HomeMy WebLinkAbout078-200-009SPECIAL INSPECTION 92-52
9/21/92
DOLORES RUDOLPH
5640 Farley St, Oroville
Permit#695-86B,P,E,M(addition/SF)
PPermi�30-86B,g,E add laundry/SF)
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Dolores Rudolph
5640 Farley Street
Oroville, CA 95966
Dear Ms. Rudolph:.
September 21, 1992
RE: Special Inspection #92-52
(A.P. #036-37-0-009)
With reference to the above subject and your request for inspection of the
woodburning stove at 5640 Farley Street, Oroville, the inspection was made
August 18,1992.
tb The woodburning stove was installed without permits, so we were not able to
perform the required inspections.
We made a -reasonable visual inspection and found the woodburning stove appears
to conform to the intent of;code requirements. '
This inspection by the County of Butte does not act as a guarantee or warranty
on the woodburning stove.
Should you have any questions concerning this matter, please contact David
Purvis of this office at (916)538-7541.
DP:dms
cc: Assessor
Building Inspector, Oroville
e
Yours very truly,
David Purvis
Supervisor, Building Inspection
File No.
BUTTE COUNTY (For Action 1, 2, 3)
Public Works Dept. (For Information or )
Director
Dep. Dir.
Sec.
Rd. & Br. Mtce.
Shop & Yards
Bldg. Insp. Admin.
Design Engr.
Bridge Engr.
Constr. Engr.
Surveys
Mapping
Transp.
Land Dev.
Drng. /S.I.
Sub. & Pcl. Maps
Permits
Addr.
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1'•�w-r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, California 95965
* Telephone: 538-7541
APPLICATION FOR SPECIAL INSPECTION
qo,,-5z-
t
Mailing Address T69 �� � ,. `� S Telephone No
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Mailing Address
Building Location 5 6 0 rU- L E 'f S -.-r DUD
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I hereby request a special inspection of the following building:
1. Dwelling (if only a portion, specify)
0 2. Apartment House (if only a portion, specify)
3. Commercial (specify present occupancy)
4. Other (specify) WOOASToyc ((
WoQCT, s-�o� �aS o� vaa,j, c1�4'�c,�d 5 6� w� req���c�X GlGu�awces'.
I am requesting a special inspection foY the purpose of:
--T—"-- p L--� r�e,g-es
1. Moving the building.
iS c` old Po+ belly fYpc trtr S u �l a�pea�e •fry I; o'K
2., Financing (specify agency) 7 -ase No. '
3.
Change of occupancy to 4
4. Other (specify)
•I hereby certify that I will obtain the necessary permits and make any necessary correc-
tions, alterations, or repairs required by the County of Butte, as a result of this inspec-
tion, to comply with building and._ housing code requirements. I also certify that prior
to the use or occupancy of this building, I will complete the above required corrections,
alterations, or repairs, or, if the building is presently occupied, I will complete the
above required corrections, alterations, or repairs within 30 days.
I certify that I have read this application
and hereby authorize representatives of the
mentioned property for inspection purposes.
Signature of Owner
Fee Paid $
1st-DPW/2nd-Inspector/3rd-Applicant
and state the above information is correct
County of Butte to enter upon the above -
Date (.
Receipt No. / 3
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COUNTY OF BUTTE'-.. MENT OF PUBLIC WO F - BUILDING DIVISION
-, "f''
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER T,)V L_oK a S
Proposed Building Use P G
iZ V OO L i0 -H
No.Q-tD
N S Building Inspector
At time of per Qxit 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. ...........
10. Fees of $ ..........................................
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 . ................. .
14. Sanitation and plot plan approval Health Department . .............
15. City of Chico plumbing permit .....
.
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. ... request
20. Pre -inspection for to Bussing Ins ct
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 you issue the permit, process as follows: Mail to owner
Telephone and hold for pickup -at'
Other r.f
Parcel Creation
Acreage Applicant
Mail to contractor.
- office. Deliver with inspector.
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date
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:
to
By
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
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
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
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
S0. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $ 155.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
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
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G I W I @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑
Describe work:
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200A OR LESS 18.50
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
17-7(
IX
I`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
Main service 200ATO1000A, 37.50
NEW CONST./ 3.60 sq.ft. DWELLING OCCUP.&)
OR ADDNS. ( ACC. BLDGS. I
NEW CONSTR ULT LOUTLET
NON-RESID BRANCH CIRC ITS @ 5.00
(POWER APPARATUS a,)
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20@76d
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESID.) EA.1 I 3.00
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 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 liabilities, judgments, costs, and expenses which may in any way accrue
agns .s Co my in conseque e g nti of this permit.
