Outdoor Unit Model Cooling Capacity Bir Date of Verification Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration (must be checked monthly) Standard Chame Measurement (outdoor air dry-bulb 55 °F and above) - Note: The system should be installed and charged in accordance with the manufacturer's specifications and installer verification shall be documented on CF -6R before starting this procedure. If outdoor air dry-bulb is below 55 *F rater shall use the Alternative Charge Measure Procedure Procedures for Determining Refrigerant Char a using the Standard Method are available in RACM, Appendix RD2. ✓ ❑ Yes O No Acopy of CF -6R (Installation Certificate) has been provided with refrigerant charge me" urcment documented. Residential Compliance Forms April 2005 Butte County Department of Development Services. o�TrE. artr� N O T E S 7 County Center Drive, Oroville, CA 95965 (530) 538-7601 anvw-t)uttOCOtinty neUdds °�uwft RESIDENTIAL APN: Permit No. Owner 071-400-028 06-0189 j HILL, CRAIG & KIMBRLY - Site Address: 59 MAYBERRY RD, BERRY CREEK Cont: WV ALTON INC Contractor. CHANGE OUT HVAC HEAT PUMP Type of Permit: Al cmzj/y��-� SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: • e P SIGNATURE- 1 • t J� - r } i RESIDENTIAL APN: Permit No. Owner 071-400-028 06-0189 j HILL, CRAIG & KIMBRLY - Site Address: 59 MAYBERRY RD, BERRY CREEK Cont: WV ALTON INC Contractor. CHANGE OUT HVAC HEAT PUMP Type of Permit: Al cmzj/y��-� SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: • e P SIGNATURE- 1 OK = Not OK RESIDENTIAL (Single & Duplex) I DATE JUNDERFLOOR DATE IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub. Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1..l Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE IM E C H A N I C A L 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 61 AC Ducts Insultn & Support _ 14 Girders-Sills-Anchr Bolts Joists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16•Insulation 64 Furnace -Vent Acc-Comb Air RtrntVent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic c` ` o DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE F I N A L 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-CImc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & BearnsSz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties -Pu rlin-Roof Brac TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat CImc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Apptnc; Grnd-Air-Gap-Cooking CImc. 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrfir Acc Mech Prtctn; LPG Appince Undr House 3"' drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Lottn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnis 83 Insultn-Foam-Looked in Attic 38 Ins ultn-Walis-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 CImc Drnge Planters Dyes DN. 87 Stucco Brown -Finish 88 AC Unit Dscnnct. Elec-Plmb 89 Wits abv Roof, Plmb-Apptnc-Frplc-Clrnc to Opngs DATE JELECTRICAL 90 Wtr Well, Dscnnct, Elec, Plmb 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous lnspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz 9a ❑ CU or ❑AL 98 Address Posted AC Wire Sz ga ❑ CU or DAL 99 Fire Sprinkler 48 Range Circ ga ❑ CU or DAL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral Dyes ❑No 160, °,� o` 49 Service -Riser Cndctrs &Grnd Main Dscnnct 50 Eqp Clrncs pnis-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector' = OK .nv MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat ❑ 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 -00 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 `G A R A G E S i Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls 4. 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-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bokes-Enclsrs-pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide �c A Pool Drawing r I' 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. BP060189 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: 01/26/2006 APN: 071-400-028-000 the Business and Professions Code, and my license is in full force and effect. License Class: C. LO License Number: 231 -t I O Site Address: 59 MAYBERRY RD BCK Date: t Z 6 b Contractor: M,tR, Map Index: Description: CHANGE OUT HVAC - HEAT PUMP 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 permit to construct, alter, improve, demolish, or repair any structure, prior Owner: HILL CRAIG A & KIMBERLY to its issuance, also requires the applicant