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HomeMy WebLinkAbout073-180-034r l 1 ®FIRE DAM « SPORT DATE z i r i 073-180-034 PERMIT#96-0139 KNAUTH, David & Dollie7 /& 19154 New York Flat Rd.,7eorF bestocJn� y Cont; William V. Matihugh Const. Repair Storm Damage/SF 073-180-034 PERMIT#96- 2 5 KNAUTH, David &' Dollie � �3�&�9�, 19154 New York,Flat Rd., Forbestown Cont; Wiliam V. Matihugh Const. Repair Porch Cover/SF d FIRE DAMAGE REPORT OWNER: S us 5 �VV \ DATE: '� 7 LOCATION: M54 A.P. # 013 — /fid ' 3 5 CONTRACTOR:- ZONING:. V DATE TO INSPECTOR: �` ' 4 PERMIT HISTORY ( ) NONE AS FOLLOWS: (k pa.LY Sh rm '� Q F, BUILDING INSPECTOR' REPORT . Building Description: Commercial/Usage: w� Residential # of Units: Currently Occupied ( ) Yes ( ) No Abandoned/Vacant: - Electric: + Electric Currently () On ( ) Off, Condition of Electric .ry Gas: Currently () On A )Off Condition Sanitation: Plumbing Worldng O Yes ( ) No Obvious Sewage Problems ( ) Yes ( ) No Mobile Home Condition of Utilities:( ) Damaged -Requires Permit ( ) Undamaged —No Permit Required Description of Damaged Area: S Estimate Cost of Repairs: Condition of Foundation: ( ) Good ( ) Poor Explain if repairs needed: Inspector: Date: l� P •.� Sketch building on reverse and indicate area of damage. r 4 r; 073-180-034 PERMIT#96-0139 KNAUTH, David & Dollie 19154 New York Flat Rd. , �o bet�!� Cont; William V. Matihugh Const. Repair Storm Damage/SF 073-180-034 PERMIT#96-Q265 KNAUTH, David US" Dollie 19154 New York -Flat Rd.,'Forbestown Cont; Wiliam V.,Matihugh Const. Repair Porch Cover/SF it 13 so FQ DATE REPORT TIME 22:21 INCIDENT NUMBER EVENT NUMBE LOGGED B MB ......... . LOCAL FIRE NUMBE RO DELONG -PU"its, 7Z"l! gm!:l STATE FIRE NUMBER 3551 Bi 56B CASE NUMBER 751 MEDICS LOCATION 19154 NEW YORK FLAT RD i PRA D6, ECC LJ RP SUSAN PHONE NUMBER REPORT METHO 911 WILDLAND FIRES El ESTIMATED ACRES STRUCTURE FIRE RESIDENTIAL OTHER FIRE MEDICAL AIDS PSA/OTHER HAZ MAT COMMENTS SING WIDE MOBILE EMD El OEs El FIRE INFORMATION TO — T' FIRE INFO SENT HO jFA54 7 -DAY LOGGED INITIALS jJK INCIDENT NAM IFORBESTOWN START DATE 7/18/2004.1 START TIME 22:1511 DIAMOND # 1.1-1.8 CAUSE ARSON LAND USE IDOMESTIC ACRES 0 TYPE OF ACRE DIAMOND 5 ONLY $ DAMAGE TYPE DOLLAR DAMAGE 30000.00 SAVE 0.001 INJURIES/FATALITIES ❑ #CIVILIAN INJURIES 01 #CIVILIAN FATALITIES 01 — 17 #FFINJURIE 0 # FF FATALITIES j F FC -40 INFORMATION New ilft dide FC -40 ❑ DATE OF FC -40 INC r . . .. ....... ..... ..... . ..... AGENCY INC # INC P# FC -40 COMP DATE. FC -40 COMP BY F -71 County Notifications EARS Hard Copy Recieved ❑ EARS Checked Agenst EARS Computer ❑ D INCIDENT NUMBER r ___8565 DATE 711812004 EVENT NUMBE 8647 LOGGED B MB REPORT TIME 22:21 LOCAL FIRE NUMBE I asf I nral Fira , RO DELONG STATE FIRE NUMBER BI 56B CASE NUMBER � 75 MEDICS LOCATION 19154 NEW YORK FLAT RD PRA 66 ECC ❑ RP ISUSAN PHONE NUMBER 675-1106 I REPORT METHO 911 I WILDLAND FIRES ❑ ESTIMATED ACRES STRUCTURE FIRE RESIDENTIAL OTHER FIRE MEDICAL AIDS PSA/OTHER HAZ MAT COMMENTS SING WIDE EMD ❑ OES ❑ FIRE INFORMATION FIRE INFO SENT HO EMAIL BY MB TO STA 54 7 -DAY LOGGED INITIALS JK I INCIDENT NAM �FORBESTOWN START DATE X1 START TIME _ 22:15 DIAMOND # r 1.1-1.8 CAUSE ARSON LAND USE DOMESTIC ACRES .�0 TYPE OF ACRE DIAMOND 5 ONLY $ DAMAGE TYPE DOLLAR DAMAGE 3000000 SAVE 0.00 INJURIES/FATALITIES ❑ # CIVILIAN INJURIES 0 # CIVILIAN FATALITIES0 # FF INJURIE 1 01 # FF FATALITIES 1 01 FC -40 INFORMATION New Incident FC40 1:1DATE OF FC -40 INC ' AGENCY INC # INC P# FC -40 COMP DATE I FC -40 COMP BY _ County Notifications 0 EARS Hard Copy Recieved ❑ EARS Checked Agenst EARS Computer ❑ a� .�.-..�- ..ysw �v..r-.-...•�e••w,w`.�M.•.,,y,:T;;,«.n,en,,�,�,.,,�r��:..n� .y:. ��. ,:."i � E�'� -�!' m4%"H'Y �°' .'