Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
078-280-005
Y JACK WALKER 3090 Oro Bangor Hwy, Oroville LL Contr: LeGrone Heating & AC, Oro°�� 7 � • Permit#3586-82P,M(replace htg &.AC OZ -0 . 1 system)SF A i 3.x-3 1- 923._1F /'�jlKq 9jy Permit,#2057-83B(add covered patio/SF) j Contr: Acro Lume �/� -P_Prmi_t4k3.2_4.3�84B,E(n'ew g�)��� 93-99O_B_______`) WALKER, JACK & DOROTHY 3090 ORO BANGOR HWY, OROVILLO h.Cl CONTR: VINYL DESIGNS VINYL •SIDING/SF., 01-2084 SAETERN, OU SIN rl iJtt- 3090 ORO BANGOR OROVILLE CONT: LUMEN ELECTRIC $I3 Ohl ELECTRIC SERVICE CHANGE 0� 01-2128 SAETERN, OUSIN 'Aug f 3090 ORO BANGOR, OROVILLE VINYL SIDING 078-280-005 06-0140 TERN, TONY OU 3090 ORO BANGOR, OROVILLE Cont: OWNER -05 RE ROOF ka Aa f L ' i Ii I. ' P.C. T �v:s.+w•v f.� . «rte_ .�:. �• ;.:r,, ,..rw" �•.T.+«•` ..:-..., ,;� .. ..•.-•., .... .,.-...�.- ._ ., .- 9 ... �. ���::}�..-. ` 036-023-004 01-2084 SAETERN, OU SIN' 5 3090 ORO BANGOR OROVILLE CONT: LUMEN ELECTRIC ELECTRIC'SERVICE CHANGE >r' �~ ,�VO-o 2L) �k� r • n OFFICE COPY Address Y G AS Mete -r By Date ELECTRIC Meter By ` D `f COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT O. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 036-02.3-004 ZONING AR BUILDING PERMIT OWNER SAEMNI, OU SIN TELEPHONE 532-4255 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 3M ORO BAN" WY MOVIT LE WA O�N�1T�RRA��CCTTO��rR'S NAME CONTRACTOR'S JfUmic TELEPHONE 511-1170 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation is ARCHITECT O NGIIOEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT1- RES Plan Checking Fee $ Syl IN DR Ss 0 vjw, CA 95966 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNISIGNS PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF 0. Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 e TYPE OF WORK New ❑ ❑ Remodel ❑ Utilities 1 Installation ❑ Other ❑ • Describe Work: FLFi''IiiTC,AT. SERVICE MAF F'Y AM Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 OR LESS Main Service p A OR LESS 23.00 i 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 i //'? 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 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.) 15� 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' compensatiggn provisions of section 3700 of the Labor Code, I shall forthwith comply witIft o e provisions. X Date - 40 , _ Signature of AppfiCant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in hei�7/�o ght. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( 6 ACC. BLDS. 3.5QFT. I,K)µREOSIU MUL,', U ET @7,50 POWER APPARATUS 8 SINGLE OLlTLEr CIR. E(, OCCU CUTLET OR FIXTURES SAL ® 1.000 Ex. Occup. OUTLETS(RESIO.DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ' _ 7 -- -- PERMIT FEE $ F` MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FE1= $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 66.00 HA2. D. FEEs IMP I FLOOD I COF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By ,Date Of PERMIT EXPIRES ONS eta Receipt No..=2 el" 1746 , ) WHITE-D.D.S.-B.D. CANAR AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT NOTES RESIDENTIAL PERMIT NO. 036 023-004 01-2128 SAETERN, OUSIN 3090 ORO BANGOR, OROVILLE 1 VINYL SIDING 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) r Signature { 1 i i i RESIDENTIAL PERMIT NO. 036 023-004 01-2128 SAETERN, OUSIN 3090 ORO BANGOR, OROVILLE 1 VINYL SIDING 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) r Signature J = OK 0 = Not OK - = Not Applicable * = Nol Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 8. 1. Zoning Requirements -Setbacks -Easements 9. 2. Soils; Special MH Support Sketch 10. 3. Sewer; Location -Test -Fall -C/O -Concrete 11. 4. Water; Location -Test -Easement Needed (Sketch) 12. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /"L"tt./ /'LPG 7. Well Clearance 8 Disconnect 8. Utility Clearance FINAL (Plans) OK except #'s 1. Setbacks -Easements Date Soils; Compaction -Structure Stability Card B-1 Date Card B-1 Date Pool Structure; Steel -Connections -Thickness Dead Men -Lining 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 Can. Date 10. Exits; Insp.-Sketch Date 11. Cert. of Occupancy 12. Permanent Foundation Only; License Decal 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 r 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 FINAL (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 in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 /= OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (: Date Underfloor (Plans) OK except #'s Hangers -Post Caps -Anchors -Connectors 1. Zoning-Setbacks-Easements-Flood-Slope Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rfng. 2. Ftg., Main; Soils-Elec. Grnd.-/ r Ftg. Depth Fireplace Ties or Type A Flue -Fireplace Throat Clearance 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ r Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4. Ftg., Porches & Decks; Soils-Steel-/ r Ftg. Depth Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 5. Stemwalls, Main; Steel-Blockouts-Wrapped Garage Fire Protection Framing 6. Stemwalls, Garage; Steel- Blockouts-Wrapped Property Line Firewall & Openings 6a. Hold Downs and Special Anchors Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 7. Slab, Steel-Wrapped Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 8. Piers-Fireplace Ftg.-Steel Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 9. D.W.V.; Fall-Fitting-Test-2 Way C/O-Sewer Test Siding -Nailing Veneer 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 11. Water Pipe; Test-Anchors-Regulator-Service Test Glazing Area -Glass Protection -Skylights -Plastic 12. Electric Underground Shear Walls; Nailing -Bolts 13. Plenums & Ducts; Clearance-Material-Support-Ins. Brace Interior/Exterior Wall Panels 14. Girders-Sills-Anchor Bolts-Joists-Vents-Crippies Insulation -Walls -Ceilings 15. Access & Ventilation Infiltration -Walls -Windows 16. Insulation Date Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings 17. Water Htr.; Vent-Access-Combustion Air Baffle Smoke Detector 18. Water Pipe; Test & Anchor-Nail Protection Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 19. D.W.V.; Test Fittings & Anchor-Nail Protection Bedroom Exiting 20. Shower Pan; Test, First Floor-Tub Access G.F.I. & Bath Fixtures & Tub Access -Spa 21. Test Tub & Shower, Second Floor-Tub Access Elec. Trim & Subpanel, Breaker Sizes & Labels 22. Gas Pipe; Sixe & Anchors Stairs & Rails 70. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Elec. Outlets & Receptacles at Kit. Counter 23. Fixture & Transformer Clearance-Ins. Protection Garage Fire Door; Swing -Landing -Closure 24. Elec. Receptacles Spacing-Lights & Switches at Doors A.C. Duct in Garage -Damper 25. Size Boxes & No. of Conductors Stapled Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Romex Installed Close to Edge of Studs & C.J. Plb., Elec. & Mech. Equip. Listed for Location 27. Equip. Ground made up w/Mech Fasteners-Bond Gas & Water Elec. Receptacles in Garage (F.F.I.)