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072-061-025
I 72-061-2� EDWARD &SARAH LEERS 116 Lost Horizan, Oroville Permit#749-85B,P,E,M(new single family) �72-061-25 Permit#1417-86B(new storage bldg) 072-061-025 03-1410 LEERS,ED 116 LOST HORIZON, OROVILLE CONT: GEORGE ROOFING RE -ROOF -z� c i L a - r I 72-061-2� EDWARD &SARAH LEERS 116 Lost Horizan, Oroville Permit#749-85B,P,E,M(new single family) �72-061-25 Permit#1417-86B(new storage bldg) 072-061-025 03-1410 LEERS,ED 116 LOST HORIZON, OROVILLE CONT: GEORGE ROOFING RE -ROOF -z� I a R COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 �IT,10• (Rev. 12/96) APPLICATION AND PERMIT �--T(— ASSESSOR PARCEL NUMBER '702 - 6/ d -� ZONING BUILDING PERMIT OWNER TELEPHONE /- SO. FT. OCC. BUILDING VALUATION 0 OC OO OWNER'S MAI GAD KESS / r7 66 CO OR'S NAME � TELEPHONE CONTRACTORS h7 ADDRESS n CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ (� 10 ARCHITECT OR ENGINEER LICENSE NO'. Film Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADD S Energy Plan Checking Fee $ / 010�/ $ PERMIT FEE $ 9100 LOT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFA Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: JQ�Q�A,� Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 800VOR LESS Main Service A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect./ h ^ License Class (7 q Lic. No. `, l s- oC OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-insure.for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' co pensatio Insuranc carrier and policy number are: Carrier _�- = Policy Number --OA (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with thos provisions. X �[ _ Date -03 Sig tura of Applicant - 0 Uw-hir actor ❑ Agent An OSHA permit is required for excavaIons over 60" deep and demolition or construction of structures over 3 stories in ei ht. Main Service TO 46.00 W:U200A NEW CONST. DWEWNG OCCUP. SO CCU OR ADDNS. ( a ACC, BLDs. 3.5¢FT: .ESID.T MULTI -OUTLET 97,50 POWER APPARATUS & SINGLE OUTLET CIR. EX. OCCU . OUTLET OR FIXTURES BAL @ I. 0 LNS Ex. Occup. °=A°.R., 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE i MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ /V ?,00 HA2.D. FEES IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have y �� 1L1� we " PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date o s Receipt No. O/ . 6-b WHITE-D.D.S.-B.D. CANA -A SESS R PINK -INSPECTOR GOLDENROD -APPLICANT PERMIT NO. ? 749-85B', P, E,M {/ PERMIT EXPIRES t. OWNER EDWARD & SARAH LEERS CONTR. unknown ASSESSOR PARCEL 72-061-25 a 1 LOCATION 116 Lost Horizon, Oroville R� 19 4t{ TMCiyj` Id N � ±i • �.k mh ' It}. 33<<�940' f, OFFICE COPY Temp. Power Address i t Called P GAS Temp, Elec.: Met Dat j s ELECTRIC I CalledP� Meter- By Date Temp. Gas Servrce — — Called PG&E JOB FINALED (Date) Signature e. J J" = OK' 0 = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS •) Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except H'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 Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/0 to Grade -HD Approval 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 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 -Enc losures-Panelboards-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-1 Date Card -BI Date Card -BI Date Card -BI Date e w e V = OK 0 = Not OK Net Applicable RESIDENTIAL (Singlb and Duplex) = 14ot Ready. • Date UND FLOOR Plans OK except #'s Date FRAnyavG (Continued) It" Zung requirements—Setbacks—Easements Pr "perty Line Firewall &Openings . Ftg., Main; Soils—Steel—Elec. Grnd.— / fo /" Ftg. Depth Garage; Soils—Steel— / /" Ftg. Depth 4 xt. Doors—One 3'—Check Garage -3rd story, 2 exits idth—Headroom—Rise—Run—Landing—Fire Protection 4. %` Porches & Decks; Soils—Steel— / /" Ftg. Depth 5 �wood on Roof Overhang—Attic Vents—Rafter Outriggers Stemwalls, Main; Steel—Blockouts—Wrapped—Slab 521 Siding—Nailing—Veneer b:—Stomwalls, Garage; Steel—Blockouts—Wrapped—Slab co Mesh—Drip Screed—Fdn. Vents—Underflr. Access Z ier Fireplace Ftg.—SteelROWa01 54 'ng Area—Glass Protection—Skylights—Plastic Ar-TW.V.: Fall—Fittings—Test-2 way C/O—Sew r T 5 ar Walls; Npiling—Bolts 9. GM Pipe; Size—AnchorsLo!07�Lbe2L.6txyJ 1 . ater Pipe; Test—Anchors—Regulator—Seryice Test . Electric; Underground 19 ts; Clearance—Material—Support—Ins. 1 irders—Sills—Anchor Bolts—Joists—Vents—Cripples Card -BI `" Date / y Card -BI Date Card -BI W Date " Card BI Date Card -BI Dat Card -BI Date Card -BI Date Card -BI Date Date FI fans OK except q's Card -BI Date Card -BI Date Date PLU ING (Permit) OK except q's 5 xt eps—Door & Sidelight Protection—Landings 57 moke Detector 1 W41,Err Ht.; Vent—Access—Combustion Air 58. Fur — earance—Comb. Air—Connector- In ge; Above Floor—Ducts—Mech. Protection 1 a_W Pipe; Test & Anchors—Nail Protection 16 ; Test—Fttngs & Anchors—Nail Protection om Exiting S we a irst Floor—Tub Access 60 G. & Bath Fixtures & Tub Access 1 I<T Tub & Shower, 2nd Floor—Tub Access 61 IK.,Trim & Subpanel; Breaker Sizes—Labels ipe; Size & Anchors 6 s & Rails uw 6 i I ce or Stove; Clearances -Hearth 17 6 ' c. Ovilets at Wood Panel; Int. & Ext. Card -BI DateCard-BI Date ixt. & Appliance; Grnd.—Air Gap—Cooking Clearance Card -BI Date Card -BI Date F:'- - Outlets & Receptacles at Kit. Counter Date ELE TRICA Permit OK exce t Ws arag Fire Door; Swing—Landing—Closer u in Garage—Damper ture & Transformer Clearance—Ins. Protection ft—. Wtr. Htr.; Vents—Clearance—Comb. Air—Connector—P.R.V.— Above Floor—Mech. Protection ec. Receptacles Spacing—Lights & Switches at DoorsIry@arage; tP-Plb., Elec. & Mech. Equip. Listed for Location • / S" Boxes & No. of Conductors—Stapled p acles in Garage; (G. F.I.)—R rotec. / Romex Installed Close to Edge of Studs & C.J. 24. qu' round made up w/Mech. Fasteners—Bond Gas & Water 7 nsuletion—Foam—Looked in Attic Z1 Yes ai s & Deck Construction—Post Caps 2 Appliance Circuits ' Kitchen pductor Size �ire'Stze a� o -AJ Wire Size-/--/-ga-Eu" o —AI 74. Fdn. Vents & Crawl Holeainage & Wood -Earth Clearance Looked under Floor ❑ as 27. ange Circ. / A 'r --Oven Circ. / / ga. Cu or At, Insulated Neut s ❑No 75. Following instld.: Drive��ul Yes No; Walks [I Yes No; Planters El Yes ❑AVo 28._,Service—Riser Con ors & Ground—Main Disconnect '6 , rown—Finish Equip. Clearances; Panels—Motors—Mech. Equip. isconnect—Clrnces—Brkr. & Cond. Size -115V Outlet �thes Closet Light—Shower Light 7g, bove Roof; Plbg.—Appliance—Firepl.—Clearance to Opngs. 79. at ell; Disconnect, Electrical, Plumbing 80. xte ' lec. Trim; G.F.I. Receptacle—Underground Card B-1 qj2 Date 51r-2Card-BI Date 81. ' e ' at' n throughout House Card B-1 Date I' Card -BI Date 82K12eTProtection Date ME 3 NICAL (Permit) OK except H's .C. Ducts; Insulation & Support 831y1Correc!.Wgs from Previous Inspections gg, est—Meters Tagged; Gas—Electric a r & Sewer Connected—C/O to Grade—HD Approval ergy Compliance Certificate—Other Certificates 3r Vent Fan; Exhaust above Insulation 33. Condensate Drain & Overflow; Size & Grade .3a` Furnace—Vent; Access -Comb. Air—Return Air Vent -115V outlet —e5--Attfc Access & Platform if Furnace in Attic Card -BI ofDate Card -BI Card -BI Date Date Card -BI Date Card-BDate Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRA G(Plans) OK except q's Comments at Final: S' Proper Material & Anchors / 3 Is; Studs—Nailing, Spacing & Bracing—Plates—Sound r Baring Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) e Stops; Furred Ceilings—Stairs—Chases—Tub . Hader & Beam—Size & Bearing .17 42. angers—Post Caps—Anchors—Connectors 4i. cfv Cing. Joist—Rftr. Ties—Purlin—Roof Brac.—Truss—Shthng.—_Rfn_g_._ _ fireplace Ties or Type A Flue—Fireplace Throat 4 Attic Access; Size & Romex Protection—Draft Stop—Ins. Baffles Bdrm. Windows or Exiting Doors—Sill Hgt. & Dimensions ,Q;--fafage Fire Protection Framing (NOTE:Anentrymust be made each time you visit job site) Owner: Permit No. T-7 " LOCATION ROOF Material Thickness(inches) ENERGY CERTIF ICAT ION DESCRIPTION OF INSULATION EXTERIOR WALL Material Thickness(inches) 3 CEILING Batt or Blanket Type Thickness(inches) Loose Fill Type Minimum Thickness(Inches) Area covered(ft. ) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) '0 A. P. No. Brand Name Thermal Resistance (R Value) Brand Name ST "I Thermal Resistance(R Value) Brand Name D e Thermal Resistance(R Value) .5'0 Brand Name Number of Bags Wt. per bag lb. Thermal Resistance(R Value) Brand Name M Thermal Resistance(R Value) l/ Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building in conformance with the State of California Energy. Reg4iriements. 4' LzEre"S�_ FleafaM NAME/OWNER STATE'CONTRACTOR'S LICENSE NO. SIG TURE OF INS LATION AP LICATOR DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. LEE /-'2 FIRM /OWNER (Please pr' ) STATE CONTRACTOR'S LICENSE N0. SIG OF (31NERAL CONTRA TOR OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. January 1984 'COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memori9l Way, Chico — Phone: 891-2751 7 County Center Drive; OroviIIt — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 i CORRECTION NOTICE 0 PERMIT NO. 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 Jma`tter, or need additional explanation, please contact this office immediately. t e,, 4 -C14 o n, Inspector �1w'`- Date 'COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS ' 196 Memorial Wayl Chico — Phone: 891-2751 7 County Center Drivq, Orovilie — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE OWNER PERMIT NO.. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. 20 (A n. ci a 4-,'6 ti Inspector `i_/ _ Date— JCOUNTY OF BUTTE.- DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. T_�, I .—? / - ASSESSOR PARCEL NUMB `7 -- �j ZONIN BUILDING PERMIT OWNER �4 TELEPHONE 78-4W) S3Q. FT. OCC. BUILDING VALUATION 04c>, OWNER'S MAILING ADDRE l�44-tV–h &jA 6–d4 95-: O 7 Z&0 bP&J 0. 00 ONT ACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace- CONSTRUU[CfSL65NDER UNKNOWN Total Valuation $ , WV Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 00 ARCHITECT OR ENGINEER - LICENSE NO. Plan Checking Fee .$ / Pana) t•• /�-"~ v $ Be) ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ O BUILDING ADDRESS PLUMBING PERMIT Filing Fee ' 10.00 Each Trap •(21,FL&Cif— 2.00 6 , D�; Solar Water Heater 20.00 ciO,QO ILLC Water piping 5.00 x,00 LOT NO. o21 SUBDIVISION NAME PARCEL MAP 1 i- .) III .Each (laS water heater Or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF g Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 S.e)E) Mobile Home I S I G JW I 10-00e TYPE OF WORK New Addition❑ Remodel❑ Utilities❑ Installation❑ Other❑ Describe work: — l oZ �P,� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00. Main service 100V OR LESS 100 AMP OR LESS 1 10.00 Main service EA. ADD'L 100 AMP q^ CC^ 2.50 dV1✓ NEW CONST. DWELLING O&` OR ADDNS. ACC, BLDGS t / 2h0sq it 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 CON5TR ULTI.OUTLET 2,50 ea NON•RESID BRANCH CIRCUITS) NEW CONSTR POWER APPARATUS & NON•RESID. SINGLE OUTLET CIR. Ex. Occu SAL030 P�o TS OR FIXTURES SAL®30Q FIXED FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID,) EA./ 2.00 Temporary service 10.00 0.010 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 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 1, P2ZS 7744il) /DOX !aco &.0,D Cooling -3 (�.� (o•pa Hood 3.00 ,QO 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 eep harmless the County of Butte against gments, costs, expenses which may in any way accrue-� all liab' iLCoun agai y i seof the granting of this perm' X Date Si 3 tur of Applicant — n 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 $ 3_jV i4/, /tali C' a. TOTAL PERMIT VEE $ u,q oc OUP PE F CONST. PARCE PD H 19 E This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC - R OF PUBLIC By P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date -7Q1—i?1.S Receipt No. la1 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT 4, COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLECALIFbRNIA 95g65 - TELEPHONE' 916/534-4541 OWNER Proposed Building Use. Permit Fee Based Upon Building Inspector PERMIT APPLICATION DATA SHEET - Permit No. , 5 A. P. No. Complete Contract Price A DPW Valuation Other (EXDlain) /1 / I ' Date 3 At time of permit application, I was advised the following data must be submitted prior to permit processing andJor issuance: DATE RECEIVED• APPROVED 1. All items have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate./triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . 6'. State Energy Forms No. ' 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . rLetter of signature authorization. ! ":.Sanitation approval from 01 Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. �. 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . • 17./Pre-Inspection for Pre-Inspec. request to Required. Building Inspector (Dote) t Recorded copy of Agricultural Acknowledgment Statement. K9� - 3/2_r—gam r' LAI. Other n L PA-tUF [ lFD When you issue the permit, process as fol s: ail to owner. Mail to contractor. Telephone N and hol for pickup at _office. Deliver w. /inspector. Other0-441,1. (°e -)L1 /-'i-C-7 QUIDS T tlu� "\0 Applicant �/ '���vt Date 1/134 Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items riot checked above of time of application, circle item.) 1. Index permit,,for--'above Items No. 2. Additional'}items required: (Contractor, Desi , Owner) was advised of above required data by Telephone Mail Other 1 By Date Plans check4 by Date Plans approve +' - Date G! Other: Copy—DPW To: Building Department ' From: Environmental. Health Subject: Sanitation Clearance + �..�wN�.r'�"atiem4aY(t N' ..'�l,MaidlfµlCWe ier aoz 3. On Plan Approved for: Sewage Disposal Hold Final for: 72- o6 - Water Supply Water Supply Final Clearance O.K. for: Water supply Clearance for 2-- bedro house/ obilehome or other NOTE 3 -06 ?=— -�s m— wr sawN.N,. 8211 Return to DPW AGR1C:UL'1'UTUL STkTU4V,'F OF AUNNI-. DGEMERr 5UTTE C0U"TY (;A4 ` FOR RES';IUF i('IALJ)EVEL,OPrfEN'T M � ilECORDS REQUE15TEO -8? Section 26-8.1 of the Butte County -Code requires this acknowledgement Malt 25 NO All 0.65 be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included C 141-Rlk - wrca within an area zoned for agricultural purposes, and residents of thisl" property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All_ that real property situate in the County of Butte, State of California-, described as follows: Dater 2-4 IQ - State of �� ) SS. County of ) On this me, the PROPE,RT ERS : 3Z the day of 19 EE, before undersigned Notary Public, personally appeared / Personally known to me. b7l Proved to me on the basis of satisfactory evidence. to be the person(s) whose names) /.lro bscribed to ,,. OM=SUL the within instrument and acknowledged that EWiANUEIG.POME executed the same for the purposes therein contained. MARY KMC-CJUJFOM IN WITNESS WHEREOF, I hereunto set my hand and official seal. SAN 10AQULR COUNIY 69p Comm. EQims Sept 26,1986 Present A:P. No.O�o�—��— Notary Public a42, ( G. /0.� 1j t' MIB1T "A- A portion of Lot"154, according b the official map of the Oroville- Wyandotte Fruit Lands Unit No. 59, which map was recorded in the office of the Recorder of Butte County State of California, in book 8 of maps, at page 3;'A and 38A on July 9, 1928, and being more particularly described as follows: COMMENCING at the'Southwest corner of Section 1;, Township 19 North, Range 5 East, M.D.B. & M. thence North 00 10' East along the Easterly boundary line of said lot 15 , a distance of 250.00 feet; thence North 890 50' West 128.0 feet to the Northwest corner of a parcel of land as described In Deed to Narold Oats, et uz, recorded June 9, 1950 in Book .543 of Butte County Official Records, at page 172; thence Borth 00 10' East, 592.47 feet to the true point of beginning for the parcel of land herein described; thence North 890 50' West to a point on the Easterly boundary fine of a .parcel of land described in Deed to Walter Patrick Mcl.ogan at u=, recorded July 20 1965 in Book 1382 of Butte County Official Records 3 at page 101; thence "th 150 29' 30- East along the Easterly boundary line of said McLogan parcel to the Southeast corner thereof; thence South 890 50' East to a point on the hest line of the parcel of land described in a Grant Deed to Ralph W. and Ethyl M. Aizson, recorded October 31, 1978 In Book 2,339 of Butte County Official Recorda, at page 387; thence North 00 10' East along said line to the true point of beginning. This is a Boundary Line Modification approved by Botta County on February 15, 1979. gs i N1f ■ i c COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovillej,California 95965 -.-Telephone 916/534-4541 APPLICATION AND;PERMIT PERMI , 3)i ASSESSOR PARCEL NUMBER 72-061-25 ZONING BUILDING PERMIT OWNER Edward & Sarah Leers TELEPHONE SQ. FT. OCG`, BUILDING VALUATION OWNER'S MAILING ADDRESS 7141 Richland Way, Stockton CA 95207 CONTRACTOR'SNAME unknown TELEPHONE st teneval permit CONTRACTOR'S MAILING ADDRESS - Fireplace CONSTRUCTION LENDER none UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee @ FEE $ ARCHITECT OR ENGINEER none LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ i ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 116 Lost Horizon Permit tee $ 163.50 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 f Oroville 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 SFO Duplex[] Mobilehome❑ Other E 1 SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New❑ Addition ❑ Remodel[:] Utilities[] Installation❑ Other❑ 1 Describe work: 1st renewal of permit #749-85 Permit Fee $ Contractor , ELECTRICAL PERMIT Filing Fee 10.00 iMain 1/1 CONTRACTORS LICENSE LAW I I declare under per: alty of perjury (check one): l ❑ 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 for sale. (Sec. 7044) ! ❑ I, as the owner, am exclusively contracting with licensed contract- j ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this ason ORKMEN'S COMPENSATION INSURANCE Tonalty I declare under 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. I Notice to Applicant: It 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. service j00 AMP LOR ESSLESS 10.00 Main service EA. ADO'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.a , OR ACDNS. (ACC. SLOGS. ) �=¢sgft NEW CONSTR ULTI.OUTLET NON.RESID BRANCH CRCI 5 2.50 ea POWER APPARATUS e\ (SINGLE OUTLET CIR. / Ex, Occup(OUTLETS OR FIXTURES 20050c SALO 3011 FIXED APLNS Ex. Occup. OU LETS P(RESID.lRE A.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Coolin g Hood 3,00 Ventilation Permit Fee $ Contractor 1 certify that I haveiread 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 i Butte to enter upon the above-mentioned property for inspection purposes. i 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 Inal.,.Applicant — Owner ❑ Contractor ❑ Agent ❑ ! An OSHA permit is required for excavations over S'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 163.50 OC CUP. CONST, TYPC [FLOTARCELI PD ND I I53U[ 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 EXPIRE:, Date 4-11-87 Receipt No. WN17[-D.P.W.. Y[LLO W-A9e[!lOR, PINK -INSPECTOR, COLO ENROD•AP►LICANT O = Not OK - = Not Applicable RESIDENTIAL (Single and=Duplex) = Not Ready Date UNDERF OR Plans OK exc pt#'s Date FRAMING (Continued) oning requirements -Set acks-Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils -Ste -Elec. Grnd.- / /" Ftg. Depth' 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits Ftg., Gar e; Soils- teel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection d43 . Ftg., P rch s & D cks; Soils -Steel- / /" Ftg:'Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stem IIs, MXi Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Ste alts, G ge; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Pi s -Fire ac Flg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D .V.: II -Fit ings-Test-2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. s P' e; Size -A chors 10. at Pipe; Test- nchors-Regulator-Service Test 1 ctric; Undergrou d• arance-Mater i a l -Support- Ins. - - 3. •Girders -Sills -Anchor Bolts -Joists -Vents -Cripples - Card -BI Card -BI Date Card -BI Date Date Card -BI Date _ Card -BI Date Card -BI Date Card -BI Card -BI D Card -BI Date Card -BI Date Date FINAL (Plans) OK except k's Date 0, PLUMBING (Permit) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector _ 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air-Connector- In Garage; Above Floor-Ducts-Mech. Protection 15.- Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.: Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting - 17. 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. Fireplace or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64. 65. Elec. Outlets at Wood Panel; Int. & Ext. 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 p'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. 22. Elec. Receptacles Spacing -Lights &Switches at Doors Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 23• Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. _ 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails & Deck Construction -Post Caps 26. Subfeed_Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes - 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral "Yes :D No Service -Riser Conductors & Ground -Main Disconnect 75. Following instid.: Drive ❑ Yes ❑ No; Walks EJ Yes ❑ No; Planters ❑Yes ❑No 76. Stucco; Brown -Finish - 29. Equip. Clearances: Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet - ^30. - - Card B -I Card B -I -- Clothes Closet Light -Shower Light - - - -- Date _ Card -BI Date Date Card BI Date 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 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 H's 83. 84. Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric 31. 32. 33. AC. Ducts: Insulation &Support - Vent Fan; Exhaust above Insulation Condensate_D_rain & Overflow: Size & Grade 85. Water & Sewer Connected -C/O to Grade -HD Approval 86, Energy Compliance Certificate -Other Certificates _ Card -BI Card -BI 34. 35. Furnace -Vent. -: _ Access -Comb. Air -Return Air Vent -115V outlet Attic Access & Platform if Furnace in Attic -- Date Card -BI __ Date Date Card -BI Date-' Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING(Plans) OK except q's _ 36. 37. 38. 38. 39. 40. Sills; Proper Material &_Anchors__ Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders& FI_oor Nailing_ _ Draft Stop in Walls (rat proof) 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-Rfir. Ties-Purlin-Roof Brac.-Truss-Shlhnq.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles _ Bdrm. Windows or Exiting Doors -Sill H_gt..& Dimensions Garage Fire Protection Framing - - (NOTE: Anentrymust be made each time you visit jobsite) OK. . . A-\ . ,I,. Not OK = Not Applicable MOBILEHOMES MISCELLANEOUS Not Ready Date MOBILEHOME UTILITIES (Plans) OK except #'S Date DECKS OVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements o 'ng Requirements—Setbacks—Easements / 2. Soils; Special MH Support—Sketch _ ootings; *f6 --De —Spa ConbeCfors 3. Sewer; Location—Test—Fall-C/O—Concrete S. Deck; Gitoefsand/or J ' s—Decking—Bracing Stagy — ails 4. Water; Location—Test—Easement Needed (Sketch) 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete ood Awn.; Posts—Beams—Rftrs.—Connec.—Shing.—Rfg.—Bracing 5Alum. 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 7 - �-.S Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s Date OLS (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements 1, Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 3. Gas; MH Test—Demand—Valve—Connector 4. Electricity; MH Test—Crossovers—Breakers—Clearances 2. Soils; Compaction—Structure Stability 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 Lghig. Boxes—Enc losures— Pane lboards— 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 r. ..'. PERMIT NO. 1417-868 I PERMIT EXPIRES— EDWARD XPIRES EDWARD LEERS f OWNER i !r CONTR. owner ASSESSOR PARCEL 72'061-25 ' LOCATION 116 Lost Horizon Dr, Oroville I s Temp. Power Pole Called PG&E Temp. Elec. Service E Called PG&E • F Temp. Gas Sei Called PC- JOB C JOB FINALE[ Signature i 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 CORRECTION NOTICE aig, S-0 1411- 6 VNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. �za will ILI i=_' f023 "0 A VY • Vwi Inspector ► Date s. 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 CORRECTION NOTICE I A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional i'Alanation, please contact this office immediately. r' � 4 r Inspector _ Date 9 -1d COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PER!MIT NOA, 7 County Center Drive - Oroville, talifornin 95965 -Telephone 916/534-4541 0 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER �- p6 - CZ ZONING BUILDING PERMIT OWN/E.R' f�W TELEP oNE - SO. FT. OCC. BUILDING VALUATION ER'S MAILING ADORE 5 OWNell /I Tqst©✓`2d� r ►^ `lid CO RAC TOR'S ME V Lq TELEPHONE CO TRACTOR's MAILING ADDRESS Fireplace CONS 7CTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAI UNG ADDRESS Permit Fee $ ARCHIT T OR ENGINEER LICENSE No. Plan Checking Fee $ / , Energy Plan Checking Fee $ ARC ITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS /I b 0, r Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME P REEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTU SF ❑ Duplex❑ Mobilehome❑ Other s c Fv Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S TG W 10.00ea TYPE OF WORK NewX Addition ❑ Remodel ❑ Uti lities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 10.00 100 AMP OR LESS Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F-1 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 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.N OR ADDN9. ( ACC. BLOGS. , /2OSq ft ' NEW RES'.. UL I -OUTLET CU 2,50 ea NON.R ESID BRANCH CIRC ITS POWER APPARATUS .&) (SINGLE OUTLET CIR, Ex. Occup(ouTLETs OR FIXTURES eALO 30 FIXED APPLNS. OR Ex. OCCUp. OUTLETS IRESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Yirin 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate /�f Consent to Self -Insure. XI 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 Coolin g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify&andpepmless the County of Butte against all liabilit' s, judgments, costses which may in any way accrue against s County i c f sequanting of this permit. ��ii %� Date S —Zi5' 6 to Signa ur of APPlicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for ex avations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CON9T.TYPE FLoo PARC PN 139UE 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. C WORKS / DI=�977?z_ By.P/ ` � PERMIT EXPIRES Date Receipt No.�� (n WHITE-D.P.W., YELLOW -ASSESSOR, PINx-INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT 'OF;,PUBLIC WORKS - BUILDING D-IV'ISION 7 COUNTY CENTER DRIVE - OROVILLE CALYf 03RNIA 95965 - TELEPHONE: 916 534,4541 PERMIT APPLICATION DATA SHEET OWNER Cl W(A VC( �Oe V5 Proposed Building Use L Permit Fee Based Upon I Building Inspector Complete Contract Price 'Y Permit No. / A. P. No. DPW Valuation At time of,permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1.. All items.have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . Letter of signature authorization.YZW t' _VVPlanrfing, Sanitation approval from �•� Health Dept. approval for (A) Use: (B) Parking: 12'Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . .. 16. Mobilehome Installation Data. • 17. Pre-Inspec. request to (Dote) Pre -Inspection for Required. Building Inspector 18. rde r� r , P �f�ur 'o strucltion approval required RecOther— prior to occupancy 19. Other When you issue the perm' =process as follows: Mail tg owner. Mail to contractor. �� ) Telephone] and hold for pickup at 0office. Deliver w/inspector. Other \ Applicant Dates' Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above time of application, circle item.) 1. Index permit for above Items No 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail By f' Date Plans checked by - Plans approved by Other Copy—DPW ate ate Other To: Building Department From: Environmental Health Subjelct: Sanitation Clearance 61 Owner Location AP# Plan Approved for: Sewage disposal � water supply. Hold final for: water supply Final clearance O.K. for: water supply Clearance for bedroom mobile home.' Other f r4 C4 � ke.1 NOTE kA Sanitarian IDate s i N COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 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). 2. I (have/ a not) `, Wg 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 Signed: Property Owner Y—,.e i1G,4�z Social Security Number Date J 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. A setback of 5 ft. from the Property lines and a setback 3 3 3 of 50ft. from the road y� centerline shell be clear of strUctures or equipment except gdVe overhang. 55 a L.U%` Ine C Gv F - 3 &,e rho,- D /Z..... GUTTE COUNTY Tic Nt Of AM and ipecificafions MUST be WLDIHG DEPARTME LeF* so tine job at all times and it is unlawful to '6 any changes or alterations on some wlfkottf p P R V WNW per nission from the Department of Public , Worla, Caanty of &04.0 i� X a5�' MAX STv�p�-G� sl�f l7 t :. •� ,� a•� �u r G t. s,"i,:. • �• F+a:,sit "sTn tt zow ry & Workmanship Shap b ;ognized Good Practices Cnd c quditY prescr�oed for the Specified use in the Uniform Bu7ding, Plumbing & Machaniw! Cods and t�o �Wjonal Sectricel Code. y..� t! f0✓ % /e I OWE BUILDING ENT ®VED � a � STv�p�-G� sl�f l7 t :. •� ,� a•� �u r G t. s,"i,:. • �• F+a:,sit "sTn tt zow ry & Workmanship Shap b ;ognized Good Practices Cnd c quditY prescr�oed for the Specified use in the Uniform Bu7ding, Plumbing & Machaniw! Cods and t�o �Wjonal Sectricel Code. y..� t! f0✓ % /e I OWE BUILDING ENT ®VED