HomeMy WebLinkAbout071-400-0480714
40-0-—
04.8,93',323
MHI:
DONAHUE, EDWARD
X258 MIDDLEFORK,LN, OROVILLE
CONTR : MH CENTER 15�j V
MHI/EXISTING SITE
B07-0641 071-400-048
MISCELLANEOUS Electrical
UPGRADE ELEC SERVICCEE.FO/R RES
258 MIDDLEFORK Electric]
SUNSHINE LIVING TRUST, NELMS E
01/0_40or"j
11
BUTTE COUNTY AREA
DEPARTMENT OF DEVELOPMENT SERVICES 2
INSPECTION CARD MUST BE ON JOB SITE
24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico)
Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds
Permit No: B07-0641 Issued: 03/28/2007
Address: 258 MIDDLEFORK LN Area: RRY CREEK
Owner: SUNSHINE LIVING TRU,APN: 071-400-048
Applicant: ELIZABETH NELMS Map Page:
Permit Type: Electrical
Description: UPGRADE ELEC SERVICE FOR RES WEL F
Flood Zone: None SRA Area: Yes
SETBACKS
Front Setback: Side Setback:
Rear Setback: Other Setback:
Minimum Setback From Centerline of Street:
ALL PLAN REVISIONS MUST BE APPROVE BY THE COUNTY BEFORE PROCEEDING
Inspection Type
IVR INSP DATE
Setbacks
132
Foundations / Footings
111
Pier/Column Footings
122
Grade Beams
114
Eufer Ground
216:
Forms/Steel/Holdowns
122
Do Not Pour Concrete Until Above are Signed
Pre -Slab
124
Gas Test House
404
Gas Test Yard
404
Masonry Grout
120
Masonry Bond Beam
119
Underfloor Framing
149
Underfloor Ducts
319
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Gas Piping
403
Do Not Install Floor Sheathing or Slab Until Above Signed
Holdowns/Straps
122
Shearwall/B.W.P.-Interior
135
Shearwall/B.W.P.-Exterior
135
Roof Nail/Drag Trusses
129
Do Not Install Siding/Stucco or Roofing Until Above Signed
Rough Framing
128
Rough Plumbing
406
Rough Mechanical
316
Rough Electrical
208
Gas Piping
403
Shower Pan/Tub Test
408
Fire Sprinkler Test
702
Fire Sprinkler Final
702
Building Final
802
Electrical Final
803
Mechanical Final
809
Plumbing Final
813
Pool Final
802
Mobile Home Final
802
i
Inspection T e
1 IVR I INSP DATE
Do Not Insulate Until Above Signed
Wall Insulation
117
Ceiling Insulation
118
Do Not Cover Until Above Signed
T -Bar Ceiling / RC
145
Stucco Lath
142
Stucco Scratch
143
Stucco Brown
144
Swimming Pools
Setacs
132
Pool Plumbing Test
504
Gas Test
404
Pre-Gunute
506
Pool ElecBonding/Light Nitch
502
Pool Fencing/Alarms/Barriers
503
Pre -Plaster
507
Manufactured Homes
Setbacks
132
Blocking/Underpining
612
Tiedown/Foundation System
611
Site Utilities/Trench Insm --1 — — — —
Gas Testi �
Manomej - - OFFICE COPY M
Continuit
Skirting/Address
Manufact, GAS N
Date of N Meter By 1 - Date
Model Nd ELECTRIC S Date /� M
Serial Nui Meter By
LIA Length x
Insignia:
Publtc Wor s Fina
538-7681
Fire Department/CDF
538-7111
Env. Health Final
538-7281
Sewer District Final
IZ
"PROJECT FINAL
801 P c
-rrolect rium is a -,ernucate of occupancy for txesiaennan Vmy)
PERMITS BECOME NULL AND VOID I YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR
RENEWAL 30 DAYS PRIOR TO EXPIRATION
Inspector Copy
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
FEE INFORMATION
DBE Single Phase Service-Resid $55.00
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect.
X 03/28/2007
Contractor's Signature
Date
WORKERS' COMPENSATION DECLARATION I
I 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 is issued.
❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
X
Carrier: Policy Number: Exp. Date:
(This section need not be competed if the permitis oror one hundred ($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 the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
compenSiatian provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
03/28/2007
sig - Date
WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Lender's Address
City State Zip
Total Charged: $55.00 Fees Paid: $55.
Balance Due: $0.00 Receipt No: B23
OWNER / BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are not intended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof 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 Provessions Code:
The Contractors License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a oontractor(s) licensed pursuant to the
Contractor's License Law.).
F I AM EXEMPT under Section B. & P.C. for this reason:
� n
03/28/2007
Date
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
��ve mentioned property for inspection purposes. I hereby certify that I am the
mentioned
act lh prop rty ower behalf.
_ 03/28/2007
flaffie 7ermi ee [SIGN] Print Date
1�1wner ❑ Contractor OR;Agent for Owner ElAgent for Contractor
FILE COPY
PROJECT INFORMATION
Site Address:
258 MIDDLEFORK LN
Owner:
Permit No: B07-0641
APN:
071-400-048
SUNSHINE LIVING TRUST, NEIL
Permit type:
MISCELLANEOUS
42 VALLEY VIEW DR
Issued Date: 03/28/2007 By KCG
Subtype:
Electrical
OROVILLE, CA 95966
Expiration Date: 03/27/2008
Description:
UPGRADE ELEC SERVICE FOR RI
(530) 533-3383
Occupancy: Zoning: U 00
Contractor
Applicant:
Square Footage:
ELIZABETH NELMS
Building Garage Remdl/Addn
42 VALLEY VIEW DR
OROVILLE, CA 95966
Other Porch/Patio Total
(530)533-3383
FEE INFORMATION
DBE Single Phase Service-Resid $55.00
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect.
X 03/28/2007
Contractor's Signature
Date
WORKERS' COMPENSATION DECLARATION I
I 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 is issued.
❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
X
Carrier: Policy Number: Exp. Date:
(This section need not be competed if the permitis oror one hundred ($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 the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
compenSiatian provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
03/28/2007
sig - Date
WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Lender's Address
City State Zip
Total Charged: $55.00 Fees Paid: $55.
Balance Due: $0.00 Receipt No: B23
OWNER / BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are not intended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof 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 Provessions Code:
The Contractors License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a oontractor(s) licensed pursuant to the
Contractor's License Law.).
F I AM EXEMPT under Section B. & P.C. for this reason:
� n
03/28/2007
Date
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
��ve mentioned property for inspection purposes. I hereby certify that I am the
mentioned
act lh prop rty ower behalf.
_ 03/28/2007
flaffie 7ermi ee [SIGN] Print Date
1�1wner ❑ Contractor OR;Agent for Owner ElAgent for Contractor
FILE COPY
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION '
An application for a_ building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. I PERSONALLY POYES
PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
EMENT.NO)
2. (HAV HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME
ADDRESS_ CITY
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME
ADDRESS 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
Description: UPGRADE ELEC SERVICE FOR RES WELL
Reference Number: B07-0641
Applicant Name: ELIZABETH NELMS
Owner's Name: SUNSHIN E S E AP # : 071-400 048
Signature of Property Owner: _� Date: F v/0
res
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name Gi'TS
I ,jVame
Mailing Address/ _w b
I %i4 c:L� V
City kD Vt tie
State
Zip�S�n
77
Phone 6_3 3 - 33 $ 3
Fax
E-mail D1 KPitr -L sbe �ot1 • /1
J
APPLICANT INFORMATION
CONTRACTOR
Name
,
Address
Phone
City
E-mail
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
State
Address '
Phone
City
E-mail
State
Zip
Phone
Fax
E-mail
Stale License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
PROJECT LOCATION
AP# � I_�DG1-D �-L906
Property Address 'g �, e�
City Cid V, l/P
PERMIT
NO.
BIN #
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK•
uAi�ad P_,41 l
zZR77
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
ILA I Flood Zone
I
SRA I Yes
I No
Occ.
Type Const.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovilld; CalifoFnia 95965 - Telephone: 916/538-7541
• '~�• APPLICATION AND PERMIT
ERMIT NO.
ASSESSOR PARCEL NUMBER
071-400-048
ZONING
U
BUILDING PERMIT
OWNER
Edward W. Donahue
TELEPHONE
429-2324
SO. FT. oCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
5841 Stubblefield Way, Sacramento 95823
CONTRACTOR'S NAME
Mobile Home Center Inc.
TELEPHONE
533-4403
CONTRACTOR'S MAILING ADDRESS
1740 Feather River Blvd., Oroville 95965
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $ 20.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $ 35,00
lie
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE QF STRUCTURE
SF ❑ Duplex❑ Mobilehome�J/ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G I W @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instal latioo Other ❑
Describe work: 2 Bedroom MHI
1,405 sq. ft. Existing Site
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200AORLESS 18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the BUSIne$S
and Professio Code and my license is in full force and effect.
License No. ClassificationCc��
r-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
Main service 200A TO 100OA1 37.50
NEW CONST. DWELLING OCCUP.N) 3.6ysq.ft.
OR ADDNS. ACC. SLOGS.
NEWCONSTR ULTI-OUTLET
NON.RESID BRANCH CIRCUITS) @ 5.00
POWER APPARATUS e1
SINGLE OUTLET CIR. /
EX. OCCUp( OUTLETS OR FIXTURES 20 76
PP
Ex. Occup. FIXED AS L SID.IREA.) 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring -15.00
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
y� 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 15.00
Heating
Cooling
Hood
H650
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 indemnify and keep harmless the County of Butte against
all liabilities, u ments, costs, and a penses which may in any way accrue
against said 0u in conseq n e of a granting f this permit.
X ate
An OSHA
ion of HAstructuresmit is uiredes r:xc h ions over 5'0' deep and demolition or construct -
stars
Mobile Home Installation Fee $70.00
q -Inspection Fee $ do
occ
CONST TYPE
TOTAL FEE $125.00
HAz
DFEES
IMP
FLOOD CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES Date
Receipt No. 135330 '/Q
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK-INSPE OR. GOLDENROD -APPLICANT
.. .. , •..•', .. +..iy ...,..Yw+ .. .•f T4 Y.'.._ �. V. .1,.� r .. X76• •
•R �
COUNTYOF BUTTE -DEPARTMENT OFD.�V9LOPMENTRVIC
'S ES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHO (916) 538-7541
PERMIT APPLICATION DATASHEET
OWNER EDWAVLD
CA.).
LDOAI9
HU0
A. .N .0 /— 4/l/"076)4E
Proposed Building Use ,AA I-/ I
EXST
S I TFF,
Building Inspector
Date d cj
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
All items have been submitted . ....................................... .
2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
Complete plans, 3/4 sets, signed by preparer of plans . ......................
.4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ........................................... .
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
ngineered truss details and layout in duplicate (required prior to plan check). .....
Mobilehome data and manufacturer's installation instructions, 2 sets. lhu4aa0.4i U� .ZL,44
10 Fees of $ fib,y U .........................................
1. Impact fees as shown on attached schedule . ..............................
California Department of Forestry plan approval/fees. ....................... .
VA Flood elevation letter (100 year flood) by California Engineer . ................. .
✓(1 Sanitation and plot plan approval 012 Health Department . ............
i City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . .........
Contact Land Development about (A) Improvements (B) Drainage. .......... .
Driveway permit (construction approval required prior to occupancy). . .
ti Pre -ins
-inspection for M H I �X S T" Preanspedion reque—{s
``20. h �7 / l li required. .. co B� id �9 i�spedo� (Date)
L Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
Owner -Builder Verification (Given to owner , Mail to owner �. .......... .
24: ecorded copy of Agricultural Acknowledgement Statement . ..................
Letter of signature authorization. ... ......................... .
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :.............
.... -
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephones 33 1/ y03 and hold for pickup at office. Deliver with inspector.
Other /1 .t •
Parcel Creation
Acreage Applicant
Date z 0/ /--3
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution %
Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted
1. Index permit•for above items No�
2. Additional items required:
e new item not checked above).
Contracto , designer, owner, was advised of above required data by phone _ mail Counter by Date _.?41493
actor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by bd Date 2 2 Plans approved by Date
Sets of plans on hold in File cabinet AP folder
L, Copy - Department of Public Works
COUNTY OF BUTTE — DEPARnMNT OF PUBLIC WORKS — BUILDING DIVISION
7 COUNTY CENTER DRIVE — OROVILLE, CALIFORNIA 95965 — TELEPHONE (916)5387541
A . P . NO . U— — D 0
°OPOSED BUILDING USE A4 H DATE
REC. DATE_ REC
School Distric Fees _
aid at District Office) .... .
2. Sheriff Fees
(paid. at -Building Department)
_,L//T3-
Residential X 3 % 0 =$�i
unit amt.
Commercial(per sq.f t.) X =$
sq.ft. amt.
Urban Area Fees
(paid at Building Department
Residential (per unit) X =$
" units amt.
Commerical(per sq.ft.) X =$
sq.ft. amt.
Recreation District Fees
(paid at District Office)
Drainage District Fees
(Contact Land Development)
6. Other
7. Other
At time of permit application, I was advised the above fees are required to be paid pr'
=o issuance of the per„zj�t.
-PPLICANT
DATE I D/0?
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form Per Building)
School -District W_ 0 U/t/ H '` Building Department No. z
A.P�Number O % Jurisdiction City 0 County
Property Owner E V VJ A l_C> IBJ , DO/V A H VF—
Property Location/Address 12,J ? / l DD L F1=70 9 /G. L ///
Subdivison',
Residential Development
j..
7 tr.tw
Commercial/Industrial
Departme
Lot No.
0 0/ 0 Sq. Footage 0�
No. of Living , MHI Addition (Group.R)
Units ,a
00 Sq. Footage
New; .,� I `A-
I
1.1 Addition
ax 4.
(Floor Plans reviewed by School District Personnel)
(Including Exterior
Roofed Areas)
oZ / 0 9
Date
District I'dent'ificationNo. T/l J 0738
A
tjt
(,(i11,�' 0'. Schon' District certifies that )GI',t,�r-�,�.9.0
r z;, (Applicant)
(Street Address) V. (Phone Number)
ACM
(Zip Code)
k 'A
has complied with the requirements of Resolution No. / 'S % U by payment of $ � 3) g • o? S
OF 4AJ
representing y0 square feet. t b -0 0�
School
Bank Number
Paid by Cash
CAAXtAx-
Date -�
Remarks: �a - f '1
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act_(CEQA), this,project may be subject to
additional school fees to fully mitigate its impact on the school district's schools..
White (applicant), Yellow (building department), Pink (school district)
N
feeformmkl (4/92)
mow■ wAmmik ■ . m .A�A� ■ ■wft MAMMAPM
� F, 9i■ 6` -■ mai N i�--7
COUNTRY ESTRTE
0
CE566S1
1,405 S0. FT. (56X25'4")
FEATURES
CONSTRUCTION
• 2' x 6' Exterior Walls -16' on Center.
• Fully Vaulted Cedkgs Throughout.
• White Frame, Dual Glazed Windows.
• 16' or 6' Eaves on Skies. (Size depends on Model).
INTERIOR
• 1/2' Sheet Rock. Taped, Textured and Painted throughout.
• Passage Doors and Wardrobe Doors are White, 6-ponel Colonist Style.
• Bright Brass Lever Hardware on All Passage Doors.
• Colonial Style Door Casing.
KITCHEN
• GE -18 Cu. Ft., Frost Free Refrigerator.
• GE - 30' Free Standing Gas Range with Electronic Ignition, Window In the
Door. Clock and Tkner.
• GE - 3 -Cycle. 5 -option Dishwasher.
• 1/3 H.P. Garbage Disposal.
• Single Lever Mbcer Faucet.
• Hardwood Cabinets, Fully Lined with White Melamine.
• Adjustable Shelves In Overhead Cabinets.
MASTER BATH
• Porcek]In Sink with Pop-up Drain and Single Lever Mbcer Faucet.
• Oval Tub with Separate Stall Shower, Walk-in Shower or Tub/Shower
Combination per Floor Plan.
• Single Lever Mbcer Faucet on Shower.
• Fluorescent Lighted Soffit over Lavatory Top.
GUEST BATH
• Porcelain Sink with Pop-up Valve and Single Lever Mixer Faucet.
• Tub/Shower Combination with Single Lever Mixer Faucet.
• Fluorescent Lighted Soffit over Lavatory Top.
UTILITIES
• Plumbed and Wired for Washer.
• Wired for Electric Dryer.
• 30 Galion Gas Water Heater.
• Overhead Utility Cabinets with Hanging Rod and Adjustable Shelving.
AVAILABLE POPULAR OPTIONS
• FIREPLACE • SKYLIGHT • ENERGY CONSERVING INSULATION PACKAGE
• BUILT-IN APPLIANCES • BAY WINDOW • OAK CABINETS • BUILT-IN HUTCH/BUFFETS
GOLDEN WEST HOMES 9998 Old Placerville Rood, Socromento, cR 95827 (916) 363-2681
10192
PRE -INSPECTION
OWNER: DO &14 Hy E DATE -0-1104913
Oleo//
LOCATION: Fl X le-' L-/ A.P. #07/ -
CONTRACTOR: 6�eW F, ZONING
PRE -INSPECTION FOR: H-1 )0; 7 -
DATE
DATE TO INSPECTOR
PERMIT HISTORY: LL::l NONE E:] AS FOLLOWS:
TYPE OF OCCUPANCY
FIELD - INFORMATION
BUILDING USAGE:
TENNANT:
[� OCCUPIED HAS ELECTRIC HAS GAS Q HAS SANITATION FACILITIES
[� HEATED -COOLED " PERSON CONTACTED
OTHER COMMENTS:
ACTION RECOMMENDED:
ISSUE 0 HOLD FORCCs S
OTHER:
BY Z2 DATE*/��..