-Romex Protection 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI Insulation -Foam -Looked in Attic 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI Guard Rails & Deck Construction -Post Caps 30. Range Circle / / ga Cu or AI-Oven Circ. / / ga Cu or At Insulated Neutral ❑ Yes ❑ No Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Service-Riser Conductors & Ground Main Disconnect Clearance Looked under Floor O Yes 32. Equip. Clearances Panels-Motors-Mech. Equip. Following Instld./Drive :1 Yes p NoMalks ❑ Yes :) No/Planters Yes ❑ No 33. Clothes Closet Light-Shower Light-Spa Light Stucco Brown -Finish 34. Smoke Detector A.C. Unit Disconnect, Electrical -Plumbing 85. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Ventilation Throughout House 35. A.C. Ducts Insulation & Support Glass Protection 36. Vent Fan, Exhaust above insulation Corrections from Previous Inspections 37. Condensate Drain & Overflow, Size & Grade Gas Test -Meters Tagged, Gas -Electric 38. Furnace-Vent Access-Comb. Air-Return Air Vent 115 outlet Water & Sewer Connected -C/O to Grade -HD Approval 39. Attic Access & Platform if Furnace in Attic Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Date FRAMING (Permit) OK except #'s Comments at Final: 40. Sits Proper Materials & Anchors 41. Walls Studs-Nailing Spacing & Braces-Plates-Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings-Stairs-Chasers-Tubs 45. Headers & Beams-Size & Bearing >ingle & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. 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 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 82. Following Instld./Drive :1 Yes p NoMalks ❑ Yes :) No/Planters Yes ❑ No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted 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 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT 01-212$(., ASSESSORPAi0�C¢j M73-.4 36 ZONING BUILDING PERMIT OWNER OUSIN' SAEURN TELEPHONE 5�")'�-4255 SO. FT. OCC. BUILDING VALUATION EST- 6200.00 OWNERS MAILING ADDRESS 5090 ORO BANGOR, OROV'I,i.$' 95966 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 6200.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 90.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 3090 ORO BANGOR OROVIME Energy Plan Checking Fee $ PERMIT FEE $ !O, LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 1 7.00 USEOFSTRUCTURE SF EX 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 ❑X Describe Work: V'1'1QYt, SIDING I NSTAI ED RRFMITS BY PitEVIO1IS IMMER Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W (GP20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200AORLESS 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.POWEPPARATUS License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License w 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. ..GN" I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. I 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.) "'I7• 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. � t+G i CDate "` iF�" e..' % rXignature 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 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO LAS. 3.5¢ OR ADONS. ( a ACC. Bx," Np pESIp ' MULTI.OUTLET 97,50 8 SINGLER AOUTLET CIR. 20 .00 EX. Occup. OUTLET OR FIXTURES BAL 0 1.So Ex. Occup. OUTTLEETSR�D.) E& 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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 $ 110.00 HAZ. p. FEES IMP FLOOD COFpARC0. PD HD IS 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. ,a t �uss �� Date i ®"✓ PERMIT EXPIRES ON✓ r't 1 41Defe ReceiptNo.� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 PERMIT NO. BP060140 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 01/20/2006 APN: 078-280-005-000 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 Site Address: 3090 ORO BANGOR ORO effect. License Class : License Number: Map Index: Date: Contractor: Description: RE -ROOF (16 SQ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Owner: TERN TONY OU & KHAE SHELLY Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 3090 ORO BANGOR HWY signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA 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 95966 she is exempt therefrom and the basis for the alleged exemption. Any (530) 532-0557 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I� I, as owner of the 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 Applicant: TERN TONY OU &KHAE SHELLY Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 3090 ORO BANGOR HWY provided that such improvements are not intended or offered for OROVILLE, CA sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 95966 proving that he or she did not build or improve for the purpose of (530) 532-0557 sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Prdfessions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' State License Law.). O I am Exempt under Article 3 of the Business and Professions Code Dale: igO6 Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: License #: CII 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. Architect: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy#: Total Square Ft: 0 S. F. Valuation: $0.00 C3I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 0,0 -OG 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 Code and/or I hereby affirm that there is a construction lending agency for the Resolution to do work indicated bove for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Date: Name: By: PERMIT EXPIRES ON: Address: (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code. which regulate the storage. handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health' & Safety Code is not applicable to the scheduled construction) of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify. that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and stale 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. Print Name: l' Oh y �P�� Signature: c �Z 6 Dale: 24 0wner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor IN.- 0-41"IMPA' � U BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND. SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE 9: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name 7-e✓ki First Name; O Address 016 City 0"0 WN- StateC� n om' Zip q h—!6j Phon 5_3 U 53 G 5-S Fax E-mail APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State . Zip Phone Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning AP# Flood Zone Property Address 3090 SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL KLQUIKLIV1t_N l5 PERMIT NO. BIN # Description or Scope of Work: PROJECT LOCATION AP# - 9S0- o05 Property Address 3090 oro r Cit �r ovi Ile Cross Street WORKER'S-COMPENSATION- ORKER`S COMPENSATION -...Policy PolicyNumber Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Re -rod 1 co SQ) Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. -- 00 Received by: K Amount: (to, Bldg SRA Receipt #:q 1 3W7 Sheriff SMIP Other Dater -20-OG 'rly � Total SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in. triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5.. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. El 8; Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if'required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. O 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the.person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary. delay in processing -and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [�/+ NO [ ]. 2. I HAVE [-] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: . NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: DATE: �– 0 NOTE- This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services. IN O T E S 7 County Center Drive, Oroville, CA 95965 (530) 538-7601 v%-v.butteco�mtyneVdds RESIDENTIAL APN: CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE c » DATE JOB FINALED: `SIGNATURE: 078-280-005 06-0140 �• 1,0wner- _ TERN, TONY OU 3090 ORO BANGORN, OROVILLE ` Site Address: _ Cont: OWNER RE ROOF Contractor. Type of Permit: CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE c » DATE JOB FINALED: `SIGNATURE: = OK MANUFACTURED HOMES MISCELLANEOUS DATEPERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/CIO-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat Q or LPE • Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr ' 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D EC K S'C O V E R S`C A R P O R T S `G A RAGES 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts -Beams -Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls s` r DATE IPOOLS 1 Setbacks -Easements 2 Soils; CompactionStructure Stability 3 Pool Structure; Steel -Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7. Elec Bonding; Metal w15'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bones-Enclsrs-pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Encisr, Fencing Alarms 13 Bonding, Diving board or Slide p� 0� Os 0w 1�15 0 4e ds Pool Drawing OK = N°1 RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Fig Porches/Decks; Soils -Steel ' Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd flr - Tub. Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 69 Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fali-Fitting-Test-2-way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1.1 Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE M E C H A N I C A L 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 61 AC Ducts Insultn & Support 14 Girders-Sills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16. Insulation 64 Furnace -Vent Acc-Comb Air Rtrn[Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic DATE FRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clmc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrflr Acc 35 Glazing Area -Glass P rtctn -SkyLts-Plas tic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Ins ultn-Walls-Ceilings 39 Infi Itration-W al Is -W ndws s DATE JELECTRICAL 40 Fxtr & Trnsfrmr CImc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GF] 47 Subfeed Wire Sz ga ❑ CU or [:1 AL AC Wire Sz ga ❑ CU or ❑AL 48 Range Circ ga ❑ CU or ❑AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral E] Yes F-1 No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp CImcs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clmc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Lottn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Dmge Planters ❑Yes ❑No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc to Opngs 90 Wtr Well, Dscnnc% Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous lnspctns 95 Gas Test -Meters Tagged, Gas-Elec .96 Wtr & Sewer Cnnctd-C10 to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted -99 Fire Sprinkler �� s COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 01 —21 28 ASSESSOR T�f1UMM-004 (� ZONING BUILDING PERMIT OWNER OUSIN SAETERN TELEPHONE 533-4255 SO. FT. OCC. BUILDING VALUATION EST 6200.00 . OWNER'S MAILING ADDRESS 30.90 ORO BANGOR, OROVILLE 95966 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 6200.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 90.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 3090 ORO BANGOR OROVILLE Energy Plan Checking Fee $ PERMIT FEE S 110.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF IN 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 ❑X Describe Work: I'TINXISIDING—I� STAI I EIRERD4ITF) Bu IRR 1.11101-12— Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W (iP20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 600V ORLESS Main Service zo..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 aw 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. —2r I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. I 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.) .®- 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. Q X ` _ Date �— �7_©� gnatureof 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 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR SO OR ADONIS. ( . ,,DµpalpT MULTI.OUTLET 97.50 OWER APPARATUS 8 PDLE OUTLET CIR. 20 Ex. Occup. OUTLET on FixUREs ' BAL .SO Ex. Occup.. ounFrs AE�ssiD.OE. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI: $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 110.00 HA2. D. FEES IMP I FLOOD I COF PARCEL I PO I HD ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated eb ve for which fees ave been paid. 10 V za §"� toReceiptNo. PERMIT EXPIRES O V Oen 3 19 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 PER No. (Rev. 12/96) ; APPLICATION AND PERMIT 1 a 1 a"0 ACCECCORPARCELNUMM ! Z'~NO BUILDING PERMIT owNER Texr�aNe OCC. BUILDING VALUATION �'1 (�- � 3-' S0. FT. —T!MUNO AD CONTPACTORI MOW NO AODM8 CONSTRUCTION LEWEA ILENOEA'C MNLNO ADDRESS ARCHITECT OR ENGINEER UCENCE No. ARCNRECT OR ENONEERI "QUIN10 ADDRESS LAT NO. 1111JOWIS 'S NAME USEOFSTRUCTURE SF Duplex O Mobllehome ❑ Other sPeclFv TYPE OF WORK New O Addition O Remodel LJl95ft ❑ Installation O Describe Work: 1/ ,I 1 ` �Q (jam ri LAS owk\-� *PERMIT FEE PAID SRA '- SHERIFF OTHER AMOUNT RECEIVED •RECEIPT NUMBER 33 • TO BE PVT INTO COMPUTER Valuation Is rnin i-ee s Permit Fee y Plan Ch cking Fee s Energy Plan Checking Fee s s PERMIT FEE s PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping Each gas water heater or vent Gas piping astern 1 - 5 outlets Building sewer Mobile Home S G W PERMIT FEE I It 20.00 91ing Fee 20.00 7.00 23.00 15.00 15.00 15.00 15.00 @20.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service °O°'r 0R LEss 2'OOA OR tEsa 23.00 Main Service 260A TO IOWA 40.00 11E14 CONST. DWELUNO OCCUP. ORNEV—ADONs. A ACC. aLDS. 3.5QR. NON•RE910. MULTI -OUTLET @7.50 POWER APPARATUS A SWOLE OUTLET OR. Ex. Occup. OUTLET oR PottLRE8 --g-0100 I 6AL SO � Ex. OCCV 0Vnt I TsESID. EA 5.00 1 Tem orar Service t 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 G.50 PERMIT FEE s Mobile Home Installation Fee $ Energy Inspection Fee s ' ocC 06"T• TYPE TOTAL FEE S IHAz. D. FEES I LMP I rLAoO CDF PARCEL I ND I ISSUE This permit Is hereby Issued under the applicable provisions Of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT o. �j/ (Rev.12/96) APPLICATION AND PERMIT � T ASSESSOR PARCEL NUMBER 036-023-004 ZONING AR BUILDING PERMIT OWNER SAF!"ERN OU SIN TELEPHONE 532-4255 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 3090 OR CONTRACTOR'S NAME LUMEN ELECTRIC TELEPHONE CONTRACTORS MAILING ADDRESS �O CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flirt Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 309IN0 ORO BANGOR MI . OROVILLE CA 9906 Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF N Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 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 )p Installation ❑ Other ❑ Describe Work: .F.M RLC —SERI-TC.F C14ANfsE EX � Gas piping system 1 - 5 outlets 15.00 . Building sewerrF 15.00 Mobile Home S G W Q20.00 E PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service '..A ORBS 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. S�� ^ �r ` (/ License Class (� O Llc. No. J OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. �C3 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWFILING OCCUR OR ADDNS. ( a ACC. sD REB OONST MULTI.OUTL NON - U 97,50 POWER APPA US a SINGLE OIJTItT CIR. Occup. Ex, OOUTLET OR FDRURES RAL @ I'00 LNS Ex. Occup.. ouT FIXE�s p s,D,°EA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE -INSPECT - PERMIT FEE $ 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 We valuation of one hundred dollars ($100) or less.) 1Z 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' compensa i n provisions of section 3700 of the Labor Code, I shall forthwith comply wit th a provisions. �l �- — Date 5 oZa -B r Signature of A cant - Owner ❑ Contractor Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in he'ght. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI: $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 60.00 HAZ D FEES IMP I FLOOD I CDF PARCEL I PD 1 HD ISSUE This permit is hereby Issued under of the Butte County Code and/or indicated above for which fees have B PERMIT EXPIRES the applicable provisions Resolutions to do work been paid. d Dat Q d 7 fe ReceiptNo. :or 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) 538.754 P -R NO. (Rev:12/96), APPLICATION AND PERMIT _ ad re% RNER'S ESSOR PARCEL.- ZOW HER BUILDING PERMIT — NE CV •; S �' -M 7��� SO �• OCC. BUILDING VALUATION MMUNO ADDRESS - L C% /K <kc Z-Xl c �NTRACTORTI MMJNO ADDRESS �^ �O QLc1% G✓-^�/L�c�/'%/fit' CONSTRUCTION LMER LENDER'S MNUNO ADDRESS ARCMITECT OR ENMNEER LICENSE No. AACNnECT OR 04ONEUM MAUNO ADDRESS ::j I LOT NO. I SUSONLSION•SW1ME I USEOFSTRUCTURE SFP Duplex O Mobilehome 0 Other New O Addition O Describe Work: TYPE OF WORK O Utilities O installation O� Other *PERMIT FEE PAID SRA SHERIFF OTHER AMOUNT RECEIVED $_ 6 6 - 0c) *RECEIPT NUMBER * TO BE PUT INTO COMPUTER Fire Ince Total Valuation E Fling Fee Permit Fee Plan Checking Fee Energy Plan Checking Fee E S E a PERMIT FEE i Main Service oR LEss PLUMBING PERMIT Each Trap Soiar or heat Pump water heater OA OR LESS Fling Fee 7.00 23.00 Water pi In 15.00 Each gas water heater or vent . i ACC. aLDSNM 15.00 Gas piping system t - 5 outlets 15.00 Building sewer 8 SIN OUTLET CIR. 15.00 Mobile Home S G W 020.00 — PERMIT FEE S ELECTRICAL PERMIT — Main Service oR LEss OA OR LESS ' Main Service 200A To 1000A NEW CONST. OWEu_"O OCCUP. OR ADDNS. . i ACC. aLDSNM CONST- NON•RESID. MULT40LTLET POWER APPARATUS 8 SIN OUTLET CIR. i Ex. Occup. OUTLET OR FWTUREs 23.00 4e.00 ia5 z. 07.50 20.00 20.00 20.00 t Ex. OCC- . FIXED APPI.M. OR 40 .30 I OUnt�s Esio. EA 5.00 1 Temporary Service . 23.00 Mobile Home Facilities • 20.00 Misc. Wiring— — - 23.00 .—_ PERMIT FEE ti MECHANICAL PERMIT Fling Fee 20.00 Heating 6.50 PERMIT FEI: S Mobile Home Installation Fee i Energy Inspection Fee E I oco CONST.troE TOTAL FEE Z NAZ• 10. FEES I WP I FLOOD I COP I PARCEL I PO I IID I 6SUE 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 PERMIT EXPIRES ON Date r 11''.1. � � .. •,. X '.;R'4. ':�f .1YR. <.' �'" �:: d' � 17.;f•. ..i. 5��- ;W + 'i.1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: S - ASSESSOR PARCEL NUMBER: o Z N _D;L 3 Proposed Building Use: _44A Ck/k5l. Building Inspector: 27 Date: At time of permit application, I was advised tl9 following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- E32. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ 03. ----------------------------------------------------------- ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.-------- 115. ------- ❑5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ ❑ 6. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------ ❑ 10. Fees of $------------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. --------------------- ❑ 12. California Department of Forestry plan approval/fees.------------- 1113. ------------❑13. Flood elevation certificate. --------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. 1115. City of Chico plumbing permit. --------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ❑ 17. Planning approval for (A) Use: (B) Parking:. ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 19. Encroachment Permit (construction approval prior to occupancy). --------------------- �21 0. Pre -inspection for E' w C/,,C/n 9 Qrequired. Request to Building Inspector on 021. Contractor's license information. (Number, Name Style, Classification). ----------------------------- 022. Workers' Compensation carrier and policy number. --------------------' ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). 024. Letter of signature authorization. ------------------------------------------ 025. Recorded copy of Agricultural Acknowledgment Statement. ----------- 026. Letter of intent on building use. -------------------------------------------- 027. Manufactured Home utility clearance. ------------------------------------- 028. Existing violations and/or expired permits. ------------------------------- 1:129. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ 030. Other: (Date) en you issue theermit, rocess follows El Mail to owner, ❑Mail to contractor. elephone Cj3 �3 �� as and hold for pickup at 0 Q D office. ❑ Deli er with inspector. Applicant: Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution ate: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. El B.I_N. REQUEST FOR I SPECTION Permit No. a> © Location: Owner. C^'� 41`' ContractororTenant: C. n: 11 , PLUMB/MECH LECTRIC M.H.I./M.H.U. B DG. NSPECTION _F.o Rough Frame/Underfloor Top Out Temp. Service Corrections Final Housing 9 Job Status Stucco 'CathPermit Gas Piping/Test Service Temp. Gas Underground Renewal Stucco Brown Fireplace Sewer Piping Well Circuit Verify Utilities Bond Beam Water Piping Light Niche OTHER Insulation SV— rl� Nailing �` Corrections — Corrections Corre ions Final READY FOR Q� �'�a,3, Final Final INSPEC. ON 19 —AXP-. Date: Time: Note: Ste` -- �s �47 ��, ��I/ lr✓2 . PRE -INSPECTION REPORT LOCATION: 9 0 ne) U CONTRACTOR: PRE-INSPETION FOR: �9- 011(it1_n6;W DATE: A.P. #- ZONING: DATE TO INSPECTOR: PERmrr HLSTORY:( ONE ( 4S FOLLOWS: BUILDING INSPKL-rOR'S REPORT Building Description: Commercial/Usage: Residential/# of Units: Currently Occupied Abandoned/Vacant Electric: Yes No Electric currency On Off Condition of Electric Gas: Natural Propane None Currently On Off, Obvious Problems: Sanitation: Plumbing Working Well Working Potable Water Obvious SewageProblems ACTION RECOMMENDED: ISSUE: _ HOLD FOR _(�L���. Inspector: 2) -1q Sketch buildings on reverse and indicate location on property. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. tRevr,2/9t3) 3 - -OCA APPLICATION AND PERMIT AssasoR►ARcnNu no BUILDING PERMIT �3b-a�3-Ap __ OU -SI�Q AI Teurm"�SQ. FT. I OCC. BUILDING VALUATION 33--/370 (3pWRACTW1 M"J►a Wome UNOER's MA%M AOORESS ARCHITECT OR COMEER MENBE NO. EN9 ARCH"M OR ONEEAVQuNO AOORE98 WT W. I susOly "wo mME USEOFSTRUCTURE SF Duplex O Mobllehoma O Other •PEcsv TYPE OF WORK New ❑ Addition O Remodel ❑ UM ❑ installation 0, Other Describe Work: A - *PERMIT FEE PAIb SRA •- SHERIFF OTHER AMOUNT RECEIVED *RECEIPT NVMSER * TO k PVT INTO COMPUTER Fireplace Total Valuation Is Filing Fee S Permit Fee $ Plan Checkina Fee 5 Energy Plan Checking Fee E S PERMIT FEE $ PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping Each glas water heater or vent Gas piping system 1 - 5 outlets Buildin sewer Mobile Home I S I G I W PERMIT FEE 1 $ 7.00 23.00 15.00 15.00 15.00 15.00 @20.00 20.00 0.00 •V PERMIT FEE S 00 MECHANICAL PERMIT Fling Fee 20.00 Hood I 1 6.501 1 PERMIT FE1: S Mobile Home Installation Fes $ Energy Inspection Fee S acC 4NST�T20TAtL:FEES AM�� HAL CO/ PAR 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. I By Date PERMIT EXPIRES ON ELECTRICAL PERMIT Filing Fee 20.00 - Main Service ��Itsa 23.00 (J. Main Service looA To r000A 48.00 NEW CONST. OWELlHO OCcuP. o. OR AOONS. i ACC. BUDS. 3.5orT. NO"ESIO. MULTI -01 M ET @7.50 POWER APPARATUS Ex. OCCU . ovnET OR fDUREB 20 0 i•-- R GAL .90 I 1 FIXEDp E, 5.00Ex. Occu , 1 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirino 23.00 •V PERMIT FEE S 00 MECHANICAL PERMIT Fling Fee 20.00 Hood I 1 6.501 1 PERMIT FE1: S Mobile Home Installation Fes $ Energy Inspection Fee S acC 4NST�T20TAtL:FEES AM�� HAL CO/ PAR 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. I By Date PERMIT EXPIRES ON 36-023-4 JACK WALKER Fin 3090 Oro Bangor Hwy, Oroville 1gq Contr: LaGrone Heating & AC, 0,104 oo+�' Permit#3586-82P,M(replace htg & AC system)SF _ 36-023-4 I'iKa Permit #2057-83B(add covered patio/SF) > -4 Contr: Acro Lume agoer-mitlk3243 �36-02 _ 036-02-3-004 93-990 B� WALKER, JACK & DOROTHY 3090 ORO BANGOR HWY, OROVILL'k cl CONTR: VINYL DESIGNS VINYL SIDING/SF S f � le ` -C) Bufteeounf*of OROVILLE, CA,LIPRNIA GENERAL' CLAIM CLAIMANT: Vinyl Designs ADDRESS: 11344 Coloma Rd. CITY & STATE: Gold River, CA 95670 IMPORTANT: May 10, 1993 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE r, SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT 4 Owner has decided not to do work. Permit #93-990 B AP#036-023-004, Receipt #140483, dated 4/15/93. Total Permit Fees Paid -------------------------------- $90.00 Retain Building Permit Filing Fee--------- $15.00 Total Permit Fees Retained--------------------------=- 15.00 TOTAL REFUND DUE -------------------------------------- $75.00 TOTAL $75 00 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performs delivered, and that this claim is true and correct asj/stated. 9z ///� p Dated this ......<�.��CJ�... day of ,��1!`„I n!`- 19.1. A et ��(X /t /�G Cel1..... ................................ {� Si ature of Claimant ' I, the undersigned, hereby certify that, to the beat of my knowledge, the services or articles spec d above a been performed or de• ' livered and that there is a Budget Appropriation ❑ or Specific Board Approval ❑ (Check one) forte ame t, Dated this .......... !Otl1.............. day of ...MaY.................. 19 93 at Oroville...... Calif. . ..... .. ....... .............. _...... Department Head or Authorized Deputy Dep” Code 440-002 .................... C de ........ 421.. . Q .................... PAYABLE: FROM ........iiS�iASX.w...A.t* IA7............................................ 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. COUNTY OF BUTTE BUILDING DEPT MAY 0 3 1993 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS O ERMIT 7 County Center Drive - Oroville, California 9F965 - Telephone: 916/538-7541 'f APPLICATIONND fERMIT ASSESSOR PARCEL NUMBER 036-023-004 ZONING AR BUILDING PERMIT OWNER JackDoroth Walker TE�_E`HONE 534-0233 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADOR SS 3090 Oro BAn or Hwy., Oroville 95965 Contr. Est. 6 200.00 CONTRACTOR'SNAME TELEPHONE 464-1330 CONTRAC OR'S MAI ING ADDRESS 11344 Loma Rd., Gold River 95670 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 6,200.00 LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 75.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 90.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each pas water heater or vent 7.00 USE OF STRUCTURE SF [I Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home is G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[- Other ® Describe work: New Vinyl Siding Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): 1 am licensed under provisions of Chapt. 9, DIV. 3 of the Business and Profes$ionnsCote rd my license is in f I force and effect. License No. 7 Classification F1 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200ATO 1000AI 37.50 NEW CONST. / DWELLING OCCUP.yd\ 3.6Q sq.ft. OR ADONS. 1 ACC. SLOGS. // WCOCONSTR BRANCH CIRC U TIITS.OUTLET @ 5.00 SID (POWER APPARATUS Q) SINGLE OUTLET CIR. EX. OCCUp�OUTLE TS OR FIXTURES 20 76 Ex. Occup. OUTLETS IIRESID 1REA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Iyirin g -15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 1 15.00 Heating Cooling g Hood 6.50 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in c nsequence of the granting of this permit. q �� Date ��- I ignotu of Applicant — Owner ❑ Contractor Agent An OSHA ion of HAstructuresmit is quired f or exc v excavations over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE$90.00 HAz OFEES IMP I FLOOD CDF PARCEL I PD HD ISSUE i 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 p id. DI R F P BLIC WORKS BY ate 3 PERMIT EXPIRES Receipt No. 140483 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT T PERMIT NO. 3243-84B,E -PERMIT EXPIRES [0//5 / r�5 OWNER JACK WALKER CONTR., Acro Lume, Oroville ASSESSOR PARCEL 36-023-04 LOCATION 3090 Oro Bangor Hwy, Oroville Temp. Power Pole 1 Called PG&E c Temp. Elec. Servi Called PG&E Temp. Gas Servici Cal led PG&E JOB FINALED (Date) Signature V = OK 0 = Not OK = Not Applicable MOBILEHOMES MISCELLANEOUS * = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -.Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ P , t./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except q'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 Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness -Dead Men-Lini 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Elec.; Pool Liqhtinq; 15 volts-GFI o. water; mm lest-neguia[or-connector o. rzrec.; cncruaures; iunurut carnes -r U111111141 -1-U. 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date �/07K 0 = Not OK - = Not Applicable * = Not Ready RESIDENT IAL'-�Singte and Duplex), Date UN LOORPlans OK exce t#'s Date FRAMING Contin JP'Zoning requirements -Setbacks -Easements 4 ine Firewall ,& Openings 2. Ftg,,Wain; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. E oors-0 heck Garage -3rd story, 2 exits 34-�g., Garage; Soils -Steel- / " Ftg. Depthitiidth-Headroom-Rise-Run-Landing-Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 1 51. 451ry_wedTon Roof Overhang -Attic Vents -Rafter Outriggers 5. Stem ails, Main; Steel-Blockouts-Wrapped-Slab 52 iding-Nailing-Veneer emwalls, Garage; Steel-Blockouts-Wrapped-SI 3. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 5. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Slwar Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10._Water Pipe; Test -Anchors -Regulator -Service Test OK Electric; Underground,,. 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Z Date `" Card -BI Date Card -131 Date Card -BI Date Card -BI Date Card -BI Date Card -B Date/Z9_,:?©- Card -BI Date Date FI lans) OK except #'s Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent -Access -Combustion Air 56. xt. Steps -Door & Sidelight Protection -Landings 57. 5 5 'a 60 - earance-Comb. Air -Connector - In Garage - Mech. Protection ro di Exiting Fixtures & Tub Access 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 611,11�lec. Trim & Sub anel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors a" ce or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64.1 65• Errec. Outlets at Wood P Int. & Ext. e; Grnd.-Air Gap -Cooking Clearance Card -BI Date Date Card -BI Date ELEC ICAL Permit OK except #'s 66. 67 . utlets fdeceptacles at Kit. Counter ge Fire Door• Swing -Landing -Closer 68.t 69•- in Gar - e -Damper earan a -Comb. Air-Connector-P.R.V.- n ra ; Above Floor-Mech. Protection 2%,"'Fi_xtereA Transformer Clearance -Ins. Protection 2 Spacing -Lights &Switches at Doors e Boxesxes & & No. No. of Conductors -Stapled 70. Ib lec. & Mech. Equip. Listed for Location 2 ex Installed Close to Edge of Studs C.J. 71. ec. Rece to Garage; (G.F.I.)-Romex Protec. i t 246' Equip. Ground made up w./Mech. Fasteners -Bond Gas &Water 7 • a ion -Foam -Looked in Attic E] Yes lance Circuits in Kitc Conductor Size 73 ails &Deck Construction -Post Caps 26 Subfeed Wire Size / AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood arth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or A1, Insulated Neutral ❑Yes ❑No 75. Following instld.: Driv Yes o; Walks ❑Yes o; Planters ❑Yes o 28. S vice -Riser Conductors & Ground -Main Disconnect finish 29. Eq 'p. Clearances; Panels-Motors-Mech. Equip. 7 ,-connect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Cloth s Closet Light -Shower Light 78. Ye o Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. ; Disconnect, Electrical, Plumbing �' 80. erior Elec. Trim; G.F.I. Receptacle -Underground Card B -I = Date / . �,5 Card -BI Date 8Z on roughout House 4 ass Protection j, Card B-1 Date Date Card -BI Date MECHANICAL (Permit) OK except #'s rec ions from Previous Inspections 84. est- eters Tagged; Gas -Electric 31. A. . Ducts; I ulation &Support 8 ater & Sewer Connected -C/O to Grade -HD Approval 32. Ven Fan• xhaust above Insulation 86 gy Compliance Certificate -Other Certificates 33. Con d s e Drain & Overflow; Size & Grade 34. rn -Vent; Access -Comb. Air -Return Air Vent -115V outlet Attic ccess & Platform if Furnace in Attic Card -BI Date ,, Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMI P s OK except #'s 36.PSiLWrProper Material & Anchors 37. alts; Studs-Nailing,Spacing & Bracing -Plates -Sound 3 aring Walls over Girders & Floor Nailing 39 op in WaILI&W proof) 4 s; Furred Ceilings -Stairs -Chases -Tub 41. jKader & Be -Size & Bearing 41?-P.ost Caps=Anchors-Con nectors 43. eng. Joist=Rftr. Ties-Purlin-Roof Brac._-Truss-Shthng.-Rfng_._ ies or Type A Flue -Fireplace Throat e omex Protection -Draft Stop -Ins. Baffles ows or xi in Doors -Sill Hgt. & Dimensions rage Fire. Protection Framing ' r ' (NOTE: An entry must be made each time you visit job site) J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, C-lifor0&95965 - Telephone 916/534-4541 APPLICATION AND PERMIT _PERMIT NO. ASSESSOR PARCEL NUMBER _ � � +J ZONING BUILDING PERMIT OWNER . �. c YL Gu n L TELEPHONE Z5 SQ. FT. OCC, BUILDING VALUATI IN OWNER'S MAILING ADDRESS V 1,+) a 6 s CONTRACT 'S NAME C. TELi PHONE ��( CONTRACTOR'S MAILING ADDRESS I r V4 )Jb • ."__ v<_ 2dL;iL�— Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ / Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ . ec, ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 2 " PV Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMITg Filin 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 STRUCT��— SF ❑ Duplex ❑ Mobi lehome ❑ Other I Ya1ZY► �— _ SPECIFY Building sewer 5.00 Mobile Home JSJGJWJ 0:0::e::, TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work:.Eer-e- i %meq y- 7-y ETA )2-nd-1 � ' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service &OOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONS. DWELING O OR ADDNST ( ACCLBLDGS.CCUP.&) 21/20sgft CONTRACTORS LICENSE LAW I declare under penalty perjury p y of p y (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. %r License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR MULTI -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS. NEW CONSTR (POWER APPARATUS &'I\ NON-RESID. (SINGLE OUTLET CIR. 2@50a OR FIXTURES 9AD Le30 Ex. OCCup(OUTED A PP LNSOR FIXED A Ex. OCCUp. OUTLETS (RESI.D.) 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. 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. 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 liabilities, judgMnts, costs, and expenses which may in any way accrue against s In nsequence of the granting of this permit. X Date&'��� Signature of Applica ` Owner El ContractorR Agent F1work 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 $ OccUP. GROUP I TYPE OF CONST. I PARCEL PD I VIV I ISSUE This permit is hereby issued under sions of the Butte County Code and/or indicated above for which DIRECTO F PUBLIC By PER&I EXPIRES Date?ij the applicable provi- resolutions to do fees have been paid. WORKS Date O V Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT : PERMIT NO. J�057=83B PERMIT EXPIRES OWNER J.R. WALKER CONTR. owner ASSESSOR PARCEL 36-023-4 LOCATION 3090 Oro Bangor Hwy, Oroville j t. `a I t Temp. Power Pole Called PG&E Temp. Elec. Servi Called PG&E Y Temp. Gas Servi c Called PG&E i JOB FINALED (Date) y ' Signature v-7 h E _. = OK ' 0 = Not OK = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS` - Date MOBILEHOME UTILITIES (Plans) OK except k's Date DECKS, C , CARPORTS, ETC. (Plans) OK except q's 1. Zoning Requirements—Setbacks—Easements oning Re ujements—Setbacks—Easements 2. Soils; Special MH Support—Sketch _ Ings; Size-Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete _ a—Beck —G7r i'rs and/or Joists—Decking—Bracing—Stairs—Rails i 4. Water; Location—Test—Easement Needed (Sketch)od Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6, r s; Windows—Doors 7. Utility Clearance Card -BI Date Card -BI Date B Dat .— Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except k's 1. Zoning Requirements—Setbacks—Easements Card -BI Date _ Date Card -BI Date POOLS (Plans) OK except N's .1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test-Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances 4, Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater B. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes— Enc losures— Pane lboards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK 0 = Not OK = Not Applicable = Not Ready RESIDENTI,4L (Single and Duplex) , Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. 3. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth Ftg., Garage; Soils -Steel- / /" Ftg. Depth 49. 50. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouls-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped=Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54, Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date _ Date Card -BI Date PLUMBING (Permit) OK except #'s 14. Water Ht.: Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 57. Smoke Detector 58. 59. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection Bedroom Exiting 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels _ Gas Pipe; Size & Anchors 62. Stairs & Rails _ ___19_._ 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except #'s 68. 69. A.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meth. Protection 20. Fixture & Transformer Clearance -Ins. Protection -- 21. Slee. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. _-_ 23. 24. Romex Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. 73. Insulation -Foam -Looked in Attic ❑Yes Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size 26. Subieed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes - 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, r l Insulated Neutral ,-Yes El No Service -Riser Conductors & Ground -Main Disconnect 75. Followin instld.: Drive Yes No; Walks 9 � ❑ ❑ ❑Yes ❑ No; Planters El Yes FJ No 76. Stucco; Brown -Finish -_- 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet - 30. Clothes Closet Light -Shower Light _ 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. ----------------- Card B -I ----- ----- _Date_ Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim: G.F.I. Receptacle -Underground 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except #'s 83. _ Corrections from Previous Inspections 84. 85. Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/0 Grade -HD Approval -- 31_ A.C. Ducts; Insulation &Support _ _ 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain _& Overilow; Size & Grade 86, -to Energy Compliance Certificate -Other Certificates _ Card -BI Card -BI 34. -.Furnace -Vent: Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic ---- ------ -------- ---- .----.----- Date _ Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except #'s Comments at Final: 36. Sills; Proper Material & Anchors 37. 39. Walls; Studs -Nailing, Spacing & Bracing-Plates-Sound38. Bearing ll Was over Girders & Flo_o_r_Nailing___ Draft Stop in Walls (rat proof) _ 40. _Fire Stops; Furred Ceilings -Stairs -Chases -Tub . 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthn..-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Atlic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm.-Windows or Exiting Doors -Sill Hgt. & Dimensions__- -- Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS -t _196 Mgmorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, 'please contact this office immediately. Inspector/ t %e�, I.Cf Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 15965 - Telephone 916/534-4541 APPLICATIONIND ERMIT PERMIT /N�O. /r1 ASSESS R PAR EL NUMBER ZONI BUILDING PERMIT OWN TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION V OWNER'S MAILINV KIDDRESt, A rN 1 V CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS 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 �'7t� $ 10 BUILDING ADDRESS v 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 LJ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ AdditionRemodel Q It ElInstallation❑ Other EJ Describe work: 1 c3 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 1 2/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElI am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and mylicense 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 CONSTR MULTI -OUTLET 2.50 ea NON.RESID BRANCH CIRC TS NEW CONSTPOWER APPARATUS &' NON- RRESID. (SINGLE OUTLET CIR. 20e50e Ex. Occup(o OR FIXTURES BAL®30 FIXED A Ex. Occup. OUTLETS PLNS (RESID )REA.) 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. ❑ 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. 1 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. 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 Date ,u w <,3 Si ature of Applicant — Owner [ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ --� OCCUP. GROUP I TYPE OF CONST. PARCEL PD H ISS This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY PE IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date' ) / r/ Receipt No. 6 In (D R WHITE-D.P.W., TELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF 9UTTEr- DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,r,CI LIR�IA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET r A ^ P 't N OWNER Proposed Buil in Use. Permit Fee Based Upon Building Inspector erml U. rr A. P. No. XV V - Complete Contract Price Othor (Explain) //DPW Valuation Dater - At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate. . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . ���� Letter of signature authorizartion. CDR�i0. Sanitation approval from -- Health. Dept. • . . 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner, Mail to owner �•) 15. Improvements may be required. . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . •Pre-Inspec. request to (Dote) . . 17. Pre -Inspection for Required, Building Inspector 18. Other When you issue the permit, process as follows: Mail to owner. _ P.-'��(I_ A233 and hold for pickup at %) r4i office. Other Applicant Copy of plans sent Health Dept., Fire Dept:, Other Mail to contr` ctor. _Deliver w/�inspector. Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of ap lication, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by r' Date Plans aooroved by Date 9�.7-��? Other Copy—DPW To: Building Department From: _Environmental Health Subject: Sanitation Clearance ZC�--Oro O:aner Location APAr Plan Approved for: Sewage e disposal water supply Hold final for: •:rater supply Final clearance O.K. for: water supply Clearance for bedroom mobile home. Other V J Sanitarian Date COUNTY OF BUTTE - Department of Public Works • 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and maters is for construction of the proposed property improvement (yes or no) �. 2. I (have/ dt signed an application for a building permit for the proposed 46rk. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address. City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed : Property Owner52��C� Social Securi umber Date__:2-,-') NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code., This verification must be completed and returned to our office before we are permitted to issue the permit. � ^ -� Pacmlt#3586-82P,D{ Jack Walker � GrOUNT-Y OF BUTTE - DEPARTMENT OF PUBLIC VIOR4 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL ENUMBER ����-(JJ( l�/']ZZ — ZONING BUILDING PERMIT ow R G ZL 14JA LdCC TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESSSCONTRAC� 'J'% / �- / 1�4 6%TOR'S NAME �4./'1 / rNC 14 6 �•y `y Q✓�� CO(VTRACTO•CRP_5/(A—I LI. (N G�ADR ESS�^.vILG �i , Fireplace COr/NNSSjTRRUlCTION LENDER • 1 ,.- // V`� UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEE % A"q-t— LICENSE NO. Plan Checking Fee ,$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDI G ADDRESS O �� /��/� I I 7C 'I`//-.y/W/j PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 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 5•VU USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home FSTG'I W I 10.00e TYPE OF WORK New ❑ Addition ❑ RReJmmodeI [JUtilities ❑ Installatign ❑ /Other Describe work: +�'�� ( G 1-174 �/C — SS•s��- I(�f Permit Fee $ /S.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service tOOO1 OR O AMP ORSLESS 10.00 ' Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWEL114G OR ADONS. ( ACCLBLDGS.CCUP.&� 21/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): 0 -1 -am licensed under provisions of Chapt. 9, Div. 3 of the BusinessEx. and Professions Code and my license is in full force and effect. License No.; 27 7 % / 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 CONSTR ULTI.OUTLET 2.50 ea NON.RESID. BRANCH CIRCUITS) NEW CONSTR. POWER APPARATUS .&) NON•RESID. (SINGLOUTLET CIR. E Occup(ouTLETs OR FIXTURES 920@5ALk-Q FIAPPLNS. 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. - ❑—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. Heating /QQ GU Uc2u s �' �— Cooling 3 . /1,00 Hood 3.00 Ventilation permit Fee $ GG 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 liabilities, judgments, costs and expenses which may in any way accrue against said County in consequence of the granting of this permit. �/ -r/ // X -' .µ -r"��' _r Date Y, Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over S'0" deep and demolition or construct-IRECTOR of structures over 3 stories in height. Mobile Home Installation Fee $ , TOTAL PERMIT FEE $ 41Z 00 OCCUP, GROUP I TYPE OF CONST, PARCEL PD 1 D ISSUE This permit is hereby issued under 'Butte County Code and/or wordabove for which sion1/i. OF PUBLIC By �-�' PERMIT EXPIRES Date/ the applicable provi- resolutions to do fees have been paid. WORSion Date �• '� / /71?� Receipt No. 7GG WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Centel -Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N ASSESSOR ��E�NO7 _ S1lQ_ 23 ZONING BUILDING PERMIT OWN 64L 14JA LIGE TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS C Q/�JARf�`T 'SN ,A�),/ lS/////// /�/,(V�r✓(.J�J/��V CLL/ � O Rs I ILING ADDRe--eelT // V CJ � �aj V 7 Fire lace P CONSTRUCTION LEND R UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILIN ADDRESS Permit Fee $ ARCHITECT OR ENGIN LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDI G ADDRESS O,vV �� / �� r��,/ 0 'Av/ / I 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 '5-,00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition F-1-ejmmode1 ❑ Utilities ❑ Install ❑ ther Describe work: �` �r l� - Permit Fee $ 15- pct Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10ov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2/20sgft 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.�; 7 �� 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 CONSTULTI-OUTLET NON- R(RESID. `BRANCH CIRC ITS 2.50 ea NEW CONSTR (POWER APPARATUS &) NON-RESID, SINGLE OUTLET CIR. Ex. OCcuP 20050Q OR FIXTURES sALO 300 FXED A PP LNSOR FIXED A EX. QCCUp. FI OUTLETS (RESI.D,) 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. LA-1_1_hiiv_e 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 /per 000 •p0 A: CoolingZ J1, 0o Hood 3.00 Ventilation permit Fee $ gp 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, osts, nd expenses which may in any way accrue against id County • co e u Ce of the gra g of this permit. X Date. 7�— Signature Applicant — Owner El Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in Mobile Home Installation Fee $ TOTAL PERMIT FEE $ 2_po OCCUP. GROUP TYPE OF CONST. PARCEL PD I ND ISSUE This p rmit is hereby issued under sion o the Butte County Code and/or wor i icated a ove for which CTUR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 3 pheight. '7506,r" Receipt No.17- WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT a 03 co- o114,-02� Z3aa v -co rFor ��- Urgent LJ Date Time + While You ,Wpre Out M Of ( A3 y c-4.X—x-k , Phone .53 Z --Cy Z I O AREA CODE NUMBER EXTENSION NU Telephoned Please Call Came To See You ❑ Will Call Again ❑ Returned Your Call ❑ Warats To See You ❑ Signed J 9711 ADAMS BUSINESS FORMS FF#, . R Urgent ❑ Time 3; Z Were Out M OfLl Phone O �� AREAODE NUMBER EXTENSION Telephoned Please Call or Came To See You ❑ Will Call Again ❑ Returned Your Call ❑ Wants To See You ❑ Messa e . ILL Urgent ❑' For Date — Time While Yo sere Out M Of '�77 Phone AREA CODE NUMBER EXTENSION Telephoned Please Call Came To See You ❑ Will Call Again ❑ Returned Your Call ❑ Wants To See You ❑ �. Signed rr I r" 9711 ADAMS BUSINESS FORMS i Signed 9711 r s •�� rte. �� ru ADAMS.BUSINESS FORMS r MEMORANDUM TO: Jill Broderson FROM: Steve Betts SUBJECT: Code Enforcement at V-6 Rd. and Oro -Bangor Hwy., Oroville DATE: June 22, 1995 SUMMARY: DISCUSSION: I went to this location on Jun. 21, 1995, at 2:02 pm. As no exact address was given I drove west on V-6 from Oro -Bangor Hwy. for approximately .25 mile until the dirt road became very narrow. I did not observe any vans being lived in, no Cadillac, and no trash on the ground along this portion of the road. However, at 2362 V-6 (APN 036-071- 025) there is a single-family dwelling and a mobile home. The mobile home is being lived in but there is not a use permit for it (as far as I can tell). Attachments: Complaint Form W�ZL� �� May 20, 1993 Jack R. Walker " 3090 Oro-B6ngor Hwy. Oroville, CA 95966 RE: Recent Correspondence --A.P. 11 036-02-3-004 3090 Oro Bangor Hwy, Oroville Dear AIr. Walker: With reference to the above subject and your _letter dated May- 19;- 1993, building permits were -not' required for single family residences and duplexes in the unincorporated areas of Butte County until February of 1962. Prior to that date, no permits, inspections 'or approvals were necessary on those buildings, except for sewage disposal requirements of the Butte County Environmental Health Department. Should you have any questions concerning this matter, please contact this office. Yours very truly, y DP:dms David Purvis Manager, Building Inspection 5-1 /a1q3 8c) ItdiN� (apt Pbeovse 13espomc) -to wheA3 Qu`���i NS P`ecAA,tS (e-u�CCZQ 13LI JJPu-tte COC/nl-F M 3A S ked /fie -�-� g I' C) e --(A QM Sl`>Menl6 .Zllli U3\ 1 ere a (� s 3dSv QPM CERTIFICATE OF ROOF COVERING OWNERS NAME: A.P. #: ADDRESS: PERMIT #: BUILDING SIZE/AREA: BUILDING USE: FIRE HAZARD ZONE ALLOWED ROOFING FROM LISTS BELOW ❑ VERY HIGH #1, #2 ❑ HIGH #1, #2, #3 ❑ MODERATE #1, #2, #3, #4 LIST #1 LIST #3 ❑ CLASS 'A' ASSEMBLY ❑ CLASS 'B' ASSEMBLY ❑ CLASS 'A' PREPARED ROOFING ❑ BUILT-UP ROOF PER 3203(e) ❑ CLASS A OR B PREPARED ROOFING T,TS'T' #2 ❑ ASBESTOS CEMENT SHINGLES ❑ METAL ROOFING ❑ CONC. OR CLAY TILE a (OTHER FIRE RETARDANT ROOFING) ❑ SLATE SHINGLES LIST #4 (0'1111?R NON4,10MBUST1.Ii1.J; ROOFING) ❑ CLASS 'C' 235# ASPHALT SII.I.NGLES I HERFBY CERTIFY, I INSTALLED ROOF COVERING AS INDICATED ON THE ABOVE BUILDING, TN CONFORMANCE WITH STATE AND LOCAL REQUIREMENTS. FIRM NAME/OWNER (Please Print) STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF GENERAL CONTRACTOR/OWNER DATE THIS CTRTTFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL. January 1988