X e (,
$ignature of Applicant — Owner � Cont for ❑ Agent ❑
An OSHA
ion of structures toverr 39 stories ineheight ions o S'0" deep and demolition or construct-
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
HAz
1 0FEES I
IMP
FLOOD
I CDF
I 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
BY DatePERMIT EXPIRES Date
Receipt No.
WHITED. P. W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
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_ C LINTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND'RERMIT
ASSESSOR PARCEL NUMBER
_
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
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
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
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G 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
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
F -1I 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
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)
❑ 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
Main service 200A TO 1000A) 37.50
NEW CONST. ( DWELLING OCCUP.&\ 3.6Q sq.ft.
OR AODNS. ACC. BLDGS. I
NEW CONSTR ULTI-OUTLET
NON -RE BRANCH CIRC ITS @ 5.00
(POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20 @ 7614
FIXED APPLNS. OR
EX. OCCUp. OUTLETS (RESID.) EA.1 I 3.00
Temporary service 1 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.
rVf I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 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 County or
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
ag ns• s Co my in conseque o e g anti of this permit.
f
Xot-e Y
of Applicant — Owner �J Cant a for ❑ Agent [:]
An OSHA -1
F is required for excavations o 5'0" 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 $
HAz
DFEES
IMP
FLOOD
CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the applicable provi-
sionsSignature of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By DatePERMIT EXPIRES Date
Receipt No.
i
WNITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
• 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
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
S0. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
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 $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
UBDIVISION NAME
is
PARCEL MAP
Water piping 7.00
Each pas water heater or vent 7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other
SPECI FY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home I S I G JW I@ 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
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
Imo-{
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 IOOOA, 37.50
NEW CONST./ DWELLING oCCUP.&\
( 3.60 sq.ft.
OR ADONS, ACC. BLDGS. /
NEW CONSTR ULTI-OUTLET
NON.RESID BRANCH CIRC ITS @ 5.00
POWER APPARATUS 6l
(SINGLE OUTLET R. I
Ex. OCCUp(OUTLETS OR FIXTURES 20 76
FIXED APPLNS. OR
Ex. Occup. OUTLETS IRESID.1 EA.) 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 Filing Fee 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.
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
agal SC said Co my in consequen(% o(Yt/h'e granti g of this permit.
)( ��) e 9 (� )•-
/ ❑
Signature of Applicant — Owner � Cant tor for ❑ Agent
An OSHA permit is required for excovations ova S'i)" 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 $
HAz
1 OFEES I
IMP
I FLOOD
COF
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
By DatePERMIT EXPIRES Date
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
.: sz.s'.; x --r: •^.it��- :._._. _ _. .. :/fit 'a8e r :a. _ .�,. _. ,
. `..,.�.�, t,a..-'-riw'`�--•-rti�—.".✓✓ti'r-. L,��tir.,,�......t,..,,,y�.• `u --...-r+
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California.95965 - Telephone: 916/538-7541
APPLICATION ANb'.PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
TELEPHONY
,
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
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 $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $
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 1 7.00
Each Qas water heater or vent 1 7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 1 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 600V OR 200A OR LESS 18.50
Main service 20GATO 1000A, 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)
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
NEW CONST.ADONIS.( DWELLING OCCUP.&\ 3.6Q sq.ft.
OR ADDS. ACC. SLOGS. /)
NEW CONSTR MULTI -OUTLET @ 5 00
NON•RESID BRANCH CIRC ITS
POWER APPARATUS IN
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20 764
Ex. Occup. OUTLETS (RESID IED APPLNS. REA.) 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.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 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.
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
againstsaid County in consequent// -le o((t'ihe granti g of this permit.
X � .. !Rafe �' / r Y,
""'" w / r
Signature of Applicant — Owner W Contra for ❑ Agent ❑
An OSHA t
ion of structures toverr39storriesoineheigvht Ions Ove 5'0" deep and demolition or construct-
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE TOTAL FEE $
I
HAz
I DFEES
I IMP
I FLOOD
I 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 j
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By DatePERMIT EXPIRES Date
Receipt No.
WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building per has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing 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) PI_signed an application fora building permit
for the proposed work.
3. I have contracted with the foll'owing.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 S;.it'
Date /
I
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
-19832 of the- California Health -:and-.Safety•.Code.t.--• >- - - -
This verification must be completed and'returned to our office before we are per-
mitted to issue the permit.
PERMIT NO. 1030-86B,P E
PERMIT EXPIRES
OWNER DOLORES RUDOLPH
CONTR. owner
ASSESSOR PARCEL 36-37-9
LOCATION _ 5640 Farley St, Oroville
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
Temp. Gas Ser i—
Cal led PC
JOB FINALE[
fi Signature
SIA.
a,
,i
r,
c
PERMIT NO. 1030-86B,P E
PERMIT EXPIRES
OWNER DOLORES RUDOLPH
CONTR. owner
ASSESSOR PARCEL 36-37-9
LOCATION _ 5640 Farley St, Oroville
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
Temp. Gas Ser i—
Cal led PC
JOB FINALE[
fi Signature
SIA.
V = OK
0 = Not OK
= Not Applicable MOBILEHOMES
* = Not Ready
41.1. ,
•MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
_
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts- Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat.or/ - /"L"ft./ /"LPG
7. Utility Clearance
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7., Elec.
Card -BI
Date Card - BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Card -BI
-Date
Date Card -BI Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4• Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/0 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater ;
8. Gas and Electricity Tagged -
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval -
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
- Date Card -Bl 'Date,
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
V -2 OK'
0 = Not OK
= Not Applicable
* = Not Ready RESIDENTIAL (Single and Duplex)
Date
UNDE FLOOR Plans OK except#'s
Date FRAMING (Continued)
Zo ' g requirements -Setbacks -Easements
rop Line Firewall & Openings
40
tg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
xt. Doors -One 3'-Check'Garage-3rd story, 2 exits
3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth
idth-Headroom-Rise-Run-Landing-Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depthywood
on Roof Overhang -Attic Vents -Rafter Outriggers
. Stemwalls, Ma•in;Steel-Blockouts-Wrapped-S
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
5d__Stat.'C"esh-Drip Screed-Fdn. Vents-Underflr. Access
7. Pi Fireplace Ftg.-Steel
rea-Glass Protection -Skylights -Plastic
>7 -
W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
a s; ailing -Bolts
9. Gas Pipe; Size -Anchors
10. Water Pipe; Test -Anchors -Regulator -Service Test
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. -Girders-Sills-Anchor Bolts -Joists -Vents -Cripples
C Dat Card -BI Date
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Card -BI
DateS-6Card-BI Date
Date FINAL�Plans) OK except N's
C -BI Date _ Card -BI Date
Date
_
PLUMBING (Permit) OK except q's
14. W58.
t.; Vent -Access -Combustion Air
�Ex�ps-Door & Sidelight Protection -Landings
57. moke Detector
Furnace- V omb. Air -Connector -
n Garage; Above Floor -Ducts -Meth. Protection
LIS Pipe; Test & Anchors -Nail Protection
. D. t-Fttngs & Anchors -Nail Protection
m xiting
_
7. Shower Paten; Test, First Floor -Tub AccessaFixtures
& u ccess
6 ec. Trim & Subpanel; Breaker Sizes -Labels
18. Nest Tub & Shower, 2nd Floor -Tub Access
_
1 Pipe; Size & Anchors
ails
_
_4'9_x_
e or Stove; Clearances -Hearth
6 . Elec. Outlets at Wood Panel; Int. & Ext.
-BI
Date I Card -BI Date
ixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
c. utlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except q's
ire Door; Swing -Landing -Closer
GaraiJ-damper
20. Fixture & Transformer Clearance -Ins. Protection
6 Wtr�. Ht/r.- Vents -Clearance -Comb. Air-Connector-P.R.V.-
In � Above Floor-Mech. Protection
_
�_ _Receptacles Spacing -Lights &Switches at Doors
ize_oxes & No. of Conductors -Stapled
7 Ib., Elec. & ui . Listed for Location
eceptacles in Garage; (G.F.I.)-Romex Protec.
3. o Installed Close to Edge of Studs & C.J.
