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HomeMy WebLinkAbout078-320-013j Jack Perkins Oak-Knoll Way, Oroville ` DAMAGE REPORT — 7/10/80) 17Jack Perkins 2733 Oak Knoll Waj, Oroville 1-1Y-9a- Permit #3686-80B,P,E(repair fire dama ' new roosure, elec, plbg vent & r type A Flue/SF) WUBBOLDING, ROBERT 2733 OAK KNOLL WY., OR OWNER r�4( �� 0 ROOFWb WORK & NUSC W Fit a -6��b'e'fiS BP040721 ; 1 WUBBOLDING, ROBERT 2733 OAK KNOLL WAY;, GASTIPING- 3 �% D'I k, -Z f i r i V BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 ` WEBSITE: www.buttecounty.netWds PERMIT NO. BP040721 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date• - 03/16/2004 APN• 036440-013-000 the Business and Professions Code, and my license is in full force and _effect. License Class: License Number: Site Address: 2733 OAK KNOLL WAY ORO Date: Contractor: Map Index: Description: GAS PIPING FOR INSTALLATION OF p OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the PROPANE TANK Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: WUBBOLDING ROBERT & LISA TRUST signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or ' WUBBOLDING ROBERT T & LISA A she is exempt therefrom and the basis for the alleged exemption. Any TRUSTEES violation of Section 7031.5 by any applicant for a permit subjects the 84 JIMS BAR ROAD applicant to a civil penalty of not more than five hundred dollars ($500).): OROVILLE, CA 95966 iff 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for Applicant: WUBBOLDING ROBERT &LISA TRUST sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting withOFFICE { licensed contractors to construct the project (Sec. 7044, Business I COPY and Professions Code. The Contractors' State License Law does Address not apply to an owner of property who builds or improves thereon, ( and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). j _ GAS ❑ 1 am Exempt under Article 3 of the Business. and Professions Code Meter By Contractor: ELECTRIC Dat_-! �! �1fX�l7li�.6/,c/�,y Date: Owner: Meter By Date , WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self -insure for /�% workers' compensation, as provided for by Section 3700 of the ( / —0 y - Labor Code, for the performance of the work for which this permit l is issued. License #: Jill I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Architect: Carrier: Engineer: Policy #: ❑ 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 Total Square Ft: 0 S. F. become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Valuation: $0.00 compensation provisions of Section 3700 of the Labor Code, I shall ,forthwith comply with those provisions. Census Code: Date: c4_�� �/� I Applicant: � WARNING: Failure to secure workers' compensation coverage unlawful, and shall subject an employer to criminal penalties and one �Q 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 rmi 's he eMena applica le provi 'ons of the Butte County Code nd/or I hereby affirm that there is a construction lendingagency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resol tion o d v wh es been paid. I y Name: By. J Date: PERMIT EXPIRES ON: to Date Address: O 1 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. O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Signature: Date: 'Owner 0 Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT' OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP040721 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 03/16/2004 APN: 036-440-013-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 2733 OAK KNOLL WAY ORO Date: Contractor: Map Index: Description: GAS PIPING FOR INSTALLATION OF p 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 PROPANE TANK 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 Owner: WUBBOLDING ROBERT & LISA TRUST signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or WUBBOLDING ROBERT T & LISA A she is exempt therefrom and the basis for the alleged exemption. Any TRUSTEES 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).): 84 JIMS BAR ROAD ' OROVILLE, CA 95966 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for Applicant.. WUBBOLDING ROBERT &LISA TRUST sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, ' and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code /'' / I• Contractor: Date: r;�� Owner: �' ����/�'•-�� , WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. License #: I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Architect: Carrier: Engineer: Policy #: ❑ 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 Total Square Ft: 0 S. F. become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Valuation: $0.00 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Census Code: Date: Applicant: UI 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 rrni 's he eby s e n er a applica le provi 'ons of the Butte County Code nd/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resol on o d wo i di a v w h es been paid. 164 -- Name: BY Date: l L� PERMIT EXPIRES ON: 1 Date Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: 2 Signature: Date:/16--/0/{ Owner 0 Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. . BP a' 00 DATE: J 0 4— APN: 1 'O I ZONING: OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE: STRE ADDRESS: 0.P -- FAX, CITY, ZIP: olfe__ C' %S e,�X-' E-MAIL: SITE ADDRESS: CITY, ZIP: If d le— NEAREST CROSS STREET: S TRACT/LOT tk. APPLICANT NAME: PHONE: STREET ADDRESS: FAX, CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAx CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: /; -- ❑ 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 fees will be required. 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. For office use only: Notes: Application Received by: ' Date: 23- /& Receipt number:41z�)Amount Received: L —3 - U � ��QQ Master application 31-04 • •.49 1. 1 . O.B.- I OWNER -BUILDER VERIFICATION - Attention Property Owner: 4 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: • � �. ` - ' r ,. I personally plan to provide the major labor and materials for construction of the,proposed t ' ` property improvement : YES-Al.,NO ❑ , 2 I HAVE.4Y HAVE NOT ❑ signed an application for a building permit for the proposed work .. I have contracted with the following person (firm) to provide theproposed construction: " NAME: ADDRESS: ,CITY," , PHONE: CONTR.ACTOR'S' 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: C=— , PHONEc CONTRACTOR'S LICENSE NO. t 5. I will provide some of the work but I have contracted (hired) the following persons to provide L the work indicated: NAME ADDRESS. 'PHONE TYPE OF WORK SIGNED— 1 DATE: O NOTE: This Owner -Builder Verification is required by ,lection 19831 and 19832 of the California Health and Safety Co& This verification must be completed- and returned to our office before we are permitted to issue the permit: OVER T SIGNED— 1 DATE: O NOTE: This Owner -Builder Verification is required by ,lection 19831 and 19832 of the California Health and Safety Co& This verification must be completed- and returned to our office before we are permitted to issue the permit: OVER OB. -1 I OWNER BUILDER INFORMATION Dear Property Owner.- An wner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourse14 you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply If you -plan to do your own work; with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (Including materials and other costs) is $300' or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not cant' out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal R:evenne Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your .obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a. licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street; Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these ratters. The building permit will not be issued until the verification is retuned. rely, ,,. Mic 1 C. Vi ira, C.B.O. M ger, Building Inspection NOTE: T7tis Owner Builder Information is required by Section 19830 of the California Health and Safety Code OVER ........... 03 -.0-01 T #98-2,723 3 t44 4 3 #98 2723 0' #9 �D NG ROBERT Bo VUBBOLDING, ROBERt; 2 0 0 L y Opo 733 OAK ]KNOLL WY., ORO K OWNER 00 �Wo & NUSC Wn ROOFNNTG �-WORK & NUSC WHUN .. r ;` : .yy�+r../�- ..�.:,�; .. .. ..t:y�". . ., ;.n.H,.....ip.r�c �ry►.,-•-^�nR�r.7ew�[:.a+rvx-F.. S'vr...++si{c 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 1 21D.-?. ASSESSOR PARCEL NUMBE036--4406-013 ZONING BUILDING PERMIT OWNER WUBBOLDING, ROBERT ' "�g1 SO. FT. OCC. BUILDING VALUATION �+ OWNER'S MAILING ADDRESS TIM BAR RD. OROVILI E V'�i J.L�7J EST 1300.00 CONTRACTOR'g V W ,�y i;�rlS TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 1300.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 31.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDR033 OAR KNOLL WAY Energy Plan Checking Fee $ OROVILLE $ PERMIT FEE S 51,00 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF l 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 ❑ Installation ❑ Other ❑ Describe Work: ROOFING WORK MD MISC WIRING Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 "OV OR LESS Main Service zo.AORLESS23.00 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.PO License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: AQ� 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.) ,Qtr I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X 'T -,�►f .���,lr-. e� ..�-� Date &,1Z19iP Signature of Applicant - JR Owned 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 OR ADDNS. ( & ACC. BLD S. 3.50FT. N0µRESIDT' MULTI-OUTI IITs @7,50 APPARATUS 8 SINGLE 011fLET CIR. 20 Q 1.00 Ex. Occup. OUTLET OR FIXTURES BAS @ .50 APPLNS Ex. Occup. oUUTTlETS RI ID.OEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ 43.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 4 "Z.D. FEES IMP I FLOOD I COF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. // By }r .1. >. . E. Date ///-0/ A�r PERMIT EXPIRES ON !