for such permit to file a 59 MAYBERRY ROAD 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: W V ALTON INC pp Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 211 ELM ST such work himself or herself or through his or her own employees, MARYSVILLE, CA provided that such improvements are not intended or offered for 95901 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-742-7119 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: W V ALTON INC and who contracts for such projects with a contractor(s) licensed 211 ELM ST pursuant to the Contractors' State License Law.). MARYSVI LLE, CA ❑ I am Exempt under Article 3 of the Business and Professions Code 95901 530-742-7119 Date: Owner: License #: 231910 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 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. 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: 4- Carrier:i- L S�if r -U C Total Square Ft: 0 S. F. 13 " b, I (� 2- -k Policy #: Valuation: $0.00 ❑ I 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 forthwith comply with those provisions. 2 c Date: Applicant: a�--- WARNING: Fai ure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit i er y issueo under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolu ' s ork Indic ted above for which fees have been paid. 11 performance of the work for which this permit is issued (Sec 3097 Civ.) Name: BY q�te: PERMIT EXPIRES 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. O 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. (i 1 47 W N"Signature: Print Name: (iL I 1�. Date: ❑Owner❑ 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: www.buttecounty.net/dds **PLEASE PRINT CLEARLY*Y CONTRACTOR OWNER INFORMATION Last Name City m g Sv 4 I First Name Address 51 Phones, 7 i 1 Ita Ci" NbU AL E-mail SLla _ Zl��nl lo� Phone Book Fax E-mail Planner CONTRACTOR Name U C_ Address Z I( City m g Sv 4 I State CIp, zip? S9 U Phones, 7 i 1 Ita Fax S-3 X72,-iyZ� E-mail Uc. # 3 t q/ o Class C, APPLICANT INFORMATION ARCHITECT/ENGINEER Name , City ryk J v l Address Z'pyS'g rV City Fax -7 y q- NZ - State . Zip Phone Book Fax E mail Planner State License Number APPLICANT INFORMATION Name 'a' (. t nd Address 2,1) SP City ryk J v l State A- Z'pyS'g rV Phone �c Fax -7 y q- NZ - E -mail APPLICANT SIGNATURE X For office use only: Zoning Prop ert res Flood Zone Cross Street SRA Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT �O U l BP :. BIN # PROJECT LOCATION U L- r Y1 Ute. Prop ert res City _ J\ Cross Street ❑ Structure Built without Permits WORKER'S COMPENSAT40N- Policy Number _7 -.-2-) C-) <D 1 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 S pe of Work: U L- r Y1 Ute. . ClVc 6-+ t.& 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: Amount: �J� Bldg SRA Receipt M. � � Sheriff SMIP Other Date: I LL Total i SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Fomi (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. Califomia 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. ❑ 1.1. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation"and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant of (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 KAFORMSSUILDING F0RMSUdgApp1SubRgmts.doc Pape 2 of 2 RF\i R -17 -ns ' • PERMIT NO. 3672-82B,P,E,M PERMIT EXPIRES OWNER CRAIG HILL CONTR. owner ASSESSOR PARCEL 71-40-28 LOCATION —NIS Mayberry, app 600' E Simmons Rd. Berry Creek area Temp. Power Pole Called PG&E W"4 Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (D Signature V = OK 0 = Not OK • - = Not Applicable * = Not Ready " RESIDENTIAL (Single and Duplex) Date UNDE OR Plans OK except N's x-74 Date FRAMING, Continued Zonjyg•requirements-Setbacks=EasementsOA--property Line Firewall & Openings Main; Soils-Steel-Elec. Grnd.- /% Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd s or 2 exits 3„.E4g.-Garage; Soils -Steel- / /".Ftg. Depth 56. Stairs; Width -Headroom -Rise -Run Landing- ire Protection 4. Ft Porches & Decks; Soils -Steel- / /" Ftg. Depth . Plywood on Roof Overhang -Attic Ven s- a ter Outriggers — temwalls,. Main; Steel-Blockouts-Wrapped-Slab Siding -Nailing -Veneer el+s Garage; Steel -Blockouts-Wrapped-Slab b - ts'ed-Fdn. Vents-Underfir. Access 7. -DIETS=Fireplace Ftg.-Steel lazing Area -Glass Protection -Skylights -Plastic V.: Fall -Fittings -Test -2. way C/O -Sewer Test arhfng=Bolts ipe; Size -Anchors ater Pipe; Test -Anchors -Regulator -Service Test 11.-.EIP_c1ric; Underground, - 12.-124soums & Ducts; Clearance -Material -Support -Ins. 13.-Q4dVM-_Sills-Anchor Bolts -Joists -Vents -Cripples Card -B . Date Card -BI Date d -BI Dat and -BI Date Card -BI Date Card -BI Date Date Card -BI Date Date FINAL E1ans) OK except H's BI Date `a- Card -BI Date R Date PLUMBING (Permit) OK except Ws -- 14. W�Ht.; Vent -Access -Combustion Air 1f6!rqje�Pipe; Test & Anchors -Nail Protection 55 -Door & Sidelight Protection -Landings 6z;�;�rmoke 58. Detector Furnace• nts-Clearance-Comb. Air-Connector- I ge; Above Floor-Ducts-Mech. Protection 1Cr-D.W.V.; Test-Fttngs & Anchors -Nail Protection 5 ed m Exiting an, , First Floor -Tub Access Bath Fixtures & Tub Access _ 9� Test Tub & Shower, 2nd Floo-Tub A ess ec. Trim & Subp , Breaker Siz -L 1 Anchors 'S irs FirepFeee-er Stove; Clearances -Hearth ,6 1; Int. & Ext. Card-BI Date `L Card -BI Date �SyKfC Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance ' C I to ,-Card-BI Date c. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Perrrdt OK except N's 67. 68. - r --- or Fixture &Transformer Clearance -Ins. Protection eq. Receptacles Spacing, -Lights & Switc sat Doors ize Boil & No. of Cd uctor St d' 69. Wtr. Htr.; Vents -Clearance -Comb. Air=Connector-P.R.V.- In Garage; Above Floor-Mech. Protection b., Elec. & Mech. Equip. Listed for Location '22,'-Romjpgx4nstalled Close to Ede of uds & C.J. 7 in Garage; (G.F.I.)-Romex Protec. _-_ �_-- quip. Ground mad p w : Fasteners -Bond Gas & Water Insulation -Foam -Looked in Attic ❑Yes 'Appliance Circuits in en &Conductor Size 3. IL Guard Rails &Deck Construction -Post Caps Jk! _ 26. Subieed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes s 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, _Insulated Neutral ❑Yes El No 75, Following instld.: Drive E]P'i Yes No; Walks ❑,Yes No; Planters ❑Yes _ 28. iervic fFisW Conductors & Ground -Main Disconnect 76 - finish — 29. Equip. Clearances; Panels-Motors-Mech. Equip. - ces-Brkr. & Cond. Size -115V Outlet _- - Light -Shower Light — e ove Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. -- - --- 7 ater l disconnect, Electrical, Plumbing ---- 804-e5"Rerior Elec. Trim; G.F.I. Receptacle -Underground ----- Card B- ___Date _a• and -BI _ Date 81 ation throughout House C I to 6 Card -BI Date 8 rotection Date MECHANICAL (Permit) OK except q's from Previous Inspections 84rs Tagged; Gas -Electric _ 31_ A.C. Ducts: Insulation &Support g Sewer Connected -C/O to Grade -HD Approval _ 32. Vent Fan; Exhaust above Insulation _33. Condensate Drain _& Overilow; Size & Grade nergy Compliant Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet _ 35. -Attic Access & Platform if Furnace in Attic �g ard- ate- Card -BI Date - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI ate Card -BI Date Card -BI _ Date Card -BI Date Date FRA G(Plans) OK except k's `- ' GQnri. atnal: Proper Material & Anchors _ Wa ;_Studs -Nailing, Spacing & Bracing -Plates -Sound 3✓' Bearing Walls over Girders & Floor Nailing_-� _ 39. -I -Draft Stop in Walls (rat proof) /�-- _4ae- ire Stops; Furred Cei.kngs-Stairs-Ch. es- Ii — 11. -Header _&_Beam -Size &_Bearing _ Han s -Post Caps -Anchors -Connectors 43: Ing. Joist-Rftr. Ties-Purlin-Root Brac. r �ht�h'��_��Rfnq. replace Ties or Type A Flue -Fireplace Throat �) At . Access; Size & Rom_ex Protection -Draft Stop -Ins. Baffles 4 Bdrm. Windows or Exiting Doors -Sill Hgt. &Dimensions 47. Gclion Framing - (NOTE:Anentrymust be made each time youvisit jobsite) . = OK = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4, Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing_ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete _ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports: Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI _ Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Date POOLS (Plans) OK except #'s r 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining _ 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date 3672-82 1 - •fir PERMIT NO. 4138-83B PERMIT EXPIRES OWNER CRAIG HILL CONTR. owner t _ ASSESSOR PARCEL 71-40-28 LOCATION N/S Mayberry Rd, 600'E Simmons RdBC i Temp. Power Pole t Called PG&E Temp. Elec. Service Called PG&E j Temp. Gas Service r Called PG&E JOB FINALED (Date) Signature /,\/ V = OK 0 = Not OK - = Not Applicable * = Not Ready _ MOBILEHOMES tAw Wwj MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's Date D OVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements-Setbacks-Easements1. ng Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch Fo_ s; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete ecks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing_ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete _ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 7. Utility Clearance 6. Carports; Windows -Doors 7. Elec. Card -BI Date Card -BI Date Card -BI KK Date/ - Card -BI Date Card -BI Date Card -BI Date Card -BI _ Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector Date _ POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed -7. Water and Sewer Connected -C/O to Grade -HD Approval 7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date f J = OK r x 0 = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) * = Not Ready Date UNDERFLOOR (Plans) OK except#.s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50.' Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. _ Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access - 7. 8. Piers -Fireplace Ft .-Steel D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11: 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except k's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date _ Date Card -BI Date PLUMBING (Permit) OK except q's 14. Water Ht.: Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting _ Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels Gas Pipe; Size & Anchors 62. Stairs & Rails _ _19._ 63. 64. Fireplace or Stove; Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except #'s 67. Garage Fire Door; Swing -Landing -Closer, 68. A.C. Duct in Garage -Damper --- 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection _ 21. _Flet. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. &Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic EJ Yes -- - 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. 74. Guard Rails & Deck Construction -Post Caps Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth ClearanceLooked under Floor ❑ Yes 26. Subieed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At - _ 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, r' Insulated Neutral Yes ❑No `- Service -Riser Conductors & Ground -Main Disconnect 75. Following in lDrive E] Yes E] No; Walks ❑Yes C1 No; Planters ❑yeYes ❑No 76. Stucco; Brown -Finish -- 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _ 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. ------------------ Card B -I ----Date Card B -I ----- - -_-__- _--- _ Card -BI Date Date Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Permit) OK except q's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric - - 31. A.C. Ducts; Insulation &Support 85. 86. Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates 32. 33. Vent -Fait; Exhaust above Insulation - Condensate Drain _& Overilow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI .Card -BI -- - - - Date_- Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Date FRAMING(Plans) OK except a's 36. Sills; Proper Material & Anchors Comments at Final: _ 37.Walls; 38. 38 39. Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing__ Draft Stop in Walls (rat proof) _ 40. _Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing_ Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties- Purlin-Roof Brac.-Truss-Shthnq.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. &_Dimensions_ _ Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS Z MIT NO. 7 County Center Drive - Oroville, Caltforniar9t965 - Telephone 916/534-4541 - t• APPLICATION AND PERMIT. ASSESSOR�PARCEL NUMBER ` ZONING BUILDING PERMIT OWNER i TELEPHONE - D�3SQ. FT. OCC, BUILDING VA AcT�IO UNC Y111CONTRAC OWNER'S M LI G A015RESS r1b OR'S NAME TELEPHONE CONTRACTOR'S MAILING AD .ESS Fireplace CONSTRUCTION LENDERUNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER it e -Penalty LICENSE NO. Plan Checking Fee $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING A RESSPLUMBING a a PERMIT Filing Fee 10.00 41 101f S Each Trap 2.00 Solar Water Heater 20.00 - Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other ' SPECIFY Building sewer 5.00 Mobile Home S G W 10-00ea TYPE OF WORK New ❑ Addition LvI Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: 12 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000 AMP ORv OR LESS10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLOGS. 21/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): El 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 Q_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- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. ULTI.OUTLET 2.50 ea NO..RES,. BRANCH CIRC ITS NEW -CONSTR. POWER APPARATUS & NON RESID. SINGLE OUTLET CIR. ( zoesoa Ex. Occup(OUTLETS OR FIXTURES SAL®30 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 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. ❑ 1 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit 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 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. Date �`t—//�Z8 Signature of Ap cant - Owner El Contractor ❑ Agent ❑ An OSHA permit is required for.excovations over 5'0" deep and demolition or construct- ion of structures over 3vQstories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ , occuP. GROUP M,_ T PE F CD T. I VPARCEL PD (/ N 15511 This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO OF PUBLIC: BY P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date/Z 0,Z ��' Receipt No. ©Q/7— '� WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT 0 71-40-28 953-90E 7. ,HILL, Craig X59 Mayberry Road, Oro' ille ,(new 200 amp elec ser)SF OFFICE Copy Address AR ra r -7 — 0^Z AA By 1� 11 ELECTRIC D Meter By e i , I r 1 COUNTY OF BUTTE - DEPA'RTME'NT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 71-40--28 ZONING U BUILDING PERMIT OWNER CraigHill TELEPHONE 589-0430 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 59 Mayberry Rd, Oroville 95966 CONTRACTOR'S NAME Owner TELEPH ONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 59 Mayberry Rd Oroville Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME .PARCEL MAP Water piping 5.00 Each gas water heater or vent 5.00 USE OF STRUCTURE SF X Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G IN 0.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Ej Describe work: New 200 A Sp_rvieP _ H Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP r�• 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of p y perjury Iur y (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 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 forsale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.&\ OR AODNS. ( ACC. BLDGS. I 2/,20sgft NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS &` SINGLE OUTLET CIR. / Ex. Occup( OR FIXTURES 20050Q 9ALe 30 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 15.00 Permit Fee $ 37.50 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. I shall not employ any person in any manner so as to become subject Jam- 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 FiIingFee 10.00 Heating Cooling 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 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 against said County in consequence of the granting of this permit. [' X %0 Date 1 /� IT Signature f pplicant — Owner Contractor ❑ Agent ❑ 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 $ Occ CONST TYPE TOTAL FEE $37.50 HA2 I CUA PARK I SCHL I FLD I PAR PD HD Is u This permit is nereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fhaid. '4r fees have been p DIRECT R Oft PUBLIC WORKS By ��� �. 5 PERMIT EXPIRES Date Receipt No. 63826 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - 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 COR ECTION NOTICE /17', 1 �. 2 (7 1- 7 36 VNLH 0 PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist rtheve address and should be corrected. Please notify this office when cf work is completed. If you have any question pertaining to this matterdditional explanation, please contact this office immediately. $ .� A ._. WI R V ��jrAr w --- I ofFORM OR t<r�ar �� PEE I- '1Lt°veilfi . ten► �� � _ 4WO 1;1. zi WIT �.,owl .a - `f/' : k� L! Inspector_ T' �t �/�' `� ,I Cate i n COUNTY OF BUTTE r. DEPARTMENT OF PUBLIC WORKS i96 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 L. 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 ,atter, or need additional explanation, please contact this office immediately. y� Z A f t_ 41-1— F Llz. CG! PXK/fy LS PA (M, 1<,vs P4 CT XjT7 (j, 01 Inspector Date COUNTY OF BUTTE - Department of Public -Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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) and. 2. I (have/have not) b Ayl-e 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 - — City - - - Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors 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 i Signed: Property Owner Social Securit Numbe Date -y ? 9 t 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 per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS _. 7 County Center Drive- OroSiIle, ICa6ifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. 9S.3- 90 ASSESSOR PARCEL NUMBER 71-40-28 ZONING U BUILDING PERMIT OWNER Craig Hill TELEPHONE 589-0430 SO. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 59 Mayberry Rd Oroville 95966 CONTRACTOR'S NAME - Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 59 Mayberry Rd Oroville Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 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 SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other [ Describe work: Npur 900 A Ser.,;cP _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP V OR LESS 10.00 10.00 Main service EA. ADD -L 100 AMP 2.50 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- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ACDNS. (ACC. BLDGS. 2/z ¢sq ft NEW RES ULTI.OUTLET NON •R RES BRANCH CIRC ITS 2,50 ea POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 0A 090 FIXED APLNS Ex. Occup. OUTLETS P(RES(D )REA.) 2.00 Temporary service 1 10.00 Mobile Home Facilities 15.00 Misc. Ilyirin 9 15.00 15.00 Permit Fee $ 37. 50 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 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 % 3 �� Signature pplicant _ """ Owner Contractor ❑ Agent ❑ 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 $ occ CONST TYPE TOTAL FEE $37.50 HAZ I CUA PARK I SCHL I FLO I PAR I PD HD I u This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees R CT R O PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS D to Receipt No. 61826 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT L Y 'OFFICE COPY Address ELECTRIC pate � Meter BY PRE -INSPECTION REPORT OWNER: \4 r ", 4�� LOCATION: 15 I CONTRACTOR: DATE: 1 ' A.P.# DbQ,'� ZONING: REASON FOR PRE -INS E TION. I C. DATE TO INSPECTOR: PERMIT HISTORY ( ) NONE A SEE ATTA CI -ED BUMDING INSPECTOR'S REPORT Building Description: Commercial/Usage: _ Residential # of Units: Currently Occupied AbandonedNacant: Electric: Electric Currently Condition of Electric Gas: Mobile home # of Units: (.) Yes~� ( ) No � ( )On ( )Off Currently ( ) On Condition Sanitation: Plumbing Working ( ) Yes` Obvious Sewage Problems ( ) Yes ACTION RECOMMENDED: Hold for permits or verify: _ Inspector: ISSUE ( ) Off ( ) No ( ) No f(/. Yes O No Date: i CRAIG HILL 71-40-28 NYS Mayberry, app 600'Simmo s Rd Berry Creek area net) ��,tamily) ' Permit#3672-82B,P,E,M(new single 71-4 - Pe rmit��4138-g" 0 28 B(add open deck/SF) 71-40-28 HILL, Craig 953-90E 59 Mayberry Road Oroville (new 200 a amp elec ser)SF E F i. i s i i. i i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION "PLEASE PRINT CLEARLY" I CONTRACTOR I Name Address --i City ^ Ph E-mail Zip OWNER Lasl me First me Address City J4,/ F Stat% zip Phone Fax Fax E-mail Phone I CONTRACTOR I Name Address --i City ^ Ph E-mail Zip APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax -stat Zip Phone REV 7-27-04 Fax E-mail State License Number APPLICANT NAME Name: Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X 1-� For office use only:, Zoning Flood Zone I I SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. B���� BIN # LOCATION AN,� C) l • Q� a Property Address City Cross Street WORKER'S COMPENSA •ION Policy Number `` �� �v r . c5A -I Carrier if h nng an one 6`15er than Igense contractors, cern irate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY -dam REV 7-27-04 Address Description or Scope of Work: Sq. Footage /v 0 Structure Built without Permits O 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 OVER FOR SUBMITTAL REQUIREMENTS U K:TORMSWILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 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 k Sheriff SMTP Date: l � " I Other Total REV 7-27-04 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 "PLEASE PRINT CLEARLY" I CONTRACTOR I Name Address City /' e G Phone E-mail Zip ARCHITECT/ENGINEER OWNER Last me First -Name Address City J Sta� Zip Phone Fax Fax E-mail Policy Number Carrier I CONTRACTOR I Name Address City /' e G Phone E-mail Zip ARCHITECT/ENGINEER Name Address City State Zip Phone Fax E-mail State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT 6 - 3)IT5 BI BIN # Description or Scope of Work: 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 OVER FOR SUBMITTAL REQUIREMENTS L, K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 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: Receipt #: �) ) L Date: 1/6 ___1 Sheriff, SMIP Total REV 7-27-04 LOCATION AP# '' ll I. L V ®00 � Property Address1,n2 I City Cross Street 3+5t 1-1:393//l WORKER'S COMPENSA ION Policy Number Carrier n �! v 2 ki y Af k�; � U . If h ng anrone olger than h1rense contractors, cern tate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY —Name Address Description or Scope of Work: 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 OVER FOR SUBMITTAL REQUIREMENTS L, K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 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: Receipt #: �) ) L Date: 1/6 ___1 Sheriff, SMIP 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 paperl ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paperl) 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 faxesl ❑ 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 en ineer. ❑ 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). ❑�_3—Sanitationand sit oJan-appmyalAom-the-EnvirDnmentaLHeaW)-Depadment. 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. ❑ 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 KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 RE/ 7.27_04 let a I =Wei 1144? ���NAME'� ADDRESS PLEASE POST THIS IDENTIFICATION CARD IN A CONSPICUOUS PLACE AND VISIBLE FROM THE ROAD 12/2/90 A.P.N.07I' IfOO w'104 8 ,- �r• I.i .. :'S: 5.11 -i .p ��. 'i, -R?. '.i_ n.. �:. COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDING.DI.VI.SION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: `t r 1 ASSESSOR PARCEL NUMBER_ Proposed Building Use: Counter Technician: Date: I r Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order t ap y. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. Cl 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design. review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. Cl 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form ❑ / 27. Encroachment Permit for�driveyfay from the Public Works Dept ........................... (� 28. Pre -Inspection for n 0 (� 0 i renuired I i'' ❑ 29. Contractor's license information' Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: r. When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required ontracto designer, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by -.-IV- Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP043195 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: 11/05/2004 APN: 071-400-028-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 59 MAYBERRY RD BCK Date: Contractor: Map Index: Description: replace damaged panel OWNER43UILDER 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: BRANDON WRIGHT permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 59 MAYBERRY ROAD 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 Cade) 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: NORTH BUTTE CONSTRUCTION INC Code: The Contractors' State License Law does not apply to an 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 1784 PALERMO ROAD sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of PALERMO, CA 95968 proving that he or she did not build or improve for the purpose of 530-533-2840 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: NORTH BUTTE CONSTRUCTION INC pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code 1784 PALERMO ROAD Date: Owner: PALERMO., CA 95968 530-533-2840 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 #: 569053 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: Total Square Ft: 0 S. F. Policy #: ❑ I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, 1 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, 1 shall forthwith comply with those provisions. Date: 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 CodR anrvor I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)— - ---- — - - ---- ---- -- -- _ Name: By: Date: Address: PERMIT EXPIRES ON: 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: Signature: Date: ❑ owner 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor I I 'r. I 110 r , , I r v, I I I I I I a_ , r. r I .I ,, I �. .I:: ., I: ,. I r. I , u I, ., .., i n I I I r I. r , , I _ ry a ,I I ;:., -„ 1. I I:. r r I r r ! t I I I t - f s r f L,, I ,I-: -. ,. ._. 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