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Home My WebLink About078-240-005COMPLAINT TO INSPECTOR W'17 � J t3 `-5- \WILLIAM F. CONNELLY '5490 Debbie Ave, Oroville�� Contr: Servamat'ic Solar �P_ermit��865-84P(solar water heater/SF) -n 36--64r. g:;4 --��/ CONNELLY, WILLIAM 93-512 B�FE 5490 DEBBIE AVE, OROVILLEf REHAB SF/LTR 9-14-92 ,30-93 0367660--005- 02-2689/�,' �iT4t '.,o- CONNELLY, BILL �J�' i 5490 DEBBIE AVE., ORILLE v �'1- UPGRADE ELECTRIC -636-660-005 07$-Z.yo-o0.5 ' 02-2821 CONNELLY, BILL 5490 DEBBIE AVE., OROVILLE DETACHED GARAGE 02-3006 CONNELLY, WILLIAM 5490 DEBBY, OROVILLE DETACHED DECK �6f 071'240 -ops 03-3525 CONNELLY, BILL 5490 DEBBIE AVE, OROVILLE CONT: OWNER GAR.AGETOLIVING/NEW GARAGE '636'0 5 C)IS-2.10.005 04-2475 CONNELLY, WILLIAM 5490 DERBY AVE, OROVILLE Cont: OWNER DEMO GARAGE REBLD03-3525 i v w� A 9-22-92,. REHAB INSPECTION. CONNERLY & ASSOCIATES I 11 i t 036-660-005 02-2689 CONNELLY, BILL e DEBBIE AVE., OR UPGRADE UPGRADE ELECTRIC Y / +� r A ce o,o OFFICE COPY Address GAS Meter By Date ELECTRI / Meter By Date3671 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541�y P,E7/T (Rev.12/96) APPLICATION AND PERMIT V( ` ASSESSOR PARCEL NUMBER _Gr ZONING BUILDING PERMIT OWNER OWNERSMAILING ADDRESS MIE AVE. CONTRACGA 95966 TOR'S NAME TELEPHONE TELEPHONE SO. FT. OCC. BUILDING VALUATION CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee'$ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other ❑ Describe Work: SDE ELECTRIC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 020.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 600VOR LESS Main Service zo.A OR LESS73.00 23.00 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. 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 Main Service 200A TO II00A 46.00 NEW CONST. DWELLMq OCCUR OR ADDNS. ( a ACC. BLD S. SO 3.5¢FT. NEW CONST NON-RESID. MULTI -OUTLET 97.50 PSOWERINGLEUTLET APPARATUS a OCXR. Ex. Occup. OUTLET OR FIXTURES s20 ® 1: 0 FlXED APPLNS. OR Ex. Occup. OunETs RESID. EA S.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 _ Oction PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I 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' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forth ith comply with those,,Provisions. / 0�% X t 5-r"r �►c 4 " Date jo _ Signature of Applicant - ❑ Own ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 116.00 HA2. _1M D. FEES IMP FLOOD CDF PARCEL PD HD 5S , This permit is hereby issued under the of the Butte County Code and/or Resolutions indica ab63e for whi h fees have By I ( PERMIT EXPIRES ON applicable provisions to do work been paid. / - ! r ; ' Date 7 � Data Receipt No. 363814 $66. '/ � r � WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 PERMIT NO. BP042475 LICENSED CONTRACTORS DECLARATION 1 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: 08/23/2004 APN: 036-660-005-000 the Business and Professions Code, and my license is in full force and License Class :�^P' License Num�b/er:(Oos Site Address: 5490 DEBBY AVE ORO Date: ^-13�iYContractor: C b"�'�l CS Map Index: Description: DEMO GAR $ REBUILD FRO BP#03-3525 OWNER -BUILDER DECLARATION of 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 Owner: CONNELLY WILLIAM F & JEANNE C JT permit to construct, alter, improve, demolish, or repair any structure, prior to, sits issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 5490 DEBBY AVENUE 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 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 j Code: The Contractors' State License Law does not apply to an Applicant: CONNELLY WILLIAM F & JEANNE C JT owner of property who builds or improves thereon, and who does pP ! such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 5490 DEBBY AVENUE y sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of OROVILLE, CA proving that he or she did not build or improve for the purpose of 95966 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, �I and who contracts for such projects with a contractor(s) licensed 1 pursuant to the Contractors' State License Law.). Contractor: ❑ I I 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: 11 1 have and will maintain a certificate of consent to self -insure for License #' ' workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as t' Architect: required by Section 3700 the Labor Code, for the performance of } i the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: 9 Carrier: Total Square Ft: 0 S. F. Policy a. O I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: kand 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. Date: ��, �j� �j� ! ✓� `c `� a[ l / �� 49 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. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Cope 2nrvor v I hereby affirm that there is a construction lending agency for the to Resol io to do work indicate bov for which fees have been paid. ` performance of the work for which this permit is issued (Sec 3097 Civ.) Name: B : Date: PERMIT ON: a Address: Date ❑ , 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. ❑ f 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 any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. `n Print Name: ` �/ t I� `D �N �' ' 7 Signature: Date:' ( Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541^ PERMNO. 4 (Rev. 12/96) APPLICATION AND PERMIT -, ' 15 ASs�b PbbVNLIV ZONINGRI BUILDING PERMIT OTILL COW= 533-1516 TELEPHONE SO. FT, OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS 5490 DEBBIE AVE OROVILLE CA 95966 528 U 9504.00 528 U—R 10 568.00 CONTRACTOR'S NAME OWNER TELEPHONE 410 R 22 140.00 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $142,212.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 369.00 ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ 239.85 BUILDING ADDRESS 5490 DEBBIE AVE OROVILLE CA Energy Plan Checking Fee $ 23.00 $ PERMIT FEE $ 651.85 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7-0021.00 Solar or heat pump water heater 23.00 Water piping 15.00 5.00 Each gas water heater or vent 15.00. TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ADD TO EX GARAGE; & CONV TO LIVING ADD NEW GARAGE 22X24 Gas piping stem 1 - 5 outlets 15.0015.00 Building sewer 15.0015.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ Rr, no ELECTRICAL PERMIT Filing Fee 20.00 Main Service aOOV OR LESS 2o0A OR LESS 23.00 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. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: wIr d 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 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' compensation insurance carrier and policy number ark' Carrier Policy Number (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 0 1 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date /� '_' t Signature 16f Applicant - ❑ OvVner ❑ Contractor ❑ Agent An OSHA permit is required for excavation over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO IOOOA 46.00NEW CONST. DWG OCCUP. SO OR ADDNS. a ACC. S. 3.50x. UM NON.R SID. T. MULTI.OUTLET 97,50 POWER APPARATUS a BINGLE ovner CIR. Ex. Occup. OUTLET OR FO(TURES 20 Q 1.00 SAL @ .SO Ex. Occup. OFlx�1E�OSA R D OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ %1,31 MECHANICAL PERMIT Fling Fee 20.00 Heating 15.00 Cooling 20,00 Hood 6.50 Ventilation PERMIT FEt $ 55.00 Mobile Home Installation Fee $ Energy Inspection Fee $ 46.00 Occ CONST. TYPE TOTAL FEE $ HA p, IM D CDF PARC PD 5S This permit is hereby Issued under the applicable provisions ofutte Cou Code and/or Resolutions to do work in cafe ve fees have been paid. ` By Date �� O3 PERMIT EXPIRES ON 12 3� Dete Receipt No. WHITE-D.D.S.-B. CANARY -ASS S R PINK -INSPECTOR GOLDENROD -APPLICANT �,. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPME +, 7 County Center Drive a Oroviill►e1/,ppCalifornia ��,t959 (Rev. 12/96) AP P LI CATI V N AN D USESSORPARCEMLNUMBER ZONINGG AD S- NAME / C� RVI - BUILDING DIVISION el p (530) 538- 4 P IT NO. BUILDINGPERMIT SQ. FT. OCC. BUILDI G VALUATION i? - te� & K) CONSTRU=ON UMEA Fire lace IEMUM MAILING ADDRESS Total Valuation EMEND' Fria Fee $ 20.00 ARCNRECr OR ENGINEER $ —' Permit Fee ARCIcrL= OR ENGNEER"S 0LM ADDRESS Plan Checking Fee $ Energy Plan Checking Fee $ SULONG ADDRESS 5, 1"C ` 1 $ PERMIT FEE $ 5 PA -7M MAP PLUMBING PERMIT Firing Fee 20.00 IDT N0. SUSDN6ION5 NAME 7.00 l USEOFSTRUCTURE ' 4 ) AL Each Trap Solar or heat pump water heater 23.00 SF Duplex Mobllehome ❑ Other sPMFY Water f ing Each gas water heater or vent 15.00 -� 15.00 TYPE OF WORK r Gas piping system 1 - 5 outlets 15.00 - New 1:1. Addition ' Remodel C3UliG 6es stallation E3 In 13 Other 13 Building sewer S G W 15.00 -� @20.00 : ^ Y q �p Mobile Home - Work: ,Despribe FEE S * QPERMIT ELE TRICAL PERMIT Filing Fee 20.00 ,: F(.,C l� ov Service 020DOA oat 23.00 Main Service 2NA TO ICOCA 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. a A. BIDS. CC 3.501 L MULTIOUrLET R @7.50 ~. PERMIT, FEE PAID $ POWER APPARATUS a saGu DImET. Ex. Occu . DUTurr OR FwuRES m 0' .00 SAL .50 �-•--�— Ex. Occup. D �eA 5.00 SRA Rf�1 $ Temporary Service 23.00 Mobile Home Facilities 20.00 Mise. Wiring 23.00 SHERIFF $ PERMIT FEE s rJ MECHANICAL PERMIT Feng Fee 20.00 $ Heating OTHER O Coorurg _ Hood 6.50 Ventilation $ PERMIT FEt S Mobile Home Installation Fee $ $ Energy Inspection Fee $ QAL FEE$ _I � 9)0, /`CONSTTYPETO � (/� NAZ 0. FEES M D CDF FiD ESUE AMOUNT RECEIVED $ /�J This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work l' I ( indicated above for which fees have been paid. DATE RECEIVED — -3 9 --3 f ) I By Date DFRMIT FXPIRES ON \COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Orovilie, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: i ASSESSOR PARCEL NUMBER ✓ 65� Proposed Building Use: Counter Technician: Date: �terts required i 'der to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plan , 3 dr 4 sets, signed by the preparer of the plans. 2. Complete p ans, 3 or 4 sets, signed by the preparer of the plans. 3: Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl 5: Energy compliance design and supporting documentation in duplicate. 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. . Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ \. , ❑ 9. Site plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Fire Sprinklers......................:..................................................................... ❑ 14. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 15. Other r Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) #t❑ 16. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... 1-1 .7. Statement of Intent for Non -heated and A/C Buildings ..................................._ ... . 8. Sanitation and site plan approval from the Environmental Health Department i8 019. City of Chico Plumbing permit........................................................................ ❑ 20. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 21. Planning", for (A) Use: O k (B)Parking: (C) Parcel Check:S- ❑ 22. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... D23. NPDES Form.................................:........................................................... ❑ 24. Encroachment Permit for driveway from the Public Works Dept ................................. ❑ 25. Pre -Inspection for required ................ ❑ 26. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 27. Worker's Compensation Carrier and Policy Number ............................................. 28. Owner -Builder Verification�Miven to owner, ❑ Mailed to owner) ..................... ❑ 29. Letter of Signature authorization.................................................................... ❑ 30. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 31. Manufactured home utility clearance............................................................... ❑ 32. Existing violations and/or expired permits......................................................... ❑ 33. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 34. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above items nu Bred: elan Check Letter \Z� 2. Additional it r Ab Contractor desi owner, was advised of the above data by ;' phone, ❑ m-07 ❑ counter, by A0AX Date: Contractor, designer, , was advised of the above data by ❑ phone, ❑ mail, ❑ counter by, V Date: Plans reviewed by: Date: Plans approved by:Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: - Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 SCHEDULE OF FEES DUE OWNER ezmi-211 A.P. #� G' G I PROPOSED BUILDING USE r �v DATE 1 ` ' 3 ' RECEIPT # DATE REC. 1. BUILDING PERMIT FEES Balance Due ....................... $ Additional Fees Due ................. $ Additional Fees Due ................. $ Revised Plan Checking Fee ...... $ 2. SCHOOL DISTRICT FEES (paid at District Office) (Available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential ...................... x $360.00 = $ Units Commercial (sq. ft.) ............... x $0.03 = $ Sq. ft. r 4. URBAN AREA FEES (paid at Building Division) Residential ................... -x-=$ # Units Amt. Commercial (sq. ft.) ............ x = $ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER At time of permit application,I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00) OB. -I 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. .11-(D personally plan to provide the major labor and materials for construction of the proposed property improvement: YOt NO ❑ I HAVE.0 HAVE NOT ❑ signed an application for a building permit for the proposed work . I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: . CONTRACTOR'S LICENSE NO. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: / PROPERTYOWNEI L " SOCIAL SECURITY NUMBER: NOTE. This Owner -Builder Veri�cation is required by Section 19831 and 19532 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. OVER OB. -1 I OWNER BUILDER INFORMATION -I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party ofrecord 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. Ifyou plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300' or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments 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. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contract 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 stricture 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 contractors is to secure an "owner builder" building pezmit, 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. rely, Mic 1 C. Vi ira, C.B.O. M ger, Building Inspection NOTE: This Owner-Builderlnfomwdon is required by Section 19830 of the California Health and Safety Code. OVER School District A.P. Number Property Owner BUTTE COUNTY SCHOOLS IMPAC' FEE CERTIFICATION FORM (One form per Building) 0(01A,fly,2 061 Building Department No. c�o—/�q�5 Jurisdictio : Q City ©County Property LocationlA 6�-�525 Subdivision Lot No. Residential Development M _ �� Q Sq. Footage No of Living Units Mobile Home installation Addition/ Conversion 'Supplemental to {{{{ (Group R) Permit # *(No foundation Inspection) _ Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q Sq. Footage New /% Addition (Including Exterior Roofed Areas) Building Department Representative Z�? - a� Date District Identification. No. (,o �tQ o School District certifies that �j �� Co hVNt� -4 ; . (App icant) (Street Address) (Phone Number) CA q�`ilab (City) (State) (Zip Code) has complied with the requirements of Resolution No. p t "o Z -j w by payment.of $ -�- representing t b - squarefeet. 2926 : FULL MMGATION j Z t.1LA `1 d�3 3 School District Reprilentative Date Paid by Check # Remarks:,Qj�,� o Nodes: You may protest the Imposition of the fess Ideidi shove by suixNtting a written protist to the DlsbK In compliance with Govsnrmnt Cote Section 66020(a), within 90 days from the dab fees are pall Failure to submit a timely written protest witprot" you from challenging the Imposition of the fess In any court scHorL f. subsequent to the School District Representative signing this Suite County schools Impact Foe Certification Form, the Shehool Dls"Mct is notified by the applicable Local Planning Agency that this ptolecI Is being revNwed under the California Environmental aua tr Act (CEC14 this pio)oet may be a toci to adtAtlonal school foes to fully mlflptte.Ifs hripa I on the school dtetrid'a sctwo(s. White (applicant), Yellow (building department), Pink (school district) feeform.xas (10l03)dmm I� School District A.P. Number Property Owner Property LocationlA Subdivision BUTTE COUNTY SCHOOLS IMPAC*Fr-E CERTIFICATION FORM (One form per Building) IJ OA 14 Building Department No. JurisdkUo : City ©County X53- 5"25 Lot No. Residential Development a rte,► lip Q ��~ Q j Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to t (Group R) Units installation Conversion Permit 9 _._-(No foundation inspection) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/industrial Q Q Sq. Footage Now' Addition (Including Exterior Roofed Areas) . z� - a� Building Department Representative Date District Identification .No. School District certifies that .1 1 C-0 Yxy\,e��y ' (App scant) /� i1AV e- (Street Address) (Phone Number) CA (City) (State)Rip Code) has complied with the requirements of Resolution No. p t o 2:J by payment.of $ representing t o square feet. IM 2926. t FULL MMGAT10N = School District RepriAentative. Date Paid by Check tRemarks: Noffc : You may protest the Imposition of the fess Iderdifled above by submitting a written protest to the DlsMst, 'in compliance with Govarrarwit Code Section 66020(m), within 90.days from the date fees we paid. Fallum to submit a timely written protest wlltprol m you from challenging the imposition of the fees In any court action. If. subsequent to the School District Rep vserdative signing this Suite County Sdrools Impact Fee Certification Form, the School Dh#W Is n Alin b,;#* applkabls Loess Planning Agency that this project Is being rwkwed under the California F.nOut nsrdal Quslky Act (CEQ4 Oft project may be subject to eddltloral school fees to tuhy I.... te.lts Impact on the school distrsdlt echo* White (applicant), Yellow (building department), Pink (school district) feeform.4s (10/03)dmm COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) d APPLICATION AND PERMIT 02-3006 ASSESSOR PARCEL NUMBER ® 660-005 ZONING BUILDING PERMIT OWNER WILLIAM CONED I Y TELEPHONE SQ. FT. OCC. BUILDING VALUATION 208 0 1456.00 OWNER'S MAILING ADDRESS 5490 DERBY OROVTIJE 959(,r, , CONTRACTOR'S NAME 0> TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 35.00 ARCHITECT OR ENGINEER5 MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5490 D ED BY Energy Plan Checking Fee $ $ PERMIT FEE S 55,00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF M Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Others Describe Work: NE4d DETACHED DECK Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W11 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800V 0' ' LESS Main Service 20.AORLESS 23.00 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 ql full force and effect. License Class LB Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law or 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 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' compensation insurance carrier and policy number are: Carrier Policy Number (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. ,r7 � X �/ Datey - �� Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service zooA To 1000A 46.00 NEW CONST. DW EWNG OCCUP. SO OR AODNS. ( a ACC. S.3.50FT. NEW HEOSIO MULTI -OUTLET 97,50 POINGLE OUTLET CIR. WER APPARATUS a S pI:� Ex. Occu OUTLET OR FTTUREs ear so Ex. Occu . ouT PRM.oea 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 55.00 HAZ. D. FEES IMP I FLOOD I CDF I PARCEL Po N UE This permit is hereby issued under of the Butte County Code and/or indicated above f , .,whi fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date !,, Date ReceiptNo. 364109/$55.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 P R IT Nc (Rev. 12/96) APPLICATION AND PERMIT ASS ES`+DRPARCEL NLMBER oti/ _ 20NIH0 BUILDINGPERMIT OWNER �`\ ( \ \ C', w\ I rl TELEPHONE SO. FT. OCC. BUIL ING TION VALUATION - OWNER'S MAILING ADDRESS J,J COtrTRACTOR'S NAME✓TIYE�L'-5EP•/N,10NE ` _ -----. CONTRACTOMAILINGMAIINGG ADO DRESS CONSTRUCTION LENDER Fireplace- LENDER'S MAILING ADDRESS Total Valuation $ __ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20 GC Permit Fee _ _ $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ _ BUILDING ADDRESS— Energy Plan Checking Fee $ - - - $ PERMIT FEE $ LOT NO. SUSONISIONS NAMEPARCEL MAP PLUMBING PERMIT Filing Fee 20.CO Each Trap 7.00; USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater _- 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other j$ Describe Work: Gas piping system 1 - 5 outlets Building sewer�- 1 5201 15.00 Mobile Home S GI JV I @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Feel 20.00 --- Main Service zc..OR LEss 23.00; --'- F . " PEPJMIT FEE PA10 s SRA SHERIFF- gHeating i �tA6VNT RECEM0 co ) �) wRNVAM / v �• TO r-- Main Service 200A TO I000A 46.001 NEW CONST. DWELLING OCCUR OR ADONS. ( d ACC. RIDS. ) 3. SCSC� FT.I NEW CONST. MULTI -OUTLET S NON-RESID. CIRCUITS L,I@7.5O POWER APPARATUS b SINGLF. OUTLET CIR. OUTLET OR FORURES 20 Cw 1.00 Ex. Occu sA.50. FIXED APPLNS. OR 5.001 Ex. Occup. OUTLETS RESID. EA ._ Temporary Service 23.00 Mobile Home Facilities 20.001 Wiring 23.00 Misc.— PERMIT FEE 1 $ MECHANICAL PERMIT Filing Fee 20.00 _. Cooling__. Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HA2. t= IMP I FL000 COF I PARCEL I PO I HO i ISS. This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do wor'', been paid. Date Dere ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT VARIES o N , 41% --4 I -v a m C� 36" MIN. LJ -(s 'Ti -P 9 X 0 N X N x' -& -;,. r w . .. ; • gyp_ y cj N F -u .� 34" 7v i MAX. —1 o b 7Q n za 36"MIN.STAIR � 6. BUTTE COUNTY n a � WIDT� BUILDING DEPARTMENT INO D y. -(s 'Ti -P 9 X 0 N X N x' -& -;,. r w . .. ; • gyp_ y cj N F -u .� 34" 7v i MAX. —1 o b MAX. J,�HEUIuRAII. za 36"MIN.STAIR � 6. BUTTE COUNTY n a � WIDT� BUILDING DEPARTMENT -40 APPROVED y. �a) .� C Cq 0-•4. to -a m b r- DO "m� � mom+ a m N CN • O A N -(s 'Ti -P 9 X 0 N X N x' -& -;,. r w . .. ; • gyp_ y cj N F -u .� 34" 7v i MAX. 6.5 - 406HT 1 MAX. J,�HEUIuRAII. 7° 36"MIN.STAIR � 6. BUTTE COUNTY n a � WIDT� BUILDING DEPARTMENT APPROVED y. 6.5 - COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 07 _._ PER j►�O• (Rev.12/96) APPLICATION AND PERMIT POT ASSESSOR PARCEL NUMBER 036-660-005 ZONING BUILDING PERMIT OWNER . OWNERSMAILING ADDRE ? OR GA 95966 CONTRALTO TELEPHONE TELEPHONE SQ. FT. OCC. BUILDING VALUATION CONTRAC OR UNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS DEBRIE AVE 0R01.U11F Energy Plan Checking Fee5490 $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: UPGRADE ELECTRIC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 020.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800V Main Service zo.A OR tESS 23.00 93-00 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.POWEPPARATUS License Class Lic. No. 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 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (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 fortlywith comply with those ovisions. _ i^� X Datey Z Signature of Applicant - ❑ Own ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service sow TO tOooA 46.00 NEW CONST. DWELLNG OCCUP. SO OR ADDNS. 8 ACC. S.3.50FT. NO1+ReeSID. T. MULTI -OUTLET 07,50 8 SINGLER AOUTLET CIR. EX. QCCU OUTLET OR FDTTUREs SAL @ 1.00 .30 Ex. Occup. ounEis Aa D.OEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 _ -PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 116.00 HAZ. I D. FEES IMP FLOOD LC.F PARCEL PO HD ISS This permit is hereby issued under the of a Butte County Code and/or indica a e for whi h fees have P By PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid. ��/� Date Drte) ReceiptNo. 363814 66 WHITE-D.D.S.-B.D. CANARY -ASSESS PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 1 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-75"0�in Rev.12% 6) APPLICATION AND PERMIT ASSESSOR PARCEL NUMSEA/�� / O V - U� 20004 BUILDING PERMIT °'""ER - ,n Y-) v� SO. FT. OCC. BUILDING VALUATION owNERs AD ( j„� J l/ Y U 1 59 G SO CONTRACTORS NAME ,+ 1 TEL° IONS CONfRACT0R4 MAJUNO ADDRESS CONSTRUCTION LINDER 7 Fireplace U:NOERS MWUNO ADDRESS Total Valuation b ARCMRECT OR ENGINEER LICENSE No. Filing Fee b 20.60 Permit Fee b AACM1TECr OR ENGINEERS MAa1ND ADDRESS Plan Checking Fee b euaDINoADOREss ''V U Energy Plan Checking Fee b b PERMIT FEE S LOT NO. sueolvsansNAArt PARCEL 111P PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other 8PEC-Y Each Trn 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ubbs installation ❑ Describe Work: Other ❑ C— Gas piping stem 1 - 5 outlets t 5.00 Building sewer 15.00 Mobile Home I S I G W C9t20.00 PERMIT FEE _ ELECTRICAL PERMIT Filing Feel 20.00 Main Service zo"'voA o.R t�Ess 23.0 PERMIT FEE PAID SRA SHERIFF OTHER (^ $ Vl $ $ $ n�n / Main Service 200A TO 1000A 46.00 NEW CONST. DWELLM OCCUP. so. OR ADONs. a ACC. sins. 3.5¢Fr. NON•RESID. MULTFOlJT1Er 07.50 POWER APPAilAT1A a s ountT as Ex. Occup. OUTLET OR FUTWES s20 0 1,00 .000 O OR Ex. Occup. O �s . EA 5.00 I Temporary Service 23.00 Mobile.Home.Fecilities 20.00 Mise. i n 23.00 PERMIT FEE MECHANICAL PERMIT Filing Fee 20.00 ' Heating I I —' Cooling — –I Hood 6.50 i Ventilation PERMIT FEI: ! OJ Mobile Home Installation Fee i Energy Inspection Fee i occ CONST. TYPE TOTAL FEE $ 11AZ D. FEES WP 1 -0 1 CDP PARCEL PO ISSUE This permit Is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutions to do work AMOUNT, RECEIVED . $ :'V- . RECEIPT- # = L.AC — :' Indicated above for which fees have been paid. By Date PERMIT EXPIRES ON i REQLfEST FOL R� INSPECTION(� Permit No. �Az--� Location: `� • Owner: Comment: Contractor: BLDG. PLUMB/MECH ELECTRIC M.H.I./M.H.U. PRE - INSPECTION Form Rough Rough Fnd/Ftg Frame/Underfloor Top Out Temp. Service Job Status Stucco Lath Gas Pipinglrest Main Service Corrections Per ewal Stucco Brown Temp. Gas Underground Final erif UtiliY Woodstove Sewer Piping Well Circuit Ex Mobile Site Brace Panel Water Piping POOL Insulation Shower Pan Nailing Gunite Demo Bonding Light Niche Corrections Corrections Corrections Final Final Final Corrections Ready for Final Inspec. on: Date: Call L] Phone: PRE -INSPECTION REPORT OWNER: Coy-) l LOCATION: CONTRACTOR: cry"`� DATE: A.P. #.63�. �4�G• �� ZONING: j PRE-INSPETION FOIL L112 a6Q. 0-- 11 DATE TO INSPECTOR: ', PERMIT HISTORY:( ) NONE Y) AS FOLLOWS: # BUQ.DING INSPECTOR'S REPORT Building Description: Commernial/Usage: ResidendaY# of Units: Currently Occupied Abandoned/Vacant Electric: !" --- Yes No Electric currently On Off Condition of Electric Gas: Natural Propane None Currently On Off Obvious Problems: ' Sanitation: Plumbing Working a� Well Working _ Potable Water Obvious SewageProblems Comments: �C_ G%/.> ACTION RECOMMENDED: LSSUE: HOLD Inspector. /r3—/Q Date Sketch buildings on reverse and indicate location on Pi opert ` i. �, " • , • ` a 1. • :0 In aL ozO OM o �H �tyrrn� nor cn t7l t� I r• n �<rnrt U a cn pm C)\HtrJgl �cD a- H I Ln aro i cc m �,o�Co a LCn)41 C z0 •� � �O3 to r � z lb cn H ►t O O 1"4 ON H. fb Pt I� �. ft N ® fD m uj a • _ - W N fD` rt b N Ft lxj Lj a 0-, tzy tz � z rn C:) PO b o CLf,� H O H cn r-- e�-- N � N i 10 N r •. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 1 Rev. 12/96) APPLICATION AND PERMIT MIT N0. ASSE9aDRPARCe. NUYe01 U� n BUILDING PERMIT ,nyn °5 r, INE I SO. FT. OCC. BUILDING VALUATION owNOLs COMMCTOR'S NATE/+ �1 1010111r4I /^ \` � TEID/gN! comrm4rroA7 hVAJNG ADDRESS coNSTRUCnON LENDER i LENDER'S LWLWO ADDRESS Fireplace Total Valuation $ ARCNRECT OR ENGINEER LICENSE NO. Filing Fee S 20.60 Permit Fee E ARCWMCT OR ENONEEAB YAUNG ADDRESS Plan Checking Fee S SULLMOADORESs (� �r - ` Energy Plan Checking Fee i $ PERMIT FEE $ IDT NO. SUSOMSION7 WAX PARCEL YAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome O Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New O Addition ❑ Remodel ❑ Ulihes. Instalation ❑ Other ❑ _ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 —Mobile Home I S I G I W Q20.00 PERMIT FEE t ELECTRICAL PERMIT Filing Fee 20.00 Mein Service o0 o�R LESS 23. I PERMIT FEE PAID $ C� SRA $ SHERIFF $ Main Service 200A To IOOOA 46.00 NEW CONST. DWEi1)�0 OCcuP. 90 OR AODNS. a ACC. gD9. 3.50' YULTFOIRCLq La 7.50 NOWRESIO. BRANCH POWER APPARATUS A SNOLZ OVMU Cm Ex. Occup. wnzr OR FwruRE9 L'0° SAL .SO D.0 APPtNS1Ew 5.00 Ex. Occup. vnFrs MES i Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. " n 23.00 J PERMIT FEE MECHANICAL PERMIT Filing Fee 20.00 ' Heating Cooling Hood8.50 i OTHER $ °ug� AMOUNT - RECEIVED $ RECEIPT- # rEnergy e Home Installation Fee i Inspection Fee i TOTAL FEE $ 11AZ. 10. MES I WP F _RMO I COf I PARCEL I PO I ND 1 WV6 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 PERMIT EXPIRES ON PWAM ONVNER-BUILDER VERIFICATION A;tentlon Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your sismamm Please complete and return this information at your earliest opportunity to avoid noneoessacyde4y in processing and issuing your building permit. No building permit will be issued tmtH dds verification is received. rl . I personally plan to provide the major labor and materials for construction of the' proposed property improvement: YES C3 NO 13 I HAVE 0 HAVE NOT C3 signed an application for a building permit for the pe mg .1ed W=L I have contracted with the following person (firm) to provide the proposed eonstrue i - PHONE: COIN-MkCTOR'S LICENSE NO. 4. I plan to provide rtions of this work, but I have hired the following person to coordinate, supervise, and provi the major work: N ANIE: ADDRESS: PHONE: NTR.4 OR'S LICENSE NO. 5. I will provide some of the work but I v contracted (hired) the following persons to provide the work indicated: NAME ADDRES PHOr4 TYPE OF WOZtIC 11-100, SIGNED: PROPERTYOWNER. SOCIALS CURITY NUMffi DATE: -- NOTE: This Owner -Builder Verification is required by Section 19831 and 1983108bt California Health and Safety Code. This verification must be eompl&W turd returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION Cez: Proeer^� An application for a building permit has been submined in your name listing yourself as the builder of property improvements specified For your protection, you should be aware that as "owner -builder" you are the responsible party of" +eeoe+d onsueh a permit. Building permits are not required to be signed by property, owners unless they are personally perfoemiog 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 you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family. and the work (including materials and other toss) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ [f you are an emplover, you must register with the State and Federal Governments 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. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with aspect to worker's compensation insurance. ♦ For mere specific information about your obligations under Federal Law, contract the Intemal Revenue Service (and, if You wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, cCncac' 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 contractors is to secure an "owner 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 worts personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm thatyou are aware of these matters. The building permit will not be issued until the verification is returned. I rely, c el C. Vi ira, C.B.O. ht ger, Building Inspection NOTE: Tina Owner -Builder Information is required by Section 19830 of the California Xta11h and Safety Codes OVER ... ,- _... . ,.._ �:,�y;.y;..:�+_:.'^FF'_F.!.�.:.�f1.z wr "R'.'i�i+�V['+, qf'.y �F�u✓^.v�A!.ae� ..`f �S'9{��'"-'i++,•CC�S,�i�"'y4r'�u+t'iir.'a��".:� R!2S�!f�Ad,�,'t"f iCr": 7.,r,�rs r' o %% COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASS ESSOfJSf C LA V BER U�.�—�U 1—�'U� ZON ING� 1 BUILDING PERMIT OWNER gilill , C0y7M.1.I11y TE�3j"—i� G SQ. FT. OCC. BUILDING VALUATION n T T 10 OWNER �iyf,�f1i.E 9L O�O`.'71I'' 5S t1V n / �� I. 7O �m, CONTRA4,T,UQ R'S NAME ...L , TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTR U, iC.TION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee ,$' 15,00 Permit Fee $ 180. C0 ARGHIT9,l.T OR ENGINEER .. L J LICENSE, NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ GR BUILDIJ` iV�DI)�S Sr AVE 0?Ot�I1.I' Permit fee $ 195.C>7 PLUMBING PERMIT Filing Fee 15.00 Each Trap 3 5.00 • V r Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL LAAP Water piping 7.00 Each qas water heater or vent 7.00 •� USE OF STRUCTURE SF EJ Duplex ❑ Mobilehome ❑ Other' SPECIFY Gas piping system 1 - 5 outlets 5.00 u Building sewer 15.00 �• Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition [_ Remodel ❑ Utilities ❑ Installation❑ Other f], Describe work: ;IF= R-,nI li"I`1 A�1l-L n D9�14/91 Penult Fee $ C,h CO Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service LESS 200A 00vOR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Cha t. 9, Div. 3 of the Business p and Professio s Code and my license is in full fof ore and effect. License No. n -� Classification El 1, I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200ATO1000AI J 37.50 NEW CONST. / DWELLING OCCUP.tr\ 3.6Q sq.ft. OR ADONIS. 1 ACC. BLDGS. II NEW C0N5TR. UL I -OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS tr SINGLE OUTLET CIR. I Ex. OCCup�OUTLETS OR FIXTURES 20 76 Ex. OCCUp. OUTLETS (RESID )FIXED APPLNS.R 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 r, my Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating t) C;J GAS hITRIACE Cooling �•(`„ Hood 6.50 Ventilation Penult Fee 23 • ; Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, juggments, costs, and expenses which may in any way accrue against said Coun In coequen of the granting of this ermit. Date Signature of Applicant — Owner El c trDctDr Agent ❑ An OSHA permit is required for excavations over 50 'deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEES 322.CQ HAz I DFEEs I IMP I FLOOD I CDF PARCEL I PD I HO ISsu A This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indica ed above1fof v6hich fees have been paid. / 7DIRECTOR�Oh_�,PUB41C WORKS r BY � - �•-. . n ,�1 �: r.Date !• J PERMIT EXPIRES Date I Receipt No. 135501-322.130 WHITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT :FOww September 14, 1992 Connerly and Associates 2215 21st Street Sacramento, CA 95818 RE: Rehabilitation Inspection - 5490 Debbie Avenue, Oroville AP# 36-66-5 Gentlemen: An inspection was made of the above premises as part of the Butte County Rehabilitation Project currently underway. The dwelling is a one story wood frame and wood siding structure with composition shingle roof. The wood floor and dwelling is supported by a perimeter concrete foundation, posts and piers. The dwelling is served by public water, sewer, natural gas and electricity. This Department recommends completion of work as included within the Rehabilitation Work Specifications dated August 7, 1992. The following items are required to comply with minimum requirements of the California State Housi g Law. The occupant indicates the septic tank was not pumped and backfilled at the time of connection to public :sewer. Properly pump and fill the tank with sand or other approved material. aTHIER TOMORROW n A CLEAN INDOOR F:lR ENVIRONMENT FOR A HEAL -. tte Count - LAND OF NATURAL WEALTH AND BEAUTY DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH THOMAS REID, DIRECTOR 18-B County Center Drive Oroville, California 95965 Telephone: (916) 538-7282 FAX: (916) 538-2165 RE: Rehabilitation Inspection - 5490 Debbie Avenue, Oroville AP# 36-66-5 Gentlemen: An inspection was made of the above premises as part of the Butte County Rehabilitation Project currently underway. The dwelling is a one story wood frame and wood siding structure with composition shingle roof. The wood floor and dwelling is supported by a perimeter concrete foundation, posts and piers. The dwelling is served by public water, sewer, natural gas and electricity. This Department recommends completion of work as included within the Rehabilitation Work Specifications dated August 7, 1992. The following items are required to comply with minimum requirements of the California State Housi g Law. The occupant indicates the septic tank was not pumped and backfilled at the time of connection to public :sewer. Properly pump and fill the tank with sand or other approved material. aTHIER TOMORROW n A CLEAN INDOOR F:lR ENVIRONMENT FOR A HEAL Connerly and Associates September 14, 1992 Page 2 epair or replace the roofing and otherwise eliminate roof leaks. Replace any deteriorated sheathing discovered at the time of roofing work "'rovide adequate eave and attic ventilation. Eliminate the moist and standing water condition beneath the dwelling. Lot grading and foundation perimeter drains may be necessary to adequately address the drainage problems. f' `' rovide adequate openable window area for the living room. Provide tempered -glass within 18" of the floor surface. Provide an electrical cleanup. Eliminate open splices, exposed romex, buried romex and questionable grounding. Provide adequate combustion air for the furnace. Provide operable smoke detector within sleeping areas and hallways leading to sleeping areas. All repairs, reconstruction, replacement or patching shall be completed to extent necessary to result in a finished product. This may require new materials. Inspection permits shall be obtained as required. Very truly yours Thomas Reid, Director Division of Environmental Health TR/mlf Cc: Bill Connelly COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESS6�6Ag66�EOUUL ONu�BER ZONI_ GR1 BUILDING PERMIT OWNERWILLIAMCONNELLY TE�33"`�6 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS . 5490 DEBBIE AVE OROVILLE 95966 FST 20.600 co NTROWNERS NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRbRON LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 180.00 ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILD15 90 DDEMBIE AVE OROVILLE$ Permit fee 195.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 31 5.00 15-00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 1 5.00 SF ba Duplex❑ Mobilehome❑ Other Building sewer 15.00 Mobile Home S I G I W I @ 15.00 SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other [ Permit Fee $ Describe work: REHAB PER LETTER DATED 9/14/92 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200V OR LESS 00A OR LESS 18.50 Main service 200A TO IOOOA1 37.50 CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.Sd) 3.6dsq.ft. I declare under penalty of perjury (Check One): OR ADDNS. ACC. BLOGS. // l am licensed under provisions of Chapt. 9, Div. 3 of the Business NEW CONSTR. MULTI'OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 and Profess io s Code and my license is in force and effect. _I (POWER APPARATUS e) SINGLE OUTLET CIR. ,,full License No. Classification+.�� /\ EX. OCcup(OUTLETS OR FIXTURES 20 76 -� ❑ 1, as the owner, or my employees with wages as their sole compen- FIXED APPLNS. OR Ex. OCCUp. OUTLETS IRESID,1 EA.) AL P 46 3.00 sation, will do the work,and the structure is not intended or offered Temporary service 15.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- Mobile Home Facilities 1 1 15.00 ors. (Sec. 7044) Misc. Wiring g -15.001 15 QQ ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ 30.00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 15.00 ❑ The permit is for $100.00 (valuation) or less. Heating 9.00 I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling .00 ❑ I shall not employ any person in any manner so as to become subject Hood 6.50 to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you become Subject to the W. C. provisions of the Labor Code, you must forthwith comply with such Penn Permit Fee $ 33.00 provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee S is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Energy Inspection Fee $ Butte to enter upon the above-mentioned property for inspection purposes. occ CONSTTYPE I also agree to save, indemnify and keep harmless the County of Butte against TOTAL FEES 322.00 all liabilities, ju gments, costs, and expenses which may in any accrue HAz DFEES IMP FLOOD CDF PARCEL PD HD Issu against aid Co in co�uen of the granting of this�?ermlt. c� Date 1 This permit is hereby issued under the applicable provi Signature of Applicant — Owner el ❑ C tractor Agent ❑ Bions of t utte County Co a and/or resolutions to do An OSHA permit is required for excavations over 5' ' deep and demolition or construct. work i Ica d above ich fee a been paid. ion of structures over 3 stories in height. DIRECT U IC S Receipt No. 135501-322.00 By ate PERM E I Date WNITC-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSEpR ARCEL NU BER L/ ��—�� ZONI BUILDING PERMIT OWNER, e n ELEPHONE -/ SO. FT. OCC. BUILDING VALUATION LING A OWNER'S MAIRE 5 > e vl' r CONTRACTOR'S NAME tle V, TELEPHONE C ACTOR'S MAILING ADDRESS Fireplace CONST UCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHIT CT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS o I,F •' C ` ` V1 V ` 21 U Permit fee $ p PLUMBING PERMIT Filing Fee 15.00 Each Trap I 1 5-001/ Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 ^C1 Each qas water heater or vent 7.00 USE OF STRUCTURE SFX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 fL5'.,(_q Mobile Home - S I G I W 015.00 TYPE OF WORK New ❑ Additionemo el ❑ Utilities ❑ Installation❑ Other Describe work:A�t? % �- Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service z0000A OOR LESS 18.50 Main service 200A TO 1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. ' License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCuP.IY OR DONS. ACC. BLDGS. ) 3.60sq.ft. NEW CONSTR MULTI -OUTLET 5.00 NO N.RESID BRANCH CIRC ITS POWER APPARATUS 6 SINGLE OUTLET CIR. ) Ex. OCcup(OUTLETS OR FIXTURES 20 @D 76d ED APLNS. UTLETS P(RESID )REA.) I 3.00 Ex. Occup. Oemporary Tservice 1 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ ©I� WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $.100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Coolin g I� Hood 6.50 Ventilation it Fee ee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — OwnerElContractor❑ Agent ❑ An OSHA ion of structures tover 3gstoriesoinehe excavations over 5'0" deep and demolition or construct- Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES ® HAz 1 DFEES IMP I FLOOD I CDF I PARCEL I PO HD ISSUE This permit is hereby issued under the applicable sions of the Butte County Code and/or resolutions work indicated above for which fees have been DIRECTOR OF PUBLIC WORKS By DatePERMIT EXPIRES Date provi- to do paid. l� S S Receipt No. I WHITE-D.P.W.. YELLOW -AS BES SON. P NR -INSPECTOR. GOLDENROD -APPLICANT fA , D -- G I ,L"-- September 14, 1992 Connerly and Associates 2215 21st Street Sacramento, CA 95818 RE: Rehabilitation Inspection - 5490 Debbie Avenue, Oroville AP# 36-66-5 Gentlemen: An inspection was made of the above premises as part of the Butte County Rehabilitation Project currently underway. The dwelling is a one story wood frame and wood siding structure with composition shingle roof. The wood floor and dwelling is supported by a perimeter concrete foundation, posts and piers. The dwelling is served by public water, sewer, natural gas and electricity. This Department recommends completion of work as included within the Rehabilitation Work Specifications dated August 7, 1992. The following items are required to comply with minimum requirements of the California State Housing Law. 1. The occupant indicates the septic tank was not pumped and backfilled at the time of connection to public sewer. Properly pump and fill the tank with sand or other approved material. A CLEAN INDOOR AIR ENVIRONMENT FOR A HEALTHIER TOMORROW ' L A N D O F N A T U R A L W E A L T H A N D B E A U T Y DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH THOMAS REID, DIRECTOR, 18-B County Center Drive Oroville, California 95965 Telephone: (916) 538-7282 FAX: (916)'538-2165 September 14, 1992 Connerly and Associates 2215 21st Street Sacramento, CA 95818 RE: Rehabilitation Inspection - 5490 Debbie Avenue, Oroville AP# 36-66-5 Gentlemen: An inspection was made of the above premises as part of the Butte County Rehabilitation Project currently underway. The dwelling is a one story wood frame and wood siding structure with composition shingle roof. The wood floor and dwelling is supported by a perimeter concrete foundation, posts and piers. The dwelling is served by public water, sewer, natural gas and electricity. This Department recommends completion of work as included within the Rehabilitation Work Specifications dated August 7, 1992. The following items are required to comply with minimum requirements of the California State Housing Law. 1. The occupant indicates the septic tank was not pumped and backfilled at the time of connection to public sewer. Properly pump and fill the tank with sand or other approved material. A CLEAN INDOOR AIR ENVIRONMENT FOR A HEALTHIER TOMORROW Connerly and Associates - September 14, 1992 Page 2 2. Repair or replace the roofing and otherwise eliminate roof leaks. 3. Replace any deteriorated sheathing discovered at the time of roofing work 4. Provide adequate eave and attic ventilation. 5. Eliminate the moist and standing water condition beneath the dwelling. Lot grading and foundation perimeter drains may be necessary to adequately address the drainage problems. 6. Provide adequate openable . window area for the living room. Provide tempered glass within 18" of the floor surface. 7. Provide an electrical cleanup. Eliminate open splices, exposed romex, buried romex and questionable grounding. 8. Provide adequate combustion air for the furnace. 9. Provide operable smoke detector within sleeping areas and hallways leading to sleeping areas. All repairs, reconstruction, replacement or patching shall be completed to extent necessary to result in a finished product. This may require new materials. Inspection permits shall be obtained as required. Very truly yours Thomas Reid, Director Division of Environmental Health TR/mlf cc: Bill Connelly . Jim Glandes L_ HOU S T NG REPAT R PROGRAM L CONNERLY & ASSOCIATES, 2215 21ST STREET, SACRAMENTO, CA 95816 <916> 456-4794 EHAB1:•I' .::::A..:. T:IGN::':WJDR:K :SPE:C:I:P:I:CAT:l:Dt4S:: - WORK WRITE-UP - COUNTY OF BUTTE BUILUWG DEPT APPLICANT Bill Connelly AVG- 10 1992 PROPERTY ADDRESS 5490 Debbie Ave 10-4-4 P1 __a CITY, STATE, ZIP Oroville, Ca 95966 MAILING ADDRESS.: SEE PROPERTY ADDRESS CITY, STATE, ZIP : SEE PROPERTY ADDRESS PHONE NUMBER : DATE : (916) 533-1516 August 7, 1992 The following work is to be performed by licensed contractors and/or the homeowner for the purpose of bringing the subject property, which has been found to be substandard, into compliance with l.ocal housing/building codes and regulations. The contractor or owner, in the case of an owner performing his/her own work, shall be responsible for determining the applicable code requirements and for performing work in compliance therewith. Estimates shall be based only on the work specified in this work write- up. Contractors discovering or suspecting an error or omission in either this write-up or plans (when applicable) shall promptly report to the Housing Rehabilitation Consultant (916-456-4784) so that items in question may be investigated for possible addition to required work. All work must be performed in compliance with published "grades and standards". Materials must match, be of equivalent quality, or exceed those published on "materials list". If not listed, "medium grade" should be assumed. Owner's preference for style and color should be followed wherever possible. Please see attached Materials Allowance Breakdown for guidelines pertaining to allowances. Any measurements and drawings attached hereto are to be considered approximations unless otherwise stated. The responsibility for determining the exactness of structural measurements and other specifications shall be that of the contractor and shall be a condition implicit in all bid or proposal submittals. 1 HOUSING REPAIR PROGRAM - WORK WRITE-UP - A copy of the building permit will be required BEFORE construction begins and shall be provided by the contractor. The contractor will secure all necessary permits to complete the entire project and must submit to the local entity a signed -off building permit at the completion of the project. IT IS THE CONTRACTOR'S RESPONSIBILITY TO ASCERTAIN, OBTAIN, AND MAINTAIN RECORDS OF ALL REQUIRED PERMITS. $ Provide dumpster service or daily removal of construction debris for duration of contract. Premises to be left in a broom clean condition on a daily basis. 93. ROOFING rip and dispose of existing deteriorated roof covering over residence to bare wood sheathing. `Remove all nails or pound flat. All holes over 1/2" in diameter shall be covered with metal flashing. Provide and install 3/8" CDX plywood sheathing over entire roof area. Nail and space as per manufacturer's specifications. Provide and install eyebrow vents for adequate attic insulation. Provide and install a 240 lb, 25 -yr, Class "A" fire- rated fiberglass composition roof shingles per manufacturer's specifications. Install over a layer of 30# non -perforated roofing felt. REPLACE ALL SHEET METAL WITH NEW: including roof jacks, crickets, saddles and or flashing/edge strips. NOTE: ALL ROOFS TO HAVE A 5 YEAR WARRANTY ON LABOR/INSTALLATION AND A SUPPLIERS WARRANTY ON ALL MATERIALS INSTALLED. (APPROXIMATE NUMBER OF SQUARES: 20 ) Provide and install new gutters downspouts. (TYPE OF GUTTER: Galvanized ) (APPROXIMATE LF: 108 ) (NUMBER OF D.S.: 4 ) NOTE: SOME JURISDICTIONS REQUIRE DRAINAGE TO THE STREET. H I HOUSING REPAIR PROGRAM WORK WRITE-UP - HEATING AND AIR CONDITIONER a. Heating: Provide and install complete forced -air furnace system. Hook up to existing supply and return ducts. Provide registers for each habitable room, blowers, controls, heat exchangers and wall thermostats. Test and balance unit after installation. All cold air returns and ducting in unconditioned space to be insulated•to conform with current code requirements for replacement units. b. Provide and install all materials necessary to replace the swamp cooler. All new work to be done to local code. o► Provide and install a new fan unit in the bathroom ceiling, including all wiring. Install duct to exterior of dwelling. (MATERIALS ALLOWANCE: See Attached Materials Allowance Breakdown) (LOCATION: Bathroom #2) $ 7. PLUMBING Provide and install all materials necessary to run gas line for water heater. All work to be done to local code. $ Provide and install "UL Approved" ignition, glass -lined fiberglass insulated, gas water heater. Connect to existing hot and cold water pipes. Provide pipe fittings, union, supports, shut-off valves, temperature and pressure relief valve. Relief valve shall have a 3/4" diameter copper drain pipe extending to the exterior of the building and shall point downwards. Install a suitable draft diverter and vent pipe. Provide and install a 2" wide by 18 gauge, galvanized metal (seismic) strap around the water heater. Fasten straps to the walls with 3" #10 diameter bolts,into wall framing. NOTE: FOR GARAGE INSTALLATION: Raise the water heater providing a pressure treated wood platform so that pilot light is at least 18" above the finished floor. (MATERIAL ALLOWANCE: See Attached Materials Allowance Breakdown) (SIZE OF HW HEATER: 50 gal) Provide and install a Delta (or approved equal) single control, 4" center, lavatory faucet, with pop-up drain and aerator. Install with new supply valves, tubes and trap assembly. (LOCATION: Bathroom #2) (MATERIALS ALLOWANCE: See attached Materials Allowance Breakdown) E: 3 HOUSING REPAIR PROGRAM - WORK WRITE-UP - Provide and install a breakdown fiberglass stall shower kit. Install as per manufacturer's specifications. Caulk with white mildew resistant caulking. (LOCATION: Bathroom 02) Provide and install a new chrome -plated brass escutcheons and spout with automatic diverter, and 1/2" diameter shower arm tree, and 2 inch diameter shower head at location indicated below. Connect water supply to existing hot and cold water supply line. All new work to be in copper. Use Delta or equal fixtures with an allowance of $75.00 for assembly. (LOCATION: Bathroom #2) El Provide and install light fixture for the room listed below. Use existing light switch for this fixture. (NUMBER OF LIGHTS: 1 ) (LOCATION: Bathroom 02 } (MATERIALS ALLOWANCE: See Attached Materials Allowance Breakdown) $ Provide and install all materials to run new wiring to garage up to code. 143 a. Doors: Replace deteriorated sliding glass patio door with a set of dual -glazed tempered glass sliding patio doors to fit existing opening, with patio locks. Door frame to be (bronze /satin) finish aluminum. ALL WEATHER OR APPROVED EQUAL. (MATERIALS ALLOWANCE: See Attached Materials Allowance Breakdown) (LOCATION: Diningroom ) b. Windows: Remove existing deteriorated window units. Install All - Weather or approved equal, (bronze/satin) anodized aluminum replacement windows in existing window openings with (vertical/horizontal) slider, pin locks and screens. NOTE: CONTRACTOR TO VERIFY ALL WINDOW SIZES (QUANTITY: 6-4x3, 1-3x3, 1-3x2, 1-3x6, 1-8x6) (TYPE OF GLASS: Dual Pane ) 4 HOUSING REPAIR PROGRAM - WORK WRITE-UP - ---------------------------------------- ---------------------------------------- Install new 1/2" thick regular GWB as per code and manufacturer's specifications. Apply metal corners on all outside edges. Tape,top and texture. (Texture to match existing textures.) (LOCATION: Bathroom #2 ) $ Clean all interior walls, ceilings, doors, and trim of all rooms. Remove all dirt and grease to achieve a sound painting surface. Fill all irregularities in areas to be painted with approved fillers and sand [or texture] to match existing surfaces in kind. Paint interior walls and ceilings of all rooms with a premium quality latex paint installed as per manufacturer's specifications. Paint color to match existing as closely as possible. Paint (trim/doors) of rooms noted below and walls and ceilings of kitchens and baths with a premium quality semi gloss latex enamel, installed as per manufacturer's specifications. Colors to match existing as closely as possible. Provide and install a vanity cabinet including cultured marble top with molded bowl. Color and style of unit to be selected by property owner. ALL EDGES OF TOP TO BE CAULKED. (LOCATION: bATHR00M #2 ) (MATERIALS ALLOWANCE: See attached Materials Allowance Breakdown) H Provide and install all materials necessary to replace the deteriorated subfloor in bath #1. 13. APPLIANCES Provide and install a new built-in oven and cooktop. Haul away existing appliance. (MATERIALS ALLOWANCE: See Attached Materials Allowance Breakdown ) (LOCATION: Kitchen ) $ 5 HOUSING REPAIR PROGRAM - WORK WRITE -UP' - 14. INSULATION Provide and install R-30 blown insulation in the attic over area of residence. NOTE: PROVIDE CANT STRIPS AT EAVES (APPROXIMATE SQUARE FOOTAGE: 1,700 011ie] 101 1 -co Ole I k Remove deteriorated vinyl floor. the living WHERE RIGID INSULATION IS USED. $ Provide and install 3/8" particle board underlayment. Securely nail and glue all edges and fields. Apply joint filler at all seams, for smooth finish. Provide and install vinyl 'sheet floor covering with rubber molded baseboard. Use adhesive recommended by vinyl manufacturer. Property owner will select color and design of floor covering. (APPROXIMATE SQUARE YARDAGE: 14 ) (LOCATION: Bathroom #1, and #2 ) (MATERIALS ALLOWANCE: See attached Materials Allowance Breakdown) R Pressure wash the exterior of structure with a 2,000 PSI water blast as needed to achieve a sound and tight painting surface. Allow to dry thoroughly. Burn (hot-air/torch), scrape, and/or sand as needed to remove loose/spalling paint from woodwork. Fill all depressions and cracks in exterior surfaces with approved fillers, to create a uniform finish. Include caulking all lap joints/trim lines for exterior siding. Prime entire exterior with one coat of premium quality oil base primer/surface conditioner, to manufacturer's specifications. Paint entire exterior with a premium quality latex, applied per manufacturer's specifications, to achieve a uniform color. coat. Property owner to have a choice of one base and one trim color. SUBTOTAL $ OVERHEAD/PROFIT $ TOTAL .$ M HOUSING REPAIR PROGRAM WORK WRITE-UP - Any deviation from this bid in cost, materials, labor or scheduling shall be documented in a change order in accordance with the provisions in the owner/contractor agreement. j«i PREPARED BY TOW CELIZ Inspector S -7-9a DATE The undersigned hereby certifies that the above information is accurate to the best of his/her knowledge, that he/she. agrees to abide by regulations and specifictions set forth in this proposal and attached Materials Allowance Breakdown, and that he/she has the authority to legally bind and negotiate for: COMPANY NAME: ADDRESS: TELEPHONE: CONTRACTOR LICENSE: EXP. DATE: DATE I ACCEPT THIS PROPOSAL SUBJECT TO LOAN APPROVAL AND EXECUTION OF OWNER/CONTRACTOR AGREEMENT. OWNER OWNER 7 DATE DATE HOUSING REPAIR PROGRAM - WORK WRITE-UP - MATERIALS ALLOWANCE BREAKDOWN August 7, 1992 Material allowances are applicable only on those attached Work Write Up. These allowances, w purchase prices which are intened to maintain a All items purchased as "allowances" must be ap At the owner's request, the contractor will allowanced items. If it is determined that the on allowanced items than the amount specified amount will be credited to the "Owner" in the reduction in the original contract amount. P lumb ino Water heater (50gal) Kitchen sink (stainless steel, 20 guage min) Kitchen sink (cast iron porcelain) Fixtures (bath and kitchen, Delta or better) Water closet Bathtub (cast iron) Bathtub surround (tileboard bath panel) Enclosure (tempered glass) Electrical Bathroom exhaust fan (no light) Light fixtures (interior and exterior) Light fixtures (florescent kitchen) Doors Exterior (steel, prehung, 6 panel) Interior (prehung) Screen door (security) Screen door (regular) items identified in the hen listed, are minimum given level of quality. proved by the homeowner. submit all receipts for contractor has spent less in this Breakdown, that form of a change order $250 $ 75 $160 $ 70 $150 $250 $ 75 $120 $ 25 $ 20 $150 $100 $ 50 $ 80 $ 50 Cabinetry Kitchen cabinets $150/LF Counter top (formica) $ 17/LF Bathroom vanity (including cultured marble top)' $400 Bathroom medicine cabinet $ 50 Appliances Oven/stove (4 burner gas stove/oven) Air conditioner (1,400 BTU window unit) Wood burning stove (or pellet) Flooring Vinyl (medium to high quality) Carpet (medium to high quality) Miscellaneous Gable end attic vents $350 $500 $1,300 $ 15/yd $ 21/yd $ 30 Bedroom #2 HOUSING REPAIR PROGRAM WORD WRITE-UP - Bathroom #1 Bedroom #1 C 1 Bathroom o #2 s e t J' Hall Bedroom #3 m� Livingroom 9 C7 'K LD oGGv�l Tom Reid Division of Environmental Health Jim Glander- Building Inspection Division 7 County Center Drive Oroville,-California 95965 Gentleman: I/We request an inspection of the property identified below for the purpose of obtaining financial assistance for home repairs under the County's Community Development Block Grant Rehabilitation Program. I/We understand that if this inspection uncovers health and safety. violations, we may be required to remedy these problems whether or not we receive financial assistance under this program. SIGNED: 14ner Owner w�.. 4c- Proper y ress T ionf e 7 a�a—y3 ae Permit#865-84P Wm Connelly 5490 'Debbie Ave, Oro_ y � L' COUNTY OF BUTTE - DEPARtMENT OF PUBLIC WORKS 7 County Center Drive - Oroville; California 95965 - Telephone 916/534-4541 V APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ,nth - / t- - rin4i ZONING BUILDING PERMIT OWNER` — hii. i I �1.Aicr:rlG. nw�iur, r r �/ TELEPHONE Fi: ;R11 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING•ADDRESS- s h 11lnl�n I1r/ t C '' CO"TRACTOR'S NAME 4,e_ :;, t f.A,AA A -r I r A o r- %I c T r ,.�A C TELEPHONE = 7 I CONTRACTOR'S MAILING ADDRESS - - - - iC) IAt11 r i &. e- 'D r.- 1 A) <ett C. �r J i Fireplace CONSTRUCTION LENDER— - UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS ' f?e c,n Thr t�.air a,fG nPrikitl I G PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 - — Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF �r Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other Describe work: flIf% epi A %A A. tr 9::Z,^ i A 0 <`It_ t `"" < �w ni A /'1 IA t�A „T,�('� �` ^�,. G -LG 11 �c Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 .ii - Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.&) OR ADONS. ACC. BLDGS. 21h¢SQft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): r I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No' hnr A f" Classification r y ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR ULTI.OUTLET 2.50 ea NO BRANCH CIRC ITS NEW CONSTR. IPOWER APPARATUS &'1 NON-RESID, SINGLE OUTLET CIR. / Ex. Occup( R 20050¢ OUTLETSSAL0300 APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. O--1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. • ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments,,costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X �- �� 1 �_ _ Date �� ti - J, V A`•' '� �' m�t-� Signature'of Applicant — Owner 1_I Contractor E]Agent2' An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories .in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ 40,/,!n OCCUP. GROUP I TYPE OF CONST. PARCELPD ND ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. - DIRECTOR OF PUBLIC WORKS t �1 ,� .may By,4. 41 14 All l ifl. Date G��7 PERMIT EXPIRES Date '^'� •� '� ""' ' Receipt No. WHITE-D.P.W.• YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPI,�ATMFNT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. EERMMIITNO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT DW L TELEPHONE SQ. FT. OCC. BUILDING VALUATION O R'S MAILING ADDRESS N ACTO A E TELEPHONE 3Qj O TRACTOR'TRYAMS AILING A DRESS gtC f MCDL_Fireplace CONSTRUCTION LEN ER ONKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee .$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUI DING—ADDRESS PLUMBING PERMIT9 Filin Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Z,0,4t Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 �/ USE OF STRUCTURE SF 2? Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: �� p wAaER &R /� �tx- A Q A �'� �� Permit Fee $ Contractor ELECTRICAL PERMIT FiIin9 Fee 10.00 Main service 0ov OR LESS 1 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 21/20sgit CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. Y License No. Classification e-g.� ❑ I, as the owner, or my employees with wages as their sole compen• sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR.ULTI.OUTLET 2,50 ea NO N.RESID BRANCH CIRC TS NEW CONSTR. (POWER APPARATUS &') NON RES,D. 1 SINGLE OUTLET CIR. 1 Ex. Occu Zoeaom Occup(OUTLETS OR FIXTURES 9AL030 A FIXED APP LNS. OR EX. QCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor 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 authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabil'tdgments, os s, and expenses which may in any way accrue againJsjiielp, d Ct in -of the granting of this permit. �� .bra X Date —�DD l Signature kf Ipplicant — Owner Contractor ElAgent®' An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structuresoverover 33 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $�iQ� OCCOP. DROOP I TYPE OF CONST, PARCEL PO HD ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY fia 1AAUa131A J — PERMIT IBES Date M the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. ! 7 7 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT CLAIMANT: ADDRESS: CITY & STATE: n ATC nc rl AICA - County of Butte Oroville, California GENERAL CLAIM Bill Connelly 5490 Debbie Avenue Oroville, CA 95966 11/19/n3 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim- See attached calculation sheet APN: 036-660-005 Permit No.: 02-2811-1 PAID RETAINED REFUND Development Services $ 200.80 $ 123.50 $ 77.30 SRA $ - $ - $ - Sheriff $ - $ - $ - Other: $ - $ - $ - TOTAL $ 200.80 $ 123.50 $ 77.30 .................. ;.. o...... .......... .... .:.'. .:.:... . BREAi{ijiOW1V :::::::::::Bi DGEI`:::: 1�CGO JNF::::A3VIOI31�i`C:: Development Services 440-001 4210500 $ 77.30 SRA 0100 4617240 $ Sheriff 280 1011811 $ - Other $ - TOTAL $ 77.30 $ 77.30 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been pertormed or delivered, and that tnis claim is true and correct as stated.y Fc Dated this )-day day of , 2003, at Cta , Calif. - - Signature of aimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Checthe same. Dated this day f , 200gat Oroville t d or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE -AUDITOR'S USE ONLY DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. CLAIMANT: ADDRESS: CITY & STATE: DATE OF CLAIM County of Butte Oroville, California GENERAL CLAIM Bill Connelly 5490 Debbie Avenue Oroville, CA 95966 11 /1 ?/nn SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 036-660-005 Permit No.: 02-2821 PAID RETAINED REFUND Development Services $ 200.80 $ 123.50 $ 77.30 SRA $ _ $ _ $ _ Sheriff $ _ $ _ $ _ Other: $ - $ - $ - TOTAL $ 200.80 $ 123.50 $ 77.30 .......•.•.......•..... .. .... •. •. •.. .. .. ... •.. «+...... •. •. .. :::BR Ai{iiE W T ::.::::':':::::BDDGET.::A ........ ............... :.: ::::::..:::::.:.•......:.•.•.:. .............. . . , AMOIT1�i.. . Development Services 440-001 4210500 $ 77.30 SRA 0100 4617240 $ - Sheriff 280 1011811 $ - Other $ _ TOTAL $ 77.30 $ 77.30 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this day of . 2003, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or . delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of 2003, at Oroville Calif. Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITORIs USF nNI v DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. I ' REFUND CALCULATION SHEET I MANT: Bill Connelly 4ESS: 5490 Debbie Avenue 'Y & STATE: Oroville, CA 95966 TE OF CLAIM: 11/12/03 APN: RECEIPT INFORMATION NUMBER: 363936 DATE: 10/07/2002 ISSUED TO: Connell CHECK #: 5147 AMOUNT: $200.80 PERMIT #: 02-2821 Yes No Yes No Yes No PRIOR REFUNDS: I X FEES VERIFIED X REFUND BREAKDOWN 440 001 0100 280 DETAIL PAID RETAIN REFUND 4210500 4617240 1011811 BLDG ........................................ FILING FEES Building 20.00 20.00 Plumbing Electric 20.00 20.00 Mechanical PLAN CHECK Plan Check 1 58.501 58.50 Energy INSPECTION Energy SRA -BLDG Building $46 PERMIT FEES Building 90.00 90.00 90.00 :::::::::::::: .............. .......................... Plumbing ............................ ........... Electric 12.30 12.30 12.30 .............. ::::::::::::::::::::::::::::::::: .......................... Mechanical ............................ ........... OTHER BLDG Overcharge REFUND PROCESS FEE 25.00 -25.00 -25.00:.:_:.:.:..... ::::::: ............................ »: >:::::::' ::: »>::' :: >: ........... BUILDING TOTAL 200.80 123.50 77.30 77.30 .............. :::::::::::::::::::::..................... .......................... ......................... .......... . SRA -FIRE SRA - FIRE ........................... ........... Fire $43 SHERIFF - $360 SHERIFF Sheriff OTHER NON -BLDG OTHER $ 200.80 $ 123.50 $ 77.30 $ - $ - $ - $ 7%.3O BLDG SRA SHERIFF 440-001 0100 280 4210500 4617240 1011811 CHECK: $77.30 DIFFERENCE: (Should be blank) APPROVAL Date Reviewed 11/13/200 Michael Vieira 2 Building Manager c7 03 AP NO.: DATES: OWNER: Phone: SITE ADDRESS: Zoning Acres Name/Date Flood Map/Book Page Block Lot Panel Snow Load Other SRA VALUATION CODE SQ FT $/SQ FT VALUATION Garage or Storage Shed U 352 $18.00 $ 6,336.00 0 0 $ - Re -Roof I X I SQ $ 60.00 Calculatesquares 20 ft x 30ft = 60 sf = 6 squares Fireplace A (Zero Clr): Masonry: $ - - TOTAL VALUATION $ 6,336.00 BUILDING PERMIT FEES QTY FEES FILING FEE - "" 1 $ 20.00 $ 20.00 Permit Fee - Full 1 Permit Fee -1/2 (MH& $ 90.00 Plan Check @ 65% Permit Fee ___•._ 1 $ 58.50 Plan Check Minimum/Mobile Home State Approved Plan $ 23.00 $ - Plan Check MASTER PLANS ONLY 7 $ - Revised Plan Check $ 46.00 $ - Energy Inspection Fee $ 46.00 $ - Energy Plan Check Commercial 4000+: $ - Residential To Master: $ - Mobile Home Installation Inspection $ 100.00 $ - $ - TOTAL BUILDINGYPEAMIT FEES $ 168.50 PLUMBING PERMIT FILING FEE :_ $ 20.00 $ Each Trap $ 7.00 $ - Solar or heat pump water heater $ 23.00 $ - Water piping $ 15.00 $ Each gas water heater or vent $ 15.00 $ - Gas piping system 1-5 Outlets 5+ Outlets $15/$3 $ - Building Sewer $ 15.00 $ - Mobile Home Utilities Sewer: I Water: I Gas: $ 20.00 $ - ars TOTAL PLUMBING PERMIT FEES $ - AP NO.: DATES: OWNER: - Phone: SITE ADDRESS: ELECTRICAL PERMIT - FILING FEE 1 $ 20.00 $ 20.00 Main Service 600V or less/200A or less $ 23.00 $ - 200+A to 1000A $ 46.00 $ - New Construction or Addns Dwelling Occupied & Accessory Bldgs 352 $ 0.035 $ 12.32 New Construction Non-Residential Multi -Outlet Branch Circuits $ 7.50 $ Power Apparatus & Single�Outlet Cir. $ - Existing Occupied Outlets or Fixtures1-20 $ 1.00 $ - 20+ $ 0.50 $ - Fixed Appliances or Outlets (Res) ea. $ 5.00 $ - Temporary Service "- $ 23.00 $ - Mobile Home Facilities $ 20.00 $ - Miscellaneous Wiring .. $ 23.00 $ - Pre -Inspection (existing MH, existing site) $ 23.00 $ - Pool Electric -- $ 30.00 $ - TOTAL ELECTRICAL. PERMIT FEES $ 32.32 MECHANICAL PERMIT FILING FEE $ 20.00 $ - Heating Up to and including 100,000 BTU $ 15.00 $ - Greater than 100,000 BTU $ 20.00 $ - Cooling Up to 3 HP and 100,000 BTU $ 15.00 $ - 3+ to 15 HP and Over 100,000 BTU $ 25.00 $ - Evaporative Cooler $ 15.00 $ - Extend Ducts in Additions " ' $ 15.00 $ - Hoods $ 6.50 $ - Ventilation $ 4.50 $ - Gas Fireplace 15.00 $ - .. Is MECHANICAL. PERMIT FEES $ - TOTAL OF ALL BUILDING�PERMIT FEES 200.82 Occupancy: Construction: ISSUED HAZ FEES IMP FLOOD CDF PRCL PD HD Butte County Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the.fees, whose name is on the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued - if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Develo ment Services—fcwpayment processing, CLAIMANT'S NAME: ..... -..,..+.,x....u_ e.�n.i:cn"zana=vvn'vxa'igaP:ala!:n!'n!I=kk :•„,:nr:uN::�R,iaiGx'rxax%JnaxnYvnV+:!:4Fj2,45xii!-pi. arx !Yyy'Y"'a+Y:dv"dx:!YNY"......;.?'Vyv .es;3!xuxazp!`s+'sul'aCpix=; - . n %_a. v,a... -xr,n.ixxka:i:�Fxp''nxxi v :' % Pxa? 01.1 f P:n"4 Y ,dR]!L a n MAILING ADDRESS: :z rx nY Nr , a ? rr nr>, t 4 r n n n n ° ar r ;:� .:, YR nY''4 ' VaS ]GNaur r ' r d Y dA na` a !r �. ... F ..du i 14 n dngm 4 d .. a '! r Vin.' S. S�1 n a n 6.nA ;id PHONE:. d N a 4 a�aa n ,:x r....E.: ......r..!n.-._.......r.S.._ .! n__....... �...,..%._ .....P.._ ad d: n....s d _ .r.. rN 3 r r a•°:�1a;aaaaaa'.a;n'c,Ga`9'::�a!!A:`!ie":%Nrun,a;. n'nVc:x .ggaxa::apaa.!n.nxa%%xx%<!:x.....F:::anx::r5 q, _ n.Yax4:!C.4.nnxxu:v,P..,xx.n..pnn:'4<:nnrzYEn .; !;xax'xxza; ax:.'mxx.:Yxzcnux, x,xzpn: i�nx%ai kii!xxx!!:a.x:N .. naRxaa %ran'!Yi,:dn%axzxc:pn!€nx:„aua:ix::xdal ,- RL6j J '. °xnna 'dz "nn4nxana.'-.'dnni r �i. VC °ad R- .d.aY dtl�d ¢df • nn+iaP}a"Yaa aro ASSESSOR'S PARCEL NO.. d a ` rn..........___...__..a„�a;r__.._.....nx..._....._.n..........�>+:'�?r._...�_....ae_...__..4�_..._....:nxn4xxxx:nax..,xx,n!��nn.anti;::ei9:a?';n�a�Ya:Mw.x+;::�:x,aa;n ii!: "'Y:!5!:i:i"��"i:Sa"xNFV'n:. '. 'IVG"ii5a' ,..• •..;: xY,:Y x vv, - • .. .... I.. .. N... .. a '!!!i'E•':.N; N.:: !4a N4%MvY^'iy::::i1 :Ir..m-N]5F"'•_...•YSpRG::eiiVl!V'x",^V'Gi!ri'Vn",!ii,Gi!4zi:.-..n+a:L::.�ii:iiG•aiv^.5v ahxx<xax...r _ aaSFaeaaEa: !aa nnu : x nF %Na m=`'a ++xa.+n„ ! .:G; is Please use one claim form per permit.] nn: -, n.n.x+:.,,xnna?a?aana n.�nx naaa;a.aa.x �d a; iN, r' N..... k.:aa aax r n nr.x F.d.rx < !ej� yn;° € data,x:nYYaxxan+xux a ,xax.x..Yaraxaaax..r. as ., nadxaxr x..x. [ P P 1 - _ n.;nx,a r:x:xax. i r.:c' :xnxrtnr x !n'vnar d: 'acaan'rxna.aaa+na.aaa' :ertin,:',Ga`"'•a5u"'>'n"xanzxniiieejinei'a':inNr2v"'-.aau°':�::xx::4::x:: ,s>vx: , nrt:..aazzxe- rasa-x<x n,d. dxx„ ..:{i xnx_ .7!I � r arYrv:'!!YGnnn ��.'�"�''..r' :Y :xv�a . ::nd dx4xau ,r nanai'tiannnn:: x a::n""'naaan xx:xx:1a al! Eri x w!nnnnnn'!j±nnn4::::Yndn'�nnnannnn.:+ax,xaxxx,c aGn' uan ... j;nn9i�.,.R +d: a. xa,nxn:nxx:_++ BLDG PERMIT NO. a`a.ax. • ++n,YaxxYxae::avx. -R ---annrxn �•j'; - nnnnnanxagarannxnn~.;'nx;.:�,+,°aa„�'” _ LL�,n„<a:a:nr.'xrR^nadaaaannnnar�aRannaa; ....__..!.«..._......_.............__.._�..._.._._�1.�._..�%:........__.-u..-._,-........................d...-_......a.-...q.L!5..a:...r!...isiax!ii%�_._.S5]:':::9n.-R'S!!:.._.._..-..-....�... Receipt No. 1 Receipt No. 2 Receipt No. 3 rx.Y+zxxq:a„nnxxz>::v x:,aa::xa::::pxr:ana iparxzvvY..rc v:vi!:ny:: q.n.xax+aN:n,::E-,a:aanaxxb ::axx,c:"n'naa"<ai" G u° vnauassn:a x <, .. 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P ..... .. aa: ,p?. ' r a a I ?.:—yn.r .+EaEr LEE.PP,:d a. q 4 }... Yd aHE g ,a/ a' pati /dti8" a3 Ky a.._. k IIr —MUHHURNE '� da ria d n ti 1 / n RECEIPT DATE:.Y Sd9 ay kana�td n ' R a n/ .1, a —,d —� —P, — P r �r.�"" = rfNSS nn I , nrN .' n' .Gin 9n �dn9 '.:.9.'C ' z,a a v 41kq n4s9!dti . !':ssss<. xxx, dr;' na:ax a:xx.,a,.x. ., .. aaas r01-11Hnvv_.ay.v , . xnaanaanann"...x:179 xslxx:n:,vazxxx,xvvy xn , n' papa �dN�a r Nn.. nr �°9:;E1 Bnnan v as aa:v:na`=a nu avazaan nav"v:,v'r.10,aaC+,aaA"- anG=a± '-flE.10,00" axanaanxxrxR RECEIPT AMOUNTaxa xxa.,.ad nxaa+arxa +=tin: xnna• a:aaAtin^atia"a °'va:eR 86,nx+r: na a � a+a..a +n,,:! •_: .,:a::x .:a: n a.xn„ r: aax,+ax g.ax n�3;i aG°RRar. 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Yax.:�i:ax;p�:!an!,.x5,i.a+ae:.xr+.n:.>:xaax.agx]xx.--]ax,wr:P-_.. ,x=::tea, „ x, ::,.,.ax,xx„nn%+,i. Ya..aaaxa,ax..a}_.xxx..<xa....:�.r:..a.!axx...,..ma+na,a.axx,P.a..x.�..,.,.:+_, x,x,.a..�.::x:axa_.,aa+x.....a:..asa=x�vana�aaa:°,:_nnan'::�1^?annnRRna;aana! < x_x x:::xnx:i!-! nn n>x<xax:a:a~ a:n !:!aanx�a ::x,::::,:x}t x:nc:.auvxvxax....xc:::x:xa:anxxx=aY.:as!:vn>,xaarnka::++n+aavazx::z,n .u,ua!n2:r_e:r,mn+xaxx„ ::x+vx:m:xza:a:axaxw :::c_ ......_ ...__._ ..._ _ . ,.. _.. .. ._ R......___ ._. ._ _.rxx�.v!i:,riP.._.... ._".-Pd,nx::avzaxurr::xn!c:ux!,xxu,i:xxdx x q:nM1ri,!Niiv!:N.•>l;!,i_,;aun:;:xxna:,in:vxx::x <.,c...._ „a..<::xxxxvv:: u:,,,:x:n va,axvx,xu Other (specify).R+.xxvp N «._ ....:?x.xxx..,,a.;,,r.., !!..gz!:-x!N.. xzzrtxxxx:ir:.. i:Rx..... . .:. .. ... _. ..... a .._ .. ...... ._ _.. wnNR dk I?..%q N.. Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the tansyou may ick them up prior to that time. ....__ u a:d; !'.!`�i-�iigg�:!N:!:!!le!i!:i::i-i<-_-viis�i::::::x:ix:P4ax�:i: d?';a!:d�: ;a: _ v::da>, =.E:q'^'r•4_.xx. ra-?;;; q;; _l..xd!.,w xd::i: •r ... aLi:i': ...........::...a...:;.".1._c:2..N:.AL!a.:a. _...-...Na.. v..]N.........._...__..........]._.,y_.. Date 140 RESIDENTIAL _1 PERMIT NO. — 036-660-005„ 02-2821 CONNELLY, BILL 5490 DEBBIE AVE., OROVILLE DETACHED GARAGE 0�' SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature J=OK 0 = Not OK Not . NotReadyable MOBILE HOMES Date MOBULE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements - 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking - 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test . 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI. 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 - Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 17. Water Htr.; Vent -Access -Combustion Air Baffle Fireplace Ties or Type A Flue -Fireplace Throat Clearance 18. Water Pipe; Test & Anchor -Nail Protection Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 19. D.W.V:; Test Fittings & Anchor -Nail Protection Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 20. Shower Pan; Test, First Floor -Tub Access Garage Fire Protection Framing -RC Channel 21. Test Tub & Shower, Second Floor -Tub Access Property Line Firewall & Openings 22. Gas Pipe; Sixe & Anchors Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 23. Fire Sprinkler; Test 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) Date 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs Date 46. Headers & Beams -Size & Bearing 59. Glazing Area -Glass Protection -Skylights -Plastic Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes _ 83. Following Instld./Drive O Yes O No/Walks O Yes O No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 O� �+M,IT Flo• (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER S ZONING I BUILDING PERMIT OWNER ' TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 352 U 6336.00 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 6336. 00 ARCHITECT OR ENGINEER LICENSE NO. Film Fee $ 20.00 Permit Fee $ 90.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 58 BUILDINGADDRESS AVE, OROVITLE Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other PRIVATE GARAGE SPECIFY Solar or heat pump water heater 23.00 Water g piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: DETAC:M GARA(;F Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 R LES Main Service ZD.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 1 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.�O/� License Class f� `� Lic. No. 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 Main Service 200A TO 1000A 46.00 NEW CONST. ( DWEwNG OCCS.UP. 3 5QF°: 12• �/� .7�J NEW CONS MUACC-OUTLET NON RESID. @7.50 POWEPPARATUS 8 SINGLERAOUTLET CIR. Ex. Occup. OUTLET OR FaTUREs 20 Q I o0 SAL .50 Ex. Occup.OUTLETS R DOEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirino 23.00 PERMIT FEE S 32.30 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' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation �f one hundred dollars ($100) or less.) 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 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. X _ Date ��7�i_-- Signature of Applicant - C!?Wwfier ❑ 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 Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 200.80 HAZ. D. FEES IMP FLOOD cDF PARCEL I PD HD ISS This permit is hereby issued under the of the Butte County Code and/or Resolutions indicated above for which fees have By /.( PERMIT EXPIRES ON� o applicable provisions to do work been paid. Date 1 46),—.1, Receipt No. 6.3916 $200,80 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541®2� �y p0• (Rev.12/96) APPLICATION AND PERMIT lj ASSESSOR PARCEL NUMBER 036-660-005 ZONING 1'P_1 BUILDING PERMIT OWNER TeLEIFHONE OWNERS MAIUNG ADDRESS r 5490 T)EBBIE AVE QRWIT IF CA 95966 SO. FT. OCC. BUILDING VALUATION 352 U 6336000 CONTRACTOR'S NAME y TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 6-336, OC ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 90.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5490 DERRIF AVE-! OROVIIIE Energy Plan Checking Fee $ $ PERMIT FEE $ 168,90 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other PRIVATE GARAGE SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: DEMACRED GARAGE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 'DDA OR IES.' 23.00 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. //'' f License Class fp®lZ� �j Lic. No. — 'OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law, for the following reason: �0I, 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 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' compensation insurance carrier and policy number are: Carrier Main Service zoOA TO tOooA 46.00 NEW CONST. DWELLING Occup - OR ADONS. ( a ACC. Occ s. 3.5¢x: NEW CONST. MULTI.OUTLET NDN REslo. 97.50 POWER APPARATUS BSINGLE OUTLET CIR. Ex. OCCU . OUTLET OR FIXTURES 20 p 1.00 BAL @ .50 Ex. Occup. ouTIEEOTSA R D.DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 32.30 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation one hundred dollars ($100) or less.) 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 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 Wit9hose provisions. X Date "' �/ Signature of Applicant - O er ❑ 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 $ Energy Inspection Fee $ Occ COINST. TOTAL FEE $ 200.80 HAZ. _ D. FEES IMP FLOOD COF PARCEL pD HD ISS This permit is hereby issued under the of the Butte County Code and/or Resolutions indicate above for which fees have PERMIT EXPIRES O applicable provisions to do work been paid. Date J D l ate ReceiptNo.�9�F,�n(i Rn _ WHITE•D.D.S.-B.D. CA ARY-ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-75 1 PERMIT r (Rev. 12/96) APPLICATION AND PERMIT - ASSESSOR PARCEL NUMBER 0 3 VJ BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDIN VALUATION OWMAIUNO ADDRESS w� C�1 —.— CONTRA T 'S NAME J TELEPHONE -----. CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuatlon $ —_ ARCHITECT OR ENGINEER LICENSE NO. Fling Fee $ 20 OC Permit Fee $ — ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $S _ BUILDING ADDRESS�- Energy Plan Checking Fee $ _ $ _.—._. PERMIT FEE $ , LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00, USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other 1 �)iC�t� rI SPECI Solar or heat pump water heater 23.001 Water piping 15.001- Each gas water heater or vent 15.00! TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 1 5.00 Buildingsewsr 15.00 Mobile Home I S G I W 1720.00 PERMIT FEE _ ELECTRICAL PERMIT Fling Fee! 20.00 "OR LESS Main Service 2GOA OR LESS 23.00; *PERMIT FEE PAID Sn . R/1 SHERIFF O � gHeating AJKOl1W RECIE EO U p ATo a � � �� Main Service 200A TO I000A 46.001 NEW CONST. DWELLING OCCUR 3.5CSF�C. �^,2� OR ADONS. ( d ACC. BLDS. t/d �J NEW CONST. MULTI.OUTLhT 1 NON•RESID. BggNC HSIRCUITS L�_ ^7.5D; �% (FOWER APPARATUS 6 SINGIF. OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 30 (g 1.00- aAL Q .so . _ FIXED APPLNS. OR Ex. Occup. S.00 OUTLETS RESID. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 — - PERMIT FEE MECHANICAL PERMIT Fling Fee 20.00 _ Cooling Hood 6.501 Ventilation I —_ PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TO AL FEE $ `=• D. FEES 000 0 P EL I D , 5� This permit is hereby issued under the applicable provision: of the Butte County Code and/or Resolutions to do wor: indicated above for which fees have been paid. By Date PERMIT EXPIRES ON Dale ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 I PERMIT APPLICATION DATA SHEET OWNER: h 1 Al,�$ESSOR PARCEL NUMBER O 0 QS Proposed Building Use: LCounter Technician#Omar�ked Date: �� IDD - Items required in order to a p for a p mit. All boxes MUST be checked NA in order to pply. 0/ . Plot plans, 3 or 4 sets, signed,ty the preparer of the plans. �. Complete plans, 3 or 4 sets, signed by the preparer of the plans ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 14. ❑ 15. 16. ❑ 17. ❑ 18. ❑ 19. ❑ 20. ❑ 21. ❑ 22. ❑ 23. ❑ 24. ❑ 25. ❑ 26. ❑ 27. ❑ 28. ❑ 29. ❑ 30. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... Statement of Intent for Non -heated and A/C Buildings ........................................ Sanitation and plot plan approval from the Environmental Health Department in e• -Ip 04 City of Chico Plumbing permit........................................................................ California Department of Forestry plan approval 0 paid. Sent by: ...................... Planning approval for (A) Use: cno K, (B)Parking: (C) Parcel Check: 10- 1 O- e1Z_ Contact Land Development about ❑ Improvements, ❑ Drainage ............................... Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). Pre -Inspection for required ................ Contractor's license information. (Number, Name Style, Classification) ...................... Worker's Compensation Carrier and Policy Number ..............:.............................. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... Letter of Signature authorization.................................................................... Recorded copy of Agricultural Acknowledgment Statement .................................... Manufactured home utility clearance............................................................... Existing violations and/or expired permits......................................................... ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone - and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: /0/%/G -�X- 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised cfthe above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, ow er was advised of the abo e dto by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: 6 /O 0 Z- Plans approved by: Date: p 6 d?-- Structural ZStructural reviewed by: Date: f Structural approved by: Date: Note transfer by: Date: Yellow: Buildine Division Department of Development Services Building Division 7 County Center Drive 'Oroville, CA 95965 (53&j538-7541 (530)`538-2140 FAX DETACHED ACCESSORY BUILDING OWNER'S STATEMENT OF USE Plan review will not be started until this form is completed, signed by the property owner, and returned to the Butte County Building Division. Attached Accessory Buildings and Additions will be checked for residential use. Exception: Garages and Carports. Owner: tly,4(4�,_4 _QAm,_ c0=14 Phone: 5' Mailing Address ti (4 °D &. L, off- Site Address: exx Assessor's Parcel Number:. ��p r (Q 0 O' Zone: �' I f16' -Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of this form. GENERAL INFORMATI0N: 1. Is there a primary dwelling on the property? YesJ5 No ❑ 2. Is the structure already built, under construction, or under notice of code violation? Yes ❑ No 3. Will items produced in this building be offered for sale? Yes ❑ Noig 4. Will the public have access to this building? Yes ❑ No,® 5. Will any advertising, on or off site, be associated with the use of this building? Yes ❑ Nojjj) SITE CONDITIONS: 6. Is the structure foundation within 5' of septic tank or 10' of leach lines? Yes ❑ No [ff 7. Is any portion of the structure located closer than 20' to your front property line? Yes ❑ No ER S. Do you plan to add a driveway or modify existing access to a county maintained road? Yes ❑ No f` 9. Will the proposed structure encroach within any recorded easement? Yes ❑ No E' CONSTRUCTION FEATURES: 10. Will this building have insulated floor, walls, or ceiling? Yes ❑ No EB 11. Will this building be heated or cooled? Yes ❑ No 12. Will this building have a water closet/toilet? Yes ❑ No E' . 13. Will this building have a sink? Yes ❑ No ®' 14. Will this building have a water heater? Yes ❑ No 0 15. What type of floor covering will the building have? 16. What type of wall covering will the building have? � OVER 1 of 2 PROPOSED USE: (check only one box) 1. ❑ Residential Storage Shed — I will be storing' in this building and it will not be used for any other purpose (no bathroom andno. heating or cooling). 2. Private Garage — "A building or a portion of a building not more that 1,000 square feet (3,000 by exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are stored or kept." A garage door is required. 3. ❑ Residential Carport — A covered structure intended for parking of vehicles. Two or more sides must be entirely oven. 1. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport. If you checked ##4, please check the uses below which best fit this building. ❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-law quarters ❑ Recreation Room ❑ Game Room ❑ Study ❑ Library ❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio ❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Sewing Room ❑ Canning Kitchen ❑ Music Room ❑ Family Room ❑ Sun Room ❑ Private Office F-1Workshop 1 ❑ Home Occupanry 2 ❑ Other — Use = I. Describe type orworlohop :. Must be approved by the Butte Coutuy Plamting Division Explanations: This area is for explanation of any "yes" answers on questions 2-14. Please indicate the question number before the explanation. Additional Information: Plan review will not be started until this form is completed and received. A Plans Examiner will contact the owner with specific requirements per the use indicated. I hearby affirm under penalty of perjury that the above information is true and correct. I understand that any changes to the use, or character of use, of this building will require permits from the permitting authority. I understand that Real Estate Disclosure laws require disclosure of this information if or when the property is offered for sale. O�ioo %-ner's Name: Please Print W : l l f `" -) `} Owner's Signature: Date: 2 of 2 