/ v fDeta Receipt No. r , i . ' =.x' 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, CaWfornia , 95965 • Telephone (530) 538-7541—PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMB T36-440-013 ZONING BUILDING PERMIT OWNER WUBBOLDING , ROBERT SQ. SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADR4?SJIMS BAR RD. OROVILLE EST 1300.00 CONTRACTOR'810i nR VVMWAW TONE ELEPH CONTRACTORS ING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 1300.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 31.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDFD33 OAK KNOLL WAY Energy Plan Checking Fee $ $ OROVILLE PERMIT FEE $ 51.00 LOT NO. SUBDN6roNS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF W Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ROOFING WORK AND MISC WIRING Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 OOOVR LESS Main Service A 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.a License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: AiL 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 I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 31/00 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.) _AC_ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date &1-gaz%j' Signature of Applicant - 49 Own 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 WOOL TO t0CU00A 46.00 NEW CONST. DWE. OCS. SO OR ADDNS. ( DW: ACC. 3.5QFr; U LI- NOµgEOs S MULTI -OUTLET @7,50 ITN. OUTLWELER APPAREATUST CIR. 20 @ 1.00 Ex. Occup. oun.Er OR FocruREs BAL @ .50 Ex. Occup. oiniEGrs REa.GEw 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 1 nn PERMIT FEE $ 4 3.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ Qz, nn HAz. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By a Date144 PERMIT EXPIRES ON 2� Dale rReceipt No. � ��? HITE-D.D.S.-B.D.AG�NA 1^9SSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing you:' 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: YESEP NOD _ 2. I HAVEZ HAVE NOT 13 signed an application for a building permit for the proposed work, 3. I have contracted with the following person (firm) to provide the proposed eonsth a 6n: ADDRESS: CITY: PRONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to .coowinaw; supervise, and provide the major work: NAME: f1�v ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. 1 will provide some of the work but I have contracted (hired) the following persons to prpwde the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: SOCIAL SECURITY NUMBER: -- DATE: A UMBERDATE:_ 7? 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. OVER aeR o. 3686-80B,P,E PERMIT EXPIRES / /;L;t 1 - OWNER Jack Perkins 'CONTR. ower 36-44-13 LOCATION (A.P. ) 273.3 Oak Knoll Way, Oroville 1 LIL r' Temp. Power Pole Called PG&E ne Temp. Elec. Serv. `7-31-''d Called PG&E� "t Temp. Gas Serv. Called PG&E JOB I FINALED (Date) (Signature) COUNTY OF BUTTE DEPARTMENTI OF PUBLIC WORKS '•a --BUILDING INSPECT!ON",RECORD BUILDING BUILDING..(Cont'd) PLUMBING Setback firewall Soil Piping Forms Parapets 1st Floor Main Bldg. _ Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab* Roof Sheathing Water Piping Piers Roofing Sewer • Garage Fdn. Vents Fixtures Footings Stemwa l l Garage Vents Insulation Water Htr. Heaters Slab - Carport Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL - Masonry Walls Throat I Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr_ Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE �' REMARKS OR CORRECTIONS ��ii// d " L✓Gel„" .�.r � !9-.,�.� C.ZGc -�� (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/5344541 .�� APPLICATION AND PERMIT ASSESSQ,¢iP A R C�E�e_U_�F� C�.(�. �..,.[i z1 r1r, _ ° 'BUILDING PERM OW ERJ{L(/Oo_ - - - -. �f PCP TELEPHONE 533 97 SO. FT.` OCC. BUILDIN LUATION 0001 QO OW R©MAI LI NF AODpR ESSl,3 $� ®J2oV�LC� �� �.5�•�s CONTRACTOR'S NAME - TELEPHONE - •CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER I UNKNOWN +. FlfeplaCe Total Valuation $ 57S -00 LENDER'S MAILING ADDRESS ,: Permit Fee $ ,e7D ARCHITECT OR EI EER -- LICENSE NO. Plan Checking Fee $ 19-.00 Penalty 5 $ ARCHITECT OR ENGINEER'S MAILING ADDRESS - Permit fee $ rj 00 - BUILD�,G ,?DJDREss L PLUMBING PERMIT Filing Fee 3.00 j Each. Trap 2.00 Repair drainage or vent piping 2.00 2, 00 f/K�(/(�/(�� • Water piping O LOT NO. SUBDIVISION. NAME ' PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE M SF ®Duplex❑ Mobilehome❑ Other ' SPECIFY Building sewer Lawn sprinkler system 2.00 - TYPE, OF WORK New Addition❑ Remodel❑ ,�U iIities❑ Installation❑_{Other Descri6e'woJrk:,.//r �lG'G!J ®F- ��yG��T,� —&6;C7.W yip PiL(%f� Permit Fee, $ vo Contractor, ELECTRICAL PERMIT Fi.lingFee 3.00 Main service 1P.OR 000 AMSLESS 5.00 . 00 i Ate, /��L �� �V�l�✓ Main'service EA, ADD'L too AMP 2.50 - NEW CONST. DWELLING OCCUP,& OR'ADONS. ( ACC. BLDGS. - 22 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 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) t- ❑ 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 CONSTRULTI-OUTLEC ITS) R NON.R ESI D, BRANCH CI 2.50 ea -NEW CO,NSTR (POWER APPARATUS &1 -NON-RESID. SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 50 @250 BAL@toc Ex, Occu FIXED APPLES. OR \ p•(DUTLETS (RESID.) E A./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc: Wiring 6.25 t Permit Fee, $ , Z'' Contractor. WORKMEN'S COMPENSATION INSURANCE_ 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 becomersu6ject 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 . FiIingFee 3.00 Heating Cooling Hood 2.00 ' 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 allliabilities, judgments, costs, and expenses which may in -'any way accrue again>J said County in.consequence of the granting of this permit. ` .