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HomeMy WebLinkAbout073-180-0351 A:P.- 73-1 -35 CHARLES"' C': CAMPBELL' s/e corner Oro. Forbestown Rd. & Brownsville cutoff, Forbestown Permit 2469-7 B %/ 73-18-35 Permit#3057-85P( Etta propane tank & Cast r: Featheg)SFr ��'das Contr; Feather River 73-18-35 2331-91B CHURCH OF THE NEW NAME 19168 New York Flat Rd, Forbest a� cont: Chapman Const (ramada) a� 073-180-035 04-3611 MCCALL, GEORGE 19168 NEW YORK FLAT RD, FOREST RANCH Cont: OWNER ELEC SRV UPGRD 0 } f 1 t ' " 1 � 0 ONNO I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.netldds LICENSED CONTRACTORS DECLARATION 1 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: License Number: Date: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish; or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have -the burden of proving that he or she did not build or improve for the purpose of sale.). as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, 1 and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 'I am Exempt under Article 31 the Business and Professions Code Date: — Z —a Owner: WORKERS' COMPENSATION DECLARATION I 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. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy #: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, i 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. Date: Z-- Z�' Applicant WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION'LENDING AGENCY ' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec 3097 Civ.) Address: PERMIT NO. BP043611 Issued Date: 12/27/2004 APN: 073-180-035-000 Site Address: 19168 NEW YORK FLAT RD FRT Map Index: Description: ELE SER UPGRADE Owner: MCCALL, GEORGE & SHIRLEY 19168 NEW YORK FLAT RD FORBESTOWN, CA 95941 530-878-1090 Applicant: MCCALL, GEORGE & SHIRLEY 19168 NEW YORK FLAT RD FORESTOWN, CA 95941 530-878-1090 Contractor: License #: Architect: Engineer: Total Square Ft: Valuation: Census Code: 0 S. F. $0.00 isreby issued-underthe do work IndicatedVtn PERMIT EXPIRES icable provisions of the Bitl which fees have been paid. 7/Q ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 99827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that'I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substanc f any official form or do umant of Butte County. I hereby oulhorize representatives of Butte County to enter upon the above mentioned property for Inspection purposos Print Name:�"A dC�A— v v ` C" `—"� Signature: Owner O Contractor ❑ Agent for Owner O Agent for Contractor 14 F BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" CONTRACTOR OWNER Last NameC a( irst Name Address ( New r City f� Y���YN State State Tip , Phoneg_ I Fax E-mail State License Number CONTRACTOR Name Address City State Zip —Phone E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zp City Fax State Zip Phone Subdivision Name Fax E-mail Page State License Number APPLICANT NAME Name Address City State Zp Phone Fax E-mail APPLICANT SIGNATURE X For office use only: AN 73 • IBo �3S Zoning City 501 -r -es Flood Zone SRA I Yes I No Occ. If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Type Const. Subdivision Name am Map Book Page Lot # Planner Date Approved: PERMIT NO. BP C)q 3(0 BIN # LOCATION AN 73 • IBo �3S Property Address 141(00 dew City 501 -r -es Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY am Address Description or Scope of Work: LLPG2A0e (5�L=_L+ SVG RP(.0 POWO—re- PbLE, Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR SUBMITTAL REQUIREMENTS IL KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Received by: Amount: Bldg SRA Receipt #: l Q V / Sheriff Date: SMIP Other 'v v Total REV 7-27-04 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INIC ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) - ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). El _13—Sanitationandsite �1aa_aentaLHealtli-Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 .% RECORDING REQUESTED BY Mid Valley Title & Escrow Company AND WHEN RECORDED MAIL TO: GeorgeiMcCall and Shirley McCall 19168 New York Flat Road Forbestown, CA 95941 A.P.N.: 073-180-035-0 Q)Qve+ SQ178+0177 Recorded official Records I REC FEE 10.00 I TAX 118.25 CoBunty Of TE I MONUMEN 10.00 CANDACE J. GRUBBS f ROSEMARYrder DICKSON 1 Assistant I Lisa 02:04PM 22 -Dec -2004 I Page 1 of 2 GRANT DEED Above This Line for Recorder's Use Ortly The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $116.25; CITY TRANSFER TAX $0.00; SURVEY MONUMENT FEE $ File No.: 0403-1588840 (AM) computed on the consideration or full value of property conveyed, OR computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale, c unincorporated area; ( ) City of , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Shirley Byrd, Successor Trustee of Neta, S Living Truste, dated 10/23/91 who aquired title as Neta Fern Olsen, Trustee of Neta's Living Trust, dated 10-23-91 hereby GRANTS to George McCall and Shirley McCall, husband and wife as joint tenants the following described property in the unincorporated area of , County of Butte, State of California: COMMENCING AT A POINT IN THE HOMESTEAD LODE, U.S. MINERAL SURVEY NO. 5757, FROM WHICH POINT THE QUARTER SECTION CORNER BETWEEN SECTIONS 10 AND 11, TOWNSHIP 15 NORTH, RANGE 6 EAST, BEARS NORTH 28 DEG. 05'44" WEST A DISTANCE OF 565.20 FEET; THENCE SOUTH 8 DEG. 27' EAST A DISTANCE OF 118.44 FEET; THENCE SOUTH 14 DEG. 11' EAST, A DISTANCE OF 234.26 FEET; THENCE NORTH 86 DEG. 00' EAST, A DISTANCE OF 285.76 FEET TO THE NORTH AND SOUTH CENTERLINE OF THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER OF SECTION 11; THENCE NORTH 1 DEG. 41'40" EAST ALONG THE SAID NORTH AND SOUTH CENTERLINE OF SAID SECTION 11, A DISTANCE OF 277.29 FEET TO AN IRON STAKE IN THE NORTHEASTERLYBOUNDARY LINE OF THE HOMESTEAD LODE; THENCE NORTH 15 DEG. 11' WEST ALONG THE NORTHEASTERLY BOUNDARY LINE OF THE HOMESTEAD LODE, A DISTANCE OF 78.90 FEET; THENCE SOUTH 85 DEG. 14' WEST A DISTANCE OF 348.61 FEET TO THE POINT OF BEGINNING. EXCEPTING THEREFROM THE FOLLOWING DESCRIBED PARCEL: Mail Tax Statements To: SAME AS ABOVE 2 V A.P.N.: 073-180-035-0 Grant Deed -continued File No.:0403-1588840 (AM) Date: 12/06/2004 COMMENCING AT A POINT IN THE HOMESTEAD LODE, U.S. MINERAL SURVEY NO. 5757, FROM WHICH POINT THE QUARTER SECTION CORNER BETWEEN SECTIONS 10 & 11, TOWNSHIP 19 NORTH, RANGE 6 EAST, BEARS NORTH 22 DEG. 01'27" WEST A DISTANCE OF 909.33 FEET; THENCE NORTH 86 DEG. 00' EAST A DISTANCE OF 285.76 FEET TO THE NORTH AND SOUTH CENTERLINE OF THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER OF SECTION 11, TO AN IRON STAKE; THENCE NORTH 1 DEG. 41'40" EAST ALONG SAID NORTH AND SOUTH CENTERLINE OF SAID SECTION 11, A DISTANCE OF 132.40 FEET TO AN IRON STAKE; THENCE SOUTH 86 DEG. 43' WEST A DISTANCE OF 329.50 FEET; THENCE SOUTH 14 DEG. 11' EAST, A DISTANCE OF 139.95 FEET TO POINT OF BEGINNING. Dated: 12106/2004 Neta's Living Trust, dated 10/23/91 Shirley Byrd,Su ess_orXusteki STATE OF �� } }ss. COUNTY OF /y4tw"tvi } On ��' "1� before me, ri.Ol A�_personally appeared SMTfkQ personally known to rde (or p oved to me on the basis of satisfactory evidence) to be the person(s),whose name(43 is/aprtubscribed to the within instrument and acknowledged to me that,�efshe/thsKxecuted the same in hPgler/tbeWauthorized capacityjjas'jand that T her/tgetr signaturef�'on the instrument the person br the entity upon behalf of which the persbt (<acted, executed the instrument. WITNESS my hand and official seal. My Commission Expires: This area for olfrcrai nobrialP YON 0 TAOtt. G% .� t113 00 Nom.• Notary Name.0 j2R L" �Lbh�'r►`� Notary Phone:'�� Notary Registration Number: County of Principal Place of Business: #41" Page 2 of 2 i RESIDENTIAL 73-18-35 2331-91B CHURCH OF THE NEW NAME 19168 New York Flat Rd. cont: Chapman Const Forbestown (ramada) J( J=OK 0 = Not OK -=Not Applicable MOBILE HOMES' = Not Ready ., Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, Plans OK except #'s oiling Requirements -Setbacks -Easements ooti gs; Soils -Size -Depth -Spacing -Connectors -Steel ecks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh J,0!9_oof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Dat Card B- Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability _ 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P L" ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. E:ectricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, Plans OK except #'s oiling Requirements -Setbacks -Easements ooti gs; Soils -Size -Depth -Spacing -Connectors -Steel ecks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh J,0!9_oof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Dat Card B- Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability _ 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable Not Ready RESIDENTIAL (Single,& Duplex) = Date UNDERFLOOR (Plans) OK except ti's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wra pped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except N's 16. Water Htr.: Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection -------- ------------------------------ 18. D.W.V.; Test -Fittings & Anchor -Nail Protection ------------- - ----------- 19. Shower Pan; Test. First Floor -Tub Access --- 20. Test Tub & Shower. Second Floor -Tub Access 21. Gas Pipe: Size & Anchors Date Card B-1 Date Card B-1 ----------------- ---- ------------------- ----------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except N's 22. Fixture & Transformer Clearance -Ins. Protection ------------------------------ ------- ----- --------------------- ---- 23. E-lec. Receptacles -Spacing-Lights & Switches at Doors ---------------------------------------------------- 24. Size Boxes & No. -of Conductors -Stapled - --------------------- ---------- 25. Romex Installed Close to Edge of Studs & C.J. - - - - ------------------------------------ 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI --------------------------------------------------------- 28. ----- ---------------------- 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 29. Range Circ / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. ---------- Insulated Neutral O-- -------- Yes -No ---------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect --------------__ - -3 1-Equip_Clearances _Panels- Motors-Mech. Equip: 32. Clothes Closet Light -Shower Light -Spa Light ---------- - ---------------------------------- 33. Smoke Detector ---------------------------------------------------------------------------------- ------------------------ - ------------------------------------------- ---------- Date Card B-1 Date Card B-1 ------- - - ---------------------------------- ---------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except n's 34. A.C. Ducts Insulation & Support ------------- -------------------------- - ............... 35. Vent Fan: Exhaust above insulation 36. Condensate Drain & Overflow: Size & Grade ----------------------- ------------------------- - - -- -- ... -- 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet --------- ------- --------------------------------------- ----------------- 38 Attic Access & Platform if Furnance in Attic ------ - --- -- --- .. - - ------ - - ..------------------ Date Card B-1 Date Card -B-1 ------------------ -- --- - -- ------- -------------------------- --------------- Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except N's 39. Sils, Proper Material & Anchors ------ -------------- -------- ---------------------- ------- ---------- ----- --- 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ---------------------------------------- --- ------- 41. Beanng W2115 over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) ------------ ------ ---- ------------------------------------------- ------- 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub - - --- - - ----------------------- ------ -- --- - 44. Headers & Beam -Size & Bearing Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rflr. ties -Pu rlin-roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings _______ 52. Ext. Doors -One -3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers ------------------ 55. -Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows ---------------------------- - Date Card B-1 Date -------------------------- - Date Card B-1 Date Card B-1 Card B-1 Date FINAL (Plans) OK except N's _ 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection ------------ ---------------------- 64. Bedroom Exiting ---------- 65.-G.-F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels -------- - - ------------- 67. Stairs & R_ails 68. Fireplace or Stove: Clearances -Hearth - - - - - -- -- - - - - -- ------------------- 69. Elec. Outlets at Wood Panel; Int. & Ext. ------ ---------------------------------- 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter - - - -- --- --- - -- - ----------------------- ---- 72. -Garage -Fire Door: Swing -Landing -Closer ------------- 73. A.C. Duct in Garage -Damper 74. Wtr. Htr Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor-Mech. Protection 75. Plb. Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection --------------------------------- 7;. Insulation -Foam -Looked in Attic Yes ------------------------------- -- ------------------------- - 78. -Guard -Rails -& Deck -Const ruction -Post Caps ----------------------- --- 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes -------------------------- 80. -------- ----------------80. Following instld.: Drive O Yes ❑ No; Walks CI Yes ❑ No; Planters Yes 0 No 81. Stucco: Brown -Finish 82. A.C. Unit: Disconnect. Electrical, Plumbing ----- ------------------------------- - -- 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings ------------------------------------------- -- ----- 84. Water Well: Disconnect, Electrical, Plumbing ----------- ---------------- - - - - - -- - - ----------------------- 85. - -Exterior--Elec.- Trim; -G.F.I. Receptacle -Underground ------------------------ ---- --- 86. Ventilation Throughout House --------------------------- - - 87. Glass Protection 88. Corrections from Previous Inspections - - --- ---- ---------------------------------------- 89. Gas Test -Meters Tagged; Gas -Electric -- ---------- ------ ------- - -- ---- - ------------ - p --------- 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates -------------------------------------------- --- --- Date --.-Card-B-1 Date Card B-1 Date Card B-1 Date Card B-1 - ------------------------------------------ ----- Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovlller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. —9331-91 ASSESSOR PARCEL NUMBER 073-18-0-035-0 ZONING u BUILDING PERMIT' OWNER CHURCH OF THE NE14 NAME TELEPHONE 675-2018 S0. FT. OCC. BUILDING VALUATION 2064 GOV 26832 OWNER'S MAILING ADDRESS P.O. BOX 295 CHALLENGE CA 95925 CONTRACTOR'S NAME CHAPMAN CARPENTRY TELEPHONE 675-2081 CONTRACTOR'S MAILING ADDRESS P.O. BOX 295 CHALLENGE Fireplace CONSTRUCTION UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE ARCHITECT OR ENGINEER -T, LICENSE No. pian Checking Fee $ Energy Plan Checking Fee $, ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 19168 NEW YORK FLAT ROAD Permit fee $ 279.25 PLUMBING PERMIT Filing Fee 10.00 FORBESTOWN Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each gas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome[a Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W O.00ea TYPE OF WORK New ❑ Addition © Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: X RAMADA Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10ov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): VT 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. �4 �� �� Classification. � /V ��/�Di ❑ 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 OCC UP" � NEW CONSTR.A , 2�zQsgft ULTBI-OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e) SINGLE OUTLET CIR. / EX.000Up\OUTLETS OR FIXTURES oe 90 30 SALO0 Ex. Occup. OUTLETS FIXED P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin 9 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. IV I shall not employ any person in any manner so as to become subject �N 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 FiIirig Fee 10.00 Heating Cooling 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 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 per 929 . X /1A -0-1v Date /0 Si natur of Applicant — Owner g pp ❑ Contractor Age t ❑ An OSHA permit is required for excavations over 5' " deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE E TOT FEE $ 279 -25 HALcuA PARK SCH LD PAR PD 1 H IS E, This permit is hereby issued unser the applicable prov - sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been aid. p DIRECTOR OF PUBLIC WORKS BY Date PERMJIVEXPIRES Date Receipt No. 94533 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT \1 VvS�tV•.4 F.:.1�rtV'rw•y�^_'"-•'t'' .. +r. �r;""w"trr'.jsr•.-�..,Y+.rr--.-^'r'.^^.yr.r»,.Y Trr. } COUNTY OF BUTTE - DEPARTMENT�OF'PUBLIC WORKS - BUILDING DIVISION r -ti 7 COUNTY CENTER DRIVE-,PROVILI.E,.CQLIFORNIA 95965 -TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET / � � � Permit No. OWNER �f?UiGI i p _ euj C(M le, A. P. No.O73 -18-0 - 03.-- 0 Proposed Building Use �AMp/'fj /YI-fir. Building Inspector "it R% Date .740-9 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, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ................ 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ............... ........................... 12. Park fees paid ....................... ` 13. School District fees paid .............. 14. Sanitation approval from ©�l°b /(% ' Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-inspec. request to Building Inspector (Date) 21. Contractors license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization .................................. . 26. 27. When you issue the permit, process as follows: Mail to owner. V Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicanf. xi� Date %U v Copy of Haz-Mat form sent Health Dept. Fire Dept. _Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted 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 f above required data by_phone_mall_co/nter`by date + 4 Plans checked by D to Plans approved by Date _ Sets of plans on hold in/File cabinet AP folder I Copy -DPW TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance afw Owner V Location APB 1 Plan Approved for: "Sewage Disposal ._ 0/ Water Supply Hold final for: ^anal clearance O.K. for: Clearance for bedroom mobile home. NOTE Water Supply Water Supply other GL/I1l,CG�.LC D�P.�' 7 le- V Sanitarian Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N ASSESSOR ,PARCEL NUMBER O 3 — 8-0 — 03S -Q ZONIN o BUILDING PERMIT OW R cr r �r ti�� ti tit c TE LEPHO E 675 Zo i8 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAI LING ADDRESS ESS // .d g01(. C�-I�LL�iU� C� 20 civ. CONTR9 l/ 04 PA44Al C A 9 EAJ TR TELEPHONE 675--2018 coNP-TRACTOR'S t Al}�ING ADDRESS Ck l e CO—�� ZS Fireplace CONSTR/U^C TION LENDER �V UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ARCHITECT ,O'/OR ENGINEER LICENSE NO. Filing Fee $ 10-00 Permit Fee Plan Checking Fee $ 7 50 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUIL DI G ADORES (4, I 68 ovi Fl Rd Permit fee S $ 15- PLUMBING PERMIT Filing Fee 10.00 rC��e Each Trap 2,00 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 SF ❑ Duplex[] Mobilehome� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home TSTG W 10.00ea TYPE OF WORK New F] Addition R^emodel❑ Utilities❑ Installation[] � Describe work: /\/*T iJl$ Contractor Permit Fee $ ELECTRICAL PERMIT Filing Fee 10.00 Main service ;000V OR 0 AMP LESS 10.00 Main service EA. AOO'L too AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ❑ 1 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) E:1I, 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 ADONS. ( ACC. BLDGS. 2/20sq ft NEW CONSTR ULTI.OUTLET NO N.RESID BRANCH CIRCU ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20070t BALD 300 Ex. Occup. FIXED OUTLETS (PRESID.)REA.1 2.00 Temporary service 1 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 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.TOTAL 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 ❑ 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 $ Energy Inspection Fee $ occ CONST TYPE FEE $ HAZ. CUA PARK scHL FLD cDF PAR I ao i; 4D.,IssuE i This permit is hereby issued unser sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provl- resolutions to do have been paid. WORKS Date Receipt No. J NMITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT Permit#3057-85P Charles Campbell NY Flat Rd, Forbes, OF.FICE'COPY Q. � C � Address v 0 a j G By .Dat 3 •i 4 ,y ELECTRIC Metes i3Y_ _ J ��I I i �• 4 - l I COUNTY OF BUTTE - DEF LENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, alifornia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER_ _. ZONING BUILDING PERMIT OWNER TELEPHONE+r, SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS (r' CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS _ Penalty $ BUILDING ADDRESS1 I r i Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 f r r 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 SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel[] Utilities ❑ InstallationC Other ❑ Describe work: ���1J + r �' - _ �. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 r Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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. Classification El 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.& OR ADDNS. ACC. BLDGS. 2,h0sq It NEW CONSTR U TI.OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS /POWER APPARATUS 6 (SINGLE OUTLET CIR. ExOCCUp(OUTLETS OR FIXTURES ZOe50t . eAL030 FIXED K P \ Ex. Occup. OUTLETS (RESID IEA./ 2.00 Temporary service 10.00 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 Cooling 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 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 County in consequence of the granting of this permit. ,_ X ! Date/-"' Signature of Applicant — Owner'a 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occuP, CONST.TYPE FLA OI"FZ;7 ND IseuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which ` DIRECTOR OF PUBLIC 1014 By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS . Date I Receipt No. I // 4- WNITE•D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orov:ille, Californ%i 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. D b — 5____1 ASSES oR ARC€//�f�VL13 Fes- " S ZONING t BUILDING PERMIT OWN R TELEPHONE SO. FT. OCC. BUILDING VALUATION OW MAI)NI ADDRESS dd -14l CONTRACTOR' ME TELEPHONE CONTRACTOR'S MAILING A RES. Fireplace CTRUCTION LENDER 1S UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ AR ITECT OR ENGINEER C— LICENSE No. Plan Checking Fee $ EnergyPlan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS = L(^ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 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 SFXDuplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 6A0 Building sewer 5.00 Mobile Home I S I G JWT 10.00ea TYPE OF WORK New ❑ Addition ❑ .1_BemodelD lities ❑ Installation Other ❑ Describe work: r0 t Permit Fee $ 0,190 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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. Classification El 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 or 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 AODNS. ACC. BLDGS. 20sq ft NEW CONSTR. ULTI.OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS /POWER APPARATUS e) (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 20050c 30ti FIXED APPLNS. EX. Occup. OUTLETS ((RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 . MiscWiring15.00 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 ertificate of Workmen's Compensation Insurance or a Certificate f 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 10.00 Heating Cooling 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 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 sai County in consequence of he granting of this permit. ,s Date��`��'�J Sig cure of Applicant — Own Contractor ElAgent❑ 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occuP. I CONST.TYPE I IFLOODIPARrFLI PD 1 HD 1 197 This permit is hereby issued under sions of the Butte County Code and/or work ind' ated above for which DIR F PU�L�IWORKS PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. Receipt No. WHITE-D.P.W., YELLOW -ASSES R, PINK -INSPECTOR, GOLDENROD -APPLICANT -_ PERMIT NUMBER - B2469-73BgE ` a; ♦ k i P 4. I PERMIT EXPIRES OWNER Charles C. Campbell CONTR: • ' +'owner LOCATION (A.P. 73-18-35 ) J s/e corner Oro.-Forbestowa Rd.. & Brownsville cutoff, Forbestown i I El • , Zoning Foundation _ Rgh. Plumbing Rein. Steel_ Framing Wtr. Ntr. Firewall ELECTRIC Temporary _ ' Final DATE � UN 0 BUTTEYj Department• of. F>dbli6.--Works BUILDING INS.PEI TIOK RECORD Setback Ole --it ©-7� Forms ® — •� t Piers &Girders Fireplace' Bond Beam Lath & Plaster Gas Piping & Test Found. Vents Plmg. Topout Rough Elec. Furnace Kitchen Vent Garage Vents Sanitation &Water GAS BUILDING Temporary Cert. of Occ-up. Final Fina ZZ• REMARKS�i0R,*CORRECTIONS ' •�j� 1 m COUNTY OF BUTTE — DEP.ARTM,ENT OF PUBLIC WORKS`l 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. \9A - - XAA _ Date _ —/0 73 ignature of ermitee or gent Receipt No. Z�Q 2 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. DIRECTOR OFPU LIC WORKS By Date /— Niming permit expires�e BUILDING Owned SQ. FT. OCC. BUILDING VALUATION Mailing Address - Telephone No. ZQO Contractor Fireplace otal Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ d Building Adress PLUMBING No. @ FEE PERMIT FILING FEE $2.00 � �- Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50. Each gas water heater or vent 1.50 A. P. No. ._ Sr^Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 V<5 Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking I P ns ParcelParcel Declaration Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 Id .Plans Rec' Parcel+rval Mort val Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (morethonl2) Single Family ❑ Du lex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 L Water Heater or Space Heater 1.00 Ligh fixtures3 20P25 bal__(alo ,` Re s., swit hes & fix outlets X200 (d 25 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ y WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ I FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. \9A - - XAA _ Date _ —/0 73 ignature of ermitee or gent Receipt No. Z�Q 2 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. DIRECTOR OFPU LIC WORKS By Date /— Niming permit expires�e Forbestown, CA, 95941 ' July 12, 1973 County of Butte ttn: Jim Glander Department of Public Works Building Permit Division _ Oroville, C.A. 95965 Jim I didn't know who to send this too -Will you please get it to the proper person. I have paid my application for the permit. If these drawings meet with the Departments approval please mail permit. I will call for first inspection as soon as I have completed my foundation forms. �...Thank you •}•f ;Chuck Campbe F P:0.�Box,1000 Forbestowwh, C.A. 95941 f 7 7/0/7.3 o =