HomeMy WebLinkAbout073-140-029a.13-44 6. /de E. Clark
/WIS Weiss Hill Rd.,app.900'S.of
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Permit #422-81B,,F,E,M(new single. �
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!073-140-029
..94, WEISS HILL RD., OROVILLE
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073-140-029 PERMIT#95-0107
BUCK:,
UCK,;, LOYD W
- �O
94 WEISS HILL RD., OROVILLE
S LI / S : - -
;'[,GAS LINE/.SF
OFFICE Copy
Address_?�
4.4
GAS
-Meter Datez
ELECTRIC
Meter By ------- — Date
,..: �-, :7l,ya,,yyFT -.-•---s--•v. -,..-r-v-r---r .. ..,,r.:. Tom-.,—•. �-.,. _. -- : 1,3-,:r ii°3sl . �:"��rrFv'/u'VSyPn•ra�: .r.K v..+,.- .. .
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVRI N
7 County Center Drive - Oroville, ta' lifornia 95965 - Telephone (916) 538-7
,5o OPERMIT N0.
APPLICATION AND PERMIT
ASSETe{144 B '29
4W.
ZONING
BUILDING PERMIT
OWNEWn Bu -
TEL6E75-1117
SQ. FT. OCC. BUILDING VALUATION
OWNE74 `fins"dILL RD. , OROVILLE
CONTflgCTOryry'�S,ryAME
V ►Y OFRj
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEER
DCENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
94 61EI55 HILL RD.
PERMIT FEE $
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
Solar or heat pump water heater 23.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Water piping 15,00
Each gas water heater or vent 15.00
USE OF STRUCTURE
yy
SF`8 Duplex ❑ Mobilehome ❑ Other
SPECIFY I
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S G W @20.00
TYPE OF WORK i1/16
New ❑ Addition ❑ Remodel ❑ Utilities X) Installation ❑ Other ❑
Describe Work: GAB LIAiE FOR PROPANE 3TQVE
PERMIT FEE $
Contractor
ELECTRICAL PERMIT Filing Fee 20.00
Main Service"OR LESS
( 200A OR LESS ) 23.00
Main Service ( 200A TO 1000A ) 46.00
NEW CONST. DWELLING OCC P. So,
OR ADDNS. ( 8 ACC. BLDS. ) 3.5C FT,
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
❑ 1 am a licensed underP rovisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044)
' ❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON -RESID. ( BRANCH CIRCUITS ) @7.50
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00
BAL. 50
.
Ex. Occu FIXED APPLNS. OR
p• (OUTLETS IRESID.1 EA. ) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
WORKER'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
ZCertificate of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
ice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
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 Butte County Ordinances and California 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, costar—a-0' penses whi h may in any way accrue against said
County in consequence f the ting of thi ermit..-
X Date "�
nat re Applicant - ❑ nar ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
DCC
CONST. TYPE
TOTAL FEE $ S
HAZ-
D. FEES
IMP
FLOOD
CDF
PARCEL PD
HO
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
///
/ �/ h ..
By; �,__J�-
- .i.;.':� Date t -� / s
f
`lam
PERMIT EXPIRES ON ' `J �. X� l .
/(Date) / I
_
S � �� d
Receipt No. �' 1 7 I
WHITE-D.D.S.- .D. CANARY -ASS SSOR FINK, IN PECTOR GOLDENROD -APPLICANT
0
4
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DTVI N
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75 PERMIT No.
APPLICAnor ANS PERMIT - ® O.
ASSETB,PiQYRCT gII 5629
Z0613.Z0613.BUILDING
PERMIT
OWN
W. BUCK
LE
X675 e 1117
SO. FT. OCC. BUILDING VALUATION
OWNEIV41AAVE n9ssHILL RD. , OROVILLE
CONTbfM frE
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
94 WEISS HILL RD.
PERMIT FEE $
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Water piping
15.00
Each gas water heater or vent
15.00
USE OF STRUCTURE
- SF K] Duplex EIMobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00 15,00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New O Addition ❑ Remodel ❑ Utilities MInstallation ❑ Other ElPERMIT
Describework:_ GAS LINE FOR PROPANE STOVE
F $
JS-
Contractor
SQ
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service800V OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A To 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. BLDS. )
gO,
3.5C FT.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and
Code and my license is in full force and effect.
License No. Classification
1,7 I, as the owner, or my employees with wages as their sole compensation, will do
he work, and the structure is not intended or offered for sale. (Sec 7044)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
NON.RESID. ( BRANCH CIRCUITS )
@7.50
( POWERAPPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
BAL @ 00
Professions
Ex. Occu FIXED APPLNS. OR
p' ( OUTLETS IRESID.I EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certify that I have read this application and state that the above information is correct.
1 agree to comply to all Butte County Ordinances and California 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, cos , an penses whi may in any way accrue against said
County in consequence f the ting of this ermit.
Date r 3'
at re pp icant - O ❑ Cont ctor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in h'g It.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEES -35.00
HAZ.
D. FEES
IMP
F100D
COF
PARCEL PO
HO
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
I __ - Date
BY - /W//U
PERMIT EXPIRES ON
Da tel
C
54L
Receipt No. �� � S,D
WHITE-D.D.S.-137.0. CANARY•A PINK -INSPECT GOLDENROD -APPLICANT
COUNTY OF BUTTE
Department of De`'eloament Services
Building Division
Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541
Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and
issuing y
our building permit. No building permit will be issued until this verification is received.
( 1. plan to provide the major labor and materials for construction of the proposed property improvement
(yes or no)
2. (have/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 Contractor's 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 Contractor's License No.
5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated:,
Name - Address Phone Type of Work
Si d:
Prope
Socia
Date
NOTE::.
This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
permit.
i
~
PERMIT NO.
422-91 P,F;M
PERMIT
EXPIRES�L�%U�
,1
OWNER
Claude E.
Clark
CONTR.
owner
ASSESSOR PARCEL
73-14-6
LOCATION
W/S Weiss
app. 900'S.
of Fo,bestown Rd., Forbestown
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d+Fa
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4,.
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Temp. Power Pole
Called PG&E
Temp. Elec. Service
3
7
/
w�
Called PG&E
l
Temp. Gas Service
Called PG&E
JOB FINA ED (Date)
J
Signature
__
J = OK
0 = Not OK
= Not Applicable MOBILEHOMES !
= Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except k's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except a'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/ P'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 q's
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except H'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
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
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 -Enclosures -Panel boards -Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B-1
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B-1
Date Card -BI Date
Card -BI
Date Card -BI Date
= OK
= Not OK
= Not Applicable RESIDENTIAL (Single and Duplex)
= Not Ready -
Date
UND LOOK Plans OK except #'s
Date FPA"G Continued
Zo grequirements-Setbacks-Easements
Property Line Firewall & Openings
g., Main; Soils -Steel -Flet. Grnd.- / /
t. Doors -One 3' -Check Garage -3rd story, 2 exits -.
3. Ftg. Garage; Soils -Steel- / /" Fig. Depth
Slairs; Width -Headroom -Rise -Run -Landing -Fire Protection
tg., Porches &Decks; Soi -Steel- /I 2 /, p
Plywood on Root Overhang -Attic Vents -Rafter Outriggers
selstemwalls, Main; St -Blockouts-Wrapped-E4tatr- �
-,ding-Nailing-Veneer
6. Stemwalls, Gartige; Steel-Blockouts-Wrapped-Slab S
esh-Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fireplace Ftg.-Steel
lazing Area -Glass Protection -Skylights -Plastic
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test_56e-Shear
Walls; Nailing -Bolts
Gas Pipe; Size -Anchors
10. Water Pipe; Test -Anchors -Regulator -Service Test
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. Girders -Sills -Anchor Bolts -joists'- V nt - ri ples
Card -BI ate Card I Date
Card -BI Date -Z Y1Qff0BI Date
Card -BI Date Card -BI Date
Card -BI
Date Card -BI Date
Date FIND (Plans) OK except H's
Card -B Dat j Card -BI Date
Date
PLUMBING (Permit) OK except q's
W." EEc Steps -Door & Sidelight Protection -Landings
. Smoke Detector
t Ht.; Vent-Acces -C bustion Air
'Jf-7Purnace; Vents -Clearance -Comb. Air -Connector-
In Garage; Above Floor-Ducts-Mech. Protection
Water Pipe; Test §LNajjl,,Protection
W.V.; Test-Fttngs -Nail Protection
mom Exiting
hoover Pan; Test, First Floor -Tub Access
f0!ta`.F.I. & Bath Fixtures & Tub Access
-18:-Test Tub & Shower, 2nd Floor -Tub Access44--Elec.
Trim & Subpanel; Breaker Sizes -Labels
3a. -Gas Pipe; Size & Anchors
tairs & Rails
daeryeplace or Stove; Clearances -Hearth
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date 1 Card -BI Date
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
669—Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except q's
'Garage Fire Door; Swing -Landing -Closer
468--A_,C,• Duct in Garage -Damper
jb*-Fixture & Transformer Clearance -Ins. Protection
69'Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
_ Ja Garage; Above Floor-Mech. Protection
2A.-Elec. Receptacles Spacing -Lights &Switches at Doors
7Ig! Plb., Elec. & Meeh. Equip. Listed for Location
maize Boxes & No. of Conductors -Stapled
ex Installed Close to Edge of Studs & C.J.
