Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
078-140-044
0 Wynoka Homes 5715 Via Pacana, lot 44 Vista Del 078-140-044 06-1977" Cerro #2'Oroville GRAMPS, RUSSELL Permit #6737-79B,P,E,M(new single 5715 VIA PACANA, OROVILLE 71, Cont: COMMUNITY ACTION .92-'1936P,E, fm WATER HEATER04 LO J12 GILBREATH, Kyle 5715 Via Pacana, Oroville contr: Bill Connelly Z water heater & hvac/sf Iim�lhll 078-140-044 06-1976 GRAMPS, RUSSELL 5715 VIA PACANA, OROVILLE • NOTES Cont: COMMUNITY ACTION _ WATER HEATER �oorti RESIDENTIAL APN: Permit No. Owner. Site Address: Contractor. Type of Pennit: t SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDMIJNS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE CHECKED BY . 7,�� z DATE JOB FiNALED: SIGNATURE: C1 (Cs SrA DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (53 0) 538-7541 LICENSED CONTRACTORS 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. R License Number: _ I, 1 License Class : l� Dale: /J' (2L"6conlractor: I hereby, affirm under penally of perjury that I am exempt from the Contractors' Stale License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, after, Improve, demollsh, or repair any structure, prior to its Issuance, also requires the appllcanf for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Stale License Law (Chapter B commencing with Section 7000) of Divislon 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 penally of not more than five hundred dollars ($500).): 0 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' Stale 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.). Cl I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Slate License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Stale License Law.). ❑ I am Exempt under Article 3 of the Buslness and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally 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 Coda,'for•lhe performance of the work for which this permit Is issued. My workers' compensation insurance car-rimierr and policy number are: Carrier: %) / '�' A C;- Policy s: BP061976 Issued Date: 08/17/2006 APN: 078-140-044-000 Site Address: 5715 VIA PACANA ORO Map Index: Description: WATER HEATER REPLACEMENT Owner: GRAMPS, RUSSELL & ANGIE 5715 VIA PACANA OROVILLE, CA 95966 (530) 538-9175 Applicant: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC. 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 (530)538-7559 Contractor: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC. 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 (530)538-7559 License #: 61720.1 Architect: Engineer: ❑ 1 certify that in the performance of the work for which this permit Is 0 S. F. issued, I shall not employ any. person In any manner so as to Total Square Ft: become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that If I should become subject to the workers' compensation provisldns of Section 3700 of the Labor Code, I shall Census Code: forthwith comply with those provisions. Dale: TEE - V - Applicant: — i�"'II�V�VAr (Q W N Failure' lo• secur orkers compensation coverage Is unlawful, and shall subject a 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 allorney's fees. CONSTRUCTION LENDING AGENCY This permit Is hereby Issued under the applicable provisions of the Butie County Code and/or I hereby affirm that there Is a construction lending agency for the Resol 11 s to do work Ind/ a d ab a for Vffich fees have been paid. performance of the work for which this permit Is issued (Sec 3097 Civ.) By. Dale: Name: PERMIT EXPIRES ON: Date Address: ❑ CaliforniaHealth and Safely Code, which regu;ale the storage, I hereby certffy that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the handling and use of hazardous materials. ❑ Notification In accordance with Section 19627.5 of California f•leallh & Safely Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. er or the duly I hereby certify that I hWSeelal n thio buildingpiconslrucllon. above l acknowledge edge Itlls unrrect, and that I am the own lawful to alter the ubstance of any official form lorr do agent ment of Bute County. el hereby ply with all county and.slate la 9 authorize representallves of Butte County to enter upon the above mentioned property for inspection purpose Signature: Prihl Name: Dale: 4 � ❑ Agent for Owner(gent for Contractor Q Owner ❑ Contractor Y B. C. Buildinp Permit 01-16-04 pp 1 . =OK 0 = Not MANUFACTURED HOMES DATE L1 PERMANENT FOUNDATION Lj SOFTSET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer, Loctn Test; FalUC10-Concrete 4 Wtr; Loctrr Test-Easeinent Needed -Regulator 5 Elec Loctn-DImcs-Gmd `Amp -Concrete 6 Yard Gas; Loctn Test Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-DImcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits Is Cert of Occupancy 16 HUD labellinsignia Numbers Serial Numbers MISCELLANEOUS —•-,DATE IDECKS•COVERS*CARPORTS•GARAGES 1 ZoningSetbacks-Easements 2 Figs; ScitsSz-DpthSpacing-CnndrsSteei 3 Decks, GirdersfJotsts-Doing-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnncfnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-RFas Tnisses .9 Siding; Nailing VengerStucco-Lath 10 Roo; Shthg-Roofing ` 11 Ext; Steps-Doors4.and0ngs 12 Braced Wall pnis io$ vT� o� ai DATE POOLS 1 Setbacks -Easements 2 Soils;`Compaction-Structure Stability 3 Pool Structure; Steel-Cnnctris Thickness Dead Men4Jning 4 Elec RcptdstUng; Distance -GR 5 Elec Pool t ting;15 volts-GFI 6 Elec.Encisrs; Conduit Entries-Terminals--Isted 7 Elec Bonding; Metal w/S•Crdtng Egp-Htr 8 Elec Gmdng; Eqp w/V Crdtng Eqp-Pool Ightg B=es-Enclsrs-pniboards�nsultn to Main Conduit 9 Health Dept Appivl 10 Ptmb; Cir Test4Ntr Supply Test 11 U Niche 12 Endsr, Fencing -Alarms 13 Bonding, Diving board or Slide Pool Drawing = Not OK RESIDENTIAL NDERFLOOR 1 Zoninoetbacks-Easements-FloodSlope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Fig Garage; Soils-Steel-Elec Gmd Ftg Dpth 4 Ftg Parches/Decks; SoilsSteel Fig Dpth 5 Stdmwalls Main; Steel-Blockouts-Wrapped 6 Stemwalis Garage; Steel-Biockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frpic Ftg-Steel 9 DWV; fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; SzAnchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgmd 13 Plenums & Ducts; Cirnc-MaterialSupport-Insultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Acc & VnUtn 16 Insulation a` o' o ys o' m` � DATE 15RAMING 17 Sills Proper Materials & Anchrs 18 V1lalls 5tuds-Nail. Spacing & Braces-platesSound 19 Bearing Walls ovet Girders,83 fir Nailing 20 Draft Stop In Walls (rat Proof) - 21 Fire Stops; Ftirreil CeilingsStairs-Chasers Tubs 22 Headers & BearnsSi &'Bearuig' 23 Hangers-P•osfCaps Anchrs-Citnctns 24 Ceiling Joisf-Rftr Tes-Purli -Roof Brac TmsShthg 25 Frpic Ties or Typi: A Flue F ' lc Throat Cirnc 26 Attic Atm Sz &�Riezf{t-Craft Stop -fns Baffles 27 Bdrm Wndws or Exiting i)otirsSill Ht & Dimensions 28 Garage Fire Prtc bi Framing -11'C Charinel 29 Prprty Line Firewall & Opngs' . 30 Ext Doors -One 3ec 3' -Check Garage 3r4 Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Rum-.ending-Fire Prtctn 32 Plywd on Roof Ovrhng Attic Ynts-Rftr ddbUrs 33 Siding -Nailing Veneer 34 Stucco Lath Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Are PrtctnSkyL s -Plastic . 36 Shear Walls; Nailing -Bolts 37 Brace lnt/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration Walls-Wndws o'er aT d o.'r DATE JELECTRICAL 40 Fxtr & Tmsfmtr Cirnc-Ins Prtctn 41 Elec Rcptcts Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Gmd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFl 47 Subfeed Wire Sz P Oc or OAL AC Wire Sz ya D CU or O AL 48 Range Circ Qa O CU or DAL Oven Circ pa O CU or D AL Insulated Neutral ❑Yes ON, 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Cimks pnts-Motors-Meth Eqp 51 Clothes Closet LtShwr USpa Lt 52 Smoke Detector Single & Duplex) DATE IPLUMBING 53 Wtr Htr, Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DVN; Test Fittings & Anchr•Nail Pr(ctn 56 Shwr Pan; Test, First ilr-Tub Acc 57 Test Tubi & Shwr, 2nd fir - Tub Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping O+A QjS o�_i-0``r DATE IMECHAN-ICAL 61 AC Ducts Insulin & Support " 62 Vent Fan, Exhatist abv Insultn 63 Condensate Drain & Ovrfiw, Sz & Grade - 64 Furnace -Vent Acc-Comb Air RhmNent 115 Outlet 65 Attic Acc & Pitfrm if Furnace In attic DATE FINAL 66 Ext Steps -Door & SideU Pitkin -Landings 67 Smoke Detector 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr In Garage; abv-fir-Ducts-Meth Prtctn 69 Bedroom Exiting 70 GFl A Bath Fxtrs & Tub Acc-Spa 71 GFl Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, GuardlHandrails 74 Frplc or Stove, Clmc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc-, Gmd-Air-Gap•Cooking Cirnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Dobr, Swing -Landing -Closure 79 AC Duct In Garage -Damper. 80 Wtr Htr; Vnts-Clmc Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech-Eqp Listed for Loctn ,82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth .86 Clmc Dmge Planters Yes ❑ No .87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Pimb 89 Vnts abv Roof, PImb.Appinc-Frpic-CImc to Opngs 90 Wtr Well, Dscnnc% Elec, Pimb 91 Ext Elec Trim, GFl Rcptd-Undrgmd 92 Vntitn thru House 93 Glass Prtctn 94 Corrections from previous liispttns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl •97 Energy Cmpinc Cert -Other Certs 98 Address Posted •99 Fire Sprinkler W%J 1 1 L VV IJ 114 1 DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 LICENSED CONTRACTORS 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. "� _ t' License Class : License Number: Dale: .2>/__f__(IM-6conlractor: I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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, demollsh, or repair any structure, prior to its Issuance, also requires the appllcanf for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Slate 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 penally of not more than five hundred dollars (8500).): ❑ 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' Slate 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.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law). ❑ 1 am Exempt under Article 3 of the Buslness and Professions Code Dale: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally 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'lhe performance of the work for which this permit Is issued. My workers' compensation Insurance carrier and policy number are: Carrier:1111,111 111 _>- Cts �.tr Policy 1 VI \Ivll1 1a V. BP061976 Issued Date: 08/17/2006 APN: 078-140-044-000 Site Address: 5715 VIA PACANA ORO Map Index: Description: WATER HEATER REPLACEMENT Owner: GRAMPS, RUSSELL & ANGIE 5715 VIA PACANA OROVILLE, CA 95966 (530) 538-9175 Applicant: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC. 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 (530)538-7559 Contractor: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC. 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 (530)538-7559 License #: 617201 Architect: Engineer: 0 I certify that in the performance of the work for which this permit Is I not employ any person in any manner so as to Total Square Ft: 0 S. F. , Issued, shall become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that If I should become subject to the workers' compensation provisldns of Section 3700 of the Labor Code, I shall Census Code: forthwith comply with those provisions. Date: Applicant: WARN FaOure' to secur orkers'lcompensation coverage Is unlawful, and shall subject a employer to criminal penalties and one U hundred thousand dollars ($100,000), In addition to the cost of for In Section 3706 of the Labor compensation, damages as provided code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit Is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol li s to do work Ind/ a dab a for vytilch fees have been paid. performance of the work for which this permit is Issued (Sec 3097 Civ.) By. Dale: Name: PERMIT EXPIRES ON: Dale Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. O Notification In accordance with Section 19827.5 of California hleallh & Safely Code is not applicable to the scheduled construction of this project. 0 Attached are copies of the required E.P.A, notification forms. . the or the duly authorized agent of the owner, I agree to comply with I hereby certify that I have read this appllcallon, that the above Information Is correct, and that I am te o all counly andslete-laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize represenlallves of -Butte County to enter upon the above mentioned property for inspection purposes. Lf�n�e C to Signature: - Print Name: 1 e`• `� Dale: ❑ Agent for Owner O Owner Agent for Contractor ❑ Contractor v B. C. Building Permit 01-16-04 P9 1 BUTTE COUNTY Last Name PERMIT DEPARTMENT OF DEVELOPMENT SERVICES R _ NO. BUILDING PERMIT APPLICATION City 011co State AND SUBMITTAL REQUIREMENTS Phone ( HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 _ BPOCO)1i OFFICE #: (530) 538-7541 Fax A FEE WILL BE REQUIRED AT TWE OF APPLICA TION BIN # Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY*'-' E-mail Lic. #; c_,�7z_o(F OWNER Last Name irst Name Name C R _ Address ,71 City City 011co State Zip s Phone Fax D ¢ _ E-mail APPLICANT SIGNATURE X F r office use only: CONTRACTOR Name Name C R _ _ City I No C—C7 Address Phone b �'e e. City State Phone Zip Fax 7.5 Phone_. ':: _ Fax E-mail Lic. #; c_,�7z_o(F Class 61 APPLICANT SIGNATURE X F r office use only: ARCHITECT/ENGINEER Name Flood Zone Address _ City I No State Zip Phone b �'e e. Fax E-mail Phone Stale License Number APPLICANT SIGNATURE X F r office use only: APPLICANT NAME Name Flood Zone Address _ City I No State Zip - Subdivision Name b �'e e. ��_e - Lot # Phone Approved: Fax 7.5 E-mail APPLICANT SIGNATURE X F r office use only: Zoning Property Address 159 /� "e'__r- gun__ Flood Zone Cross Street SRA I Yes I No Occ. Type Const. . Subdivision Name Map Book Page Lot # PlannerDate Approved: OVER FOR SUBMITTAL REQUIREMENTS LOCATION Property Address 159 /� "e'__r- gun__ City A G 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 Name Address Description or Scope of Work: 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. Received by: V6 Amount: Bldg SRA Receipt #: —Sheriff Sheriff v SMIP DateOther '.—� ` f,. ,G`� ( V 00 Total .1.1--l" ... -.r. A-- 0-...o 1 !.!D DCV 7-7A-nr. 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 INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 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. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) 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). 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. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit 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 KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 1' PERMIT NO. 6737-79B,P,E,M PERMIT EXPIRES OWNER Wynoka Homes, Inc. CONTR. owner 36-74-44 LOCATION (A.P. ) { 5715 Via Pacana, lot 44, Vista Del Cerro#2, Oroville 4 i i r I t ti 1 Temp. Power Pole alled PG&E � -- I Tem lec. Serv. Called PG&E Temp. Gas Serv. Called PG&E 6 JOB FINALED RRq TnFNT TAT. ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT XJ % -44 (location) BUILDING PERMIT NO. A. P. NO. THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge SA Fdn. ?Jalls2YA Floors Walls/ Ceiling/Roof Ducts jC Circulating Pipes_ APPROVED HEATER_ APPROVED WTR.HTR. — GLAZING: Single Glazed Special (Insulated) X CERT. & LABELED WDS. & SLIDING DRS. x WEATHERSTRIPPED DRS. x BACK DAMPERED FANS j!-, INTER?IITTENT IGNITION DEVICES_ CERT. APPLIANCES— I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED I'N ACCORDANCE WITH TEEENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF TRIS CERTIFICATE AS SU&`tITT.F.D. Insulation Applicator Nai,:e H4iiy4eqTI __ Si0r,ature of (please print) Insulation Applicator State Contractors /1�, License No. 379'907 Cenerat Contractor/(timer Name XAC), e,4 Z'Ss (please int) Signature of General Contractor/Chaneyk-WIAate !A (meg State Contractors License No. 1e -?Z5&9 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. P L U M B I N G Check List Permit 6/7 Under, oor Sta e D.W.V.: (1) Sizing. (2) Materials. (3) Fittings. (4) Grade & Support. (5) Cleanouts & Accessibility. (6) Clearances. (7) Rough -in Locations. [1* (8) Wrapping. (9) Test - including "Ts". (10) Additional test not required.', El Water: (1) Sizing. (2) Materials. (3) Support. (4) Test. (5) Wrapping. ®,Y (6) Dissimilar metals. (7) Service regulator installed or not required.* ® Gas: (1) Sizing. (2) Materials. (3) Support. (4) Log Lighter. (5) Wrapping. r Framing Stage (Top Out) D.W.V.: (1) Size. (2) Vent Area & Termination. (3) Materials. (4) Fittings. (5) Grade & Support. (6) Cleanouts. (7) Traps. (8) Nail Protection. (9) Plumbing Access. (10) Toilet Clearances. (11) Shower size. (12) Shower Pan Test. (13) Vents - turns, horiz., runs, loop, wet, etc. Q ; (14) Additional 2nd floor test not required.* Water: (1) Pipe Test. (2) Mixer Valves. (3) Support. (4) Roof drains. (1) Size. (2) Materials. (3) PR Valve Drain. Water Heater: (1) Vent. (2) Location. (3) PR Valve Drain. Q F ina Ly .W.V.: (1) Connected to sewer system. (2) Special systems. W ter: (;/Water Source. (2) Shut-off. (3) Anti -siphon Valves. VjWja: (1) Test. (2) Connectors. er Heater: (1) Location. (2) Accessibility. (3) Clearances. (4) Stability. Zl 5) 18" Garage Floor. (6) Mechanical protection. (7) Combustion Air. 8) Draft Diverter. (9) Vent Connector. (10) Vent. (11) Shut-off and onnector. (12) PR Valve & Drain. es: (1) Approved. (2) Stability. (3) Clearances. (4) Trapped. (5) Connections. (6) Cross -connections. (7) Dishwasher Air Gap. 5/79 M E C H A N I C A L Check List ❑ Permit ® Underfloor Sta e ❑ Underfloor Supply Plenum: (1) One-story. (2) Clearances. (3)'Combustible material. (4) Insulation and vapor barrier. (5) Access. (6) Catch. receptacles and registers. (7) Fire -stopping. (8) Boots. (9) Supply ducts. (10) Gas lines and plumbing cleanouts. Ducts: (1) Size. (2) Materials. (3) Support. (4) Fittings. (5) Wrapping. (6) Insulation. (7) Clearances - ground, crawlspace, cleanouts, plumbing, etc. ❑ Combustion Air: (1) Size. ❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (4) Insulation. Frami Stage Heating: (1) Approved appliances. (2) Accessibility..(3) Clearances. _(4) Combustion air. Vent and Connector: (1) Approved. (2) Size. (3) Clearances. (4) Cap. (5) Termination. Ducts: (1) Materials. (2) Size. (3) Support. (4) Fittings. (5) Insulation. (6) Fire Damper. ❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (4) Insulation_. (5) Condensate drain. Final - He in : (1) Accessibility. (2) Combustion air. (3) Safety controls. (4) Electrical connection. (5) Fuel shut-off. Cooling: (1) Accessibility. (2) Support. (3) Controls. (4) Pressure relief valves. (5) Class 2 refrigerant. 5/79 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD Mesh 17 a MECHANICAL Grd. Fault Prot. i v Scratch Heating Service Brown CoolingTemp. Pole Finish / Ducts Underground Interior Lath r lation ane Door Closer l!j Fin Fin OEM MOBILEHOME TILITIES Elec. Service ec. Pedestal Water Piping Sewer Gas Piping MQBILEFIQME INSTALLATION . • ............ Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS 4/4/ (NOTE: An entry must be made on this form each time you visit the job site.) BUILDING BUI DING Co t'd) PLUMBING Setback Firewall CJ SolI Piping FormsParapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings 2 Windows 3rd Floo StemwalI Siding To out F Slab Roof Sheathing Water PI piDIL2 2-7B._ Piers Roofing Sewer j Gara a Fdn. Vents - Fixtures Footin s Garage Vents lv Water Htr. Stemwa I I Insulation Heaters Slab Carport Footings handicar pehysically pp Conformancdde of ex. s ure Appliances Gas Piping &Test j Temp. Gas Slab n S on Patio MREPLACE anal Footings Footin ELE RI L Masonry Walls Throat Rough 67 6 fKD Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing to Test Water Htr. Stucco a Final Final Suboanels— i Mesh 17 a MECHANICAL Grd. Fault Prot. i v Scratch Heating Service Brown CoolingTemp. Pole Finish / Ducts Underground Interior Lath r lation ane Door Closer l!j Fin Fin OEM MOBILEHOME TILITIES Elec. Service ec. Pedestal Water Piping Sewer Gas Piping MQBILEFIQME INSTALLATION . • ............ Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS 4/4/ (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTfiE ' DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT - �73�_� authorize representatives of the County of Butte to enter upon the above -menti d property for in ection purposes. X Date e Signature of Permitee or Agan Receipt No. :�M s:5�/ 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. DIRECTO F PUBLIC WORKS By Date ilding permit expires Date BUILDING Owner V No 54 HdfA E'S C SO. FT. OCC. BUILDING VALUATION Mailing AddressPo DoX do S � Telephone — 2_7�7 00 Contractor S A M 6 Mailing Address Fireplace Total Valuation _ Telephone No. Permit Fee JJ 2 Building Address Go T E. Plan Checking Fee&/or Penalty Permit Fee S VIA ACAIV4 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 ST_aviGG� Each Trap 1.50 /y00 Repair drainage or vent piping 1.50 (� `'_ A. P. No. 3 —7 (— T L n g VaISnening Water piping 1.50 Each gas water heater or vent % 1.50 6p F W. S tion Fire Dept. Fire Zone Ute Permit Gas piping system 1 -5 outlets 1.50 60 EOA Parking Plans Parcel Declaration Parcel p 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 BIffs ejdl'6 Parce A rovol Plans Approval Lawn sprinkler system 2.00 NEW ILS. ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 q 4_0 Main service 8011 OR LESS 100 AMP OR LESS 5.00 Single Family ®. Duplex Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 100 AMP6001 OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELLING OC 2QS ft q OR ADDNS. ACC. BLDGS.ZAM CONTRACTORS LICENSE LAW 1 am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: w�NC KA ��M NC NEW CONSTR. MULTI.OUTL T NON.RESID BRANCH CIRCUITS) 12.50ea NEW CONSTR. (POWER APPARATUS d NON-RESID. SINGLE OUTLET CIR. Ex. Occua(OUTLETS OR FIXTIIRES g L@; FIXED LNS. Ex. Occup. OUTLETS APP (RESID IRE A% 2.00 Temporary service 10.00' Mobile Home Facilities 15.00 License No. I F256 % Classification ��� Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ s 75 O MECHANICAL No. @ FEE 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. PERMIT FILING FEE $3.00 D� Heating S e� Cooling ellIA17pti Ventilation Hood 2.00 Permit Fee $ 42 $ 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 relatinq to buildinq construction, and hereby 1 Land Development Fee $ ZJ—dZ2+ TOTAL PERMIT FEE $si authorize representatives of the County of Butte to enter upon the above -menti d property for in ection purposes. X Date e Signature of Permitee or Agan Receipt No. :�M s:5�/ 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. DIRECTO F PUBLIC WORKS By Date ilding permit expires Date he This set of plans a d Tec MUS kept on the hob at all times Same w tlrto ° t_' P chnncles or It rc blic . ma ,P any the De ar}ment of P, _ written permission f B n th P Works, County IZ A setback of 5 ft. from the property lines and a setback of 50;t. from the road centerline sh=all be clear o — structure3 or equipment xo for a 2 ft. cave ov%hang V.. IV NOTE:—All Materials & Workmanship Shall Be in Accordance Aifh Recoan'-zed Good Practices frid Of a quality Prescribed bc ar&h,ahc+n e�fa!Cock©s nd Specified use in 'he Uniform Building, PI mi - the National fiectriedl Code. C-671 ✓ 0' HI _-VIN _ . _ 73 7-7 /•:. r� ���: � r �:: •.. ,•� ��.. `�� r� G�' � �"�: BUif.�:�`OUNTY _ `� � � v � � .-.w....a �.... ..�......-�.__._.-.-- _.'_._-.-._.._-..._.-�_...- .__..� _may-. --/-�_ � � �9 � ....�.._.....� SVB_)IVtSION l=t'rY COUNTYp{j -LJd D&PIA T .,....:_-�s�eaae.:z-.acaorsri •-^^rc_�-t+:. .s.+ e,=.soecra..-a�:._a_e+¢ss+�n�:uz-meuafi•..:.rasscs.n�rr�x»:i-s.�ea+:.rs.�r�a• :4Grr;r=S.Ino \'%tt AT E/(f !� i ��✓ .— „� i�. C7X lam; SALE r /t7 14 a r (an`� � pie:.ink ,� I L L E , 4L. o5SSS nrl ,+y'.' . _;;,;�.,: :y�l"-rs:--w`err".y'r"^yY'r^"'^...,.:,.•';i'`"''J''''�-•{`r'--.7,i„lR7tirP:+v-. Z' "ti �* 92-1936P,E,Ni=� 36-74-44 _ GILBREATH, Kyle 571Oroville 5 Via Pacana, contr: Bill Connelly weer heater & hvac/sf 1 C COUNTY OF BUTTE - DEP.ARZMENT OF PUBLIC WORKS 7 County Center Drive - Oroville+ California 95965 - Telephone: 916.'538-7541 APPLICATION ANO PERMIT PERMIT NO. g-36 ASSE. SOR PARCEL NUMBER 3674•-44 ZONING R 1 BUILDING PERMIT OWNER LYLE cILBREATH TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS , 5715 VIA PACANA CONTRACTOR'S NAME BILL CONNELLY TELEPHONE 5331516 CONTRACTOR'S MAILING ADDRESS 5490 VIA PACANA OROVILLE Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER ` l LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS _ Penalty $ BUILDING ADDRESS` - ( 5715 VIA PACANA OROVILLE Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 \ + Solar or heat `pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 7.00 r��-qr� USE OF STRUCTURE � SF9, Duplex❑ Mobilehome❑ Other! SPECIFY t;. Gas piping system 1 - 5 outlets 5.00 5 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New II Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: NEW CENTRAL MVAC REPLACE WATERT _ HEATER Permit Fee $ 00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS _ Main service 200ATO1000Al 37.50 CONTRACTORS LICENSE LAW I declare under lt of perjury . penalty P Y P Iur Y(check one): p+ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professio s Code and my license is in full force and a fect. License Ao. %� Classification s. D - 171, as the owner, or my employees with wagq'as their sole compen- sation, will do the work,and the structure is[rfot intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contractingt.with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& 3.64 sq. . OR ACDNS. ( ACC. BLOGS. ) NEW CONSTR. MULTI -OUTLET NON-RESID• BRANCH CIRC ITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES AO 76[j FIXED APPLNS. OR EX. Occup. OUTLETS (RESID,) EA.) I 3.00 Temporary service 15.00 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. 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. 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 FiIingFee 15.00 Heating 9.00 DUAL PAS( Cooling Z 9 Qfl Hood 6.50 Ventilation Permit Fee $ 33.(i0 Contractor I certify that I have read this applicationiand 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 consequ nce oft granting of this permit. X _ ,� r,.v / �� Date ''��t�+h��cy Signature of Applicant — Owncr Contractor Agent ❑� ....►:�i��"� 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 TOTAL FEE 78.00 I HAz OFEES IMP I FLOOD CDF I PARCEL I PD I HD Iss E This permit is hereby issued under the applicable provi- sions of t Butte County Code and/orf"esolutions to do work i i ated ibovporwhich fees have been paid. DIRxOF PUB lC WORKS By PUB Date��l7 PERMIT EXPIR Date 10 ...> •--✓ Receipt No. 1168$6 7$.00 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT _ I COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS F 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE or OWNER PERMIT NO A routine inspection indicates that the following violations of Butte County Ordinances exist'at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or.need additional explanation, please corpt/a�this office immediately. K�du Date - %c'- / Z -Inspector REV 11/91 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916,'538.7541 APPLICATION AND PERMIT PERMIT NO. Z4 q%6 ASSESSOR PARCEL NUMBER 36-74-44 zoNING „fir R 1" BUILDING PERMIT- j OWNER LYLE GILBREATH TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 5715 VIA PACANA CONTRACTOR'S NAME BILL CONNELLY TELEPHONE 533-1516 CONTRACTOR'S MAILING ADDRESS 5490 VIA PACANA OROVILLE Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15,00 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 ADDRESS 5715 VIA PACANA OROVILLE Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7,00 Each qas water heater or vent 7.00 7 .00 USE OF STRUCTURE SF D Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S G W @ 15.00 TYPE OF WORK Newer Addition RemodelEll Utilities[]InstallationE Other ❑ Describe work: NEW CENTRAL HVAC REPLACE WATER _ 14FA.TFR Permit Fee $ 97-00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 20000AA OR LESS 2OR LESS 18.50 Main service 200A TO 1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): y, I am licensed under provisions of Chapt. 9, Div. 3 of the Business and P.rofessio s Code and my license is in full force and a ect. License .Jo.% %� Classification �-" ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) r] I am exempt under Sec. , Business and Professions Code �,. for this reason NEW CONST. ( DWELLING OCCUPM OR ADDNS. ACC. BLDGS. 3.64sq.ft. NEW CONSTR. ULTI-OUTLET NON.RESID- BRANCH CIRCU ITS @ 5-00 POWER APPARATUS & (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20 760 FIXED APPLNS. OR Ex. Occup. ouTLETs IREs1D.I EA.) 3.00 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring '15.00 Permit Fee $ 18.00 Contractor — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. 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 15.00 Heating 9.00 DUAL PACK Cooling 21 9,QQ Hood 6.50 Ventilation Penult Fee $ 33.00 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 Cgunty in conseque� a of t granting of this permit. X Date `!�� � •� / Signature of Applicant — OwnekContractorj Agent ❑ ion of structures over 3 stories in height. An OSHA permit is required for excavations over 5'0" deep and demolition or construct-41EkXPI Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE ! HAz 1 11 FEES IMP 1 FLODO 1 COF PARCEL I PO RD ISS This permit is hereby issued under the sions of t Butte County Code and/or work i i ted ab �w,hich a DIRE UB By PERR Date applicable provi I solutions to do ave been paid. ORK$ Date A 112 Receipt No. 11 78 nn WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC 'WORKS PERMIT NO. 7 County Center Drive - Orovllle, California 95965 - Telephone 916 '538-7541 APP,LICAT ION AND PERMIT ASSESSOR PAR�,Ny=B ZONIR BUILDING PERMIT OWNERKf_ i �_ 6 i (U TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MyL{-t� /I.�D�tE 5 a C C; CONT�IO�R S N ME01 /Y I `. I ` TELEPHONE CONTRACTOR'S MAILING ADDRESS / 5V gQ _ l� ,( �� Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 57/ 0-01',� J✓,\ PAC- ,E?^ A / /I�l/�'j Permit fee $ PLUMBING PERMIT Filing Fee 15.00 l Each Trap 5.001 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each oas water heater or vent 7.00 , 0-0 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other ` SPECIFY Gas piping system 1 - 5 outlets 5.00 '--cam Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New Addition v Remodel tU In tallation[ Other 1� /A��/ ,,(�; U�t�i/ty'k Describe work: /(/6"� (;W& /,i �eqCe_V— Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600VORLESS 200A OR LESS 18.50 Main service 200A TO 1000A> 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I 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 Ao. Classification 71I, 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. 3.6Q 8q.it. NEW CONSTR ULTI.OUTLET NON.RESID BRANCH CIRC ITS @ 5 00 POWER APPARATUS & (POWER OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 20 @ 760 AL 4F;h4 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.I EA.) I 3.00 �.O Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ Contractor — WORKMEN'S COMPENSATION INSURANCE I dec'are under penalty of perjury (check one): F , 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 15.00 Heating 1 O Uve, Cooling /2 /, Hood 6.50 Ventilation perrnit Fee 21 $ 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 01 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 5 nature of Applicant - Owner ❑ agent ❑ An g pp ❑ Cs over ion oofsstructures HA }overis r3gstoriesoineheighttlons over 5'0" deep and demolition or construe,- Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEES IIAZIDFEES IMP FLOOD CDF PARCEL PO HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date CJO Receipt No. WNITE-D.P.W.. YELLOW-ASSE5SOR, P;NK-INSPECTOR. GOLDENROD -APPLICANT