�7 ' Date _/ s /%� g0 re of Applicant'— OwnerContractor❑ Agent ❑ ?.SuHA permit is required for excavations over 5'0" and demolition or construct- over 3 stories in height. -Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE _ $ OCYUP. GROUP TYPE OF CONST. ARCELJ PD 7-6-T-7.— D1.all This permit is hereby issued under sions of the Butte -County Code and/or work indicated above for which OR Odeep DIRE F PUBLIC i ' By`Date PE T •EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS:tructures %%�y�hj0 y 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, California 95965 — Telephone: 534-4541 PERMIT APPLICATION DATA SHEET Permit No. �. OWNER Vi��l� " �ll�a� A.P. No.r� , Proposed Building Use Permit fee based upon:` Building Inspector At time of permit application, I was issuance: _ Complete plain) 'A Price Date /- �r a lowing data must be submitted prior to perm DATE RECEIVED DPW Valuation processing ana/or 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 & AC Buildings ................... 8. Fees of $.................................................. 9. Letter of signature authorization............................................................. 10. Sanitation approval from Health Dept.... 11. Planning approval for - ............. 12. Cerateof,Wo, k en "Compensation Insurance ........................ -13. Contractors -License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -ins tion for required. Pre-inspec. request to ec Pre -inspection q bldg. -inspector (date) 16. Other When,Vou issue the permit, pr.,olcess s follows: T,-- Mail to owner Mail to contractor. P �� Telephone and(hold.for pickup at office. Deliver w/inspection. Other Applicant Date Co I of plans sent Health Dept., ' A Fire Dept., Other ng 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 Plans checked I Plans approved OTHER: Copy/DPW Telephone Mail Other Date Date Date 7- 2� Date— COUNTY OF BUTTE - Department .of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIF ICAT ION . 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 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. NOTE: 5. I have contracted with the following person (firm).to provide the proposed construction: Name Address City Phone Contractors License No. I plan to provide portionsofthis work, but I have hired the following person .to,coordinate, supervise, and provide the major work: Name 95 Address City Phone Contractors License No. I will provide some of the work but`I have contracted (hired) the following - persons to provide the work indicated: Name Address Phone „ Type.of Work AlOAle r S igned : / I _ --5> • J, Prop Soci Date 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. Owner: Addres Tenant • Building Location: BUTTE COUNTY DEPARTMENT OF PUBLIC V40RKS SPECIAL INSPECTION REPORT A. P. late of.Inspection Inspector - Type of Inspection requested: 1. Housing / / 2. Financing 77 3. Change of Occupancy to 4. Other (specify)tsL�-. ,O 'Present .use. of buildin A. Sanitation (Housfng) 1. Water closet: 2 . Lavatory 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: .6. Heating'facilities:' 7. Natural light and. ventilation: 8. Room and space requirements: 9.. Bedroom window or•door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection. to,sewage disposal: 12. Connection to. water',supply: 13. Rubbish and garbage facilities: 14. Comments:. B. Structural 1. Piers and footings: 2.. Floor construction: 3. Wall construction: 4. Ceiling and'roof construction: O d ctirroi.GE, 5. Fireplaces: 6. Comments:— _ iLs-i° d,-.� �r,vr - - _ /Leit�vyK?� -�/ -?�C.c�✓� �k� C. Electrical L Service and ground: 2. Receptacles:_ 3. Fusing: 4. Comments: .z• D. Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating:vesntts: A 4. Comments:Ci�_ �i21 _ �i�/� �� /7 /�� /i✓ ..�. IJLOi�. �. �s� s i s r E. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: y-- \ 4. Weatlier protection: 5. Underfloor and attic ventilation: 6. Comments: F. Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: 4. 'Rest:-oo, floors and walls: 5. Exits: 6. Improvements: _ 7. Zoning:_ 8. Comments: G. Field Problenis or Violations 1. Problem or -violation (give complete- description) :�l� I- .�7 -- 2. What 3. iota taken (give Eomplete descriptioxl) : A A�r1� Wheat action recommended: 32ZA. information only •- file. Hold for ten. (10) days, then write letter. ! / C. Write letter. /7D,. Other: 1a .••a'; encq'a .s �" "-.• r n, a +�. �-+.n•. :Y'^•'a""^„"S-'r•?•'--- ---'mi,•.-.--e -� �_ .- rn r'�w,7^r5__'^:"'_'"' ' ;! ay..:.;r+ra s .E �.�j -"°��4 .'..'#• y 4 � . v5� Q) 1 3. 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