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\� �s PERMIT DESIGNATION: B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING DEPARTMENT OF P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT BUILDING AND SAFETY T -TRAILER S/W-SIDEWALK NOTICE S -SIGN PERMIT D -DEMOLITION 600.1 Qy 31tlO 'CIS 31VO CIS 31Va 'OIs 31VO 'DIS 31Va 'CIS NOIIVNCIS3a sm39Wf1N 11Wbl3d S7Vd02fddV Sf]OMAlV77M0SIW ltlNld SH313 W S37NVIlddV V S321f11X1d NI-Honom 31VO OIS 31VO OIS 31Va 'CIS 31VO OIS 31VO CIS SLI39Wf1N 11W213d S7Vd021ddh' 7V0I2I.L. .7 ltlNld S1N3A 9 S37NVIlddV 3NIl 213M3S ONIdId U31VM 1S31 3Mf1SS3Hd SVC NI`Honou 31Va -OIs 31VO 'CIS 31VO 'cis 31VO 'OIs 31VO 'CIS IU38wnN lIWL13d S7Vd02IddV OAlISW177d S7Vd02IddV 9AlIQ7IQS CIU033H N01133dSNl 31VO 'OIs 31VO 'CIS 31Va 'CIS 31Va 'CIS 31Va 'CIS 31VC 'OIS 31Va 'OIs 31Va '+JIS 31Va 'CIS 31Va 'CIS 31Va 'CIS 31Va• =1 y r m 5 �D 2� rm m2 n� �m In ym -yl� I xz �m -N1� �M �n xl _� z 1 _� z > 3 A �'n' mA �Z � ZOn D3 0 Z 2 Cm m3 S7Vd02IddV 9AlIQ7IQS CIU033H N01133dSNl 1 078-220-024 R� Butte ca BAMFORD,= CLIFTON 06-1113 NOTES 7 Countj 2274 LAS PLIIMAS AVE, OROVILLE I (530) 53 Cont: BROWN HEATING ciC FURNACE C/O APN: Permit No. Owner: Site Address: Contractor: Type of Permit: ' �•c c CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE d D"zz. SATE JOB FINALE//I� t 1 SIGNATURE: { i J INSTALLATION CERTIFICATE (Page 3 of 12)' CF -6R Site Addre s Permit Number P1061 l 3 An installation certificate is required'to be posted at the building site or made available for all appropriate inspections. (The . information provided on this form is required) After completion of final inspection, a coX.must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a)r HVAC SYSTEMS: Heating Equipment' Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems(;>CF-IR'valuc Efficiency� . (AFUE, ctc.) Duct Location attic etc. Duct or Piping R -value Heating Load Btu/hr Heating Capacity Btu/hr 6('4 t r Btu/hr Cooling 'Equipmen't t Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency i (SEER or EER) zCF-IR value) Duct Location attic etc. Duct Cooling Load Cooling Cavacitv t r Btu/hr 1. > symbol'reads greater than or equal to what is indicated on the CF -IR. value. Include both SEER and EER if compliance credit for high EER air conditioner is claimed. ✓ ❑I I, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the'certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards • for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for trianufactured devices (from the Appliance Efficiency Regulations or Part 6),'where applicable. a Installing Subcontractor (Co: Name) OR General Contractor (Co: e) O ner Signature: Date: � V Copies to: LDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 Ca10ERTS - Certificate Page 1 of 1 CERTIFICATE FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R 2274 las plumas ave john brown htg & air / 825622 Project Address Contractor Name / License No. bp061113 Contractor Contact Telephone Permit Number John Revilak 530-518-1109 24971 HERS Rater Telephone Sample Group Number May 15, 2006 CC14-1798365553 Certifying Signature Date Certificate Number Firm: RevilaWs HERS Rater HERS Provider:CaICERTS Street Address: PO Box 1609 City/State/Zip:Magalia / CA/ 95954 Conies to: Homeowner, HERS Provider and Buildina Deuartrnent This CF -4R has been registered with the CaICERTS@ registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was 0 Tested ❑ Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape Is used before a CF -4R may be released on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. The installer has provided a copy of the CF -6R (Installation Certificate). New Distribution' system is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at dud connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: NEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 N/A 2 Fan Flow: Calculated (Nominal 0 Cooling Q Heating) or 0 Measured Enter Total Fan Flow in CFM: 1562 3 NA ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 309 5 Enter Tested Leakage Flow in CFM: Final Test of New Dud System or Altered Dud System for Duct System Alteration and/or Equipment Change -Out. 124 6 Enter Reduction in Leakage for Altered Duct System [Line 4 - Line 51 - (Only if Applicable) 185 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System - Pass if Leakage Percentage <= 6% [ 100 x ( Line 5 / Line 2 )): ❑ Pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )): 8.00% © Pass ❑ Fail 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: ❑ Pass ❑ Fail 11 Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )) and Verification by Smoke Test and Visual Inspection ❑Pass El Fail 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if One of Lines #9 through #12 pass R Pass ❑ Fail h4://www.calcerts.com/cf4r_pdnt_certificate.cf n?lots=24971&RequestTimeout=100000 5/15/06 +=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FaI1/C/O-Concrete 4 WV; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd 'Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Bickng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Dnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electrlcity Tagged 13 Tie Downs Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID 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 2 Ftgs; SollsSz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Ocking-Brcing . Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg, Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Studs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls yos` ° 0°� DATE IP O O L S 1 Setbacks -Easements 2 Soils; 'CompactlonStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec.Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcttng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcitng Eqp-Pool Ightg Boxes-Enclsrs-pnlboards4nsultn.to Main Conduit 9 Health Dept Apprvl „ 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche , 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide ory v3sy °,9 0`s Pool Drawing v=OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg DRth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Elec Gmd Ftg Dpth 55 DWV; Test Fittings & Anchr_ Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First fir -Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-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-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12• Elec Undrgrnd DATE IMECHANICAL 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 61 AC Ducts Insultn & Support 14 GirdersSills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insulin 15 Acc & Vntltn 63 Condensate Drain & Ovrfiw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Wails (rat proof) 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr 21 Fire Stops,'Furred CeilingsStairs-Chasers-Tubs In Garage; abv-fir-Ducts-Meeh Prtctn 22 Headers & BeamsSi &'Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & IRmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting DoorsSiil Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct In Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Cirnc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrfir Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace InUExt Wail pnls 83 Insultn-Foam-Looked in Attic 38 Insuitn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Pimb-Appinc-Frplc-Cirnc to Opngs DATE JELECTRICAL 90 Wtr Well, Dscnnct, Elec, Plmb 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C10 to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or DAL 98 Address Posted AC Wire Sz ga ❑ CU or DAL 99 Fire Sprinkler 48 Range Circ ga ❑ CU or DAL Oven Circ ga [:ICU or ❑AL Insulated Neutral ❑Yes ❑No o�° o``r� o°`° °•s` 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnis-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector s �� 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. BP061113 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 +�� n '%!)� I hereby affirm under penalty of perjury that I am licensed under C q. v0— 02+ provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/15/2006 APN: 036-9=024=000 the Business and Professions Code, and my license is in full force and effect.2 /z License Class : �- Zy License Number: !J_C Site Address: 2274 LAS PLUMAS AVE ORO ll Date: 9-J#'d16Contractor: 'SD t700 Map Index: Description: REPLACE EX FURNACE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the p 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: BAMFORD CLIFTON W & LUCINDA ANN 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 2552 ORO QUINCY HWY 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966 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, 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 Applicant: BROWN HEATING AND AIR, JOHN 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 1024 REGENCY DRIVE year of completion, the owner -builder will have the burden of CHICO, CA proving that he or she did not build or improve for the purpose of sale.). 95926 ❑ I, as owner of the property, am exclusively contracting with (530) 345-4654 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.). Contractor: BROWN HEATING AND AIR, JOHN ❑ 1 am Exempt under Article 3 of the Business and Professions Code 1024 REGENCY DRIVE Date: Owner: CHICO, CA 95926 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: (530) 345-4654 ❑ 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 License #: 825622 is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are: Engineer: Carrier: Policy #: Crcertity that in the performance of the work for which this permit is 0 S. F. issued, I shall not employ any person in any manner so as to Total Square Ft: Q become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall Census Code: forthwith comply with those provisions. Date: 7 /�4 Applicant: 4 �f�— WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. C CONSTRUCTION LENDING AGENCY This permit is a by ssued un r the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutio t do rk indicate bove for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: BY Dae:: G ' I S T G Address: PERMIT EXPIRES / Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 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 ofW official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes Print Name: �t5` 7%6'^� Signature: y� Dater r Cl Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. 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. BP061113 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 Issued Date: 05/15/2006 APN. ' - - 4-000 the Business and Professions Code, and my license is in full force and effect. ea72 / 7 License Class: �— Zy License Number: _G Site Address: 2274 LAS PLUMAS AVE ORO Date: "rContractor: JL7 t7eU) gee,,P) Map Index: Description: REPLACE EX FURNACE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the p 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: BAMFORD CLIFTON W & LUCINDA ANN 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 .2552 ORO QUINCY HWY 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966 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, 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 Applicant: BROWN HEATING AND AIR,. JOHN 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 1024 REGENCY DRIVE year of completion, the owner -builder will have the burden of CHICO, CA proving that he or she did not build or improve for the purpose of sale.). 95926 ❑ 1, as owner of the property, am exclusively contracting with (530) 345-4654 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.). Contractor: BROWN HEATING AND AIR, JOHN ❑ 1 am Exempt under Article 3 of the Business and Professions Code 1024 REGENCY DRIVE Date: Owner: CHICO, CA 95926 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: (530) 345-4654 ❑ 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 License #: 825622 is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are: Engineer: Carrier: Policy #: 9-�I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Q become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall Census Code: forthwith comply w,itth� those provisions. Date: J4�Ny /) Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. U CONSTRUCTION LENDING AGENCY This permit is. Pewby ssued u-n-cTqr the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutto t do rk indicatebove for which fees have been paid. ) performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By Date: PERMIT EXPIRES I ,i' C Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 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 of official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpo — Print Name: �!✓// ��%�c� Signature: //a Date: ,7 ❑ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 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 OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" ARCHITECT/ENGINEER NEI? INFORMATION fV 6A Last a6 vJ v'O t'/Z) Ael. t N W , �✓ i a e a �. Address �� ab City teen Zip Phone E-mail Fax E-mail ARCHITECT/ENGINEER CONTRACTOR Name o vJ v'O t'/Z) Ael. t N W , �✓ Address Phone City Fax St t Zip Phone Lot # Fax E-mail ARCHITECT/ENGINEER Name Address City State Zip Phone E-mail State License Num er APPLICANT INFORMATION Name 7 4v� Address % Z �t City 4 � State Zip55SZz, Phone Z Fax E -mai PPLICANT GNATURE X For office use only: Zoning Flood Zone SRA I Yes INo Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT BIN N �+ PROJECT LOCATION AP# Gq<5S �av Gly Property Address City / Cross Street i9rJe WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Rr GZ iw Sq F - 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. I Received by: Amount: Bldg I I Page 1 of 2 Receipt #: 434 SRA Sheriff Date 1'S 166Other Total 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 Signature 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 KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 T 1. r OWNER CONTR: ( LOCATION (A.P R i PERMIT NUMBER - B 110-72 P E PERMIT EXPIRES Claude Wilson owner 36-55-24 2274 Las Plumas _4ve., Oroville COUNTY OF BUTTE Department of 'Public Works BUILDING INSF�'ECTI.O.N RECORD Zoning Setback Foundation Piers & Girders _ Rgh. Plumbing Bond Beam Rein. Steel Gas Piping & Test Framing — Plmg. Topout i Wtr. Htr. Furnace Firewall Garage Vents ELECTRIC GAS Temporary Temporary Final Final Forms Fireplace Lath & Plaster Found. Vents Rough Elec. Kitchen Vent Sanitation & Water BUILDING Cert. of Occup. Final DATE REMARKS OR CORRECTIONS i COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orov,,.ille, California 95965 . Phone. 53'3-1230, Ext. 259 APPLICATION AND BUILDING PERMIT Permittee Owner Mailing Address Contractor Mailing Address BLDG. Address yI J - �-" `'-' 4' A. P. No. Fire Zone Zoning Sanitation Planning Plans Fees I W.C. NEW O ADDITION O REPAIRS O OTHER 0 Others Single Multi USE OF STRUCTURE Family [_-]Duplex 0 Dwelling 0 Others F 0 U N D A T 1 0 N MATERIAL EXTERIOR PIERS Width at Top Width at Bottom Depth in Ground SQ. FT. OCC. BUILDING VALUATION R.W. PLATE (Sill) SIZE SPACING SPAN Girders joists - 1st Floor Joists- 2nd Floor Fireplace J of st s - 'Ceiling Total Valuation Exterior Studs Permit Fee Interior Studs Plan Checking Fee &/or Penalty Roof Rafters Total Permit Fee Bearing Walls CONTRACTORS LICENSE LAW A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING: I am licensed under the provisions of Chapter. 9, Div. 3, of the State of California Business & Professions Code under the name styleof................................................................................................................................................................................................................................................ License No . .........................•. Classification,,,,,,,,,,,,,,,, and certify that the aforesaid license is in -full force and effect. B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING: I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one): 0 I am the owner of the above property and I will contract to have all of the above work performed by licensed contractors. ( Sec. 7044). Q I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the improvements. (Sec. 7044). 0 Basis, if any, for other statutory exemption...................................................................................:.............................................................................. .................................................................................................:.................................................................................................................................................................. WORKMEN'S COMPENSATION INSURANCE I am_ aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil- ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption pursuant to Section 3800. 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. X.............................................................................. Date ............................... SIGNATURE OF PERMITTEE OR AGENT Receipt No. This BUILDING PERMIT is hereby issued under the appli- cable provisions of County resolutions and/or ordinances. DIRECTOR OF PUBLIC WORKS By.............. :................................................................. Date ................................ Permit Expires Date ..................................