--
. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
-o_o ed in Attic ❑Yes
7 ai s &Deck Construction -Post Caps
—
cults in Kitchen &Conductor Size
26.- SO4ieet11ri?e Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
74. Fdn. Vents & Cra ,L,yo Door -Drainage & Wood -Earth Clearance
o -Med under Floor ❑ Yes
irc. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI,
-
Insulated Neutral !_,Yes El No
75. Fo jaglas4-1d-.�--Drive E] Yes ❑ No; Walks ❑ Yes ❑ No;
gw
Planters F-1 Yes [J_ No
_?J_.Seser Conductors & Ground -Main Disconnect
- nisfi-
29�E�nip�T earances; Panels-Motors-Mech. Equip.
nit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30:-r:'leH"&,&leset Light -Shower Light
- - - -- —9.
7C
LAr66-I�/Date ard-BI Date
Card B-1 Date Card -BI Date
78. nts Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
WNW ell; Disconnect, Electrical, Plumbing
-09-Estecie 1ec. Trim; G.F.I. Receptacle -Underground
_44-�iT'o� throughout House
_82-ass,Protection
Date
_
MECHANICAL (Permit) OK except q's
31. A.C. Ducts: Insulation & Support _
32. Vent Fan; Exhaust above Insulation _ _
33. Condensate Drain & Overflow; Size & Grade _
_
83 ' ctions from Previous Inspections
' qrGas Test -Meters Tagged; Gas -Electric
er Connected -C/0 to Grade -HD Approval
86' --Energy Compliance Certificate -Other Certificates
Card -BI
Card -BI
34. Furnace -Vent: Access -Comb. Air -Return Air Vent -_115V outlet
35. Attic Access & Platform if Furnace in Attic
Date Card -BI Date
Date Card -BI Date
Card -BI ate rd -BI Date
Card -BI Pate Card -BI Date
Card -BI Date Card -BI Date
Date
FRAMI Plans) OK except q's
Comments at Final:
_
Sill per Material & Anchors__
al s-N_ailing_Spacing & Bracing -Plates_ -Sound
3 ear' Walls over Girders & F_loo_r_N_ailing-
3 raft Stop in Walls (rat proof)__
ire Stops: Furred Ceilings -Stairs -Chases -Tub
_
& Beam -Size & Bearing
^^ Post Caps -Anchors -Connectors
Ing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfnq.
Ties or Type A Flue -Fireplace Throat
,; c�cess: Size &Romex Protection -Draft Stop -Ins. Baffles
. endows or Exiting Doors-_Sill_Hg_t. & Dimensions___ _
4•ir-9erage'F1re Protection Framing _
T
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE -
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECTION NOTICE
will
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
Inspector \ "2aA,—
Date
I
_ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS QPERMI�TN O
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSE S R PA EL MBER
_
ZONI
BUILDING PERMIT
0WNTELEPHONE
r
- 9S
SO. FT. OC BUILDING
VALUATION
OWNE 'S :MAILING AD-�iESS
I I NrCT O 'S N AM E
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTR C' ION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHIT T OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS —
Permit fee
$
x10.00
PLUMBING PERMIT
Filing Fee
Each Trap
1 2.00
V _
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00 !J
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W I
h 0.00 ea
TYPE OF WORK
New ❑ Addition10 Remodel ❑ tilities ❑ Installation❑ Other ❑
Describe work: /llll���� ed j/+ _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LI ENSE 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
lk� 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
OR ADDNST ( OWEACCLBLS.DGOCC 1/4sgft
NEW CONSTR. ULTI.OUTLET 2,50 ea
NON.RESID BRANCH CIRC ITS
POWER APPARATUS e)
SINGLE OUTLET CIR.
EX. Occup(OUTLETS OR FIXTURES eAL090
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
7 ❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
dof 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.
1 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
again said County in conse uence of the granting of this permit.
X Date /11311?,
Signature of Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee .
$
Energy Inspection Fee $
TOTAL PERMIT FEE $ l
occuP.
CONST.TYPEJ
FL.000
AR,
v
PD ND Is3u
r
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR PUBLIC
a
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
,—p .� /
Receipt No. `7 O A62
WHITE-D.P.W.. YELLOW-ASSE330R, PINK -INSPECTOR. GOLDENROD -APPLICANT
a
b
COUNTY OF BUTTE - DEPARTMENT,OF� PUBLIC WORKS !'BUILDING DIVISION /
— t4 t ti,
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541
l_ ..f
PERMIT APPLICATION DATA SHEET
% Permit No.—
OWNER
o. OWNER 1O ✓ F Su I A. P. No.
Proposed Building Use V
Permit Fee Based Upon: Complete Contract Price / DPW Valuation
Other-( x I )
Building Inspector Date Zj2 V
r
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or issuance: / DATE RECEIVED APPROVED
i All items have been �submitted . , :by
Plot plans in u lic teAriplicate. ` .
>�I,y�����
Complete plans in uplicate riplicate. (�
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
9. Letter of signature authorization. . . . . . . . . .
10. Sanitation approval from Health Dept. . .
11. Planning approval for (A) Use: (B) Parking: .
12. CertI"c to of Workmen's Compensation Insurance.
Co actor's License Information (no., name style, classif.)
Owner -Builder Verification (Given to owner, Mail to owner)
5. Improvements may be required. . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . .
17. Pre -Inspection for Required- BuildingPre-Insp
request to (Date)
p q Building Inspector
18. Recorde o f Ari u t ral Acknowledgment Statement . ,
19. Other Dk FEMAf P tN[eL� Construction approval required prior to occupancy)
When you issue the pe;
Telephoned
Other
p ges,as follows: Mail to owner. Mail to contractor.
UU and hold for pickup at 0V'0 office. Deliver w/inspector.
��
Date ?/ S
CoOv of plans sent Health DeDt..Fire Dept:: .' GOther Date
During the plan checking process, the following data must be
(For required items not checked above at ,ime
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by
Plans checked by_
Plans approved by
Other
Copy–DPW
ubmitteo prior to permit issuance.
application, circle item.)
Telephone 0Mail Other
By Date
Date
-Date -2_5'
U�
'COUNTY -OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541
OWNER -BUILDER VERIFICATION'
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this.information at your earliest opportunity to avoid
unnecessary delay in processing and issuing 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) 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
o coordinate, supervise, and provide the major work:
Namey.c�� o _
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:
Prope
Socia
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must -be completed and returned to'our office before we are per-
mitted to 'issue the permit.
,a3 0-
:3 C, -, -3
_3C,-,-3
Doloros Rudolph
5640 Farley Street
Oroville, Ca. 95965
O
13' 81'
O n 1
N 11 . 610
W .L � �
v `q MAh ��� �;� �,Ny
R000�S '40. 9"
Rccm_ J
-Patio "'
.
N
CO
0
O�
N
W
N C
2 —*+ lD
C
O
13' 81'
O n 1
N 11 . 610
W .L � �
v `q MAh ��� �;� �,Ny
R000�S '40. 9"
Rccm_ J
-Patio "'
0
fD O -•
N C
2 —*+ lD
C
N
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3
3 O w '"%%.�
O �C_
m 3
a, cD
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9'
L
(� X
°, a m
fD
OL
Lincoln Highway
PRO Vero
SP 06-�..a
O P,t
-rrN6
24 "fe
-ov�oE Socsr
. H+ w*ff es s
2 -)cc! XsVra'
'oP PLfIttr -Pes m yg" pe-59tsew
9'c cvlNa l�
o j deAf
Z x4
WIT* C-WLI"4
FOOTING FOR LAUNDRY ROOM
�`N �o�ST ZX y 5 r3 �po2tt�l6 APOQpv� V
2{(O Fv8 2y ".SPAN
Provide %s" x l0" anchor bolts'
@ 6' O.C. z"CV,
1
max. and withia FL009- 30(s -r
of join, _ 2c'tx 611
redwood sl
P-41u��pp��y\Q
Grade Level
w
Z f • c s
04
8., 8" E v
��rRc�Q 12 "
C �L 12" x 8" solid pour
�C�EO 8"x 8" x 16" cement block SUITE COUNTY
ll
rout all cells
BUILDING DEPAR'll0<01�
91 �� IMPROVED
p- ,7 w w - • - - - - .
2>O
XIS TiNS
pis r-
tc O, n Z
ZO G AO
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to
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V.
13
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V.
13
eount* of iquae
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: Hilma Keegan
ADDRESS: 2999 Oro Dam Blvd., Apt #3
CITY & STATE: Oroville, CA 95966 IMPORTANT:
April 24, 1986 SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Owner has decided not to do -work. (Bldg Permit Appin. #6�p,E,
Recei t #57703, dated 3/26/86, A.P. #36-37-9)_ Owner: Dolores
,
Rudolph.
Building permit fees paid -------------------- $199.75
Retain ir_; meg—€ee --1009
Retain plan checking fee ----------$58.25
ftr PP ---:$15 00
—
_p1nn_checkino
Amount retained ---------------------------- $ 83.25
Rpflind e-----------------------------------------------$ u 6.5(1
Plumbing permit fees paid --------------------- 36.00
Retain filing fee---------------------------- 10.00
Refunddue----------------------------------------------- 26.00
Electrical permit fees paid------------------ 19.15
Retain filing fee ---------------------------- $ 10.00
Refunddue-----------------------------------------------$ 9.15
Mechanical permit fees paid------------------ 25.00
Retain filing fee ---------------------------- $ 10.00
Refunddue----------------------------------------------- 15.00
Refund energy inspection fee-----------------------------$ 30.00
TOTAL REFUND DUE_. TOTAL
$196.65
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this
xclaim is true and correct as stated. .
/ Dated this .....��day of%VJY....... 19
..................... .....Calif.
Signature of Claimant
1, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de-
24th April 86 Oroville
livered and that there is a Budget Appropriation E] or Specific Board Approval [D (Check one) forWaent<oe�
Datedthis .................................... day of .....P..................... 19......, at .............................. , Coli f. ......�urized
......ep
Dept. Exp. '
Code............................................ Code ................................................PAYABLE FROM ......................................................................................... FU
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. PROJ.
SUB. OBJ.
CLAIM NO.
INV. NO.
INV. DATE
ENCUMB.
GROSS AMT.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APFrLICATION AND PERMIT
ERMIT� 140
ASSES PAR E NU ER
—
ZONI
BUILDING PERMIT
OWN
0 o re
LEP
TEo
- 9
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILIN�ADD ESS
r EU rovi Or
ov
CONT CTORSNAM I-
TEL PHONE
CONT ACTO 'S MArLING ADDRESS
Fireplace
' CONSTRI CTION LENDER
UNKNOWN
Total Valuation Is
6103 0
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHIT CT OR ENGINEER
LICENSE NO.
Plan Checking Fee
Is
Energy Plan Checking Fee
$ '
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS '^ ^
EL 40. Lo
Permit fee
$ -
PLUMBING PERMIT
!Filing Fee 10.00
Each Trap
2.00
11 '
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each gas -water heater or vent
5.00 p
USE OF STRUCTURE
SF ® DuplexMobilehome❑ Other
❑
SPECIFY
Gas piping system 1 - 5 outlets
5.00 j' 0
Building sewer
5.00
Mobile Home S G W
10.00 ea
TYPE OF WORK
New ❑ Addition] ode ❑ Utilities ❑ Installation❑ Other ❑
Describe work: pOlr✓L
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
L
O
Main service 6001 OR LESS
100 AMP OR LESS
10.00
Main service/EA. AOD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury
p y p i y (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)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
oR ADDNST (ACCLBLDGS.0 '/20sgft
'
NEW CONST R. ULTI.OUTL
NON•RESID BRANCH CIRCUITS 2.50 ea
POWER APPARATUS .&)
(SINGLE OUTLET CIR.
Ex. Occup(ouTLETs OR FIXTURES 2ALO 30
.200500
Ex. Occup. OUTLETS FIXED P(RESID )LNS REA.� 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 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 PERMITFi
ling 10.00
Heating e•
Cooling
Hood
3.00
Ventilation
Permit Fee
$ s
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 an way accrue
against said County in cone uence of the granting of this permit.
XZid Date
Signature of Applicant — Owner Contractor ❑ Agent ❑
rV7An OSHA permit is required ove
for excavations r 5'0" deep and demolition or construct-
Ian of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $ IV 0
TOTAL PERMIT FEE ,$ 9
OCCUP.
CONST.TYPEJ
I FLOOD
A7
(/
PD
ND ssu
This permit is hereby issued under
sions of the Butte County Code anc/or
work indicated above for which
DIRECTOR PUBLIC
BY
PER EXPIRES Date
the applicable provi-
resolutions to do
faes have been paid.
WORKS
Date ��
� 7,
LReceipt No. L"
HITE-D.P.W.. TELLOW-ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
+f 1
i
COUNTY OF BUTTE - DEPARTMENT'bFyPULIC WORKS -BUILDING DIVISION
7 COUNTY CENTER DRIVE r OF�OVILL' CALIFORNIA 95965 - TELEPHONE: 916/534 541
PERMIT APPLICATION DATA SHEET
OWNER
Proposed Building Use
es fi L4 JO /)0 ti
Permit Fee Based Upon: Complete Contract Price
Permit No.
A. P. No. C56
DPW Valuation
Building InspectoUate LTa('9 l c_3 r�z
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or issuance: .DATE RECEIVED APPROVED
All items have been submitted. . . . . . . . . . . .
2. Plot plans in plicate riplicate. . . . . . . . . . . - _ �.-
3. Complete plans in duplicate/triplicate. . . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
Fees of $ I J J�
% Letter of signature authorization. qo.✓ .%`1�:1�+?ri.
10. Sanitation approval from Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . .
1 Contractor's License Information (no., name style, classif.)
Owner -Builder Verification (Given to owner, Mail to owner XA
_=8� Wta
5. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . ..
•Pre-Inspec. request to (Date)
17. Pre -Inspection for Required. Building Inspector
18. RecOther
0 %j kJ ut Ac�Cnow�eid meap roval required prior o occupancy
19. Other `moons ruc pp
When you issue the per i , process as follows: Mail owner. Mail to contractor.
Telephone -M gs- and hold for pickup at 0 ofi ice. Deliver w/inspector.
Other Il - S
Appl ican
Date J/2 (/PC
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time of application, circle item.)
1: Index permit for above Items No. --�
2: Additional items required: Jg_ .0) 72
r�
(Contractor, Designer, Owner) was advised of above required data byyTelephone Mail Other
By Date
Plans checked by 4 Date
Plans approved by SdZ Date - [ANo
Other:
Copy—DPW
ii. �/�Aa.KE+-c.✓ OPV-.."_.. dQm+✓'�/
VL
1
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive,`Oroville, CA 95965
Phone: 916-534-4541
OWNER -BUILDER VERIFICATION
Attention Property Owner:' "
An 'owner-buildei" building permit has been applied for in your,name and bearing
your signature.
Please complete and return this information'at your earliest opportunity to avoid
unnecessary delay in processing and issuing 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 impr vement (yes or no)
2. I (have/have not) signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name '%L✓e^'y�-�
Address City
Phone Contractors -License No.
4. I plan to provide portions.of this work, but I have hired the -following person
o coor mate, supervise, an pr a 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 e worindicated:
Name Address Phone Type of Work
Signed:
Prope
Socia
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returnedlto our office before we are per-
mitted to issue the permit.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone:'916: 538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER w,
JVI✓iA
ZONI J/
• • BUILDING PERMIT
OWNER 0 `
d
TELEPHONE
SQ. FT. - OCC.1 BUILDING VALUATION
OWNER'S MAILING ADDRESS
S'6 0Cfe ST 2p
CONTRACTOR'S NAME w
vaJNC/L
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
'
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
` -
Filing Fee
$ 15,00
Permit Fee
$ ®, X10
ARCHITECT OR ENGINEER
r
LICENSE NO.
f
Plan Checking .Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
/ S�
-
Permit fee .
$ 00.
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
USE OF STRUCTURE
SF(E Duplex❑ Mobilehome❑ 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 ❑ Installation❑ Other
Describe work: (duet Sstc 1D)-0CC'IvM��
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200ATO1000A1
37.50
CONTRACTORS LICENSE_ LAW '
1 declare under penalty of check :
P Y perjury Y( 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
❑ 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044) . ,
❑ I am exempt under Sec. Business and Professions Code
for this reason
NEW CONST./ DWELLING OCCUP.&
OR ADDNS. 1 ACC. BLDGS.
3.64 sq.f[.
NEW CONSTR ULT'_ OUTLET
NO N.RESID BRANCH CIRC ITS
5•00
POWER APPARATUS tr
(SINGLE OUTLET CIR.
Ex. Occup( OUTLETS OR FIXTURES20
@ 76d
FIXED ALNS
EX. Occup. OUTLETS PP
(RESID IRE A.)
I 3.00
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 Californias
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 shal I 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.
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 - OwnerE]Contractor 1:1Agent ❑
An OSHA
ion of structures tover 3q stories in height. excavations over 5'0" deep and demolition or construct-
Mobile Home Installation Fee S
Energy Inspection Fee S
OCC
CONST TYPE
TOTAL FEE
HAz
1 0FEES I
'MP
I FLOOD
I CDF
PARCEL
PD
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.
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT