The URL can be used to link to this page

Home My WebLink About078-180-009�1 2966-91P,E SUPLITA, Michael 078- J 2966-91P,E SUPLITA, Michael 1959 Clinton AVe, Oroville (mh util)2-- Q 3. ELEC 100,4 %)6- 3/w 2 GAS ,aT z0 COMPACTION TEST REQ /✓'� SUPPORT STRUCT REQ O 0��. "——^^'--- 91-3761 1 SUPLITA, MICHAEL CONTR: OWNER a 1959 CLINTON AVE,= OROV I E��2q- l2 NEW GARAGE 946--t7=2=^J 92-3867MHi SUPLITA, Michael '--- 1959 Clinton Ave,Oroville contr: Executive Homes mhi Z 078- J Mjb RESIDENTIAL X036-17-2-001 92-3867MHi SUPLITA., Michael ' 1959 Clinton Ave,Oroville. contr : Executive Homes t f ]� ! 7� mhi l 7 OFFICE COPY Address GAS 4 j Meter Da% � EGECTRI '~ JOB FINALE Signature J=OK O = Not OK Not Applicable Not HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements-Setbacks-Easements 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 t Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s . Zoning Requirements-Setbacks Easements gooFootings; Size-Spacing-Marriage Line _1�els-,MH Test-Demand-Valve—Connector of e tricity; MH Test-Crossovers-Breakers-Clearances 5,-r0: MH Test-Fall-Flex Connector Water; MH Test-Regulator-Connector ater and Sewer Connected-C/O to Grade-HD Approval as,and Electricity Tagged tlx Insp.-Sketch ert. of Occupancy Date /rjCard 6-1 Date Card B-1 Date Card B-1 ^ Date Card 13-1 r� MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 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 V OK O=Not OK r+ =Not yable Read Not Ready RESIDENTIAL (; ' = Date UNDERFLOOR (Plans) OK except ft'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-Blockouts-Wrapped 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 ti'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 DateCard B-1 --------------------- ----------------------------------------------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ft's _ 22. Fixtur_e_& Transformer Clearance -Ins. Protection 23. Elec. 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/Meth. Fastners-Bond Gas & Water --------------------------------------------------------- ------------------- 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI -------------------------------------------------------------------------------- 28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ! ! ga. Cu or At ------------------------------------ - --------------- ------------------------ 29. Range Circ. ! r ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral 0- Yes ❑ No --------- -- ----------------------------------------------- 30.- Service -Riser Conductors & Ground -Main Disconnect -------------------------------------------------------------------------------- 31. Equip_ Clearances Panels -Motors -Meth. 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 ti'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 ti's 39. Sils. Proper Material & Anchors ------------------------------------------------------------------------ 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound ------------------------------------------------------ 41. Bearing Walls over Girders & Floor Nailing --------- --------------------------------------------------------- 42. Draft Stop in Walls (rat proof) -------- ---------------------------------------------------------------- --- ---------- 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub ---------------------------------------------------------- -- 44. Headers & Beam -Size & Bearing 'ingle & Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. 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 ----------------Date _ Card B 1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except ti'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 & Rails--------------------- _ 68. Fireplace or Stove: Clearances -Hearth ------------------------------- 69. -----------------------------69. Elec. Outlets at Wood Panel: Int. & Ext. ------------------ - ---- 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter ----------- - - ----------g ----------------- ----- 72. Gara a 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 -Meeh. 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 Construction -Post Caps 79. Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth _ Clearance Looked under Floor ❑ Yes 80. Following instld._Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No; Planters _❑ Yes ❑ 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. ----------87. Glass Protection _.. --------------------------------------- 88. Corrections from Previous Inspections ------------------------------------------ ----------------- 89. Gas Test -Meters Tagged: Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates ------- • - ---- ---------------------------- Date --------- ---------------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: MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0. Address or location of mobilehome / 7 L–' 1 T U)-- 61Z Owner's name . J A nL , i A- ad c L_ Owner's address Insignia or hud number. Manufacturer's name_ > Serial rjumber of V.I.N. tia (Official L (+ ~ q,33 ng Installation Year ofnufac //m 1Co j 1 (Da4e) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION' ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MO.fILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS V 7 County Center Drive - Oroville; Califotnia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 036-172-001 ZONING R-1 BUILDING PERMIT OWNER Michael Su lita TELEPHONE 534-3814 ,SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 2291 Fort Wa ne Oroville CONTRACTOR'S NAME Executive Homes TELEP ONE 891- 92 CONTRACTOR'S MAILING ADDRESS 3042 Esplanade, Chico Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Penult fee $ 35.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF❑ Duplex❑ MobilehomeEX Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installationo Other ❑ Describe work: MHI 3 BEdroom Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of p y perjury iur y (Check One): 01"i am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions ode 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) ElI, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200A TO 1000A, 37.50 NEW CONST. ( DWELLING OCCUP.