.74. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
32v -Foam -Looked in Attic EaAres
2 Appliance Circuits in Kitchen &Conductor Size
uard Rails &Deck Construction -Post Caps
26. Subfeed Wire Size-L-i-ga. Cu or AI-A.C. Wire Size /V�.Lga. Cu or Al
7,4-1 Fdn_. Vents & Crawl Hoole DD r-Dra' e & W --Earth Clearance
Lo ked under Floor Y les
27. Range Circ. 16 / ga. r AI -Oven Circ. / / ga. Cu or At,
I ulated Neutral Fes ❑No
7 ollowing instld.: Drive Yes alks ❑ Yes B-tQo•,
Planters ED Yes C o
Service -Riser Conductors & Ground -Main Disconnect
-44-44ucco; Brown -Finish
, Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
2 "E_ ip. Clearances; Panels-Motors-Mech. Equip.-
3 -Clothes Closet Light -Shower Light
. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
Water Well; Disconnect, Electrical, Plumbing
E rior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
ate Card -BI Date
,dation throughout House
Card B -I
Date �� Card -BI Date
GI s Protection
Date
MECHANICAL (Permit) OK except H's
rrections from Previous Inspections
4,94. Test -Meters Tagged; Gas -Electric
Ducts; Insulation & Support
er & Sewer Connected -C/O to Grade -HD Approval
Vent Fan; Exhaust above Insulation
4R67 Energy Compliance Certificate -Other Certificates
33--een4ertsate Drain & Overflow; Size & Grade
34.-F_ucaae Vent; Access -Comb. Air -Return Air Vent -115V outlet
35. Attic Access &Platform if Furnace in Attic
Card -B Date Card -BI Date
Card -BI
Date d --BI Date
Card -BI Date Card -BI Date
Card -BI
Date to Card -BI Date
Card -BI Date Card -BI Date
Date
FRAMING(Plans) OK except q'sy' �cGF /r
rlls; Proper Material &Anchors
Comments at Final:
_
_
. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
Bring Walls over Girders & Floor Nailing
Draft Stop in Wall (rat proof)
_ e Stops; Fu eilin s -Stairs -Chases -Tub
4& -,"Header & Beam -_Size & Bearings _
4 angers -Post Caps -Anchors -Connectors
FIng. Joist-Rftr. ies-Purlin-Roof Brac. Tr hthnq.-Rfnq.
ireplace Ties ype A Flue -Fireplace Throa
4 -,tic Access; Siz6 & Romex Protection -Draft Stop -Ins. Baffles
drm. Windows or Exiting Doors -Sill Hgt. & Dimensions
ire Protection Framing
(NOTE:Anentrymust be made each time youvisit jobsite)
I
Permit#
INSULATION CERTIFICATION
Weiss Hill Rd Forbstown
Number and Street City County
Subdivision Lot Number
DESCRIPTION OF INSTALLATION
ROOF
Material
Thickness (inches)
EXTERIOR WAL.L
Material Fiberglass
_ Thickness (inches) 3 211
�~
CEILING I f
Batt or Blanket Type Fiberglass
Thickness (inches). 6tt 2
Loose Fill Type r
Minimum Thickness (inches)
Area Covered (ft 21
FLOOR,ELEVATED
Material Fiberglass
Thickness (inches) 332—
FLOOR.
2t1FLOOR, SLAB �)
Material
Thickness (inches)
Width (inches)
FOUNDATION WALL
t
Material
Thickness (inches)
HEATING SYSTEM Gas Furnace
Make
Model Description
Rated Bonnet Capacity
Brand Name
Thermal Resistance (R Value)
Brand Name . Certainteed
Thermal Resistance (R Value) 11 1000 0
Brand Name Certainteed
Thermal Resistance (R Value) R-22-,-.� 1070
Brand Name
Number of bags Weight per bag Ib
Thermal Resistance (R Value)
Brand Name Certainteed
Thermal Resistance (R Value) R-11 1056
Brand Name
Thermal Resistance (R Value)
Brand Name
Thermal Resistance (H Value)
DECLARATION
I hereby certify that the above insulation was installed in the building at the above location ir. conformance with the
current regulations setting Energy Conservation Standards for new residential buildings (located in Title 74 of the
California Administrative Code).
r
7,:-� s o
Ge ral Contractor (bu' der) e License Number
Signal a and rile Date
Hawkins Insulation Co., Inc. 378407
Sub/Contractor (Insulation Applicatoo License Number
I&IL
D _—, Pres. ---
Signature and Title Date
CERTIFICATE REVIEWED BY, Date
BIN -029 (Building Inspection Ofrice)
01
} RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLTD IN CON�}F.,O`R-M"AN E WITH CURRENT ENERGY CONSERVATOOI)i. REGULATIONS
AT �/ L[ A,a� 9 •, 90 n ' S e r -
(location)
BUILDING PERMIT NO. AIZL
AP. N0. 73 —/V-e�'
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge
Fdn. Walls
Floors I& -C/
Walls --)T-7
Ceiling/Roof
Ducts
Circulating Pipes
APPROVED HEATER r a
APPROVED WTR.HTR.�_
GLAZ ING :
Single Glazed
Special (Insulated) 1,:-2
CERT. & LABELED WDS.
& SLIDING DRS. LA,�
WEATHERSTRIPPED DRS.
BACK DAMPERED FANS /3
INTERMITTENT IGNITION DEfICES
CERT. APPLIANCES —
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name
Signature of
(please print)
Insulation Applicator
State Contractors
License No.
General Contractor/Owner Name " e— r, -�--(c1-,-%
Signature of (please_print) PP
General Contractor/Owner 0 ac�,.� Date Ll
State Contractors
License No.��,?5
i
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN'THE DWELLING.
COUNTY OF BUTTE = DEPAATMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4��
• -� APPLICATIUN AND PERMIT �J
ASSESSOR PARCEL NUMBEj , ^/ '�
�r((JJ
ZONINCy
//.f�
BUILDING PERMIT
OR
NXIII) S" LdL�4
TELEPHONE
SQ. FT. OCC. BUILDING VAL ATION
0
.oa
OWNER'S MAILING ADDRESS
31 Z UNf
2 . ,Od
COyTRACTOR'S__NAME `- n%%
//QQJJ
1090,00
337;CONTRACTOR' SAgAILING AD��SS���O�� 0-9- /►,`��
Fire lace
CONSTRUCTION LEND R
UNKNOWN
Total Valuation Is
-30 (0.?.
Filing Fee
$ 10.00,
LENDER'S MAILING ADDRESS
Permit Fee
$ /-501679)
ARCHITECT OR ENGIN ER
LICENSE NO.
Plan Checking Fee
$ &5-,00
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 15-00
BUIL NG ADDR SS
G(�6(.SS H/LL ISD• XQP Sr
PLUMBING PERMIT
Filing Fee 10.00
p /� �/
�� ��/!?gt�s ��"' ��Repair
Each Trap
rj 2.00 0.Qv
drainage or vent piping
5.00
41AI
Water piping
,00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Each qas water heater or vent
5.00 '
Gas piping system 1 - 5 outlets
� USE OF STRUCTURE
SF E,--� Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
_Q
Lawn sprinkler system
5.00
TYPE OF WORK
New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work:
Permit Fee
$ 30.vo
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
500V OR LESS
Main service 100 AMP OR LESS
5.00
Main service EA. ADD'L 100 AMP
2.50
'
NEW CONSELLING OR ADDNST ( ACC. BLDGSC
20 sq ft F
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
]-'I am licensed under provisions of Chapt. 9, Div. 3 of the Business50@250
and Professions Code and my license is in full force and effect.
G
License No.;?9�rZ.5 %� Classification��+•-• �ia...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)
Elri 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
N0N.RESID R BRA cH CIRCLET
Ts 2.50ea -,
NEW CONSTR POWER APPARATUS 6
NON.RESID. SINGLE OUTLET CIR. '
Ex. OCCUp OUTLETS OR FIXTURES BAL@1
Ex. OCCup.�OUTLETS FIXED APPLNS (RESID.)REA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring
7.50
t
Permit Fee $ .Y(
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
LTJ have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00 Oo
Ventilation
U11IL- GLA�ET� 6flAct>
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 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 s 'd County in conseq nce of the granting of this permit.
X Date -G ��
Signature of Applican — Owner E] Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ 2 • 85
occuP. GRouP
.3
Tr E OF CONST.
,�P
PAR L
PD
HD
SSu
7
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREC M OF PUBLIC
By—
P4
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
�
,ssy i-f�CQ�r�1'I
Receipt No. O Z-
WHITE-D.P.W., YELLOW -ASSESSOR, INK -INSPECTOR. GOLDENROD -APPLICANT