�" -i1i. w�7 ,��^c 073-180-034. ,PERMIT#96-0139`' RNAUTH,' David, & Do11ie . 1.9'154 New York Flat Rd . , • Forbesto n` ..- Cont; William V Mat;ihugh Const*.."r;'.f. i Repair Storm •Damage/SF ?, t 1 r u 0 aY'°1Y4r ',;y -"f".7— ;iJl'j –^� -�Crn�rN.. '`i{, „t'ftf�7V"'.'`�,�ryr,.•;e.,xt. - ...t �I. i COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AMP PERMIT ASSESSOR PARCEL NUMBER73_1 ZONING U BUILDIN PERMIT OWNER DAVID & DOME KNAUTH TELEPHONE h7.CONT9 SO. FT. OCC. BUILDING VALUATION (T 7.000.00- OWNER'S MAILING ADDRESS PO BOX 368 CHALLENGE. 95925 CONTRACTOR'S NAME WILLIAM V. MATIHIIGH COMST TELEPHONE 675-2174 CONTRACTORS MAILING ADDRESS PO BOX 144 RR V't , 5414 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 90.00 ARCHITECT OR ENGINEER UCENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ I? ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 4 MY YORK FIAT R13 PERMITFEE $ 110.00 PLUMBINGPERMIT Filing Fee 20.00 HERE IN Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF 0111 Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK a New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other O, Describe Work: REPAIR STORM DAMAGE.REPLA(,E 2 RAFTER TAILS — ROOF 'SHEATHING, SHEETROCK. UPLACE 3 WINDOWS W/ABL. Mobile Home IS I GI W @20.00 PERMITFEE S Contractor 20.'00 ELECTRICAL PERMITFilin Fee1100V PANE, I REPLACE DECK GUARDRAIL,SM& SEC. OF GIRDS. OR LESS Main service ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 _ _ --. ait'�l L-, en;t mt t'Sn YJ tm . 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. License Class ID Lic. No. 0 / a' I OWNER -BUILDER DECLARATION 1 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 NEW CONST. DWELLING OCCUR S0. OR ADONS. (, 8 ACC. BLDS.. ) 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIA. Ex. Occup. ( OUTLET OR FIXTURES) 20 @ 1.00 BAL Q .50 Ex. Occup. ( OUTLETS PRESD.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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' compensation ins rance carrier and policy number are: Carrier :-'f"w.C"� �.,,., ,e,Q r MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number ''lT��� � � (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 those provisions. 4 ) ) L {�� tvy./�a Date _/ f �5�� Signature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee $ DCC CONST. TYPE TOTAL FEE $ 153.00 HAZ. I D. FEES IMP FLOOD I CDF PARCEL I PD I HD 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. Q� ` iR' l By �` Date PERMITEXPIRESONJ (Date) Receipt No. 1 908 02� I WHITE-O.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISI 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PEEERRMI NO. APPLICATF614-AND PERMIT ASSESSOR PARCEL NUMBER 73-18-034 ZONING U BUILDIN PERMIT OWNER DAVID & TELEPHONE -2569 SO, Fr, OCC. BUILDING VALUATION CONT 7 000.00 PO BOX 368 OWNERS MAILING ADDRESS CHALLENGE, CONTRACTOR'S NAME WILLIAiv V. i11ATI11UHNST. CO TELEPHONE I 675-2174 CONTRACTOR'S MAILING ADDRESS PQ BOX 144 BROWNSVILLE, 95919 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 20,00 LENDER'S MAILING ADDRESS Permit Fee $ 0.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 19194 NE11 YORK „LAT ED PERMITFEE $ 110.00 , 'Each PLUMBINGPERMIT Filing Fee 20.00 Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ELY Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Iff Describe Work: REPAIR STORi,1 DAiiMAGE.REPLACE 2 RAFTER TAILS ROOF SHEATHING, SHEETROCK. REPLACE 3 WIND014S W/DBL. Mobile Home IS I GI W @20.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filino Fee 20:00 PANE, 'REPLACE DECK GUARDRAIL,STEPS,& SEC. OF GIRDS. e00V OR LESS Main Service ( 200AORLESS ) 23.00 Main Service ( 200A TO t000A ) 46.00 LL Liuiil 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. License Class � Lic. No. 0 Jr% &' 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 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BUDS. ) s0. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RES10. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) 20 @ 1.00 SAL so Ex. Occup. ( OUTLEEDTS RE IS D.OEA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 PERMITFEE $ 43.00 Contractor 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' comp@nsation ins rance carrier and policy number are: Carrier � `,.,,mac MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number "7 5 — (The above sections need not be completed 0 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 agr a that if I should become subject to the workers' compensation provisions of ction 3700 of the Labor Code, I shall . forthwith comply with those proviTDate X ��� �_vyy_/ $1 Signature of Applicant - ❑ Owner ' Contractor ❑ Agent > An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee is Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 153.00 HA2. 1 D. FEES I IMP I FLOOD CDF PARCEL PO HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By P, &-,Yvrka PERMITEXPIRESON I '-' applicable provisions Resolutions to do work been paid. Date 1-13-96, I $ 9 % (Date) Receipt No. 1 % 0,6()s WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �.4-.� .; . , .-,P,i=,. a....ac5rri+_ ..-.w..rar�s.'3`+r�i8 "zy �%�d�: p%. �f i�;i:{��' y,.i�L'iG'y `yvys"y r',:F3�Rl���t.... , ��D .. ..x _.,r'tly `rat Y ;� I/ �o3y, 9���Z�S 37xs/L/ /��a""`i �' s. COUNTY OF BUTTE- DEPARTMENT(OF DEVELOPMENT SERVICES - BUILDING DIVISION o='7 Gounty Center Drive - Oroville, California`95965 -'Telephone (916) 538-7541 PERMIT NO. APPLICATION AND -PERMIT ASSESSOR PARCEL NUMBER ZONING ., 11 - t` BUILDINGPERMIT OWNER DAVID AND DOME KNAUTH Tt?!�D-N- 569.) SQ. FT. OCC. BUILDING VALUATION OWNERS MAIUNOADUESWX 368 CILALILENGE CA 95925 CONTRACTOR'S Y"ii�LIAPJI V MATIHUGIi CONST T572174 CONTRACTOR'SLII�C AD.I X 144 BROWNSVILLE CA 95919.. Fireplace CONSTRUCTION LENDER " UNIwOWN Total Valuation $ ti Fling Fee $ 20.00 ' LENDER'S MAILING ADDRESS +' Permit Fee $ ARCHITECT OR ENGINEER .r LICENSE NO. Plan Checking Fee $ 26.65 Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS . Penalty $ BUILDING ADDRE19154 NEW YORK FIAT ROAD, FORBEST014N PERMITFEE $ 87.65 PLUMBING PERMIT Filing Fee 20.00 . Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 L USEOFSTRUCTURE SF O Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑X Describe Work: BUILD NEW ROOF COVER FOR FRONT PORCH EXISTING DAMAGED BY STORM SEE 96-0139 Mobile Home I S I GI W 1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service 000V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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. License Class q Lic. No. L1o51rs`t 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 I NEW CONST. DWELLING OCCUR SO. OR ADDNS. ( & ACC. BUDS. ) 3.50 FT. NEW CONST, MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ( 8. SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FO(TURES) 6AL Q 1.50 FIXED APPWS.OR EX. Occup. ( ETS OUTL(RESID.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE _ Contractor 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' compensation insurance carrier and policy number are: Carrier �'jy< �. F h►V L� MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling / Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number '�T 'e 5 (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 theworkers' compensation provisions.df section 3700.of the Labor Code, I shall forthwith comply with those provisions. • ,• �z • 4 X _ o ti7.�— N ��.n�h+`� _'Date � " �i ��_ Signature of Applicant - ❑ Owner .© Coniractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee Is Occ CONST. Q'%'65 TAL FEE $ 8 r HAZ. D. +FEESIMPFLOOD CDF PARCEL PD HD R 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. By /�'%t� T//4 gut Cr Pof Date PERMITEXPIRESON I (Date) ReceiptNo. 180847 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR` -GOLDENROD-APPLICANT �, < COUNTY OF BUTTE- DEPARTMENT.OF DEIELOPM ENT SERVICES -BUILDING DIVISION 7 .County Center Drive - Orovil�6, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 073-18-0-034 ZONING 11 BUILDING PERMIT 1z OWNER DAVID AND DOLLIE KNAUTH T675N2569 SO. FT. OCC. BUILDING VAI N ) OWNER'S MAIUNGr(IDQ�EStOX 368 CHALLENGE CA 95925 iLLIAM CONTRACTOR'S V MATIHUGH CONST TELEPHONE 675 N 2174 CONTRACTORS MPUPO A¢pf5 144 BROWNSVILLE CA 95919 j� Fireplace CONSTRUCTION LENDER UNXNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAIUNG ADDRESS Permit Fee $ 41.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 26.65 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 9154 NEW YORK FLAT ROAD, FORBESTOWN l PERMITFEE $ 87.65 PLUMBINGPERMIT Fling Fee 20.00 Each Trap 7.00 IAT NO. SUBDNSIONS NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE ir SF 6 Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ X Describe Work: BUILD NEW ROOF COVER FOR FRONT PORCH — EXISTING DAMAGED BY STORM SEE 96-0139 Mobile Home S G W @20.00 PERMITFEE S Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service 0 OV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO I000A ) 46.00 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. License Class b Lic. No. 4 G 5 f �s� OWNER -BUILDER DECLARATION 1 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. ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR NS. ( &ACC. ) So. 3.5Q FT. NEW CT CONST. MULTI-OUUTLETLE NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( 8 PSINGOWELER APPAOUTRATUS ) LET CIR. EX. Occup. ( OUTLET OR FIXTURES) 20 @ 1.00 SAL FIXED APPWS. OR EX. Occup. ( OUTLETS (RESID.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE ; Contractor 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' compensation insurance carrier and policy number are: Carrier S� L FAN MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 111 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 section 3700 of the Labor Code, I shall forthwith comply with those provision . X _�1 �%�+. 'y _ Date _oi b_ Signature of Applicant - ❑ Owner 19 Con ractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 87.65 HAZ. I D. FEES IMP FLOOD cDF PARCEL PD HD ISsu 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. 2 BY 2--��— Date �t, b PERMIT EXPIRES ON 2 / (Date) ReceiptNo. 190547 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r s:• , Qiridalty'+dSti�Qp.reik�hryry' olx ii",�fiu iir"^r G�.O,UNTYOF BUTTE -DEPARTMENT A DEELOPMENTSERVICES -BUILDING DIVISION >t� 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORI�A.95965 - TELEPHONE (916) 538-7541 _ f PERMIT APPLICATION DATASHEET +o e- >; OWNER Da U t ( �- 1Jo�l i 2, l', MQ � A. P. No. "`Proposed Building Use � . Building Inspector Date - P At time of permit application, -1 was advised the following data must be submitted prior to permit processing and/or issuance: / h'ave ATE RECEIVED BY 1• All items been submitted.A f'. 2. Plot plans, 3/4}sets, signed by preparer of plans-- � .................... 3. Complete plans�t3/4 sets, signed byjpreparer of plan`s.................... le 4. Engineered plansrand calcs, 3/4 sets, with wet signature on plans. .......... �.. . t 5. Hazardous Material Form. ........... ....................... ..... 6, Energy Design Compliance and supporting documentation . ................... 7. Statement of Intent for Non -Heated and A/C Buildings. .. ............. 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. ` ......:........... I. ......... . 12. _Kalifornia 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: J - 18. Contact Land Development about (A) Improvements (B) Drainage. 19. Driveway permit (construction approval required prior to occupancy). .. ! 20. Pmanspection request Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information.No., Name'"St le Classification). *' 22. Certificate of WorkmanwCompensation 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. -.. Whe ou issue the p_ermitlprocess as follows: Mail to ow gr Mail to contractor. a q 49('0 LM k Telephoned J� and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. s Air Pollution Date Copy of plans sent fi� Health Dept. Fire Dept. Other Date By Th'e following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: 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 i a 4 oa-s Date 2-23-°!6 Sets of plans on hold in File cabinet .''AP folder Copy - Department of Public Works ALL STRUCTURES AND EOUIPMENT INOWDING O RHANGS SHALL BE CLEAR OF ALL EASEMENTS. A SET BACK OF �: ' , FT. FROM THE SIDE AND �1_5 FT, FROM THE REAR PROPERTY LINES AND. amp _ FT. FROM THE ROAD CENTERLINE SHALL BE CLEAR OF SIRUCiURES AND EQUIPMENT EXCEPT FW A 2 FT. EAVE OVERHA" H cam.. Pitt ?6scD j2 b.L iz- X Is E - New 'tbeK FL aTR 4, t BUTTE COl1HTYx BB' y GILDING DEPARTMENT � A Pf R 0 V -E-ID i. ILE COP"Yl ::. f i �Vi 0 t r �v r C)N f } i l 4 pAv►� a ooLli� kN aura, Po• 6c�y 36Ss CUDLLt trGE CASSi15 1 gIS4WEWioRk%i V-8. Fo��� %v, M CIOhi CIO. AARccL� � 3-IS�-o3y r • t t BUTTE COl1HTYx BB' y GILDING DEPARTMENT � A Pf R 0 V -E-ID i. ILE COP"Yl ::. f i �Vi c t t + -� s � . � �, t„ s � � `t_• • h 't a , }� . ,. , �.; . � �, �.� _,� J � �pt JAS SIV �O r 4 I" I 9v [ 1 c r.l_r In i,. 11A Ae yg ? ►wooD Shaial'h�1vG- $ S ® $- roc F1EL0 . iSlbFtLfi viJcar•^P �kL RA This set-ofand sRGcIfWations MUST be kapt on the Job at all t*wN and -it is =IaWW to make a 4y or alterations on G&vAe without `itten permission from the .Depart of Public Works. County of Bente. F' 3C NOGM. All Materials & Workmanship Shall Pp In — � Acoordanoe with Recognized Good Pi►aw an4 of a Quality Prescribed for the Speci$ed use - In the. Uniform Building, Plumbing & Mechanica] Codes and the National Electrical Code. A I L M i T� 3 6 �y`iJ �. L -3-,6 I I ! W/ `I:M A V o PLN,I_N-G=S� BUTTE COUNTY ..DEPARTMENT kPPR0VE`D hG.£2 caQe`ts 1 � aF a 6t� 5-ZNS-MLG, RTr- I -�.� _ _ t H ill. yct i►r.�{�aR� �p -ace ( FILE ;�I P-JZCA% Cote D uyC dID.LL.iE Lk. AF6 �1 aF3 ► �pt JAS SIV �O r 4 I" I 9v [ 1 c r.l_r In i,. 11A Ae yg ? ►wooD Shaial'h�1vG- $ S ® $- roc F1EL0 . iSlbFtLfi viJcar•^P �kL RA This set-ofand sRGcIfWations MUST be kapt on the Job at all t*wN and -it is =IaWW to make a 4y or alterations on G&vAe without `itten permission from the .Depart of Public Works. County of Bente. F' 3C NOGM. All Materials & Workmanship Shall Pp In — � Acoordanoe with Recognized Good Pi►aw an4 of a Quality Prescribed for the Speci$ed use - In the. Uniform Building, Plumbing & Mechanica] Codes and the National Electrical Code. A I L M i T� 3 6 �y`iJ �. L -3-,6 I I ! W/ `I:M A V o PLN,I_N-G=S� BUTTE COUNTY ..DEPARTMENT kPPR0VE`D hG.£2 caQe`ts 1 � aF a 6t� 5-ZNS-MLG, RTr- I -�.� _ _ t H ill. yct i►r.�{�aR� �p -ace ( FILE ;�I P-JZCA% Cote D uyC dID.LL.iE Lk. AF6 �1 aF3 t .: r f {; '�: v '. .) r ,k' f .� 4 f •� 1 •4~ ► ;,. .J i kir jT • ! f •,a t . r � � i �- r r• �-. �. � . nocowic- BUTM COUNTY wig � Fl� W% BUIILDI MENT 'A r.nvv cD