HomeMy WebLinkAbout078-280-044
E
Daniel Davis��
492 V-7 Rd., Oroville
rmit #1664-81B,_P,,E,M(remodea/SF,) ,
�ermit#1-83B(lst renewal/1
e mi #3611-83 (2 d renewal/1664 81
- WnAf 5 /4
rmit # 6-84B-.,(3rd--renewal/1664-81)
PgA-fnit#2063-85B(4th renewal/1664-81)SF
. 91-3817
DAVIS, DAN
CONTR: OWNER
2492 V-7 RD, OROVILLE
DEMO/SF
P-'�2 7' -
DAVIS, DANIEL
CONTR: OWNER
2492 V-7 RD, OROVILLE
ADD TO PATIO COVER/SF���
BABINO,.Thelma. 950-68B
a
2492 V-7 Rd., Oroville
(barbecue pit for restaurant)
}
d
RESIDENTIAL
X036-02-2-057 �92-0227
DAVIS, DANIEL
CONTR: OWNER
2492 V-7 RD, OROVILLE I
ADD TO PATIO COVER/SF
-.2
JOB FINALE
Signature
J=OK
O = Not OK
= Not FleadyApplicable, MOBILE HOMES
' =Not Ready
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Z Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / P L" ft.
/ /"Nat. or/ /"L" ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-,1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s'
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
- 7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date DEC OVERS, ARPORTS, GARAGES, (Plans)OK except #'s
oning Requirements -Setbacks -Easements
ngs, Soils -Size -Depth -Spacing -Connectors -Steel
3 s; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. F s-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Datel G ward B-1 Date Card B-1
Date Card B -T Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-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 -Panel boards -Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
V OK
O = Not OK :) Iut' O
= =•Not Applicable , a �,RESIDENTIAL (Single & Du lex) joij t P. ���� ,,.,I.o °A O - -
=Not Ready .1 �r{.�.9_ ..: �..v. A... pv.c iliL.Jc3.SC�d'c'.�
Date - UNDERFLOOR (Plans)'OK except #'s'-- a -
Date , FRAMING (Continued) IITI,SMI 1c410k a IIWl K4
---1-Zoning-Setbacks-Easements ope
-Flood-Sl
45. Hangers -Post -Caps Anchors -Connectors ,-,r,,,, ,5
2. Ftg., Main: Soils-Elec. Main: /",Ftg. Depth- - -'-
46. Cing. Joist Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
3. Ftg., Garage; Soils -Steel -Flee. Grnd.-/ ,/" Ftg. Depth 47. Fireplace Ties,or;Type.A Flue -Fireplace, Throat clearance
4. Ftg., Porches &Decks; Soils -Steel-/ /Ftg. Depth, k _ - 48. Attic, Access; .Size &.Romex Protection -Draft Stop -Ins. Baffles
5. Stemwalls, Main; Steel -Bloc kouts Wrapped rrl n� 49. Bdrm: Windows or,Exiting%Doors-Sill Hgt. & Dimensions
6. Stemwalls, Garage; Steel-Blockouts-Wrapped mIA 50._Garage -Fire Protection Framing ,r
6a. Hold Downs and Special Anchors
51. Property Line Firewall & Opehirigs
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-SteelH_,,
9. D.W.V.; Fall -Fitting -Test -2 -Way C/O -Sewer Test, I
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor- Regulator-Service;Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15., Access & Ventilation
16. Insulation- - -� �, , ry0g _ 1
Date 'M Card B-1 -Date1 ,Card B-_1 li
Date Card B-1 Date Card B-1
Date PLUMBING (Permit).OK except ti's
16. Water Htr.: Vent -Access -Combustion Air=6aff;e
--------- -- - ---------------------------
17. Water Pipe: Test &Anchor -Nail Protection' -
18. D.W.V.: Test -Fittings &'Anchor -Nail Protection j
- ------ --- - ----------------
19. Shower Pan: Test. First Floor -Tub Access
20. Test Tub &'Shower -Second Floor-Tub'Access
----- - --------- -----------------
21. Gas Pipe: Size & Anchors
--------- --------- --------- -------------------
Date Card B-1 Date 'Card B-1
--------- ------------------ --
------------
Date Card B-1 Date • Card B-1
Date ELECTRICAL (Permit) OK except tf's
22. Fixture & Transformer Clearance -Ins. Protection
23. Elec. Receptacles Spacing -Lights & Switches at Doors
-- --------------------------------------------------------------
24.'Size Boxes & No. of Conductors -Stapled
----- -------------------------
25. Romex Installed Close to Edge of Studs & C.J.
- - - - -----------
26. Equip Ground made up w/Meth. Fastners-Bond Gas & Water
------------------------------------------------ -------------------
_ 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
----------------------------------------------
22. Subfeed Wire Size / r ga. Cu or AI-A.C. Wire Size ! / ga.
I Cu
or -Al
--------------------------------------------------------------------------------
29. Range Circ. / r ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
------------------------------------------------
30. Service -Riser Conductors & Ground -Main Disconnect
-------------- - - ----------------------------------------------
31. Equip Clearances Panels-Motors-Mech. Equip.
---------- -------------------------------------------------------
32. Clothes Closet Light -Shower Light -Spa Light
----- ------ --
33. Smoke Detector
-----------------------------------------------------------------------------
DateCard B-1 Date Card -B-1 -----------------------------------------------------------------------------------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) Ok except ft's
34. A.C. Ducts Insulation & Support
------------------------------------------------7---------------------------------
--------------35.-Vent Fan:- - Exhaust above insulation
-----------------------------------------------------------
36. Condensate Drain & Overflow; Size & Grade
------------------------------------------------------ -----
37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
---------------------------------------- -- --------------------------------------
Date Card -8- I Date Card B-1
Date X, Card B-1 Date Card B-1
Date FRAMING (Plans) OK except k's
39. Sits, Proper Material & Anchors
-------------- -------- ---------------------------- ------------------ ---------
------------ 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound
------------------------------------------------------
41. Bearing Walls over Girders & Floor Nailing
------------- -- .. -
Draft Stop in Walls (rat proof)
- - ---------------------------
-----------------------------------
43. -Fire-Stops: Furred Ceilings -Stairs -Chases -Tub
------------------ ----------------------
44. Headers & Beam -Size & Bearing
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Head room-Rise-Run-Landinq-Fire. Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
156.ISt6cco Mesh -Drip Screed -Fd. Vents-Underflr. Access
- y- 157.(GIIning Area -Glass Protection -Skylights -Plastic _
58.'Shear rWall s: Nailing -Bolts'
59. Insulation-Walls-Ceilinos
60. Infiltration -Walls -Windows
-------------------------
Date Card B-1 Date Card B-1
-------- - ----
Date
------------Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except fit's
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor -Ducts -Meth. Protection
64. Bedroom Exiting
------------------
--- ------ -- - - --------- --
65. G.F.I. & Bath Fixtures & Tub Access -Spa
---------------
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
----------------
- - ------
67. Stairs & Rails
68. Fireplace or Stove: Clearances -Hearth
- ------------- ----- ------------------
69. Elec. Outlets at Wood Panel: Int. & Ext.
----------------------
7 0.
--------------------70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door: Swing -Landing -Closer
73. A.C. Duct in Garage -Damper
-- ---- - ------------------------------ -
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor -Meth. Protection
75. Plb. Elec. & Mech. Equip. Listed for Location
-------------------------------- ---
76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
----------------
77. Insulation -Foam -Looked in Attic ❑ Yes
78. Guard Rails & Deck Construction -Post Caps
-- ------------------------------------
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
80. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
------------------------------------
------------- 81,
---------------------------------81. Stucco: Brown -Finish
82. A.C. Unit; Disconnect. Electrical, Plumbing
----------------------------------
83. Vents Above Roof; Plbg -Appliance-Fireplace.-Clearance to
Openings
84. Water Well: Disconnect, Electrical, Plumbing
-------------------------------------- --
85. Exterior Elec. Trim: G.F.I. Receptacle -Underground
-----------------------------------
86.
----------- ------86. Ventilation Throughout House
-
--------------------
Glass Protection
- ----------------------------
88.
------ 88. Corrections from Previous Inspections
--------------------------------
---------- ---- -------------------------
89. - Gas -Test-Meters- Tagged: Gas -Electric
------------------- -------------
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
--------------------------------
----------------------------------------- ---- -
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 PUBLIC WORKS
7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541
APPLICATION' AND PERMIT
PERMIT NO.
0, ;a
ASSESSOR PARCEL NUMBER
036-022-057
ZONING
G- Z
BUILDING PERMIT
OWNER DANIEL DAVIS
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
/� p
140 C 1,820
OWNER'S MAILING ADDRESS
2492 V-7 ROAD OROVILLE
175 D 25
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
3045
CONSTRUCTION LENDER
NONE
UNKNOWN
Total valuation $
,
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 36,00 52,.56
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee
$ 20.00 2(0'2-S
Ener Plan Checking Fee
Energy g
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
2492 V-7 ROAD OROVILLE
Permit fee
$ 7� "►175
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
//4-87
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ® Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I W
TYPE OF WORK
New F, Addition [X] Remodel ❑ Utilities E]Installation❑ Other ❑
Describe work: EXTEND PATIO COVER (7 X 20) _
nb�m Dr -Ar- P3Ulla• W/6 fm ITS
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200A TO IOOOA)
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
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)
❑ orsa (Sec. 7044)r, am exclusively contracting with licensed contract-
(S
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUR.&)
ACDNS. ACC. BLDGS. /
3.5Qsq.ft.
NEW CONSTOR
NO N•R ESID R BRANCH CIRCUITS I
@ 5.00
POWER APPARATUS &)
(SINGLE OUTLET CIR. )
Ex. Occup(OUTLETS OR FIXTURES
AO 75
FIXED APPLNS.
EX. Occup. OUTLETS ((RESID )RE A.)
I 3.001.
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
-The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 15.00
Heating
Cooling
Hood
6.50
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
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 con quence of the granting of this permit.
X�r���+� Date
Signature pp ❑ 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 S
Ener Inspection Fee S
9Y P
OCC
CONST TYPE
TOTAL FEES J
76fl
HAz
I DFEES I
IMP
I FLOOD
—
CDF
PARCEL
PD
HD
-�
ISsu I
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated ab for which fees
I R OF PUBLIC
By
PE tXPIRES Date N,,
applicable provi-
resolutions to do
have been paid.
WORKS
Date,2-�/-tom
Q
Receipt No. 103795 /n ' „ G2'd—,2 �-�
�
WNITC•D. P. W., YELLOW-ASSE990R, PINK -INSPECTOR, GOLDENROD -APPLICANT
7�r T.nn-r .. ,_^'� • 'y� +'Fi...-.�'.�r..•..-rpt'�'.".cv'.^r"„+`^+,t<.-+r•.�+�.,, -s-•-"-_-_•-• .. .v,.,.�v., i+Y-3`
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
1.7 COUNTY CENTER DRIVE ORWILU16 CAr;FORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT AP fCKTION DATA SHEET .�.
Permit No.
OWNER U t S A.F. blo.
Proposed Building Use S %^ Building Inspector 69 Date
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, signed by preparer of plans........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions . .... .
0. Fees f $ 2 �� l3tD ut�cca�..�2ue('r w/Q Z-
- - Z
Chicol an --Area es paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from AO Pu O Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ...................................
26.
27.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
_ Telephone5,1 —1 -EJ Ind hold for pickup at office. Deliver w/inspector.
Other
r
Applicant �Z-12 4� Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted Prior to permit issuance: (Circle new item not checked above)
1. Index permit for above items No.
2. Additional items required:
Contractor, designer,wn r, was advised of above required data by L/phone_mail_counter by (L .date 2 3(07
Contractor, designer, o er, was advised of above required data by—phone _mall_counter by date
Plans checked by Date 2 3 Z Plans approved by�w Date ?j3 .[9 -Z
Sets of plans on hold in File cabinet AP folder
Copy—DPW
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovlller California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ASSESS R PARCEL NU1+IB R
`//J
ZONING.
BUILDING PERMIT
OWNTELEPHONE
n' v�
SQ. FT. OCC. BUILDING VALUATION
AJ 0
OWNER'S MAILINCVDDRESS % sql
�199V PO V i I I•
CO TRACTOR*SS NAME
6I
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONS RUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 15.00
L NDER'S MAILING ADDRESS
Permit Fee
$ 0
AR ITECTOR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDI G ADDRESS
Y,\v ' 2�
Permit fee
$ 0
PLUMBING PERMIT
Filing Fee -15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF Xr Duplex[_1 Mobilehome❑ Other
SPECI FY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.001
Mobile Home I S I G JW 1
15.00
TYPE OF WORK
New U Addition] Remodel ❑ Itilitie ❑ Installatio ❑ Other E]
Describe work: _ VC
X Jo
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600VORLESS
200A OR LESS
18.50
Main service 2ocATO1o00A1
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑NON.RES10
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST./ DWELLING OCCUPM
OR AODNS. ( ACC. BLDGS.
3.6d sq.tt.
NEW CONSTR ULTI.OUTLET
BRANCH CIRC ITS
@ 5 00
(POWER APPARATUS e
\SINGLE OUTLET CIR.
Ex. Occup( OUTLETS OR FIXTURES
20 76d
FIXFO
Ex. Occup. OUTLETS P(RES,, IREAT
1 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring15.00
Permit Fee
$
Contractor
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
Hood
6.50
Ventilation
Pertnit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Si nature of Applicant – owner
g pp ❑ Contractor ❑ Agent ❑
permit is re sired for excavations over 5'0" deep and demolition or construct-
An OSHAa
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
IHAZES
IMP
FLOOD
EW
PARCEL
PD
HD
ISSUE
{
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi- '
resolutions to do
have been paid.
WORKS
Date
Receipt No. r %
WHITE-D.P.W.. YELLOW-ASSESSOP• PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public Works
7 County Center Dr.ive,•Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
s
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no).
2. I (have/have not) signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. ,I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name'
Address City
Phone Contractors License No.
5.' I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address . Phone Type of Work
Signed:
Property Owner 12,1" ba',
Social Security Number �
Date //a174A--
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
V
NOTI—AM ftm*rials &-Workmareship
Shall ft it:
Acccod*mov, with Rvcoonized G
oad' Pra&jces
,Cf a quality proweibed for the Sx-cifled
use in ttw,-I
Lniform BuildJng, Plumbing -&Vechbnl
CII�IFATCIPI
the -National floorical Code.
P!,
--70
is set of plans and specif"Cotton
s MUS: ,be
kept on the Job at all times and it
s unlaw
make any changes or alterations on
Itt-tion from
;arise wit out
ent oINWic
or County OT DMG.
J
I
73.25
tocatim.-Of structures &
equipment shall be as sho*n
& clew of all easements.
5' stoe t eeke semAcrs
P_/W
BUTTE Cou nI
900
BUILDING DEPART V0,
APPROVED.
PW 21511)2-
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BUILDING DEPARTMENT
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PE o. 1-66 -8�� ,E,M
c PERMIT EXPIRES
b
v " OWNER Daniel Davis
CONTR. owner'
ASSESSOR PARCEL 36-022-52
LOCATION 2492 V-7 Rd., Oroville
i=
Temp. Power Pole
Called PG&E
Temp. Elec. Service
r'
Called
A
Temp. Gas
Callec
JOB FINAI
Signal
1,,
0
V = OK
O =Not OK
- = Not Applicable
-T = Not"Ready
RESIDENTIAL (Single and Duplex)
Date
UNDERF OR Plans OK exce t#'s
Date
FRA
G Continued
4 --'Zoning
requirements -Setbacks -Easements
4=y
Line Firewall & Openings
3.
Ftg., Main; Soils-Steel-Elec'. Grnd.- / L /" 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
emwalls, Main; Steel-Blockouts-Wrapped-bleb
52.
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
i
Piers -Fireplace .-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
O.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.
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
Girders -Sills -Anchor Bolts -J 'sts-Vents-Cripples
Card -BI
Card -BI
0a
it god 1,
and -BI Date
Date Card -BI Date
d�
Card -BI
Date Card -BI Date
Card -BI
Date9 Card -BF Date
Date
FIN
-(Plans) OK except p's
Card -B Dat Card -BI Date
Date
PL
SING (Permit) OK except q's
5eExt.
Steps -Door & Sidelight Protection -Landings
.,Smoke
Detector
1
t.; Vent -Access -Combustion Air
58r
Furnace; Vents -Clearance -Comb. Air -Connector -
,In Garage; Above Floor -Ducts -Meth. Protection
15. r Pipe; Test & Anchors -Nail Protection
1 .
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59. ,Bedroom
Exiting
17.
Shower Pan; Test, First Floor -Tub Access
6.01
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61
ec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
6
tairs & Rails
6a-.-_F4repIace
or Stove; Clearances -Hearth
64-,,-Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date -a rd -BI Date
65., Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card-BIDate
Date
rd -BI Date
ELECT Permit OK except q's
66.,Elec.
Outlets & Receptacles at Kit. Counter
67.
arage Fire Door; Swing -Landing -Closer
A.C. Duct in Garage -Damper
dySZ;Garage;
20.
x Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
Above Floor -Meeh. Protection
21
ec. Receptacles Spacing -Lights & Switches at Doors
7
Plb., Elec. & Mech. Equip. Listed for Location
22.
oxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23.
R Installed Close to Edge of Studs & C.J.
7
Insulation -Foam -Looked in Attic E] Yes
24.
Ground made up w/Mech. Fasteners -Bond Gas & Water
r7
Guard Rails & Deck Construction -Post Caps
25.
fAppliance Circuits in Kitchen & Conductor Size
dn. Vents &Crawl Hole Door -Drainage &Wood -Earth Clearance
oked under Floor ❑ Yes / J
_
26. S �d Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
27.
Fliffinge Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
I ulated Neutral ❑Yes ❑No
Following instld.: D,,ri_ve./ E) Yes No; Walks []Yes No;
Planters 11 Yes 91?ho
f -&;AX.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
.29.
Equip. Clearances; Panels-Motors-Mech. Equip.A.C.
Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30.
Cloths Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
0 4P
7.9.`
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B I
Date -% Card -BI Date
81!Ventilation throughout House /
Card B -I
Date and -BI Date82
(Glass Prote t' -
Date
MECHANICAL (Permit) OK except q's
3.
_
Correcti rom Previous Inspections
84.
Gas st-Meters Tagged; Gas -Electric
31.
A.C. Duc ; Insulation & Support
8 .
Water & Sewer Connected -C/O to Grade -HD Approval
_
32.
Ven an; Exhaust above Insulation
-86, -Energy
-6o Hance Certificate -Other Certificates
33.
ndensate Drain & Overflow; Size & Grade
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
Date Card -BI Date
Card -BI
-
at and -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date and -BI Date
Card -BI
Date Card -BI Date
Date
FRAMI Plans) OK except q's
Comments at Final:
36.
Proper Material & Anchors
i
37.
Studs -Nailing, Spacing & Bracing -Plates -Sound
38.-'-B
ring Walls over Girders & Floor Nailing
39.
/Deft Stop in Walls (rat proof)
40.
F' Sto s; Furred Ceilings -Stairs -Chases -Tub
_
41. eader Beam -Size & Bearing
42. H ers_-Post Caps -Anchors -Connectors
43. ng. Joist-Rftr. Ties_-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
�p ace Ties or Type A Flue -Fireplace Throat
45.
"At i Access; Size & Romex Protection -Draft Stop -Ins. Baffles
_46.
drm. Windows or Exiting Doors -Sill Hgt. & Dimensions
4
ion Framing
(NOTE:Anentrymust be made each time youvisit jobsite)
i
V = OK�
O - Not OK
Not Applicable MOBILEHOMES
* = Not Ready
MISCELLANEOUS
-'—w
Dat
_..w-
Date
MOBILEHOME UTILITIES (Plans) OK except q's
1. Zoning Requirements—Setbacks—Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK. except N's
1, Zoning Requirements—Setbacks—Easements
2. Soils; Special MH Support—Sketch
3. Sewer; Location—Test—Fall-C/0—Concrete
4. Water; Location—Test—Easement Needed (Sketch)
_
2. Footings; Size—Depth—Spacing—Connectors
3. Decks; Girders and/or Joists—Decking—Bracirg—Stairs—Rails
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./ P'Nat.or/ /"L"ft./ /"LPG
6. Carports; Windows—Doors
7. Utility Clearance
7. Elec. —
Card -BI
Date Card -BI - „°V. pate < .
Card -81
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except q's
Card -BI
Date
Date Card -BI Date _
POOLS (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
1. Setbacks—Easements
2. Footings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
3. Gas; MH Test—Demand—Valve—Connector
4. Electricity; MH Test—Crossovers—Breakers—Clearances
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
4, Elec.; Receptacles and Lighting; Distances—GF1 s
5. Drain; MH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI
6. Water; MH Test—Regulator—Connector
7, Water and Sewer Connected—C/0 to Grade—HD Approval
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas and Electricity Tagged
9. Exits; Insp.—Sketch
10. Cert. of Occupancy
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghig.
Boxes—Enclosures— Pane [boards—Ins. to Main in Conduit
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card B -I
Card B -I
Date Card -BI Date
Date Card -61 Date
Card BI
Card -BI
Date Card -BI Date
Date Card -BI Date
Ll
COUNT71 OF BUT'TE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 -Dounty Center Drive, Oroville — Phone: 53414541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the abcrve address and should be corrected. Please notify this office
when correction :)f work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
f
4r
0 AP
r,
Inspector Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
SL)rt -.11, -, .2- (' & & - <ir-y
OWNER PERMIT NO.
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 ontact this office immediately.
aN+'l V�/) I e-lv%L)
Inspector Date -7/7
COUNTY OF BlilT4TE
DEPARTMENT OF PUBLIC WORKS
1 ' 96 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
�t)C"RECTION NOTICE
r,'t _Af L7e 4,;,- Y�
OWNER PERMIT NO.
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. It you have any question pertaining to this
matter, or need additional explanation, please contact this office Immediately.
IVA
,OF
-Acxv —9446e.064 'a4v 62/UA
�JV'ftl tj
A("
Inspector Date
I I
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PERMIT NO.
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
matte or need additional explanation, please contact this office Immediately.
Inspector 4,,.. Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
I
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.
Gj
lnspector-'�� �-- -, 7 Date 9 Y--
COUNTY OF BUTTE , w__ -
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 6ounty Center Drive, Orovi Ile — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
7
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.
0 P,00�1Dz5,
C
n s p e c t o r, Date
• • . COUNTY OF BUTTE - DEPARi MEN OF PUBLICWOR P RMI No. ,/
7 County Center Drive - Oroville, California 95965 - Telephone 916/5
`APPLICATION AND PERMIT
ASSESSOR PAROC�,�. NTBER
a�)�-'{)--S-2,TELEPHONE
ZONING%
BUIL G PERMIT
OWNS
c IF ,UIS
`33-6SWZ
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADD ESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 00
ARCHITECT OR ENGINEER
kern `P—,
LICENSE NO.
I
Plan Checking Fee
$ t
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
,.
PLUMBING PERMIT
FiIingFee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO. SUBDIVISION NAME
PARCEL MAP
I
Each qas water heater or vent
55.00i ,Q
Gas piping system 1 - 5 outlets
D
,�,� USE OF STRUCTURE
SF I7 Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
r D
Lawn sprinkler system
5.00
TYPE OF WORK
New Additi ❑ Remodel Utilities Installation❑ Other [I
Describe work: r' QELECTRICAL
Q ,� \
Permit Fee
$ Q r
Contractor
PERMIT
Filing Fee 10.00
Main service e00V OR LESS
100 AMP OR LESSSob
5.00
11V "1V•••�_ C
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. / DWELLING
OR ADDNS. \ ACC. BLDG
2� S ft Q �-�
Q 3
ONTRACTORS LICENSE LAW
I declare under pe of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-.
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
-NE CONSTR -OUT ET 2,50 ea
NON-RESID BRANCH CIRC TS
NEW CONSTR. (POWER APPARATUS 61
NON-RESID. SINGLE OUTLET CIR.
Ex. Occup OUTLETS OR FIXTURES BAL@1 t
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.) EA. 2.00
Temporary service 10.00 -
Mobile Home Facilities 15.00 * t
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIirig Fee 10.00
0KMEN'S COMPENSATION INSURANCE
I declare un enalty 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
I
Cooling `,1f
Hood
3.00 •O�
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
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
agains id County, in nse uence of the granting of this permit.
4
X Date .-
Signature of Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
oc P. GROUP
` '3
TYPE OF CONST.
�_
PARCEL
PD
HSSUE
D
IN
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PU LIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. 1506 99
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
��-� ,-•.—..ww�^..v .. --..ter-..s.'R�.. :.<•.�-"-ur,Ya.'a�4:.t ::w�-r-. ......d�,.:�1P++.w:t... .�.�-�.+^rn.. ,..,,,� wrS�F�1N,•�,�,�-,r.-.wti-•..'`1---... w� .-..,c�. _ _� �
COUNTY'60FBUTE•- DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
, ,
7 COUNTY CENTER DRIVE. ,OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 4
PERMIT APPLI6ATI0' N DATA SHEET
f Permit No.
/J! EL V S r
OWNER A. P. No.34,'OZZ -SZ
Proposed Building Use 'IF ZE7� 3 4 /e S
Permit Fee BasedUpon Complete Contract Price DPW Valuation•
Other (Explain)
Building Inspector _ — Date
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. Cplete 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 $ . . . . . . . .
9. Letter of signature authorization. /�
l� - Sanitation approval from ;fi/f�i�`s� Health Dept. . . J I
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance.
13. Contractor's License Information (no., name style, classif.)
ZGC 14. Owner -Builder Verification (Given to owner, Mail to owner ❑,)
15. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . .
Pre -Pre -Inspection for Required- BuilInspec. request to (Date)
17. Pre -Ins
p q Building Inspector
18. Other
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone an• hol for pickup at( - office. Deliver w/inspecto
�r.
Other
ApplicantCG V Date -9-b-1
.
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance.
(For required items not checked above at time of applic tion, 'rcle 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
Other: '�
Copy—DPW
To: Buildfizg Departmint,
From: EuNAronmental Hcal,th-
:11.' lub j e c Swidtation Clearm,-e
0017�f C, '0" I -f
.LOCA
n
Plan approved fort St�-,%,Iage cli-sposal W8,17,Gr alpply-
Hold final for: Waysr Supply
F='al. clearance O.K. for: wate r supply
&,4
Clearance for bedroom bom, X�h%-:c
IL ar an Mte
3
A
COUNTY OF BUTTE - DEPAEITMEKT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
'APPLICATION AND PERMIT
E MIT NO.
ASSESSOR PARCEL NUMBER
,3(0 —Q�� .
ZONING
BUILDING PERMIT
OWNr���/rL�/�
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNEFj_' f (LING ADDRESS ��
7
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKN WN
Total Valuation is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee C,—
$ 96,00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking ree
$
Penalty
$
-45,-61
ARCHITECT OR ENGINEER'S VAILING ADDRESS
Permit fee
$
BUILDINGgRss
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
0&V�LL
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel�Q— u i liti ❑ Instal la 'on Other
Describe work: �5//P��6�'��
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6101 OR LESS
100 AMP OR LESS
5.00
Main service EA_ ADD'L 100 AMP
2.50
NEW CONST.( DWELLING OCCUP.5i
OR ADDNS. ACC. BLDGS. _
2� sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check One):
❑ I am licensed under provisions of. Chapt. 9, Div. 3 of the Business
and Professions `Ct,,ode and my license is in full force and effect.
License No. `Nd 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 CONNON.RESISTR I.Ou LET
D BRA NCH CIRCUITS)
2,50 ea
NEW CONSTR POWER APPARATUS 6
NON.RESID. (SINGLE OUTLET CIR.
EX. Occup OUTLETS OR FIXTURES_ BAL@1
00
IXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIirig Fee 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.
kt>7l I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
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 sW County in_coonnseq nce of the granting of this permit.
X /1 T��.tJ��� Date / 001,
Signature of Applicant — Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over/3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ , o
OccUP. GROUP
TYPE OF CONST.
PARCEL
P7[
-7T-[7=
This permit is hereby issued under
sio f the Butte Count Code and/or
wok i ed above for which
I EC'TOR OF PUBLIC
B
PERMIT EXPIRES Date
the applicable to i-
resolutions to do
fees have been paid.
WORKS
Date p C�
Receipt No. / s
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
U
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
'7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
i''-Y
ASSESSOR PARCEL NUMBER
36-022-52
ZONING
BUILDING PERMIT
OWNER
Daniel Davis
TELEPHONE
533-6542
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
2452 - Road Oro
n renews
CONTRACTOR'S NA ME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee z origins
$ .00
ARCHITECT OR ENGINEER
none
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 46.00
BUILDING ADDRESS
SV-7 Road Oroville
497
PLUMBING PERMIT
Filing Fee 10.00
.
Each Trap
2.00
Solar Water Heater
20.00
x
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
SFF1 Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile HomeS G W
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instal lation ❑ Other ❑
Describe work: 2nd renewal/1664-81
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 60 OV OR LESS
100 AMP OR LESS
10.00
1st renewal/125-83
Main service EA. ADD'L 100 AMP
2.50
NEW OR ADDNST DWELLINGOCCUP.&) S.
21/20Sgft
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 m license is in full force and effect.
y
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. ULTI.OUTLET 2,50 ea
NON.RESID BRANCH CIRC ITS
NEW CONSTR. POWER APPARATUS &'
NON.RESID.SINGLE OUTLET CIR.
20®60C
Ex. Occup(O OR FIXTURES DAL@30
APPLNS
FIXELED
Ex. Occup. our ETS (RESID )REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 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
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in conseguence of the granting of this permit.
Xjp Date ib— % 7 1.
Signature of Applicant — OwnerX 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 $ 46.00
OccuP. GROUP
I TYPE OF CONST.
I
PARCEL
PD
I ND
ssuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DI CTOR # PUBLIC
o t Ll
By.
PERMIT EXPIRES Date 5/15/84
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, C )F.ORN1A 95965 - TELEPHONE: 916/534-4541
PERMIT APPLICATION DATA SHEET f'
Permit No.
OWNER -rs, .v ,,rl/moi �5��/ice A. P. No.
Proposed Building Use--%-ir��� 1,n i� l2/>Z-;!L///off ,nom/
Permit Fee Based Upon: Complete Contract Price DPW Valuation
C n
Other (Explain)
Building Inspectornn .., �.� Date �A—i'� f~r=,
- 1
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 $ . . . . . . .
9. Letter of signature authorization. . . . . . . . . . .
10. Sanitation approval from Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
013. Contractor's License Information (no., name style, classif.)
Owner -Builder Verification (Given to owner, Mail to owner ❑.)
5. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . .•.
Pre-Inspec. request to
17. Pre -Inspection for Required. Building Inspector (Dote)
18. Other
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
Applicant _F) -r7 \i e Date
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone_ I Other
By Date
Plans checked by.
Plans approved by
Other
Copy -DPW
Date
Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
j
ASSESSOR PARCEL NUMBER'
36-022-52
ZONING
BUILDING PERMIT
1
OWNERDaniel Davis
TELEPHONE -
533-6542
SQ. FT. OCC. BUILDING VALUATION
3r d Renewal
OWNER'S MAILING D RESS
2452 V-7 Road, Oroville IRD
CONTRACTOR'SNAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
None
UNKNOWN y "
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee (2 of Original)
$ 36.00
ARCHITECT OR ENGINEER
None
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 46.00
BUILDING ADDRESS n ^���
2497 V-7 Road, Oroville `/J�'
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
SF91 Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile Home S I G I W
10-00e4
TYPE OF WORK
New ❑ Addition❑ Remodel` Utilities ❑ Installation❑ Other
Describe work: 3rd Renewal of Permit #1664-81 _
(2nd/3611-83)
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service io°°V OR o AMP ORLESS10.00
Main service EA. ADD'L too AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ( ACC. BLOGS.
1
ZhQsq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions o e and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR. MULTI -OUTLET 2.50 ea
NON.RESID BRANCH CIRC ITS
NEW CONST R. POWER APPARATUS &
NON.RESID. SINGLE OUTLET CIR.
Ex. Occu zoesos
P Ts OR FIXTURES eALeso
FXED APPLNS. OR
FIXED
Ex. OCCUp.I
OUTLETS (RESID.) EA.1 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
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
again aid County in con ence of the granting of this permit.
U`Cn Date
Signatu�re of Applicantt-- OwnerrX Contractor E] 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 $ 46.00
OCCUP. GROUP
TYPE OF CONST.
PARCEL
PD
HD
Is, Sup
�/
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for w ich fees have been paid.
DI ORO UBLIC WORKS
By Date —�`�
PERMIT EXPIRES Date 5-15-85
Receipt No.0)�S� ��
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
J
. COUNTY OF BUTTE'- DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 1
/PERMIT APPLICATIONcDATA SHEET
Permit No.
OWNER 0a /VkC P(a 4 1'1.1) A. P. No.
Proposed Building Use
Permit Fee Based Upon: Complete Contract Price DPW Valuation
(, ; O.t et (Explain)
Building Inspector �ycz Date
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 $ . . . . . . . .
9. Letter of signature authorization. . . . . . . . . . .
10. 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.) (RA
Owner-Builder Verification (Given to owner Mail to ownerEl)
15. Improvements may be required. . . . . .
16. Mobilehome Installation Data. . . . . . . . . .
17. Pre -inspection for Required- BuildingPre-InspIn request to (Dote)
p q Building Inspector
18. Other
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
Applicant oL76 V P. Date
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other
By Date
Plans checked by Date
Plans approved by Date
Other:
Copy—DPW
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
36-022-52
ZONING
BUILDING PERMIT
0 aiiiel Davis
p
j1�!=9 Y+�E
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
2492 V-7 Rd. Oroville
CONTRAC,TOR'S NAM
O
TELEPHONE
4th renewal permit
CONTRACTOR'S MAILING- ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee @ � FEE
$ 36.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 46.00
BUILDING ADDRESS ,
PLUMBING PERMIT
Filing Fee 10.00
2492 V-7 Rd.
Each Trap
2.00
Solar Water Heater
20.00
Oroville
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 ® Duplex ❑ Mobi lehome ❑ Other remadell
SPECIFY
Building sewer
5.00
Mobile Home S
10.00ee
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: 4th. renewal—permit 41 -664 -Al
(3rd renewal #2666-84)
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6001 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.
2/20sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
AI, 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 thisason
NEW CONSTR MULTI -OUTLET 2,50 ea
NO N.R ESID BRANCH CIRC ITS
NEW CONSTR POWER APPARATUS &
NON-RESID. SINGLE OUTLET CIR. )
20@50C
Ex. Occup(O OR FIXTURES BAL®30
FIXED PPLNS. OR
FIXED A
EX. OCCUp. OUTLETS (RESID.1 EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 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.
Not ce 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
in said County in cons�gyence of the granting of this permit.
�,1J'-
Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 storiesin height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ 46.00
OCcUP. GROUP_J_
TYPE OF CONST.
PARCEL
PD
I HD
IssuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREC OF P LIC
.s
BY
-
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date �-
5-86
Receipt NO. ! �/ f
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
I
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ss �
ASSESSOR PARCEL NUMBER
36-022-52
ZONING
BUILDING PERMIT
OWNER
Daniel Davis
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNCR'S MAILING ADDRESS
2492 V-7 Rd. Oroville
CO eACTOR'S NAME
TELEPHONE
5th renewal permit
CONTRACTOR'S MAILING ADDRESS
Fireplace
CW6VCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LEIIIINll770[I7lER'S MAILING ADDRESS
Permit Fee
$ 36.00
A [lSITE CT OR ENGINEER
LICENSE NO.
Plan Checking Fee
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ 46.00
PLUMBING PERMIT
Filing Fee 10.00
2492 V-7 Rd., Oroville
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
5.00
Each pas water heater or vent
5.00
USE OF STRUCTURE
SFn Duplex❑ Mobilehome❑ Other remodel
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00ea
TYPE OF WORK
New❑ Addition❑ Remodel[] Utilities[] Installation❑ Other EJ
Describe work: 5threnewal of permit #1664-81 _
(4th renewal #2063-85) -
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 8000 AMP V OR ORSLESS
10.00
Main service EA. AOD'L 100 AMP
2.50
—
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 Professions Code and my license Is In full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
ElI, as the owner, am exclusively contracting with licensed con
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this eason
WORKMEN'S COMPENSATION INSURANCE
I declare unde enalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
NEW CONST.DWELLING OCCUP.d`
OR ACDNS. ( ACC. BLDG$. / 2/e¢sgft
NEW CONSTR. MULTI -OUTLET
NO N•RESID BRANCH CIRC ITS 2.50 ea
/POWER APPARATUS d
\SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20050Q
eALO 308
FIXED
Ex. OCCUp. OUTLETS PIRESID 1REA.) 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00tract-
Misc. Wiring
9 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT Filing Fee 10.00
Heating
Cooling
Hood 3,00
Ventilation
permit Fee ;
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
Inst said County in consequence of the granting of this permit.
p �)
«� Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excovotions ovor 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ 46.00
oc cup.
CONST.TYPE
I
I FLOOD
PARCEL
PD
I Ho
I ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date ate
PERMIT EXPIRES Date__.
Receipt No.
wNITE-D. �.W„ TELLa W-A93t?iSa R, OINM1-INSPECTOR. 60LDENROD-APPLICANT
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Qrlve - Orovllle, California 95965 - Telephone: 916/536-7541
APPLICATION AND PtRMIT
ASSESSOR PARCEL -NUMB
M -022-057C
ZONING
2
BUILDING PERMIT
OWNER
DAN DAMS
TE,L P N
534
SO. FT. OCC. BUILDING VALUATION
51W LK)
OWNER'S MAILING ADDRESS
2492 Y-7 ROAD MOW=
0
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee _ $ 15.00
LENDER'S MAILING ADDRESS
Permit Fee $ 15.
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
2492 v-7 ROAD
Permit fee $ 30.00
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF FX) Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S G W @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other E4
Describe work: DEMOLITION
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 600v OR LESS 18.50
200A OR LESS
Main service 200A TO 1000AI 37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
�I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044);
❑ I am exempt uri er Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUPM 3.64sq.ft.
OR ADDNS. ACC. BLDGS. /
NEW CONSTR ULTI.OUTLET
NON•RESID BRANCH CIRC ITS @ 5.00
(POWER APPARATUS e)
SINGLE OUTLET CIR.
76
EX. OCcup(OUTLETS OR FIXTURESAO 46
FIXED APLNS
Ex. OCCUp. OUTLETS IPRESID.)REA.) I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Ho
Misc. 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.
�l shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT FiIingFee 15.00
Heating
Coolin g
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 sai ousIty- in-consequen ' .of the gr Ing of this permit.
X Date /�
Signature of Applicant — ner 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 height.
Receipt No. 101467
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE $
HAz
I DFEES I
IMP
I FLOOD
I cDF
I PARCEL
PO
HD
Iss
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or,resolutions to do
wort ,indicated aboye ar whichfftes�have been paid.
DIRECTO F `OF PUBLICWORK
By �4 DS
Kate 1
PERMIT EXPIRES Date // / Q �y•
JCOUNTY OF BUTTE'. DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, Cailfornla 95965 - Telephone: 916/538.7541
-APPLICATION AND PERMIT
PERMIT NO.
96E90 R RC N
036-022-057
ZONING
C 2
BUILDING PERMIT
OWNER DAN DAVIS
533P6ONE
542
SQ. FT, OCC. BUILDING VALUATION
EST 500. 00
OWNER'S MAILING ADDRESS
2492 V-7 ROAD OROVILLE
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$ 15.
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
2492 V-7 ROAD
Permit fee
$ 30.00
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF[� Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I IN 1
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other EX
Describe work: DEMOLITION
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200A TO 1o0OA,
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
9—+. as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
ElI, as the owner, am exclusively contracting with licensed contra
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST./ DWELLING OCCUP. &�
OR ACDNS. 1 ACC. BLDGS.
3.64 sq.ft.
NEWCONSTR ULTI.OUT LET
NON -R E." BRANCH CIRC ITS
@ 5.00
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 @ 76
FIXED APPLNS.
Ex. OCCup. OUTLETS (RESID )REAT
i 3.00
Temporary service
15.00
Mobile Home Facilities
15.00ct-
Misc. bVirin g
15.00
J
I
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.
�l shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 15.00
Heating
Cooling
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 agre to save, indemnify and keep harmless the County of Butte against®.
all liabili s judgments, costs, d expenses which may in any way accrue
against s onseq n f the gr Ing of this permit.
X Date
Si nature of Applicant - caner ❑
Signature pp ❑ 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 S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
HAz
0FEES
IMP
FLOOD
CDF
PARCEL
PO
HD
ISS
This permit is hereby issued under the
sions of Butte County Code and/o
wor di ted r which a
DI O OF UB
B
P XPIRES Date
applicable provi-
resolutions to do
have been paid.
ORKS
Date
Receipt No. 101467
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
J 4.
COUNTY OF BUTTE - DEPARrME'AT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE ' OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Permit No.
r
OWNER I IS A. P. No.
Proposed Building Use Building Inspector Date—
At
ate 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, signed by preparer of plans. . .
3. Complete plans in duplicate/triplicate, signed by preparer of plans ..
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $ ........................
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements,may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
—� Certificate of Workmans Compensation Insurance ..................
- 23. Owner -Builder Verification (Given to owner ❑, Mail to ownerA .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
5. Lettefj of signature au orization ........................... ti
_l 26. ✓� 5 e S +os vn oya i'®r h'1 7
27.
When you issue the perm*t, process as follows: Mail to owner. Mail to contractor.
Telephone Aj and hold for pickup at office. Deliver w/inspector.
Other
Applicant
Date
Copy of Haz-Mat form sent • Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other ' Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phor .._�- -_codnter by Q -date Igo'
—d -
Contractor, designer, owner, was advised of above required data by—phone _mail—counter by datepla
, ��
Plans checked by Dgte Rjans approved by Date b
Sets of plans on hold in File cabinet AP folder
Copy—DPW
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER — D�
3 p�Cj
zo" G
BUILDING PERMIT
O WNE
TE(—. ✓°/NEO
SO. FT. OCC. BUILDING VALUATION
OWNER'S 1 N ORES OI ���lJ/
/
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee $ 15.00
LENDER'S MAILING ADDRESS
Permit Fee $ li
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING g,D Ess
�(
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.SUBDIVISION
NAME ' PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SFP�_ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G I W @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti ities ❑ Installation❑ Other,
Describe work:
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
1
Main service 600V OR LESS 18.50
200A OR LESS 1
Main service 200ATO1000A, 37.50
CONTRACTORS LICENSE LAW
I declare under penaltyof perjury
p 1 y (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST./ DWELLING OCCUP.E\ 3.60 sq.ft.
DR ACDNS. 1 ACC. BLDGS.
NEW CONSTR ULTI.OUTLET
NON.RESID BRANCH CIRCU ITS @ 5'00
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20 75d
AL.
FIXED
Ex. Occup. OUTLETS 4RESID )LNS.REA.1 I 3.011
0
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT FiIirig Fee 15.00
Heating
Cooling
Hood 6.50
Ventilation
Permit Fee $
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
si nature of Applicant – owner
g pp ❑ Cs o Contractor 5' ❑ 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 S
Ener Inspection Fee $
9Y P
Occ
CONST TYPE
TOTAL FEE $
HAz
1 0FEES I
IMP
FLOOD
I CDF
PARCEL
PD HD
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT
PERMIT EXPIRES Date
Receipt No.
WNITE-O.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT
Demolition Permits
Asbestos Notification Statement
Date / l /ol /,? /
AP# �, &W — � P
Pursuant to section 19827.5 of the California Health and Safety Code, all
demolition permit applicants are required to fill out this form.
"19827.5. A demolition permit shall not be issued by any city, county,.
city and county, or state and local agency which is authorized to issue
demolition permits*as to any building or structure except upon the receipt
from the permit applicant of a copy of each written asbestos notification
regarding the building that has been required to be submitted to the United
States Environmental Protection Agency or to a designated state agency, or
both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to that part.. The permit may be issued without the applicant
submitting a copy of the written notification if the applicant declares that
the notification is not applicable to the scheduled demolition project. The
permitting agency may require the applicant* to make the declaration in writing,
or it may incorporate the applicant's response on the demolition permit appli—
cation."
Attached is a copy of my written asbestos notification to the United States
Environmental Protection Agency for the demolition project located at
Signature of Applicant
OR
I hereby declare that a written asbestos notification to the United States
Environmental Protection Agency is not applicable to this demolition project.
r
i ,t1ci _ Signature of Applicant
2/19/91
cBUIp 08PT
NOV 12 lob,
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 '
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no)
2. I (have/have not) WIV41Esigned an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. ,I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed:
Property Owner.
Social Security
Date
ber
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
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