HomeMy WebLinkAbout078-340-001f-
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WILSON DUTCH SCHMIDT
120 Inglewood Drive, Oroville(911��
Contr; George Roofing j
Permit#1560-85B(reroof/SF)
078-340-001` 06-0397
LOUDERBACK, MICHEAL
120 INGLEWOOD-'DR, OROVILLE
CONT: OWNER
GAS LINE INSTALL
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SPECIAL CONDITIONS
CHECKED BY
Q SRA
Q FLOOD CERTIFICATE EQUIRED
Q FIRE SPRINKLERS REQUIRED
❑ SPECIAL INSPECTION ITEMS
Q VERIFY
Q USE PERMIT CONDITIONS
Q SUB -STANDARD HOUSING LETTER
Q ENCROACHMENT PERMIT
Q REINSPECTION FEE PAID
Q ENV HLTH CLEARANCE
+ = OK _ ---
u = not Um - -
--- - ..
.MANUFACTURED HOMES
MISCELLANEOUS
DATE PERMANENT FOUNDATION Lj SOFT -SET DATE D E C KS -C O.V E R S'C A R P O R T S `GARAGE S
1 Zoning -Setbacks -Easements 1 Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch' 2 Ftgs; Soils-Sz-DpthSpacing-CnnctrsStee1
3 Sewer; Loctn-Test; FaII/C/O-Concrete 3 Decks, Girders/Joists-Dcking-Brcing
4 Wtr, Loctn-Test-Easement Needed -Regulator Stairs-Guard/Handrails
S Elec Loctn-Clrncs-Grnd Amp -Concrete 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg
6 Yard Gas; Loctn-Test-Wrap . Nat 0 or LP[ - Frmg-Brcng
Inch Sz Ft Lngth 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs
7 Blckng; Sz-Spacing-Marriage Line 6 Carports; Wndws-Doors
8 Gas; MH Test-Demand-Valve-Cnnctr 7 Electric
9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trnisses
10 Drain; MH Test -Fall -Flex Cnnctr . 9 Siding; Nailing-VeneerStucco-Lath"
11 Wtr .& Sewer Connected -CIO to Grade 10 Roof; Shthg-Roofing
12 Gas and Electricity Tagged 11 Ext; Steps -Doors -Landings
13 Tie Downs 0 Foundation 0 12 Braced Wall pnls.
14 Exits
15 Cert of Occupancy
°� °fie
16 HUD Label/Insignia Numbers Serial Numbers
DATE IPOOLS
1 Setbacks -Easements
2 Soils; CompactionStructure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15volts•GFI
6 Elec Enclsrs; Conduit Entries -Terminals -Listed
" 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr
8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg
Bones-Enclsrs-pnlboards4nsultn to Main Conduit
9 Health Dept Apprv1
10 Plmb; Cir Test-Wtr Supply Test
11 Lt Niche
12 Enclsr, Fencing -Alarms
13 Bonding, Diving board or Slide .
a s`
' Pool Drawing .
OK
= Not OK
- RESIDENTIAL (Single & Duplex) I I.. I
UAlt JUNDERFLOOR
DATE
PLUMBING
1 Zoning -Setbacks -Easements -Flood -Slope
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
2 Ftg Main, Soils-Elec Grnd Ftg Dpth
54 Wtr Pipe; Test & Anchr-Nail Prtctn
3 Ftg Garage; Soils-Steel-Elec Grnd Fig Dpth.
55 DWV; Test Fittings & Anchr Nail Prtctn
4 Ftg Porches/Decks; Soils -Steel Fig Dpth
56 Shwr Pan; Tess, First fir -Tub Acc
5 Stemwalls Main; Steel-Blockouts-Wrapped
57 Test Tub & Shwr, 2nd fir - Tub-Acc
6 Stemwalls Garage; Steel -BI ockouts-Wrapped
58 Gas Pip , Sz & Anchrs
6a Hold Downs and Special Anchrs
59 Fir prinkler; Test
7 Slab, Steel Wrapped
and Gas Piping
8 Piers-FrplcFtgSteel C/0
9 DWV; Fall -Fitting C/Oewer Test
-Test -2 -way -Sewer
10 UF, Gas Pipe; Sz Anchrs-Sz Test
°9a (,tom �
`c c
`
° ` "C" ° 0
1l Wtr Pipe; Test-Anchrs-Rgltr-Service Test
12 Elec Undrgrnd
DATE
M E C H A N I C A L
13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn
61 AC Ducts Insults & Support
14 Girders Sills-Anchr BoltsJoists-Vnts-Cripples
62 Vent Fan, Exhaust abv Insultn
15 Acc & Vntitn
63 Condensate Drain & Ovrflw, Sz & Grade
16• Insulation
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
O'• 0� O'• 0
O'er
O�`C oA.
0
DATE FRAMING
17 Sills Proper Materials & Anchrs
DATE
IFINAL
18 Walls Studs -Nailing Spacing & Braces -Plates -Sound
66 Ext Steps -Door & SideLt Prtctn-Landings
19 Bearing Walls over Girders & fir Nailing
67 Smoke Detector
20 Draft Stop in Walls (rat proof)
68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
In Garage; abv-fir-Ducts-Mech Prtctn
22 Headers & Beams-Sz & Bearing
69 Bedroom Exiting
23 Hangers -Post Caps-Anchrs-Cnnctns
70 GFI & Bath Fxtrs & Tub Acc-Spa
24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg
71 GFI Arc Fault
25 Frplc Ties or Type A Flue-Frplc Throat Clmc
72 Elec Trim & Subpnl, Breaker Sts & Labels
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles
73 Stairs, Guard/Handrails
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
74 Frplc or Stove, Cirnc-Hearth
28 Garage Fire Prtctn Framing -RC Channel
75 Elec Outlets at Wood Pnl, Int & Ext
29 Prprty Line Firewall & Opngs
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cirnc
30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits
77 Elec Outlets & Rcptcls at Ktchn Counter
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
78 Garage Fire Door; Swing -Landing -Closure
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
79 AC Duct in Garage -Damper
33 Siding -Nailing Veneer
80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir
34 Stucco lath -Weep Screed-Fndtn Vnts-Undrflr Acc
Mach Prtctn- LPG Appince Undr House 3" drain
35 Glazing Area -Glass Prtctn-SkyLts-Plastic
81 Plmb; Elec & Mech Eqp Listed for Loon
36 Shear Walls; Nailing -Bolts
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
37 Brace Int/Ext Wall pnls
83 Insultn-Foam-Looked in Attic
3B Insultn-Walls-Ceilings
84 Guard Rails & Deck Cnstrctn-Post Caps
39 Infiltration-Walls-Wndws
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Cirnc Drnge Planters ❑Yes ❑No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Ptmb
89 Vnts abv Roof, Plmb-Appinc-Frplc-Cirnc to Opngs
DATE JELECTRICAL
90 Wtr Well, Dscnnct, Elec, Plmb
40 Fxtr & Trnsfrmr Clmc4ns Prtctn
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
41 Elec Rcptcls Spacing -Lis & Switches at Doors
92 Vntltn thru House
42 Sz Boxes & No Of Cndctrs Stapled
ss rtctn
43 Romex Installed Close to Edge of Studs & CJ
ections from previous lnspctns
>4C
44 Eqp Gmd made up w/Mech Fstnrs
Test -Meters Tagged, Gas-Elec
45 Grndng Electrode Bond Gas & Wtr
96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
97 Energy Cmpinc Cert -Other Certs
47 Subfeed Wire Sz ga ❑ CU or ❑AL
98 Address Posted
AC Wire Sz 92 ❑ CU or ❑AL
99 Fire Sprinkler
48 Range Circ ga ❑ CU or ❑AL
Oven Circ ga❑CUor❑AL
-
Insulated Neutral ❑Yes ❑No
o`
�� s
e o'er o`
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp Clrncs pnls-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive * Oroville, CA * (53% 538-7541
CORRECTION NOTICE
OWNER -PERMITNO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
f.
the above address and should be corrected. Please call for re -inspection when correction 0
work is completed. If you have any questions pertaining to this matter, or need additional.
explanation, please contact the Building Inspector as indicated below.
10(5 61&��CTRIC u, -,t . /0,,/
- QEF LUC ISC4 CO,
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Date lo ("ARP' --1,71&12_ -,
-3-06o Inspector - �)'
REV 4/05 Phone# -
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 _
PERMIT NO.
BP060397.
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 02/21/2006 APN: 078-340-001-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
Site Address: 120 INGLEWOOD DR ORO
License Class : License Number:
Map Index:
Date: Contractor:
Description: INSTALL GAS LINE
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
LOUDERBACK MICHAEL &JOAN
Business and Professions Code: Any city or county which requires a
Owner:
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
107 INGLEWOOD DR
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
OROVILLE, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95966-7120
she is exempt therefrom and the basis for the alleged exemption. Any
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).):
11d 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
Applicant: LOUDERBACK, MICHAEL & JOAN
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
120 INGLEWOOD DR
sale. If however,, the building or improvements are sold within one
OROVILLE, CA
year of completion, the owner -builder will have the burden of
92966
proving that he or she did not build or improve for the purpose of
sale.).
(530) 53.4-0878
❑ 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'
Contractor:
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the B iness and Professions Code
Date: al U Own 7r
WORKERS' C OrV6IWSATION DECLARATION
I hereby affirm under penalty t4erjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
License #:
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit is issued. My workers' compensation
.
insurance carrier and policy number are:
Carder:—
arrier:Policy#:
Total Square Ft: 0 S. F.
Policy #:
❑ I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
Census Code:
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
'compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.Y�
GO
CJ%
Date:
Applicant:
2 - 2— k lJ G .
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
-
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Reso utio s to do work Indic ted ab ve for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
rt
-OGD
Name:
By: L
Date:/ -21-
2
PERMI EXPIRES ON:
Address:
(Date)
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms. .
I hereby certify that I have read this application, that the above information is correct, and that 1 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 substanc any official form or document of Butte County. I hereby
authorize representatives of Butte to enterupon the above property for inspection poses.
/County
lnmentioned
Loc9—d back—
Print Name: 1 Y Signatur .
Date:
Owner ❑ Contractor ❑rfor ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP060397
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 02/21/2006 APN: 078-340-001-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
Site Address: 120 INGLEWOOD DR ORO
License Class : License Number:
Map Index:
Date: Contractor:
Description: INSTALL GAS LINE
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
LOUDERBACK MICHAEL &JOAN
Business and Professions Code: Any city or county which requires a
Owner:
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
107 INGLEWOOD DR
the Contractor's State License Law (Chapter 9 commencing with Section
OROVILLE, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95966-7120
she is exempt therefrom and the basis for the alleged exemption. Any
.
violation of Section. 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: LOUDERBACK, MICHAEL & JOAN
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
120 INGLEWOOD DR
sale. If however, the building or improvements are sold within one
OROVILLE, CA
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
92966
sale.).
(530) 534-0878
❑ 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
Contractor:
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the B iness and Professions Code
Date: 0i CC Own r:
WORKERS' C MWSATION DECLARATION
I hereby affirm under penalty Xperjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
License #:
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
Carrier:
Policy#:
Total Square Ft: 0 S. F.
❑ 1 certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
Census Code:
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
(� OU
�{.�
(�•
Date:
Applicant:
2-21-0
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Reso utio s to do work indic ted ab ve for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By: Date:_ LI
PER MI EXPIRES ON: / /_1—t 1' /
(Date)
Address:
❑ I hereby certify.that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ 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 itis unlawful to alter the substanc any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon) the above mentioned property for inspection poses.
1
Print Name:, 1^� I(� Signatur .
jw
Owner ❑ Contractor ❑ nt for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE #: (530) 538-754) .
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
LIst a e \
I
First Nam ^ ,
ev
Address 1&01
T— ( w �.rDb -Oe—
city
City ec Y �
Y
Sta
��l
Zi{�}
[
Phone
q7-0-8l
7 S
I Fax
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Book
Fax
E-mail.
Planner a
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Book
Fax
E mail
Planner a
State License Number
APPLICANT INFORMATION
Name ->
Address
City
State
Zip
Phone
Fax
E-mail
or offi u o+:
AP#
D
'
Flood Zone
City
SRA
Yes
I No
0
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner a
Date Approved:
nXIC:0 CrlD CI IC21MITTAI Dl=rll IIDCInr:K1TC
PERMIT
NO.
BIN #
PROJECT LOCATION
AP#
D
Property Address/
City
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
on-),a2Z2e_ e�7a,
Az try-,
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid'the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: G Amount: ), Bldg
SRA
Receipt #: ggqo( Sheriff
SMIP
2-1i.- �+ Other
Date: V (p
l ). Total
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 of your earliest .opportunity to avoid unnecessary
delay in processing and issuing your building permit. No building permit will be issued.until this
verification is received.
1. I personally plan to: provide the major labor and material for construction of this proposed
property improvement: YES [ ✓] NO[ ].
2. I HAVE [V ] HAVE NOT [ ] signed an application for a building permit for the proposed:
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO:
4. I plan to provide portions of the work, but I have hired the following person to coordinate,:
supervise, and provide the major work: f
NAME:
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO:
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTY O R:
DATE:
. r_? A44
NOTE:. This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
This.verification must be completed and returned to our office before we are permitted to issue the
.:permit..
Rev'd 11/4/2004. .
Butte County .Department of Development Services �OTT�
ADMINISTRATION `BUILDING GIS ti PLANNING o
o
0
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile ,
OWNER -BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the 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 yourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the city or county. They are also required by law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government 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.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For. more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the 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 contractor 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 contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
Sincerely,
Scott Rutherford
Chief Building Inspector
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
Permit#1560-85B
Wilson Dutch Schmidt
120 Inglewood Dr, Oroville
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville,stalifornia 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT
ERMIIT NO.
ASSESSOR PARCEL NUMBER
'(0
ZONING
BUILDING PERMIT
OWNER
Wits m Dutch Sciatddt
TELEPHONE
533-6880
SQ. FT; OCC. BUILDING VALUATION
/
1 C__
OWNER'SMAILING ADDRESS
120 ;nglewood Dr. Chwille
CONTRACTOR'S NAME
Gearge Ibofinq
TELEPHONE
533-5393
CONTRACTOR'S MAILING ADDRESS
3923 olive 1W. Oroville
CONSTRUCTION LENDER
UNKNOWN
Fireplace
Total Valuation $
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
120 Inglempod Dry 01raville
PLUMBING PERMIT
Filing Fee 3.00
-Each Trap
2.00
Repair drainage or vent piping
2.00
^—
-,Water,piping
LOT NO.
=N NAME
PARCEL MAP,
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ® Duplex[-] Mobilehome❑ Other
- SPECIFY
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
New❑ Addition Remodel❑ Utilities❑ Installation❑ Other [0
Describe work: Rnofincr —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 3.00
Main service 100 AMP ORV OR LESS___5.00
Main service/EA, ADD'L 100 AMP
2.50
NEW CONST. DWELING
OR ADDNS. \ ACCLBLDGS.CCUP,&)
20 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. 452265 Classification C-39
❑ 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NON.RESID CONSTR. BRANCH CIRCUITS
2.50 ea
NEW CONST R. /POWER APPARATUS &�
NON-RESID. SINGLE OUTLET CIR.
5o�zsc
Ex. Occup(o XTs OR FIXTURES BAL@,O¢
FIXEEDD APP LNS, OR
Ex. Occup.(OUTLETS (RESID.) EAJ
2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 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
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.
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.
f1 -
X Date May 28, 1985
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
$
Land Development Fee $
TOTAL PERMIT FEE $ (�f
OCCUP. GROUP
I TYPE OF CONST,
I
PARCEL
PD
1 HD
seuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
_
By /' /J�i�/ r� // ! .�
- -
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date / �/ " �s (-
Receipt No. , n< -
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 Count; -Center Drive'- Oroville; Califorr"95965 - Telephone 916/534-454
APPLICATION AN
PERMIT
/ PERMIT NO.
L12 4�5
/
ASSESSOR PARCEL NUMBER
_ ,'
ZONING
-
BUILDING PERMIT
OWNER TELEPHONE
Wilson Dutch Schmidt 533-6880
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
120 Inglewood Dr. .Oroville
•TELEPHONE
CONTRACTOR'S NAME - - -
George lbofin 533-6393
CONTRACTOR'S MAILING ADDRESS
3923 Olive Hwy. Oroville
CONSTRUCTION LENDER UNKNOWN
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
Permit Fee
$
ARCHITECT OR ENGINEER - -
LICENSE NO.
I Plan Checking Fee
$ '
N Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS ,. ,• �'
Permit fee..
$
BUILDING ADDRESS - - -
120 -Inglewood Dr. Oroville .
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
2.00
Repair drainage or vent piping.
2.00
`MAP
WaterP•P I in 9
LOT NO. SUBDIVISION NAME - ___f- PARCEL
Each ctas water heater Or vent
2.00
Gas piping system 1 - 5 outlets
• USE OF STRUCTURE
Building sewer
SF ER Duplex❑ Mobilehome❑ Other
Lawn sprinkler system
2.00
' SPECIFY
'
TYPE OF WORK -
{. Permit Fee
$
New ❑ Addition ❑ Remodel ❑ Utilities ❑ •1Installation❑ • Other ®
Contractor
ELECTRICAL PERMIT
Filing Fee 3.00
Describe work: Roofing —
Main service 600V OR LESS
100 AMP OR LESS
S.00
Main service EA. ADD -L. 100 AMP-
2.50
NEW
OR ADDNSCONST DACCLBLDGS.LING CCUP.&)
20 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.
452266
License No. Classification C-39 "
ULT'_OUT LE
NON•RESID R BRANCH CIRCTITS 2.50 ea
NEW-CONSTR. POWER APPARATUS &
.NON-RESID. (SINGLE OUTLET CIR.
Ex. Occup(ouTLETs OR FIXTURES gqL ,
Ex. Occup. FIXED TS (RESAPPLNS. OR
P•(our LETS (REST D.1 EA. 1 2.00
Temporary service
10.00
❑ I, as the owner, or my employees with wages as their sole compen-
Mobile Home Facilities
15.00
sation, will do the work,and the structure isnot intended orioffered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors: (Sec. 7044)
Misc. Wiring
6.25
Permit Fee
$
❑. I am exempt under Sec. - , Business and Professions Code
Contractor
for this reason
WORKMEN'S COMPENSATION INSURANCE
'MECHANICAL PERMIT
Filing Fee 3.00
Heating .
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.
Cooling
i,Hood
2.00
' Ventilation
❑ 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.
Permit Fee
$
Contractor
I certify that I have read this application and state that•the above information
Mobile Home Installation Fee
$
Land Development Fee
$
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.
TOTAL PERMIT FEE
$
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 sal County in conseq/ueJce of the granting of this permit.-
ioccOP. GROUP
r
TYPE OF CONST.
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.
X Date Md 28 1985
-r
Signature of Applicant'— , Owner ❑ Contractor ❑ Agent ER
An OSHA permit is required for excavations over 5'0" deep and demolitiori or construct-
ion of structuresover3 stories in height.
'' IRECTO F P ELIC
I By
PERMIT EXPIRES Date
WORKS `
D to Sa�
Receipt No.- Ug��,�—
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT