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078-200-010
F`, AP . _ MRS. BILL TURPIN�tQ.e 5656 Farley St., Oroville �fl mntr: Weir Roofing, Oroville ermif-# 4467-74B(reroof) 95-2948 B,M SPEESE, Lillian, 5656 Farley St Oroville. (sheetrock, framing, wall htr) TML 078-200-010 06-2033 WAGNESS; JOHN 5656 FARLEY ST, OROVI E Cont: OWNER . RE ROOF ja - Zv -ul� B07-0694 078-200-010 MISCELLANEOUS Window/Glass Door 12 NEW WINDOWS & WALL FURNA( 5656 FARLEY ST WAGNESS, JOHN T & DEBORAH S B07-0857 078-200-010 MISCELLANEOUS Remodel GARAGE CONVERSION- AS BUILT (2 5656 FARLEY ST WAGNESS, JOHN T & DEBORAH S 6"?i- aao 01 Cj I i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 5656 FARLEY ST Owner: Permit NO: B07-0857 APN: 078-200-010 WAGNESS, JOHN T & DEBORA Issued Date: 05/18/2007 By TMP Permit type: MISCELLANEOUS 7109 HATFIELD CT Subtype: Remodel CITRUS HEIGHTS, CA 95610 Expiration Date: 05/17/2008 Description: GARAGE CONVERSION- AS BUILT (530) 321-3928 Occupancy: Zoning: RI Contractor Applicant: Square Footage: DODDS CONSTRUCTION DODDS CONSTRUCTION Building Garage Remdl/Addn P.O. BOX 272 P.O. BOX 272 270 CHALLANGE, CA 95925 CHALLANGE, CA 95925 Other Porch/Patio Total (530)675-9454 (530)675-9454 270 FEE INFORMATION DBEH Building Review Fee $75.70 DBMSC Remodel -Residential $1,143.79 Total Charged: $1,219.49 Fees Paid: $1,219.49 Balance Due: $0.00 Receipt No: B2752 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License DODDS CONSTRUCTION 744804 / B / 01/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) is in full force and eff sot. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 05/18/2007 the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: Contractors Signature Date ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑ 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: EXMEPT policy Number. Exp. Date: Contractors License Law.). (This section need not be completed if the permit is or one hundred ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: RCERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS SSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' v /` •�O�'// 05/18/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. 05/18/2007 1 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building X p Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte Coun ty, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to en er the above mentioned property for inspection purposes. I hereby certify that I am the prop o eror h ad ntheproped wnersb alf. - / -05/18/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Petmittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) FiRbwner Contractor OR; Agent for Owner ❑Agent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District 0YQ�I tl� Building Department No. Tax Rate Area No. A.P. Number U (V' V M V Jurisdiction: = City County f Property OwnerU L(S Q (^� Property Location/Address Subdivision Lot No. 3(/'I - G �5� Residential Development Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to Units Installation C 0onve�rsion�Permit # Cr.D ern € �No foundation inspection) existing sq. ft. Commercial/Industrial 0 New Addition Building Department Net total sq. ft. a? v (Group R) ( see attached ) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage (Including Exterior Roofed Areas) Date District Identification No. `j g 61 DroJ .lie hr+ School District certifies that Sb kr t"i Yne s S I (Pa .or) 565 - (Street Address) (City) (State) (p Co (Zip Code) (Phone Number) has complied with the requirements of Resolution No. 1) S --a b -09 by payment of $ /4. ( C . representing )--1 o square feet. JAB 2926 $ FULL MITIGATION $ n A School District Paid by Check #, N I t` Remarks: --,;t—,--dlO 4 -7 Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. 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 (school district), Yellow (building department), Pink (applicant) feeform.xis (12/06)dm7 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B07-0857 Date: 04/23/2007 Location: 5656 FARLEY ST By: XEJ Parcel Number: 078-200-010 Sub Type: Remodel Owner Name: WAGNESS, JOHN T & DEBORAH S Phone: (530) 321-3928 Description: GARAGE CONVERSION- AS BUILT (270) 1:1 ❑ The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No DRAINAGE DISTRICTS ❑ ❑ Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 ❑ ❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 E] ❑ City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 PARKS & RECREATION DISTRICTS ❑ ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 1:1 ❑ Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 M ❑ Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 1:1 11 Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 Signature of Property Owner: i�!e�C�� Date: 04/23/2007 FILE SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 Varysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 oville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER ❑ Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: ❑ Other: ❑ F] Other: Signature of Property Owner: i�!e�C�� Date: 04/23/2007 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestryfor their clearances and approvals. There are some things you can do to expedite your permit: O Make sure your application is complete. • Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http:Hmunicipalcodes.lexisnexis.com/codes/butteco/ Reference Number: B07-0857 Date: 04/23/2007 Location: 5656 FARLEY ST Parcel Number: 078-200-010 Owner Name: WAGNESS, JOHN T & DEBORAH S Phone: (530) 321-3928 Description: GARAGE CONVERSION- AS BUILT (270) Signature of Property Owner: _""k2Zk / /2�' Date: 04/23/2007 FILE I`LSr 0 . I f� �� 9b —CAc i0 sl OL �liiFl l� A rz CONCRE'iG DRI VEWA-y '130' G , N" ' � c N , _ N C-NTRGT INrroRMAT/ON Richard Dodds DESIGN CRITERIA -" Dodds Construction Co. OWN) )Z _- - P.O. Dox 272 John Wagness • 2001 California Building Coda (based on 1997 Uniform Building Code) , Challenge, CA 95925 7109 Hatfield Ct. 2o01 Cal fomla Mechanical Codo (based on 2000 Uniform Mechanical Code1 • 2001 CafOomla Plumbing Code (based on 2000 Uniform Plumbing Code) Phone: (530) 675-9454 Citrus Heights, Ca. 96610 • am CdOemla ElxMeal Cod.O>eeed on 1998 Netienal Electrical Cods) Cell Phone: (530) 848-0444 Ph. 916-721-2844 530-321-3928 • 2001 California Fla Cede (based on 2000 Uniform Fhe Code) Fax: (530) 675-9030 1 2001 Ceforrda EnoW SWdrda (title 24) Lic. k 744804 mm S O m ' R. R 00 by S 1 A J O O • g ao in 1 • G O UA N � , • n t ♦ 01- 13 J��wZ N �qj In N &i �• H /� J, 0"A - Vl to �O W a O T . CONTAcr INFORMATION Richard Dodds Dodds Construction Co. P.O. Box 272 Challenge, CA 95925 Phone: (530) 675-9454 Cell Phone: (530) 848-0444 Fax: (530) 675-9030 Lic. # 744804 sxisr/ovy Gert ex shy c%set wnl( C r R�zk CH W"'.r Richard Dodds u Dodds Construction Co. P.O. Box 272 •2 Challenge, CA 95925 — Phone: (530)675-9454- - John Wagness Cell Phone: (530) 848-0444 7109 Hatfield Ct. Fax: (530) 675-9030 Lic. # 744804 Citrus Hei a. 96610 ghts, C Ph. 916-721-2844 530-321-3928 CONTAUT-TN cQ'2MATIQN t Richard Dodds Dodds Construction Co. P.O. Box 272 OwNGR Challenge, CA 95925 — Phone: (530)675-9454- - John Wagness Cell Phone: (530) 848-0444 7109 Hatfield Ct. Fax: (530) 675-9030 Lic. # 744804 Citrus Hei a. 96610 ghts, C Ph. 916-721-2844 530-321-3928 r ff F V15E D l;�F P14N z O J R'r .1"8 (2) 2/a Tl*dj �X RmvS>�b 2/6 ccialrv6- 301 .IAfio�.. r ACT TNGD(2MA4i/)N RicharT Dodds dds Construction Co. P.O. Box 272 hallenge, CA 95925 -hone: (530) 675-9454 1 Phone: (530) 848-0444 - Fax: (530)675-9030 Lic. # 744804 z O J W(2p)(f u Qv tp n N 13 Q • K R'r .1"8 (2) 2/a Tl*dj �X RmvS>�b 2/6 ccialrv6- 301 .IAfio�.. r ACT TNGD(2MA4i/)N RicharT Dodds dds Construction Co. P.O. Box 272 hallenge, CA 95925 -hone: (530) 675-9454 1 Phone: (530) 848-0444 - Fax: (530)675-9030 Lic. # 744804 AX F 0&,gEr2 DB,c Too P��FrE ''/(/D �� NNCiN�R Bow : � �• C • aK RSIk+..I belowTvp of 4t AD -- --.__._.._...._.:'_...__..._._.-_.......... ___.:.__---.-_...._-- I.._. �RN �N<r SG^C7/ONffL Lr2flG40 O O / ` NorFL Vev Richard Dodds Dodds Construction Co. P.O. Box 272 Challenge, CA 95925 Phone: (530) 675-9454 Cell Phone: (530) 848-0444 Fax: (530) 675-9030 ' Lic. # 744804 Richard Dodds r ; sTu r FOUN04-TION FLRN y //= I / —1— inn a#"0 • . , q NEW C•^ RAE aY�i716A9R 11111--w 5kAO ?EMI �•1• .[• • r EK�4rMG _ LiF,Til ' 0 5i.k0 6ns'��� ��a�c noo�z oPrnrlN� , (FX IST/Nr CONTAL-r y/„FORMAT/OhI ` ( Richard Dodds Dodds Constriction Co. P.O. Box 272 Challenge, CA 95925 Phone: (530) 675-9454 Cell Phone: (530) 848-0444 Fax: (530) 675-9030 Lic. # 744804 1 o .I pv O/N �p �rX/sr/N N —1— inn a#"0 • . , q NEW C•^ RAE aY�i716A9R 11111--w 5kAO ?EMI �•1• .[• • r EK�4rMG _ LiF,Til ' 0 5i.k0 6ns'��� ��a�c noo�z oPrnrlN� , (FX IST/Nr CONTAL-r y/„FORMAT/OhI ` ( Richard Dodds Dodds Constriction Co. P.O. Box 272 Challenge, CA 95925 Phone: (530) 675-9454 Cell Phone: (530) 848-0444 Fax: (530) 675-9030 Lic. # 744804 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** APPLICANT INFORMATION OWNER INFORMATION Last Name ��� Firsme Mailing Address 7102' lzle�,-Ial C�< City Ci State State Zippj Phone` 3y, Fax E-mail Fax APPLICANT INFORMATION CONTRACTOR Name Name "Address --•__ ___� __�_ _.,_. _ Address D State City Phone Stat Zip Phone �_���� Fax E-mail C_ Lid Lic. # % Class APPLICANT INFORMATION ARCH/TECTIENGI NEER Name city "Address --•__ ___� __�_ _.,_. _ City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name l C� Address R72 - city State/' Zip %lam—l/02 Phone �^ Fax E-mail d APPLICANT SIGNATURE X PROJECT LOCATION AP# _ --�- O� Property Address S S City Policy Number Carrier PERMIT NO. BIN # WORKER'S COMPENSATION If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: over /u L k 17 /Gc Sq FT- Living Garage z� Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupan /,; I (Note previous use): 9 For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecountinet\dds PROJECT INFORMATION Site Address: 5656 FARLEY ST Owner: Permit NO: B07-0694 APN: 078-200-010 WAGNESS, JOHN T & DEBORA Issued Date: 04/03/2007 By TMP Permit type: MISCELLANEOUS 7109 HATFIELD CT Subtype: Window/Glass Door CITRUS HEIGHTS, CA 95610 Expiration Date: 04/02/2008 Description: 12 NEW WINDOWS & WALL FURL` (530) 321-3928 Occupancy: Zoning: R1 Contractor Applicant: Square Footage: DODDS CONSTRUCTION DODDS CONSTRUCTION Building Garage Remdl/Addn P.O. BOX 272 P.O. BOX 272 - CHALLANGE, CA 95925 CHALLANGE, CA 95925 Other Porch/Patio Total (530)675-9454 (530)675-9454 FEE INFORMATION DBM Heater (Wal[) •$55.00 DBMSC Window/Sldng GIs Dr -Rept $330.00 Total Charged: $385.00 Fees Paid: $385.00 Balance Due: $0.00 Receipt No: B2488 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License DODDS CONSTRUCTION 744804 / B / 01/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full force and elle of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 04/03/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by , AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the EXMEPT Carrier, Policy Number. Exp. Date: Contractor's License Law.). (This section need not be completed if the permit is or once hun reed dllars ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: ERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 04/03/2007 compensation erovisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. X )0lrt,& 04/03/2007 I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building L� Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property or am uto act on h property owners behalf. CONSTRUCTION LENDING AGENCY othorized o OW -5-04/03/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner Zearactor OR: DAgent for Owner DAgent for Contractor FILE COPY Lenders Address City State Zip License Detail California Home Page 1 of 2 License Detail CALIFORNIA CONTRACTORS STATE LICEN. Contractor License # 744804 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: . CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below.' Click on the lin button to obtain complaint and/or legal action information. . Per B&P 7071.17, only construction related civil judgments reported to the CSLB are disclosed. . Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. . Due to workload, there maybe relevant information that has not yet been entered ont Board's license data base. Extract Date: 04/03/2007 * * * Business Information DODDS CONSTRUCTION CO P O BOX 272 CHALLENGE, CA 95925 Business Phone Number: (530) 675-9454 Entity: Sole Ownership Issue Date: 01/15/1998 Expire Date: 01/31/2008 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * Class Description ©GENERAL BUILDING CONTRACTOR * * * Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 100015641 *in the ai $12,500 with the bonding company http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 04/03/2007 License Detail Page 2 of 2 AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 01/01/2007 Contractor's Bonding History * * * Workers Compensation' Information This license is exempt from having workers compensation insurance; they certified that they employees.at this time. Effective Date: 03/27/2001 Expire Date: None Workers Compensation History Personnel List License Number Request Contractor. Name Request- Personnel Name Request Salesperson Request - 'Salesperson Name Request © 2,006 State of Cafrfornia. Conditions of Use Privacy Policy } http://www2.cslb.ca.gov/CSLB_L,IBRARY/License+Detail'asp 04/03/2007 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** CONTRACTOR OWNER INFORMATION Lagt Name City Fiml Narpe Mailing resp j Cityn Stgte�r L Zi �6�0 Phone State LicensNupber E-mail CONTRACTOR / l / Name Rl 221 �S ocY5.(ok�i Addres City Stop.Zip kg�� s Phope 5 T"/ax,_4 �� a E-mail lG ` �gv, Lic. # P Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City / / /�� C �G� < Address Zip City State Zip Phone Fa E-mail State LicensNupber APPLICANT INFORMATION Name G D Address P40 City / / /�� C �G� < State/ [� Zip Phone6, Fax E-mail / G APP /CANT SIGNA URE X PERMIT NO. BIN # PROJECT LOCATION AP# O ;),®b -b Property Address City I WORKER'S COMPENSATION I Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: f � Sq FT Living Garage ,�Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA Yes I No Occ. Type Const. FEB-27-2007 10:00 IRS SACRAMENTO 916 974 5159 'P.01i01 - Date: February 27, 2007 Fax Skeet To: Karen Jones CpU County of Butte 8 i Fax Number: 530-538-5361 y 9EVE1 �1� From: JobA T.. Wagness • � gER Telephone: 530-321-3928 Please allow Richard Dodds to acquire a copy_of the"parcel map for my property at 5656 Farley Street, Oroville. - Thank you, John T. Wagness 4 } 'TOTAL P.01 F 078-200-010 , 06-2033 WAGNESS, JOHN r . 5656 FARLEY ST, OROVILLE '- - °"E. -",N O T E S • Cont: OWNER r- -P RE ROOF �" •Quid RESIDENTIAL r APN: Permit No. 4.1 Owner. t� Site Address: i i_ .f Contractor. ' $ Type of Permit- ul t , 1= ' A , t F ' F r - 3 - t { • r - i �1c SPECIAL COMMONS CHECKED BY Q SRA Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED Q SPECIAL INSPECTION ITEMS T VERIFY Q USE PERMIT CONDITIONS Q SUBSTANDARD HOUSING LETTER Q ENCROACHMENT PERMIT Q REINSPECTION FEE PAID Q ENY HLTH CLEARANCE 0 Q9 -P -JC (aNro[_a1 (vl a-rE U (S -TA DATE JOS FINALED: SIGNATURE j +=OK O = NotoK MANUFACTURED HOMES - MISCELLANEOUS• , 4 DATE PERMANENT FOUNDATION SOFT -SET ----DATED E C K S'C O V E R S'C A R P O R T S'G A R A G E S 1 Zoning -Setbacks -Easements 1 ZoningSetbacks-Easements 2 Soils; Special MH Support Sketch 2 Figs; SailsSz-DpthSpacing-CnnctrsSteel 3 Sewer, Loctn-Test; Fall/C/O-Concrete 3 Decks. Girders/Jolsts-Dcking-Brcing 4 Wtr; Loctn Test -Easement Needed -Regulator Stairs-Guard/Handraits 5 Elec Loctn-Clmcs-Gmd ' Amp-Doncrete 4 Wood Awn; Posts-Beams-Rflrs-CnnctrsShthg. 6 Yard Gas; Loctn-Test Wrap Nat Q or LPO Frmg-Brcng Inch Sz Ft Lngth 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 7 Bickng, SzSpacing-Marriage Line S 6 Carports; Wndws-Doors. ' 8 Gas; MH Test-Demand-Valve-Cnncir 7 Electric 9 Elec MH Cntnty Test-Crossovers-Breakers-D(mcs 8 Frmg Sills-Anchrs-Studs4bas Trusses 10 Drain; MH Test -Fall -Flex Cnnctr, 9 Siding; Nailing-VengerStucco-lath 11 Wtr & Sewer Connected -CIO to Grade 10 Roof. Shthg-Roofing 12 Gas and Electricity Tagged 11 Ext Steps -Doors -Landings , 13 Tie Downs Q Foundation ❑ 12 Braced Wall pnls 14 Exits 15 Cert of Occupancy 16 HUD Labetfinsignia Numbers Serial Numbers 0 1 Setbacks -Easements 2 Soils; •Compaction -Structure Stability 3 Pool Structure; Steel-Cnnc6ns Thickness Dead Men -Lining 4 Elec Rcptcls"rig; Distance -GR 5 Elec Pool Lting; IS volts -GR 6 Elec.Ericisrs; Conduit Entries -Terminals -listed 7 Elec Bonding; Metal w1T-Crcltng Egp-Htr 8 Elec Gmdng; Eqp w/5: Crcltng Eqp-Pool Ightg Boxert irclsrs-Pniboards4risultn-to Main Conduit 9 Health Dept Apprvl 10 Pimb; Cir Test-Wtr Supply Test 11 U Niche ; 12 Enctw; Fencing -Alarms 13 Bonding, Diving board or Slide 4 s �I S 1 Setbacks -Easements 2 Soils; •Compaction -Structure Stability 3 Pool Structure; Steel-Cnnc6ns Thickness Dead Men -Lining 4 Elec Rcptcls"rig; Distance -GR 5 Elec Pool Lting; IS volts -GR 6 Elec.Ericisrs; Conduit Entries -Terminals -listed 7 Elec Bonding; Metal w1T-Crcltng Egp-Htr 8 Elec Gmdng; Eqp w/5: Crcltng Eqp-Pool Ightg Boxert irclsrs-Pniboards4risultn-to Main Conduit 9 Health Dept Apprvl 10 Pimb; Cir Test-Wtr Supply Test 11 U Niche ; 12 Enctw; Fencing -Alarms 13 Bonding, Diving board or Slide = Not OK RESIDENTIAL (Single & Duple.X) DATE JUNDERFLOOR IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd FtS Dpth 54 Wtr Pipe- Test & Anchr-Nail Prtctn S 3 Ftg Garage; Soilsteel-Flet Grnd Ftg Dpth _ SS DWV; Test Fittings & Anchr Nail Frfctn 4 Ftg Parches/Decks; Soils -Steel Ftg Dpth - 56 Shwr Pan; Test, Fust fir -Tub Ace 5 Stemwalls Main; Steel-Blockouts Wrapped 57 Test Tubi & Shwr, 2nd fir - Tub Ace 6 Stemwalts Garage; Steel-Biockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frple Ftg-Steel 9 DWV; Fall -Fitting Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test a' ds v 4? 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgmd DATE M E C H A N•I C A L 13 Plenums & Ducts; ClmcdWaterialSupport4nsultn 61 AC Ducts Insults & Support 14 GirdersSills-SillsBoitsJoists Vnts-Cripples 62 Vent Fan, Exhaust abv Insulin 15 Acc & Vntltn 63 Condensate Drain & Ovrilw, Sz & Grade - 16 Insulation 64 Furnace -Vent Acc-Comb Air RtrnlVent 115 Outlet 65 Attic Ace & Pitfrin if Furnace In attic • o$ d� dr Sys DATE FRAMING 17 Silts Proper Materials & Anchrs DATE FINAL 18 Wills Studs -Nailing Spacing &Braces -Plates -Sound 66 Ext StepsDoor & SideLt Prtctn Landings 19 Bearing Walls ovet Girders., flr Nailing 20 Draft Stop In Walls (rat proof), 67 Smoke Detector 21 Fire Stops,'Firrea CeMngsStairs-Chasers Tubs 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr In Garage; abv-flr-Duds-Meth Prtctn 22 Headers &Bear isSz &'Bearing' 69 Bedroom Exiting 23 Hangers-P,osfCaps-Anchrs-Crrncins 70 GFl &Bath Fxtrs &Tub AccSpa 24 Ceiling Joist-RftrTjes�url'uk-Roof Brac TrussShthg 71 GFl Arc Fault 2S Frple Ties or Type A Fluld:f ' Ie Throat Cimc 26 Attic' ` Au.; 8: Sz Rmz F'itefn-Drafi Stop Ins Baffles 72 Elec Trim & Subpnl, Breaker Sm & Labels 73 27 Bdrm Wndws or Exiting 150orsSiH (it & Dimensions Stairs, GuardMandraiis 74 Frplc or Stove, Cimc-Hearth 28 Garage Fire Prtdri Frim g -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs' . 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 76 Ktchn, Fxtr & Appinc; Gd -Air -Gap -Cooking Clrnc 31 Stairs; Wdth4idrm4Rise-Run4-andin9"Flre Prtctn 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-R1tr Outrgrs 79 AC Dud In Garage -Damper. 33 Sidmg Nailing Veneer 80 Wtr Htr Vnts-CimaCom Air Cnnctr-PRY; abv fir 34 Stucco Lath Weep Saeed-Fndtn Vnts-Undrflr Ace Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Are PrtctnSkyLts-Plastic 81 Pimb; Elec & Mech Egp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insults -Foam -Looked in Attic 38 insulin -Wails -Ceilings 84 Guard Rails &Deck Cnstrcfi-Post Caps 39 Infiltration Wails-Wndws 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Clmc Dmge Planters Q Yes Q No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Pimb 89 Vnts abv Roof, PImb.Appinc-Frple-Cimc to Opngs DATE JELECTRICAL � 40 Fxtr & Tmsfrmr Cimc-Ins Prtctn 90 90 Wtr Well, Dscnnct, Elec, Pimb Ext Elec Trim, GFl RcptG-Undrgmd 41 Elec Rcptcls Spacing-0ts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndetrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Irispd s 44 Eqp Gmd made up w/Mech Fsbvs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnmdd-CIO to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFl 47 Subfeed Wire Sz Qa ❑CU or [:1 AL 97 Energy Cmpinc Cert -Other Certs AC Wire Szya OCUorQAL 98 Address Posted 48 Range Circ Q, Q CU or QAL 99 Fire Sprinkler Oven Circ o, E] Cu or DAL Insulated Neutral Dyes ❑No 49 Servic&4User Cndctrs & Gmd Main Dscnnct 50 Eqp Cimcs pnts-Motors-Meth Eqp ---- 51 Clothes Closet LtShwr USpa Lt 52 Smoke Detector lie BUTTE COUN �IY rtrclvll I Ivv. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING ,PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) BP062033 OFFICE #: (530) 538-7541 - PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9"(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Issued Date: 08/23/2006 APN: 078-200-010-000 effect. License Class: License Number. Site Address: 5656 FARLEY ST ORO Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: REROOF 14.5 SO Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: WAGNESS, JOHN & DEBORAH to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7109 HATFIELD CT 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any CITRUS HEIGHTS, CA violation of Section 7031.5 by any applicant for a permit subjects the 95610-3322 applicant to a civil penalty of not more than five hundred dollars (8500).): 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does WAGNESS, JOHN &DEBORAH such work himself or herself or through his or her own employees, Applicant: provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 7109 HATFIELD CT year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of CITRUS HEIGHTS, CA sale.). 95610-3322 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Contractor: Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the License #: Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are: Engineer: Carrier: Policy #: 1 I certify that in the performance of the work for which this permit is rotal Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws_ of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi�ns. Date. Applicant: WARNING:- allure to secure workers', compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars (8100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the Resolution t do work in mated ab ve for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) By. Date: Name: Q PERMIT EXPIRES ON: Address: ate ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that -the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it Is unlawful to alter the substance ny o(rcial form or document of Butte County. I hereby authorize representatives of Eutte County too enter upon the above mentioned property for Inspection pure es. �G(/�l/� Print Name: h e Signature: Date: -Owner " ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor R C- Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP062033 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. I LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter T(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): �I I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does t not apply to an owner of properly who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code . Date: � Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Issued Date: 08/23/2006 APN: 078-200-010-000 Site Address: 5656 FARLEY ST ORO Map Index: Description: REROOF 14.5 SQ Owner: WAGNESS, JOHN & DEBORAH 7109 HATFIELD CT CITRUS HEIGHTS, CA 95610-3322 Applicant: WAGNESS, JOHN & DEBORAH, Contractor: License #: Architect: Engineer: Carrier: Policy #: i I certify that in the performance of the work for which this permit is rotal Square Ft: issued, I shall not employ any person in any manner so as to ( become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall Valuation: Census Code: forthwith comply with those proved/s''pns. Date: v �" Applicant: r ' if WARNING: allure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. 7109 HATFIELD CT CITRUS HEIGHTS, CA 95610-3322 CONSTRUCTION LENDING AGENCY This permit is hereby is I hereby affirm that there is a construction lending agency for the Resolution t o work performance of the work for which this permit is issued (Sec 3097 Civ.) By. Name: PERMIT EXPIRES ON 0 S. F. $0.00 under the applicable provisions of the Butte County ated above for which fees have been paid. 15*1 Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. Cl Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner: I agree to comply with all county and state laws relating to building construction. I acknowledge it Is unlawful to alter the substance ny official formord�ent of Butte County. I hereby authorize representatives of Outte County to enter upon the above mentioned property for Inspection purp es. O /j/h r /' a/ , Print Name: / w �� Signature: Date: --- 65 -Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor C 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. " I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [X] NO[ .2. I HAVE -C�G ] 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: 4 NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some, of the work but I have contracted (hired) the -following persons to provide A. the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: i / PROPERTY OWNER: DATE: 23 4l0 NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before -we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.net/dds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by'the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "own er-builder"=building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321-CSLB (2752) or by accessing their website at www.CSLB.ca.gov. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Manager, Building Diviion NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.netldds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name /, / �SS first Nerd" _Japf Address 71 CiV. LT7Q'- / 7/ State�� Zip q lD%V Phone53o _3?/ 5 %fig Fax E-mail oljh lf/Q q f2 C _s-1, 4W J APPLICANT INFORMATION CONTRACTOR Namer Cit� yC Address Zip/��.�% City Fax State Zip Phone Page Fax E-mail Date Approved: Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name Cit� yC Address Zip/��.�% City Fax State Zip Phone Page Fax E-mail Date Approved: State License Number APPLICANT INFORMATION Name a Q 0,e-65 Address �l O q02S, I v� d J�� l Cit� yC State( Zip/��.�% Ph Fax E-mail / U U APPLIC NT SIGNATURE X TT or office use only: Zoning Flood Zone City SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BIN # PROJECT LOCATION AP# X Property Address/ S Z �(9 City Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Other LENDING AGENCY Name Address Description or Scope of Work: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by Amount: GatAmount: Bldg Receipt #: `( Sheriff SMIP Date: 8 OSI (0 Other Uv Total Pade 1 of 2 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Sig nature'authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION K TORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 . .. �.,_. _ _ rr .. s:'---�n�-•�-r'I.;.,{,,,-r--�ir�'�G+..S;,�,,..rv--._j-r�`L.ti.•r`,�-'^.-...-.+.mow-....._,,,.,ti. ,..._.. �•n �a�..✓.�-�.- �S`r_ ,,� r - El N, '40 ,,.COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, CalifcRK& 95.965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT '2W ASS My_!ARc V—_11M0 ZONING BUILDING PERMIT OL"NERMLIAN, SPEESE TELEPHONE SQ.. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 656 FARLEY ST., OROVILLE EST 1260 CONTRACTOR'S NAME VIL INC. TELEPHONE 589-1529 CONTRACTORS MAILING ADDRESS 2944 HERITAGE RD., OROVILLE Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 31.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 5656 FARLEY ST. ORQVT .i.R PERMITFEE $ 51.00 I _ � PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDN51oN'SNAME PARCEL MAP Solar or heat pump water heater 23,00 USEOFSTRUCTURE SF til-( Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other)A; Describe Work: _ SRFT?TR(k1X, FRAMTNG,, WALL HEATER • Mobile Home I S I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.00 a00v OR LESS Main Service ( 200A OR LESS / 23.00 , Main Service (r200A TO 1000A ) 46.00 - LICENSED�CONTRACTOR'S DECLARATION u 1 hereby affirm,nder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing' with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class A Lic. No. -� _3 /� / n � OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST."OCCUP. OR ADDNS.( 8 ACC. BIAS, -- ) 50. 3.52 FT. NEW CONST.MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ') @7.50 ( POWER APPARATUS ) +;• 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL so FIXED Ex. Occup. ( OUTLETS (RES D.) EA PLNS. OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' ccpensation insurance carrier and policy number are: Carrier_,, % Ep/YJ/7 rit/ S 6 49"41, MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 2. 71 -411 A/ `3 - y l5' - (The above sections need not be completed if the permit is for work of a valuation . of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ. any 'person in any -manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with. those provisions. 0��� X .., 1..12 i .rt�s•.� _ Date _5__ Signature of Applicant Owner O Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3•stories in height. - Mobile Home Installation Fee Is Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $86.00 - HAZ. D. FEES IMP FLOOD CDF PARCEL PD I HO I ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date 11 /27/95 PERMITEXPIRESON 11/27/95 (Date) ReceiptNo. 190439 I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, 15a �urnia 95965 - Telephone (916) 538-75,di,- NO. APPLICATION AND PERMIT jj ASS L"FAJ /lJ V10 ZONING BUILDING PERMIT OWN€`ULLIAN, SFEESE TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 5656 FARLEY ST., OROVILLE EST 1260 CONTRACTOR'S NAME T:IL INC. TELEPHONE 589-1529 CONTRACTORS MAILING ADDRESS 2 TIER ITAGE RD. OROVILLE Fireplace CONSTRUCTION LENDER JN OWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 31.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ SUILDINGADDRESS 5656 A?.LEY ST. OROVILLE PERMITFEE $ 51.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDIVISIONS NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF KK Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UBlities ❑ Installation ❑ Other, Describe Work:r fit- TTT FTI'`-�1rK�--F-R�—[�LI�r'T�'AT.e'P' Mobile Home I S I GI W 1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.'00 Main Service OOOV OR LESS ( zooA OR LESS ) 23.00 Main Service ( 200A TO I000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. 3 -3 4 J /� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. \\ OR NS. ( 8 ACC. BLAS. J SO. 3.5¢ FT. NEW CNS. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET US Ex. Occup. (OUTLET OR FIXTURES) 2e Q 1.00 SAL � FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workes'po__%pensation insq!ance carrier and policy number are: Carrier �%A77E Cpmt I -NS 6e,9UP Policy Number 2,_7,2, —LJ A.1 3 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisio s of section 3700 of the Labor Code, I shall forthwith comply with ose p Ions. 1/ p X -k-_MI___ Date ��Z ature of Applicant - Owner A Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ 35.00 Contractor Mobile Home Installation Fee Is Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 86.00 HA2. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date 11 /27/95 PERMITEXPIRESON 11/27/96 (Date) ReceiptNo. 190439 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �r l t,PERMIT• NO. 4467-74B t' P r i E f T. M WH UTIL. rPERMIT NO. PERMIT EXPIRES. O —7� (OWNER Bill Turpin cONTR. Wlhir Roofing, Oroville LOCATION (A.P. 36-37-10 (. 5656 Farley St., Oroville i sl ' ' 3 a J. ;s Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E t JOB FINALED (Date) (Signature) COUNTY OF BUTTE —.DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Sidinci To out Slab Roof Sheathino Water Piping Piers Roofing /0 �'�/�`% Sewer Garage Fdn.. Vents Fixtures Footings Garacie Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final O --`.S Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — J�DEPARTMENT OF PUBLIC 0 S 7 County Center Drive — Oroville, California 95965 Te1ephont:_534-4541 APPLICATI N AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Ir X"1 2 Date Signature of Permitee or Agent Receip� No. 12' (2 uI White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O= PUBLIC WORKS By Date ding permit expires Date...............1��� wilding � 7�{� BUILD G Owner SQ. FT. OCC. BUILDING VALUATION i Mailing Address e Telephone No. (111Ae 60— / WW07 Fireplace Contractor Total Valuation Mailing Address Ril' Permit Fee Plan Checking Fee&/or Penalty OAL�Telephone No. Permit Fee $ $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $2.00 r , Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 3 c� % — Zoning & Planning Gas piping system 1 - 5 outlets .1.50 Each additional outlet .30 Reee"s FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 Bldg. Plans Rec'd I Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 i �.. Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single FamilyAqJDuplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixturesbale to Receps., switches & fix outlets 20 IM CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of Califo ia. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ;I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE t $ 8 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Ir X"1 2 Date Signature of Permitee or Agent Receip� No. 12' (2 uI White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O= PUBLIC WORKS By Date ding permit expires Date...............1��� wilding � 7�{