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HomeMy WebLinkAbout073-100-020*.y F,. .r,:�sas yy ,f??_5'"WC t�..�:3 r, ii!- _t�'"_ `.'�.^;:3.;�"�^.,,. a: }n;: ..-.S; ,..,.r -.•r� �.� 073-10-0-020 9371155 E. r HEADLEY,.HAROLD 974 LOWER.FORBESTO-WN RD, OROVILLE CONTR: BUTTE ELECTRIC i� MOVE ELEC SERV/SF ' 3D— a -r i r i t - t OFFICE COPY Address ` :GAS... Met r By Date EL CTRIC§ c Meters By Dat' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 073-100-020 ZONING + t1 BUILDING PERMIT OWNER Harold Headley TELEPHONE SO. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 974 L. Forbestown Rd., Oroville 95966 CONTRACTOR'S NAME Butte Electric TELEPHONE 589-2634 CONTRACTOR'S MAILING ADDRESS 630 Zink Rd., Berry Creek 95916 Fireplace CONSTdRUCTION LENDER one UNKNOWN Total Valuation is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEERLICEN1E None NO. Plan Checking Fee $ Ener Plan Checking Fee Energy g $ ARCHITECT OR ENGINEER'S MAILING ADDRESS � Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT FilingFee 15.00 974 L. Forbestown, Oroville Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARC5L MAP r Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF L_! Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW @ 15.00 TYPE OF WORK New, I Addition i_ RemodelE Utilities❑i Installation ❑ Other ❑ Describe work: Relocate Electric Service i _ Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 15.00 Main service 600VORLESS 200A OR LESS 1 18.501 18.50 Main service 200A TO I000AI 37.50 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. 3��Si7 Classification c –�-� ❑ 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 ADDNS. ACC. BLDG S. II 3.64sq.ft. NEW CONSTR.ULTI.OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS s (SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES 20 76g FIXED APPLNS. R EX. Occup. OUTLETS (RESID )EA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 1 15.00 15.00 Pre -Inspection 1 20.0Q20.00 Permit Fee $68.50 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 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 FilingFee 15.00 Heating Cooling Hood 6.50 I Ventilation Permit Fee $ LContractor 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 author(ze,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 oflthe granting of this permit. X �- <-= - - > ► "� Date Z�-y Si nature of Applicant - Owner Signature pp ❑ Contractor " deep a d ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures ov rJstories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $� HAz 1 0FEES I IMP I FLOOD I CDF PARCEL PD J HO I 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 e,!, Date PERMIT EXPIRES Date A-. %JA. Receipt No. WHITE-D.P.W., TEL LOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT PERMIT NO. (/7 ASSESSOR PARCEL NUMBER 073-100-020 ZONING U . • : BUILDING PERMIT OWNER Harold Headley TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 974 L. Forbestown Rd., Oroville 95966 CONTRACTOR'S NAME Butte Electric TELEPHONE 589-2634 CONTRACTOR'S MAILING ADDRESS 630 Zink Rd., Berry Creek 95916 Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S NAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ Ener Plan Checking Fee Energy g $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 15.00 974 L. Forbestown Oroville 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 OF STRUCTURE SF L3 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home Is G W @ 15.00 TYPE OF WORK New!' Addition i__j Remodel [I Utilities ❑( Installation❑ Other ❑ Describe work: R(-Ioratp Flprtric ServiceContractor Permit Fee $ ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 1 18.50 18.50 Main service 20CATO IOOOA) 37.50 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 .JO. "�y�+ �7 Classification C� ��D F-1 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 AODNS. ( ACC. SLOGS. 3.6psq.ft. NEW CONSTR. ULT' -OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 20 764 Ex. OCCup. OUTLETS P(RESID IRE A./ I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 1 15.00 15.00 Pre -Inspection 1 20.0 20.00 Permit Fee $68.50 — 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. 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 1 15.00 Heating Cooling g Hood 6.50 Ventilation penult 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 gounty in c s �nce/4)the ting of this permit. X Date y Z-93 Signature pp ❑ Contractor [�6gent ❑ Si nature of Applicant - ner An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height.DIREKS Mobile Home Installation Fee $ Ener Inspection Fee $ Energy P OCC CONST TYPE I TOTAL FEE $ 68.50 HAz I DFEES I MP I FLOOD I CDF PARCEL PD HO ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees By r C�FLIC PERMIT EXPIRES Dat applicable provi- resolutions to do have been paid. WORD to SO 193 141029 Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLD ENROO-APPL I CANT :.nr•.�,z+f.«ryRr tii'�;:,i'#:- 4 v� COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTYCENTER DRIVE - OROVILLF.,'dP LIFQRNIA 5965 --,TELEPHONE(916)538-7541dw ^ PERMIT APPLICATION DATASHEET OWNER -C, rl o A. P. o. Proposed Building Use Building Inspector Date ' At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY • 1. All items have been submitted . ........................................ �. 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3, 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 . ................4..... . 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 -sets . ........... . 10. Fees of $.................................. ...... 11. Impact fees as shown on attached schedule. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. 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: . ........ 18. Contact Land Development.about (A) Improvements (B) Drainage. .......... . Driveway permit (constru tion approval required prior to occupancy). .. .. ... . Prednepection actor . Pre -inspection for � v � required. .. co euiiain9 inspector (Date) 21. Contractor's license information. (No., Name Style, assification). .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. 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. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant DateZ 1 Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollui on Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by _ phone - mail Counter by - Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date . Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works LOt � COUNTY OF BUTTE - DEPARTMENT OF PUBLiC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT ASSES ��ARCE BER ZONrNG BUILDING PERMIT • '.VV R' � /} et r o TELEPHONE SO. FT. OCC. BUILDING VALUATION O ER'S MAILINGrADORbss rsl PT ��� i Dui CON ACTOR'S NAMTELEPHONE ►" ic, t5 —x63 It CON'TRACTOR'S MAILING AgD1ESS ^� �`(j Y Fireplace CONST UCTION LENDER 19 UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ A C ITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUIL .ING ADDRESS p s Lo .' /� rPermit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF] Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW I @ 15.00 TYPE OF WORK New;_ Aodl[ion emodel Utili�tiyej� Installati Other Describe work: ! P C CQ y i e Permit Fee $ Contractor ELECTRICAL PERMIT FiIingFee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 , Main service 20CATO t000AI 37.50 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 .Jo. Classification J 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 OCCUPM OR ACDNS. ACC. SLOGS. II 3.64 sq.ft. NEW CONSTR. MULTI -OUTLET NON-RESIO BRANCH CIRCUIT @ 5'00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 46d FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EAJ I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 )S.Onl r h gn0 Permit Fee $ Contractor j — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for 5100.00 (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 FiIingFee 15.00 Heating Cooling Hood 6.50 Ventilation I 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 Signature of Applicant — Owner ❑ Contractor E]Agent ❑ permit is re sired for excavations over 5'0" deep and demolition or construct- An OSHAy Ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ f HAz 7S IMP I FLOOD CDF PARCEL PO HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do , have been paid. WORKS Date / Receipt NO. l o WNITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT PRE -INSPECTION OWNER: Iva r I 1�e 0 ". DATE �l o` a/ �J LOCATION: g / L . O C�St�J�v Y, fid, OlNi V ALA. P. # O CONTRACTOR: ZONING ---------------------------------------------------------------------- -----------.-- PRE -INSPECTION FOR: olF �� Cl G f L P I[1 c f f 1e- �4 c- r v r CC- �1'o +art DATE TO INSPECTOR �J 9 -------------------------------- ------------------------=---------------------------- ------------------------------------------------------------------------------------- PERMIT HISTORY: NONE AS FOLLOWS: TYPE OF OCCUPANCY S l F ------------------------------------------------------------------------------------- FIELD - INFORMATION BUILDING USAGE: TENNANT: OCCUPIED Eg---HAS ELECTRIC Q HAS GAS �iAS SANITATION FACILITIES (( HEATED -CSD PERSON CONTACTED OTHER COMMENTS: AOMMENDED: ISSUE HOLD FOR OTHER: BY