&\ 3.6Q sq.ft. OR ADDNS. ACC. BLDGS. // NEW CONSTR MULTI -OUTLET NON.RESID BRANCH CIRC ITS I @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APLNS. Ex. Occup. OUTLETS IPRESID IREA.) 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. 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 FiIingFee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all 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 Ifabi I ities, judgments, costs, and expenses which may in any way accrue again ' Count in con equ a of the granting of this permit. Date ��.� Signatur of Applicant — Wner ❑ 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 JCONST TYPE TOTAL FEE $ 105.00 HAz DFEE IMP Foo CDF PARCjrL I//IVI PO O t.- Iss This permit is hereby issued under the applicable provi- sions of the e C n Code and/or resolutions to do work ind• at a v f r which fees have been paid. I OF PUBLIC WORKS By Date/�� PERM EXPIRES Date �—( — Receipt No. 129541 WNITE-D.P.W., YELLOW-A88[;980R, PINK -INSPECTOR, GOLDENROD -APPLICANT rq . � � '' �yrl-r`}-."(>'�.U"r�rh.l..�r.e•. • I „+c. .'t}" �``r)`�+'r'}6•'sw+�Y�^^'"'ti-t, "sst. ..Y , ,.,;-I�:-�-�,v'" �r-. ' I` r t COUNTY OF BUTTE', "P.ARTMENT '� PUBLIC WO IMb- BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE CALIFORNIA 95965 - TELEPHONE (916) 538-7541 ' PERMIT APPLACATION DATA SHEET OWNER P No. Proposed Building Use Building Inspector 8'Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . ................. . 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... eesof$................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer. ............ . 1 . Sanitation and plot plan approval Health Department . ............. 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. ... . 20. Pre -inspection for P� I"ding In" �eq�r required. . . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification). ...:.......... 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner )......... .. . 24. Recorded copy of Agricultural Acknowledgement Statement . ................. . 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use. ....... ............................... . 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ........................................ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When , issue the permit, p ocess as follows: M to ow�yer. Mail to contractor. Telephone TJ�'/ permit hold for pickup at m- Ur office. Deliver with inspector. Other Parcel Creation Acreage Ap lisant 4� Date 3 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 is 1. Index permit for above items No. 2. Additional items required: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Plans checked by Date Plans approved by Date - J/ Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. -- 7 County Center Drive - Orovllle. California 95965 - Telephone: 816.538-7541 - APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 1 1 ZONING BUILDING PERMIT OWNER r_v0% AES Sv P�1TA TELEPHONESO. r,'3► _-3314 FT. OCC. BUILDING VALUATION OWNER'S "AILING AD�ESS Z2-011 O41xT v4 A r% G ea, -3.41 L\. E CONTRACTOR'S NAME TELEPHONE E-dEIt- v-rivC- \AVrnES 8'QII-��i`IZ CONTRACTOR'S MAILING ADDRESS -3o47- ES Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ ' LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS nT�n tAv � Permit fee $ � PLUMBING PERMIT Filing Fee 15.00 GZ-41vvf, Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEEl PARCEL MAP Water piping 7.00 Each pas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeJZJ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer Mobile Home Permit Fee Contractor 15.00 _ @ 15.00 $ 1 TYPE OF WORK New I Addition;_; RemodelC Utilities ❑ Installation V. Other ❑ Describe work: v k ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): {S 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profession 'Code and my license is in full fforrce andd effect. • License No. \ Z~2 Classification `�� / 1. as 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)Mobile ❑ 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 Main service 200ATOI000AI 37.50 DWELLING OCCUP.p,\' NEW CONST•OR ADONS. l / ACC. BLOGS. I 3.6a s0.fc. NEW CONSTR UL '*OUTLET NON-RESIP BR4NCH C,.0 Li ITS 5.00 POWER APPARATUS e SINGLE OUTLET CIR. #AL- EX• OCCUp(OUTLETS OR FIXTURES 79A FIXED APLNS. Ex. OCCUp. OUTLETS ( )-R*. I 3.00 Temporary service 15.00 Home Facilities 15.00 Misc. lyirin g 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. int I have placed on file with the County of Butte Building Department 4� 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 Cooling Hood 6.50 Ventilation Permit Fee __ $ Contractor I certify that 1 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 accrueHAZ against d County in consequence of the granting of this permit. X Date Signoture of Applicant _ Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over S'0" deep and demolition or Construct• ion of structures over 3 stories in height. Mobile Home Installation Fee . S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ /05,00 OFEES IMP FLOOD 4�� CDf ` PARCEL Po HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date ' applicable provi- resolutions to do have been paid. WORKS Date /Receipt No. WNIT E•D.P.W., YELLOW-ASSCSSOR, PINR•IN3PCCTOR. GOLDENROD -APPLICANT !'�_•�''r../�'V''i'�t4'3"'��r�"'�"w�"i�"`"``�1� �'�".�.-..�"-,�as...._..�,_.-....-._ `�y,.%,..K,•,t r��.�,,,.�...�,..7",T'4!7r't"w'7hr"'�"'^^7h`w''�.yi,tic`.'"4:ct"�i"'tr"""''§. r�'w:w- v.�, I School District BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One,Form Per Building) !2 0 e4d�5;0. 2 A.P. Number Jurisdiction Building Department No. City EE � County Property Owner A1f G /I A5� Property Location/Address % ?g % G �'�� q 6) Subdivison Lot No. Residential Development 0 [G Sq. Footage �TI No. of Living 'MHI @ Addition (Group R) Units Commercial/Industrial 0 0 Sq. Footage New Addition (Including Exterior Roofed Areas) . Z Building Departme epres ntative Date (Floor Plans reviewed by School District Personnel) District Identification No. / Is- 61 Z chool District certifies that / C� (Applicant) (Street Address) (Phone Number) (City) (State) (Zip has complied with the requirements of Resolution No. 91 - by payment of $ representing ; 13 V 74 square feet. X School District Representative Paid by Check Number Bank Number Paid by Cash Date r1�'t�►%IIII�'�l � � _ If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning -Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this.project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink ,(school district) feeform.wkf (4/92) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS.- BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 = TELEPHONE (916)5387541 )WNER /yl � SUpG /T� A.' P. N0. ,,9 7 Z )ROPOSED BUILDING USE DATE /l 3 REC . - -# DATE_ REC 1. School Distric Fees (paid at District.Office) .,, !)2. Sheriff Fees ` (paid at Building Department) Residential ..........' .%� _$ unit amt. Commercial(per sq.ft.) X =$ s .ft. amt. Urban Area Fees .(paid at Building Department Residential (per unit) 7i L"" I . a X =$ amt. Commerical(per sq.ft.) X, _$ / sq.ft. amt. 4. Recreation District Fees (paid at District Office) 5. Drainage District Fees (Contact Land Development) ......................... 6. Other 7. Other At time of permit application, I was advised the above fees are required to be paid pr:;-c7-- to rix-to issuance of the permit. DATE Aword< 'of a qu, Uniform the Nat 366- 7,, � This set of lans and specifications MUST be Xt_ kept on the job at all times and it is unlawft�� a— a any c anges or alterations on same with,. 77 741 out written permission from the DepartniW d - 1 - Publlc Works, County of Butte. C11 setback of 5 ft. from thee property lines and a setback of 5o ft. from the road ,centerline shall be clear of iiructures or equipment eX0W .fes a 2 A. eave overhang/4,-,O It Materials & 'Workmanship Shall Be in i with Recognized Good Practices and f prescribed for the -Specified use in the I'ding, Plumbing & Mechanical Codes and J Electrical Code. tUTTE COUNTY — --- --- BUIL NG MtoAn0 I APP 0,.)glz�evi: �S f -- MOBILE HOME MUST BEAR H.U.D. LABELS pole' �I GO II � CZ 9�j I dl v. I C -11 ry fO N BUTTE COUNTY 'DEPARTMENT .OF PUBLIC WORKS 7 County Center Drive., Oroville • CA " ' - — "•'••••'-•.� _,, ..... _ .. - -- . :',: :;PHON 538-7541' .._ :........_. ' T: .,: = : � .... .. .....:.:.::., MOBILEHOME INSTALLATION•SHEET ; ;'4 _ 7U:;:. -TA ..I. 1. Owner. s Name:. " SCE F S ;.. 2. Installer s Name: a 3. Is the site currently under permit? ' ' Yes " No. _.. ,.....:. (If yes, furnish permit number ) OR. -W Is the site an existing site? Yes � No (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach Yes No fields and clear of all setbacks and easements? (If no, clarify 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? -------- ----- Z 60 Amps 7, What is the mobilehome site circuit breaker rating? ----- �� Amps 8. Is there any other electric. load to be served by the o PI mobilehome site service? -------------------------------- Yes No (If yes, identify.the load and size: __(Load) (Amps) 9. What is the mobilehome site gas.pipe size? -------------- y (in.) .10. What'.'is the type of gas service? - ------------------ Natural LPG %C 11. What is'.. the gas pipe length from meter or tank to the ---------------- mobilehome? ----------------------------- 12. What is the mobilehome gas demand? „"` (BTU) than6 *(This .information not required If pipe length less : f. :.... natural gas , or .,less than 50 ft.�' on LPG, ) MOBILEHOME..SUPPORT DATA :- Mother than single wide, : Mobilehome Mfr. \ V +A. _ "furnish .-Setup'. Model :No. "" Year- :. Width 2 y (ft.) Box Length (ft:) Tagalong` or, Expando Size . e`' ft. x On all mobilehomes manufactured after;October.7, 1973, furnish manufacturer's Installation_* ---- manual and structural setup sheets '(if not -on.-f ile with."the :County of Butte)..... FO( INGS (check one)0j. 1. Wood -pressure treated or foundation grade. a 2. Other (specify)' SUPPORTS (check one)m1. Concrete block.a 2. Other (specify) Pier•Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE .r Line I Line Z+- — — �- — —Ma—in — — Main Beams' Line 2 Title — — Main Beams --- —.— — —_--� —Its Line 2 Line 1 Piers: Size-Min----------- Spacing-Max. -'------- Frnm Ends -Max. ------- L_Inc 2 "'era: Sfre-Min.------------ Spaclog-Max---------- From Finds -Max. ------- Tag or Triple line 4 r Line 1 Line 1 OveninRe: Size -Min. •- ------------- Each Side of openings With Width Over Line ] Piers: (Under Bearing Wall Only). Size-Min.------------------ uX u Spacing -Max - From Enda-Max,---- 1_lne. -1w,y[ wea 4 5_. ?I? OSS iFt * A\,t, L.oA� �%AQ, f e�-C� WAIA.S Size -Min .-------.....1 x �y —i —.x .x Location (From Front) S1LV-Mi n------------- Spot i,.g-Max---------- From Enda-Max.------- Line S Piers: (Under Bearing Walls only) Size -Min. -------- Spacing -Max ---------------- From Ends -Max -----------•-- '- .. • . r. , ox n —nx n �k a �k a �k a �.x �. nom•. , u �k n location /o RESIDENTIAL 36-172-01 - 2966-91P,E SUPLITA Michael 1959 Clinton AVe, Oroville- (mh util) JOB FINALE Signature 01 g4? qa- J1 OK O = Not OK Not = Not Readyable MOBILE HOMES .o Date MOQjkklE HOME UTILITIES (Plans) OK except #'s Zoniog Requirements -Setbacks -Easements of ;'Special MH Support Sketch ewer; Location -Test -Fall -C/O Concrete Wat ocation-Test-Easement Needed (Sketch) lectricity: Location-Clearences-Grnd- DAmp-Concrete as/Location-Test-Wrap: / /"L" ft. 20/"Nat. or/ /"L"ft./ /"LPG ce & Disconnect .2'utility Clearance Dat / /{/Card 6-1 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. Electricity; 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 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 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 -Panel boards -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 O=Not OK = Not Applicable Not Ready RESIDENTIAL (Single & Duplex) = Date UNDERFLOOR (Plans) OK except N's j 1. Zoning-Setbacks-Easements=Flood-Slope I 23. Elec. 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. Subfeed Wire Size / ga. Cu or AI-A.C. Wire Size ! / ga. Cu or AI 29. Range Circ. ! r ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No -------------------------------------------------- ------ ------------------------ 30. ---------- ----------------------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect --------------------------------------------------- ----------------------------- 31. 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 a's 34. -.A. -C.- Ducts Insulation & Support ----------------------------------------------------- 35. Vent Fan Exhaust above insulation ----------------------------------------- - --- - - -------------------------------- 36. ---------- -------------------------------------------------------------- 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 p's 39. Sils. Proper Material & Anchors - ---------------------------------------------------- ------------- ------------- ---- - 40. Walls Studs -Nailing Spacing -& Bracing -Plates -Sound 41 Bearing Walls 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-Rftr. ties-Purlin=roof Brac-Truss-Shthng.-Ring. 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 Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector ------------------------- - 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection ---------------- 64. Bedroom Exiting ---------------- 65. G F.I & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel: Breaker Sizes & Labels ---------------- 67. Stairs & Rails 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 C1Yes --- -- - -- - -- -------------------------------- 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco: Brown -Finish 82. A.C. Unit: Disconnect -------------------- ___ 83. Vents Above Roof: Plb( Openings Electrical, Plumbin Appliance -Fireplace. -Clearance to 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. ------- ------- ----------89. Gas Test -Meters Tagged; Gas -Electric ----------------------------------- 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: 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-Wrapped 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 ti'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 ---------------------------- Date Date 20. Test Tub & Shower, Second Floor -Tub Access ----------------- 21. Gas Pipe: Size & Anchors Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ti's 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. 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. Subfeed Wire Size / ga. Cu or AI-A.C. Wire Size ! / ga. Cu or AI 29. Range Circ. ! r ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No -------------------------------------------------- ------ ------------------------ 30. ---------- ----------------------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect --------------------------------------------------- ----------------------------- 31. 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 a's 34. -.A. -C.- Ducts Insulation & Support ----------------------------------------------------- 35. Vent Fan Exhaust above insulation ----------------------------------------- - --- - - -------------------------------- 36. ---------- -------------------------------------------------------------- 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 p's 39. Sils. Proper Material & Anchors - ---------------------------------------------------- ------------- ------------- ---- - 40. Walls Studs -Nailing Spacing -& Bracing -Plates -Sound 41 Bearing Walls 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-Rftr. ties-Purlin=roof Brac-Truss-Shthng.-Ring. 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 Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector ------------------------- - 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection ---------------- 64. Bedroom Exiting ---------------- 65. G F.I & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel: Breaker Sizes & Labels ---------------- 67. Stairs & Rails 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 C1Yes --- -- - -- - -- -------------------------------- 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco: Brown -Finish 82. A.C. Unit: Disconnect -------------------- ___ 83. Vents Above Roof: Plb( Openings Electrical, Plumbin Appliance -Fireplace. -Clearance to 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. ------- ------- ----------89. Gas Test -Meters Tagged; Gas -Electric ----------------------------------- 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: OWNER # cc c PERMIT it r,99�j �7 MH UZIL. CLEARANCE DATE - � � s✓�' � � INSPECTOR ELECTRIC GAS Support Struc. Compaction Test -Req. Service Size Other Load T e Pipe Size Length YESI NO YESI NO �� IA< ? -/� 1z( / r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT � PERMIT 0. ASSESSOR PARCEL NUMBER 36 -172-001 ZONING - R 1 BUILDING PERMIT OWNER MICHAEL SUPLITA TELEPHONE 534-3814 S.Q. FT. OCC, BUILDING VALUATION OWNER'S MAILING ADDRESS 2291 FORT WAYNE OROVILLE CONTRACTOR'SNAME NONE TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ Filin Fee g Q $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1959 CLINTON AVE OROVILLE Permit fee 15.00 $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 8 & 9 SUBDIVISION NAME HILL DALE UNIT SUB #1 PARCEL MAP / .— -V Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF [:1Duplex❑ Mobilehome [� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 0.00 ea 30.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities bD Installation❑ Other ❑ Describe work: MHU Permit Fee $ 40.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS) 10.00 10.00 Main service EA. ADD'L 100 AMP 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty p y of perjury y (Check One): ❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the BuslneSS and Professions Code and my license is in full force and effect. License No. Classification. 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.tr\ y:¢sgft OR DONS. ACC. BLDGS. / A NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS tr (SINGLE OUTLET CIR. I 50 Ex. Occup(OUTLETS OR FIXTURES eA 300 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 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. 1 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 agaI said County in consequence of the granting of this permit. X \ �� Date S�gnature of Applicant — Owne 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 - 2 TOTAL F $ .50 PARK SCHL F CDF PA PD 1 HD Iss This permit is hereby issued under sions of the Butte County. Code and/or work indicated abov f r which DII OF LIC By 10, �/{ PERMIT EXPIRES Date v v the applicable provi- resolutions to do fees have been paid. WORKS Date �7 1%7, Receipt No. 97422 92.50 WHITE-D.P.W.. YELLOW -ASS E33o R. PINK -INSPECTOR. GOLOENROO-APPLICANT I`% N ..•a, ",�'�i�^},,�a}t y,(j.�tti" Fr=�;�+ �r�i-'Y•.:,�...i't.' r3.,t'.,x .. COUNTY OF BUYTE DEPARTIIO "T F PUBLIC WORKS - BUILDING DIVISION �:JYOCJOY CENTER DRIVE=--_=1RO I:, CALIFORNIA 95965- TELEPHONE: 916/538-7541 • PERMIT APPLJUJION'DATA SHEET a Permit No. i OWNERG[�la e- veli 1C, - �' t1,0? -A. P. No. 72 " 00 Proposed Building 'Use /� N U building Inspector .-�'C� Date a„ At time of permit application_, I was advised the following data mosi, submitted prior to permit processing and/or issuance: + INV�� DATE RECEIVED APPROVED 1. All items have been submitted. ...r „ `'�� .... .. .:.... —1� 2. Plot plans in duplicate/triplicat ne by pr pare f ` ?_Z -i 3. Complete plans in>du;p)i6ate/tri�pIi,,ate sin by p��p4•14p ans .. / 4. Complete engineered plans an cf ��ICs✓wl wet si atu"rre 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 ,installationf/i instructions ....0 �... ....... ... ...... / `,t,, 10. Fees of $ ` r ' . �. f . r . '� r, :'ice 11. Chic �Ufban!Area fees pard .......... j Y { 12. Park fees paid .:r -..... �.� ........... ...... - 13. School p Vr"ibt 4es paid .. . - - Sanitation approval from A PUDHealth Department �� t 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) Pinning a royal for ( )Use:) �Paoin y N� 18 m1.provemen a^e retfuMd. �tagltld rev -6 01 p= ec for W riveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for - required Pre-inspec. request to Building Inspector` (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. \ 23: Owner -Builder Verification (Given to owner ❑, Mail to owner.. - - %i r' Recorded copy of Agricultural Acknowledgment Statement :.:...... R"�z" Letter of signature' authorization ................................... 5F -ZZ -C7 t 2-�2- 26. / 27. W OWen issue a emit, p " as follows: Mail owner. Mail to contractor. _rTele a,. oyd/for pickup at office Deliver w/ins ector. Other Applicant ate _�7/ 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; (C'ircle new item not checked above). 1. Index permit for above items No.' I i 2. Additional items required: eD e, +o issuer s o ® AT Contractor, designer, owner, was advised of above required,data bye ContracV,,des igner, owner, was advised of above required data byphone s checked by - -Date Plans approved by Sets of plans on hold in r File cabinet AP folder -.J Copy—DPW IA iI'_counter by r date v it counter by idMe'i-rY2W 70 Date i M l • � � TO: Building Department FROM: Encroachment Permit Section �► 4 RE: Driveway Clearance r owner location AP # Driveway permit �� 1 /il 7 G has been issued for the above property. dape' s i ature ^ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - TeieDnone: 916.,'538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMSER _36/%'2 001 ZONING _1 BUILDING PERMIT O WN E�j rI / i iIIL'ING TELEPHONE SO. FT. I OCC. tBUILDING VALUATION M-/A1/ OWNER'S AD RE 5 CONTRALTO SNAM E TELEPHONE j CONTRACTOR'S MAILING AOORE33 Fireplace CONSTRUCTION LENDER -e— e—LENOER•3 UNKNOWN Total Valuation 15 Filing Fee S 10,00 LENDER'SMAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER �INEER•S LICENSE NO. Plan Checking Fee a Energy Plan Checking Fee S ARCHITECT OR MAILING ADDRESS Penalty $ SUILDING ADDRESS Permit fee $ PLUMBING PERMIT FilingFee 10.00 - /� 6S Eacn Trao 2.00 Solar or heat pump water heater 20.00 LOT NO. +s SUB IVI310 NAME PARCEL MAP �Lj �— Water piping 5.00 Each oas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomeg Other SPECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 1. Mobile Home S W rry j10.00 ea _30 TYPE OF WORK New❑ AdditionL! Remodel❑ Utilities Installation❑ Other ❑ Describe work: 11A •H.U' Permit Fee $ Z7/0 ff Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6,00v OR L=SS f00 OR OR LESS I 10.00 �"� Main service EA. ADD—— 100 AMP I I 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) ❑ 1, 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 AOONS. ACC. SLOGS. I2+/zcsgfti NEW CONST NON.R�SIC. SPANC1.1 CIRC ) ITS I2.SOeal POWER APPARATUS e (POWER OUTLET CSR. ) I I EX. OCCUR( OUTLETS OR FIXTURES ,20 V5Ot l e.�_ ..OtI FIXE: APP LNS. OR EX. OCCuo. OUTLETS (RESIO., EA.) I 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 J UCS Misc. Wiring g I 15.00 Permit Fee S 37,10 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for S100.00 (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 FilingFee 10.00 Heating I Cooling Hood I 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, judgment costs, and expenses which may in any way accrue against said Co my in ns uence o tett granting of this permit I X Date Signature of Applicant – O-nerAW Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct. -an of structures over 3 stories in h% hit. Receipt No. l� qr) .5-1) ..,,,rc.o.P. W.. YU2w-Sec3300. -I RSPCCrOP, C0LDCHn00- PPI CAMr Mobile Home Installation Fee $ Energy Inspection Fee S occ I CONST TYPE —' TOTAL FEE S N4- :UA I PARK CML FLO COF PAH PO I I This permit is hereby issued unser the applicable provl- sions or the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Return to DPW AGRICULTURAL- STATEMENT OF AC,C1OWLEDGZ%ffiNT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1- of the Butte County Code requires this acknowledgement be- recorded prior to ,issuance of a building per 91-034700 The property described herein is adjacent to land or included within an area zoned Recorded for agricultural purposes, and residents Official Records of this property may be subject to incon- County of veniences or discomfort arising from the Butte use of agricultural chemicals, including, Candace J. Grubbs but not limited to herbicides, pesticides, Recorder and fertilizers; and from the pursuit 10:55am 22 -Aug -91 of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. tural zones which have as a priority use for productive within said zones and on adjacent property should be or discomfort from normal, necessary farm operations. I Rec Fee I Cash I I I i 1 I I X 5.00 5.00 1 Butte County has established agricul- agricultural purposes, and residents prepared to accept such inconvenience All that real property situate in the County of Butte, State of California, described as follows:,,n rYZG• Q_1(4 � � �d q � o_s 5r�� cam, � G� �e�c%^ \ 2c C? v ;G-5 Date: A v�y s+ Z y PROPERTY OWNERS- State WNERS:State of C (A- On this the day of 19 7 1 before me, the p ) SS. undersigned Notary Public, personally appeared County of ✓ Personally known to me. [yProved to me on the basis 0FRICI LSEAL # of satisfactory evidence. 1� L. LANCASTER r to be the person(s) whose name(,A S -%D NOTARGORNIA BUTTE OUNrsubscribed to the within instrument and acknowledged that h aurrei;F0WW t9.1994 executed the same for the purposes therein contained. IN WITNESS wY �f WHEREOF, I hereunto set my hand and official seal. Present A.P. No 17o", Notary Public PERMIT NO: -cc) -q, Lake Oroville Area Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95966 533-2000 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the.Butte County Department of Public Works Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by Lake Oroville Area Public Utility District, must be submitted to Butte County. Date: August 21F 1991 Applicant: Michael Suplita, Jr. Applicant Address: 2291 Ft. Wayne St. , Oroville', CA 95966 Applicant Phone No.: 534-3814 Property Location (s): 1959 Clinton Avenue Hill N Dale Subd. Unit No. 1, Lot 8 A. P. No. (s): 036-17-2-001-0 Fees due: All fees paid. Application for service approved: LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: Date: Lake Oroville Area Public Utility District release to close permit: Date: By: COUNTY OF BUTTE - Dep2r.tment of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: L An 'owner -builder" building permit has been applied for in your,name and bearing your signature. 1 Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) I`D,� (/e- signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. )I plan to provide portions of thip work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: < Property Owner Social Security Number - - Date /. NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mittled to is��hermit. p I --3470G Return to DPW AGRICULTURAL STAM ENT OF A00TOWLEDGEMNT FOR RESIDr^I, `!TIAL DEVELOPMENT Section 26-8.1- of the Butte Codnty Cade requires this acknowledgement be recorded - prior to.'dssuance of a building permit . I 91-034700 1 Rec Fee 5.00 The property described herein is adjacent 1 Cash 5.00 to land or included within an area zoned Recorded I for agricultural purposes, and residents Official Records:. I of this property may be subject to incon- County of I veniences or discomfort arising from the Butte I use of agricultural chemicals, including, Candace J. Grubbs I but not limited to herbicides, pesticides, Recorder I and fertilizers; and from the pursuit , 10:55am 22 -Aug -91 I X 1 of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All That real property situate in the County of Butte, follows: t_o�S 4S cnc�. q. 0.S • 0C) . \ 1 0A Date: A ✓y✓sl Zi I W State of County of � CA_ /I � - ) 6 v4 > State of California, described as PROPERTY 014NERS : Z' J."4zz:z On this the Z%5� day of)- , 19 °1I before me, the SS. undersigned Notary Public, personally appeared OFFICIALYO A NOTARY r 1gw,BUTTE COUNTYr Present A.P. E] Personally known to me. -Proved to me on the basis of satisfactory evidence. tobe the person( whose name ( JS subscribed to the within instrument and acknowledged that 2 executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ZZ No 67 END OF DOCUMENT Votary Public PARCEL CHECK LIST AND REQUIREMENTS Owner , Telephone No. Permit No. 2?(0(o- 9/ A. P. No. :3(o -17a. -oo 1 Date -$-Z(.- ?/ 1. Parcel creation Map Book _ Page �_ �(,p� $ Act V Legal Parcel Creation date 60' R/W Certificate of Compliance Other (Specify) 2. Parcel .created by subdivision map prior to July 1, 1949 17-23 Parcel size is less than 5 acres Parcel exempt from items 3, 4, and improvement requirements 3. Minimum Parcel Size (must meet zone or) Parcel meets frontage and area requirements of zone Parcel does not meet frontage and area requirements of zone or Parcel is merged pursuant to Section 20-180.2 Parcel has vested right to develop 4. Legal Access Parcel fronts on publicly maintained road Ck�...4oa (Road Name) Parcel does not front on public maintained road (Road Name) Documentation on legal access required (must be by Title Co. or licensed engineer or surveyor) Documentation on legal access submitted and accepted. Copy of torm sent to Land Development for improvement requirements 2-2&-9/ (Date) Copy of form sent to Building Department QRoad Improvements not Required' Road Improvements Completed and approved for Building Permit Issuance Date By 7/26/91 r ' 'RESIDENTIAL 036-17-2-001---_.__ - 9_3761 SUPLITA, MICHAEL. ~'' 1 CONTR OWNER 1959 CLINTON AVE, OROVILLE NEW GARAGE I JOB FINALE Signature V = aK O = Not OK = Not Applicable Not Ready MOBILE HOMES ' = Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 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 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s ."I'Zoglag Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 2-Beolcs►Criders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wesd.Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 59-- r . Awn.; Columns -Connections -Splice -Decal -Enclosures B�Gsrpmrts; Windows -Doors rmg; Sils-Anchors-Studs-Rftrs-Trusses _ge-8'ding; Nailing -Veneer -Stucco -Mesh Roof; Shthg-Roofing Ext.; Steps -Doors -Landings Date Card B-1 Date � — ZCard B - Date' ZjCard 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 -GF] 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 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. Electricity; 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 ."I'Zoglag Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 2-Beolcs►Criders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wesd.Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 59-- r . Awn.; Columns -Connections -Splice -Decal -Enclosures B�Gsrpmrts; Windows -Doors rmg; Sils-Anchors-Studs-Rftrs-Trusses _ge-8'ding; Nailing -Veneer -Stucco -Mesh Roof; Shthg-Roofing Ext.; Steps -Doors -Landings Date Card B-1 Date � — ZCard B - Date' ZjCard 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 -GF] 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 V OK O=Not OK = Not Applicable Not Ready RESIDENTIAL (; ' = Date UNDERFLOOR (Plans) OK except k's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 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 ft'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 DateCard B-1 ------------------- -------------------------------------------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection ---- -------------------------------------------------------- 23. Elec. 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. Subfeed Wire Size t ga. Cu or AI-A.C. Wire Size r / ga. Cu or Al --------------- ------ -------------------------------- -------------------------- ---- 29. Range Circ. / t ga. Cu or AI -Oven Circ. / ! ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No --- ------ - - ---- ------- ------------------------------------- 30. ------------------------------ 30. Service -Riser Conductors & Ground -Main Disconnect --------- - ------------------------------------------- 31. -Equip. -Clearances Panels-Motors-Mech. Equip. --------------------- ----------------------------------------------- 32. Clothes Closet Light -Shower Light -Spa Light --- -------------------------------------- ------ ------ --------- 33. Smoke Detector --------------- ----------- ----- ----- -------------------------------------------- Date ------------------------------ Date Card B1 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. CondenFate Drain & Overflow: Size & Grade 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet ------------ -------------------------------------------------- ------ 33 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 ft's 39. Sils. Proper Material & Anchors --- ---- -------------- - --- --- ----------- - -- 40. Walls Studs -Nailing Spacing-&. Bracing -Plates -Sound --------------41.-Bearing--Walls-over- Girders- -& --N-Floor ailing -------------------------------------- 42. Draft Stop in Walls (rat proof) ----------- ---------------------------------------------------------------- ----- ----- --- 43.- Fire --Stops: Furred Ceilings -Stairs -Chases -Tub -- ------- ------------------------------------------ 44. Headers & Beam -Size & Bearing >Ingle & Duplex) Date FRAMING (Continued) - 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-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. ----- ---- 60. Infiltration -Walls -Windows -------------------------------- - Date _ _Card B-1 'Date Card B-1 Date Card B-1 Date -Card B-1 Date FINAL (Plans) OK exceptg'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.- ------ -- 65. -G.-F-.I. & Bath Fixtures & Tub Access -Spa -------------- 66. Elec. Trim & Subpanel; Breaker Sizes & Labels ---------------- ------------ ------------ -------------------- 67. Stairs & Rails 68. Fireplace or Stove: Clearances -Hearth --------------------------------- - 69. Elec. Outlets at Wood Panel; Int. & Ext. -- --- - ------------------- 70. - ----------------------------- 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 -Meth. Protection ------------- 75. -----------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 Construction -Post Caps 79. Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth ------------Clearance Looked -under Floor--- ❑ Yes ------------------------------------ - 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No ---------------- -- 81. Stucco Brown -Finish 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. -- ------..----------89. Gas Test -Meters Tagged: Gas -Electric ------------------------ ------------ ------------- --------- - -------- ----------- 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates ------- - - ------ -- ----------- Date Card B-1 ----------------- DateCard -1 -------------------------- ------------------- Date Card B-1 Comments at Final: ------------------- Date Card B-1 Date Card B-1 Date Card B-1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AN1r PERWiT PERMIT NO. ASSESSOR PARCEL NUMBER 36-172-001 ZONING R 1 r BUILDING PERMIT OWNER MICHAEL ANDREW SUPLITA TELEPHONE 534-3814 SO. FT. OCC. BUILDING VALUATION 576 M 10,368 OWNER'S MAILING ADDRESS 2291 FT WAYNE OROVILLE CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 105.00 ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 52.50 Ener Plan Checking Fee Energy g $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1959 CLINTON AVE OROVILLE Permit fee $ 172.50 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. 9 SUBDIVISION NAME PARCEL MAP Water piping1 7.00 Each etas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other GARAGE SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New [� Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 Main service 200A TO 100M 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License :Jo. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.a+\ OR ADDNS. ( ACC. BLDGS. 3.60sq.ft. NEW CONSTR. ULT(.OUTLET NO N.RESID BRANCH CIRCUITS) @ 5,00 (POWER APPARATUS e) (SINGLE OUTLET CIR. Ex. Occup(ouTLETs OR FIXTURES 20 764 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin g 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 FiIingFee 15.00 Heating Cooling g Hood 6.50 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all 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. 1 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 copse enc of the granting of this permit. X ? V Date Signoture of Applicant — Own 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 S Energy Inspection Fee $ OCC coN Y TOTA FEE $ 172.50 HA DFEES I IMP f D I CDF PARCEL I PD -• I HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees ,DI EC 'R OF PUBLIC By r . P IT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date/- –'t 1--v Receipt No. 101 374 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT lim \ ` COUNTY OF BUTTE'- DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE-.O.ROVIL"LE, CALIFORNIAi95E65�.�TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET OWNER Proposed Building Use 1_ l w Permit No. Building Inspector Date a vl 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 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. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ..... ZQ 07_-2 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the perm22i,tjj proces as follows: Mai to owner. Mail to contractor. Telephone SJ7" and hold for pickup at UrQ office. Deliver w/inspector. Other ApplicantNc Date C) Qa -q 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--nail—counter by .date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by 0;ed— Date a '� 5 Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916:'538-7541 APPLICATION AND., PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER a. - o ZONIN BUILDING PERMIT OW MR LhCk\ \ TEL PHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING AIDDRESr �- 95-70 5 CONTRACTOR'S NAME TELEPHONE C NTRACTOR• MAILING ADDRESS Fireplace CONS 1UCTION LENDER ✓A`// UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 1.55,00 Permit Fee $ AR H TECT OR ENGINEERLICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS f Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT N SUBDIVISION NAME 7 PARCEL MAP Water piping - 7.00 Each qas water heater or vent 7.00 If USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 - Mobile Home S G W 615.00 TYPE OF WORK New Addition 11 RemodelUtilities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 ,1 Main Service 600V OR LESS 18.50 200A OR LESS Main service 200ATO1000A, 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business ' and Professions Code. and my license IS In full force and effect. License No. 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.&\ 3.60 sq.tt. OR ADDNS. ACC. BLDGS. II NEW CONSTR. MULTI -OUTLET BRANCH CIRC ITS � 5.00 /POWER APPARATUS &) e l SINGLE OUTLET CIR. Ex, Occup( OUTLETS OR FIXTURES 20 9 76d FIXED APLNS.❑ Ex. (RESID.)REAJ I 3.00 Ex. OCCup. OUT LE Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g '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 FiIirig Fee 15.00 Heating Cooling 9 Hood 6.50 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date signature of Applicant — Ownerg Contractor ❑ Agent ❑ An OSHA ion of structures toverr3gstoriesoineheigvfOttions over 5'l1" deep and demolition or construct- Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST TYPE TOTAL FEE $l ,S� I HAz DFEES IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS Date PERMIT EXPIRES Date Receipt No. /0� t6By WHITE-O.P.W. OR, P NR•INSPECTOR, GOLDENROD -APPLICANT C7 r utaeounty LAND' OF NATURAL WEALTH AND BEAUTY = ) DEPARTMENT OF PUBLIC WORKS WILLIAM (Bill) C.HEFF, Director u d 7 COUNTY CENTER DRIVE t OROVILLE. CALIFORNIA 95965 Telephone: (916) 538-7541 RONALD D. McELROY Deputy Director RE: Building Permit No. Expiration Date (A.P. No. ) With reference to the above subject, our records indicate that your Building Permit on the above date. Building permits are valid for one year and should construction be started but not completed by the expiration date of the permit, the permit shall be renewed for 2 the original Building Permit Fee (plus a $10.00 "Filing Fee"). The renewal permit will extend the Building Permit for an additional year from the original expiration date. Should you not renew your permit within thirty days of the expiration date, it cannot be renewed and all work must cease until a new building permit is issued. If your construction is completed or should you have any questions concerning this matter, please contact the office. For your convenience, we are enclosing a renewal application form and owner - builder form to be completed and signed by you where indicated and returned to this office together with the fee shown. Please return all copies of the application form. Thank you for your prompt attention concerning this matter. JFG:aam Attachments: Permit Application Owner -Builder Information Owner -Builder Verification cc: Building Inspector - Yours very truly, William Cheff Director of Public Works 4�lGlander ie-f Building Inspector Chico - 196 Memorial Way/891.-2751 Paradise - 745 Elliot Rd./872-6307 COUNTY OF BUTTE - Depart Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 " OWNER -BUILDER VERIFICATION Attention Property Owner: _ An 'owner -builder" building permit has been applied for in your name and bearing your signature. 1 Please complete and return this information at your earliest opportunity to avoid unnecessary,delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the ma' labor and mater'als for construction of the proposed property improvemen yes r no) 2. I (have/have not)'ZA & 49' signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. ,I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5.' I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner Social Secur'ty Number -- Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit.