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HomeMy WebLinkAbout078-340-027NOTES t , RESIDENTIAL It-. PERMIT NO. _ 036-450-027 05-1948 I DOSSETT, NEOMA $6 EDGEMONT DR, OROVILLE CONT: JENNINGS ROOFING .. REROOF •f • i! SPECIAL CONDITIONS t CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. !' SPECIAL INSPECTION ITEMS VERIFY ' USE PERMIT CONDITIONS ' SUB-STANDARD HOUSING LETTER r �I r 4 1 ! / JOB FINALED (Date) 2� �� s Signature J=OK 0 =Not OK = NotApplicablebye MOBILE HOMES . =Not Ready Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ P L'ft. / P Nat. or/ /" L "ftJ P LPG 7. Well Clearance & Disconnect ` 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s -1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Une 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-Connectot 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch .11. CerL of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits .. 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 .N.. MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric _ 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date - POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GH 5. Elec.; Pool Ughting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater .8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval , 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date _ Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable = Not Ready Date RESIDENTIAL (Single & Duplex) OK except #'s Date 1. Zoning- etbacks-Easements-Flood-Slope 2. Ftg., M 'n; Soils-Elec. Gmd.-/ P' Ftg. Depth 3. Ftg., G ge; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Po ches & Decks; Soils -Steel-/ /' Ftg. Depth 5. Stemwa s, Main; Steel-Blockouts-Wrapped 6. Stemw s, Garage; Steel- Blockouts-Wra ed 6a. Hold Do s and Special Anchors 7. Slab, St el -Wrapped 8. Piers -Fir lace Ftg.-Steel 9. D.W.V.; II -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas ipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pi e; Test -Anchors -Regulator -Service Test 12. Electric Onderground 13. Plenums Ducts; Clearance -Material -Support -Ins. 14. Girders- IIs -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation 63. Infi tration-Walls-Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING ( rmit) OK except #'s 17. Water Htr.1 Vent -Access -Combustion Air Baffle 18. Water Pi ; Test & Anchor -Nail Protection 19. D.W.V.; T t Fittings & Anchor -Nail Protection 20. Shower Pin; Test, First Floor -Tub Access 21. Test Tub & Shower Second Floor -Tub Access 22. Gas Pipe; ixe & Anchors 23. Fire Sprinkler Test 71. Fireplace or Stove, Clearance -Hearth Date Card B-1 I Date Card B-1 Date Card B-1 I Date Card B-1 Date ELECTRICAL ( ermit) .OK except #'s 24. Fixture & T nsformer Clearance -Ins. Protection 25. Elec. Rece tacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Inst Iled Close to Edge of Studs & C.J. 28. Equip. Grod.nd made up w/Mech Fasteners -Bond Gas & Water 29. 2 Applianci4 Circuits in Krtchen & Conductor Size GFI 30. Subfeed Wi Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI 31. Range Circl /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated N utral ❑ Yes Q No 32. Service-Ris r Conductors & Ground Main Disconnect 33. Equip. Clear. ces Panels -Motors -Meth. Equip. 34. Clothes Clo et Light -Shower Light -Spa Light 35. Smoke Det for 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL ( ermit) OK except #'s 36. A.C. Ducts In ulation & Support 37. Vent Fan, Ex aust above insulation 38. Condensate rain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access 4 Platform if Furnace in Attic Date Card B-1 I Date Card B-1 Date Card B-1 I Date Card B-1 Date FRAMING (Perm' OK except #'s Date 41. Sills Proper M terials & Anchors Date 42. Walls Studs -N iling Spacing & Braces -Plates -Sound Comments at Final: 43, Bearing Walls ver Girders & Floor Nailing 44. Draft Stop in alls (rat proof) 45. Fire Stops, Fu ed Ceilings -Stairs -Chasers -Tubs 46. Headers & Be ms -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One T -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infi tration-Walls-Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 83. Following InstldJDrive 0 Yes O No/Walks Q Yes O No/Plartters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: r 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. BP051948 LICENSED CONTRACTORS DECLARATION I hereby affirm .under penalty of perjury that I arr ' licensed under provisions of Chapter 9 (commencing with Section 7000) of givision 3 of Issued Date: 07/22/2005 APN: 036-450-027-000 the Business and Professions Code, and my license is in full force and effect. C— License Class: License Number: Site Address: 56 EDGEMONT DR ORO Date: �Z Z—uContractor ,�_6fS Map Index: Description: RE ROOF COMP 26 SQ'S 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 Business and Professions Code: Any city or county which requires a Owner: DOSSETT NEOMA F REVOCABLE TRUST • - _ . permit to construct, alter, improve, demolish, or repair any structure, prior- riorto toits issuance, -.also requires the applicant for such permit to file a signed statement that he or she is licensed. pursuant to the'provisions of DO.SSETT NEOMA F TRUSTEE the Contractor's. State -License Law (Chapter 9 commencing with Section 7000):bf Division 3 Business Professions Code) that he ' 56 EDGEMONT DR oVthe and or or.'. , _. she is' exempi therefrom and the basis for the. alleged exemption,. Any; OROVILLE, CA.:95966 violation of'Sectiori',7031.5 by any applicant for a Ormit:sublects the, applicant to'a.civil.penalty, of not more than five hundred dollars'($500).): O `I, as owner -of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not ...,u:.............:,.....,...:... _..............,u...,,.. ......�., Code: The Contractors''State License.,. Law does not apply to an Applicant: JENNINGS ROOFING owner.:of.property who builds or. improves thereon,:, and, who, does such.work,himself or, herself or through his or..hei own employees, ADAM JENNINGS provided that such improvements are not. intended or offered for 979 FLYING V STREET sale.`If however.' the bUifding•or improvements are sold within one CHICO, CA 95928 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 530-898-9388 sale.). ❑,:,.,:1 .: as—owner.. of..the..property=,.am:,exclusively...contracting ...with., licensed contractors to consthict:the.project (Sec. 7044, Business and Professions Code. The Contractors' State License Law• does notapply;to an owner of.property who builds or. improves thereon, Contractor: JENNINGS ROOFING --and who contracts for such projectswith.,a contractor(s) licensed pursuant to the Contractors' State License Law.). FLYING V STREET ❑ • :-:1 am Exempt under Article 3 of the Business.and'.Professions Code :. .979 CHICO, CA 95928. Date* owner: 530-898-9388 -: *•WORKERS:.COMPENSATION-DECLARATION .. I hereby.affirm underpenalty of perjury one of the following declarations: License #:798442 ❑ h.have`and'•will maintain a certificate of consent to self -insure for wortcers',.'cornpbnsation,_,as provided for.by. Section 3700,of the Labor Code, for the performance of the work for which this permit is issued. :Architect: ❑ L. have and will:*maintaih.,workers'., compensation insurance, as Engineer: ..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:.... Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 /:certify that -in` the:Perforinance�of.the.work'for which this permit is Census Code: sued.71: shall.. not-- employ any person in. any.manner so, as to become subject to the workers' compensation. laws of: California, ..and. agree. that: if'.I .should,' become isubject to'ahe workers' compensation provisions of Section 3700 of. the Labor Code, I shall, forthwith comply with those provisions. Date: 2 : o Applicani:_111' WARNING:."Fail "to` secure workers' compensation coverage is unlawful,: and' shall subject- an employer to criminal penalties and one hundred ' thousiiiid dollars ' ($106,000): in :addition to the' cost' of compensation, damages as provided' for' in'Section 3706 of the Labor code,, interest, and attorney s tees.. CONSTRUCTION LENDING AGENCY'.:, ::.::: This permit.is,her y issued under t livable provisions of the Butte County CodR ?nrVor I hereby;affirm that there is a construction lending agency for the ' Resol tions to work indicat 1 a ve f which fees have been paid: `'• vi performance of the work for which this permit is' issued (Sec 3097 Civ.j ; Name: By:_'Date: y: Address: PERMIT EXPIRES ON: Date O . I. hereby c. . y.that;the us e.of,this:facility.shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handlingand,useof.hazardousmaterials. ,. ❑ Notification in accordance wiftf Sectibri 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached.are.copfes of I e'requiredE.P;'A. notification forms.` I hereby certify that I have read this application,• that the above information, is correct, and that I am.ihe owner or the duly authorized agent of the owner. I agree to comply with all county and;siate laws relating to building construction. I. acknowledge itis unlawful to alter the substance of an official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Signature: •-7-•.Z`2' `�j.:. Date O Owner 'r Contractor - 0 Agent for Owner ❑ Agent for Contractor k 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. BP051948 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: 07/22/2005 APN: 036-450-027-000 the Business and Professions Code, and my license is in full force and effect. C" •7 License Class: License Number: _Z Site Address: 56 EDGEMONT DR ORO c Date: �ZZ U Contractor:'' � Ot ni�.CYIyfraGi Map Index:r> Description: RE ROOF COMP 26 SQ'S OWNER43UILDER 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 Business and Professions Code: Any city or county which requires a Owner: DOSSETT NEOMA F REVOCABLE>TRUST.•r•�».•., permit to construct, alter, improve, demolish, or repair any structure, prior• - _ to its issuance;�also requires the applicant for such permit to file a' i •%• signed statement ttiat he or she is licensed'pursuant to_the'1.proAsions of,, : ,t.: DO:SSETT'NEOMA F TRUSTEE the Contractor's,Sjate'License Law (Chapter 9 commencing with Section , 700b),'of Division 3,of'•tfie Business and Professions Code) or that he.or. _.' `, 56 EDGEMONT DR " she is`exempi therefrom and the basis -for the alleged exemption. Any, r ORO.VILLE,.CQ'95966 violation of Seciior"7031.5 by any applicant for a perrmrtsubjecIs I e, applicant to a civil.penalty, of not more than five hundred dollars -($500).): ` t ❑ Cas owner, of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not _intended, onoffered�for,sale,(Sec„7044,_Business.and.Qrgfessions: .,� ,,......,,...,„, •.,,,.,. <,. . •,,, .,,,.F.. ws.,.. ,-, .,...r ,� ,._,�,,...,„ ,., :.,� r .... �.�,, Code The Contractors State License•Law, does not apply to an Applicant: JENNINGS ROOFING owner of;propgrty who -builds or. improves there. on,;,and-who does ,such.work,himself oe,herself,or through his or..her.own employees, ADAM JENNINGS ., provided that such improvements are not. intended or offered for •are -sold 979 FLYING V STREET sale:`' Ifhowever, the building o'r improvements within one CHICO, CA 95928 year.of completion, the owner -builder will have the burden of "'proving that -he or she did -not buildor improve for the purpose of 530-898-9388 sale.). as—owner, of -.the,, property,-arn,.exclusively.,contracting with,, licensed contractors to coristruct:the-project (Sec. 7044, Business anal Professions Code. • The Contractors' State License Law• does not apply.to an owner o(.property who. builds or. improves thereon; Contractor: JENNINGS ROOFING -:,and wWcontracts for such projects with_ -a contractor(s); licensed pursuant to the Contractors' State License Law.)., - l� ❑ -.I am Exempt,under Article 3 of the Business and'.Professions,Code 979 FLYING V STREET ! ”' CHICO, CA- 95928 Date:? Owner: -530-898-9388 , -- WORKERS'.COMPENSATION"DECLARATION I hereby affirm under penalty of perjuy one of the following declarations. License #: 798442 ❑ • G.havg• and will maintain a certificate of consent to set -insure ,.•... • ... -.• , ..,-.,.,. _ workers';, conpensation,-,as provided for, by, Section 3700,of.the Labor Code,,for the performance of• the work for which this permit isq issued y;< . • . �Architect:......... ❑ L have 'and awill- maintairi,workers;,compensation;.insurance, asEngineer: .,required.by:Section 3700 the Labor Code, for the performance; of the work for which this pernitas issued;, My workers' compensation insurance,carrierand'policypumber.are: Carrier: ' Total Square Ft: 0 S. F. Policy #_ Valuation: $0.00 yl:certify. that in 1he;0biforinance,61' the work•for which this•permit is Census Code: sued ',^.I!shall, not -employ ' any person in- any-mariner•so•is to -become subject.to:the-workers' compensation.. laws; f: California, and. agree-: that'-if'.I°,should- become tsubject 'to';the -Workers' compensation:piovisionaof Section. 3700. of the Labor Code, I shall. forthwith comply with those provisions. Date. ,. _ .. ApplicanLs,v .r .. + WARNING Fail r 'to' secure workers''coim`pensation coverage is unlawful, and shall subject an employe'r'to:'criminal penalfies;and one .' hundred ttiousand• dollars '($1011,000): yin -:addition 't6',the' cost' of compensation, damages as provided' for- in Section 3706',of the Labor code 'interest and.attomey's fees LF q ­'. CONSTRUCTION LENDING AGENCY'., ' .?:.. This permit is her9by issued under t ap Iicabfe provisions of the Butte County Coda anrt/or I hereby:affi-rm that there is a construction lending agency for the.' Resol tions to work indicated abOve fqf which lees have been paid. performance of the work'for which this permit is' issued (Sec 3097 Civ.) /% I Z Name: BY / ?— 2 2.. / Date: Address: PERMIT EXPIRES ON: Date ❑ , I. hereby certify that;the,use of,this facility shall comply wi�th•Sections 15505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, ,,,handling:and;use of hazar.dous,materials. „ �, - .• ,,.f ,:.r: y ❑ Nbtificatiohfin-accora; nce'wifh'$ection'19827:5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached ate copies of the required E .P;.A. notification forms: I hereby certifyttiat I have read this application., t. at the above information is correct, and that I am the owner or the duly authorized agent of the owner. 1 agree to comply with all county and'state laws relating to building construction.' I, acknowledge itis unlawful to alterthe substance of an official form or document of Butte County. I hereby authorize representatives of Butte County to ente'i upon the above rnentioried property for•inspectionpurposes. ._ Pont Name A A,r.1 w %C 1�1 l� C S - Signature:- "� ^� Date / �. ' ` ❑Owner ^ • Contractor • - ❑ Agent for Owner Ugent for Contractor 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) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" CONTRACTOR OWNER L Name City C c o irst NameA Noe, e Address 4— City U rov;16f E-mail StateC q Zipq l Phone _, -33 � � q Z 't Fax Fax E-mail Stale License Number CONTRACTOR Namel7 /� &,, �t r Address r -cry � 4— 1' City C c o StateC Zip S� 3 Phone Fax E-mail Lic. #71ffYq Z class C 39 a APPLICANT SIGNATURE X For office use o ARCHITECT/ENGINEER Name ISRAIYes Address - City Occ. State Zip Phone 3 ft Fax E-mail Date Approved: Stale License Number a APPLICANT SIGNATURE X For office use o APPLICANT NAME Name ISRAIYes Address Y Ai - City C111,StateC Occ. Type Const. Zipc,� % z !! Phone � F 3 ft Fax E-mail Date Approved: a APPLICANT SIGNATURE X For office use o Zoning I Flood Zone I ISRAIYes Cross Street WORKS 'S COMPENSATION I.No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT BIN # %� �J LOCATION AP# V 5 l% .- AN,! � (J Property Address Cross Street WORKS '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 Page 1 of 2 Description or Scope of Work: 2- 1,7u+ 011 o r 031k w &0. t --r4 w Sq. Footage 2 _ ❑ Structure Built without PerrnTis ❑ 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 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. / G4 Received by: Amount: /� Bldg SRA Receipt #:' / ` / SMIP Other S, Total REV 2-24-05 r _ � SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division. in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site'plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Corr'plete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Enerby compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal;bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detac�ied Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). a Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May requirle additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. Californa Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of�Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant'at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after =xpiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date ofi fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on Issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan' checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING FORMS 1 \131dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 zoo \' 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', UMBER a Z7 ZPNING BUILDING PERMIT OWNER 1112k- TELEPHONE SQ. FT. OCC. BUILDING VALUATION ow5b ADDRESS T%/V/ C Or��' TELEPHONE CONTRACTOR'S MAULING ADDRESS �% eO -_ 2-9(,9 [`„�/NCj•�(/!'�L ��V�%/_U � CONSTRUCTION LENDER UNKNOWN ADDRESS Fireplace Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING Permit Fee $ ARCHITECT OR ENGIi EER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS i Permit fee $ BUILDINCr-0.ADDRESS �i7 r]�E411WT �k PLUMBING PERMIT Filing Fee 10.00 IEach Trap 2.00 Repair drainage or vent .pi ping 5.00 Water piping _ LOT NO. SUBDIVISION NAME PARCEL MAP Each gas water heater or vent 5,00 Gas piping system 1 - 5 outlets I USE OF STRUCTURE SF ©' Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 <;O1-/14— 14-TYPE TYPEOF WORK New ❑ Addition ❑ Remodel ❑ Uti ILittielss [I /lnstaLl on ❑O [c Other j Describe work: U %- (l / r'/�/V r I Permit Fee $ Ud Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR001 OR LESS5.00 Main service EA. ADD•L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.N) OR ACDNS. ACC. BLOGS. / 20 sq 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. :N' ' � Classification License No. rj` / (� � tl �i Vd ❑ 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. 47044) ❑ 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 4 NEW CONSTR. MULTI -OUTLET 2,50 ea NON•R ESID BRANCH CIRCUITS NEW CONSTR. POWER APPARATUS &) NON.RESID. SINGLE OUTLET CIR. 50@254 Ex. Occup ou TLETs OR FIXTURES BAL@1 LNS Ex. Occup.(OU LETS P(RESID )R EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is far $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. law's 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 S Contractor I certify that I have readjthis 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,1costs, and expenses which may in any way accrue[--� against said,County lin co sequence of the granting of this permit. • , �� I ,/� X / I '� '� �/L% �4.�"T ` - 1% Date ' Signature of Applicant — Owner❑ Contractor ❑ Agent An OSHA permit is required #or excavations over 5'0" deep and demolition or construct= ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ UO OCCu P. GROUP I TYPE OF CONST. PARCEL PD ND I ISSUE This permit is hereby issued under the applicable provi- sion$ of, the Butte County Code and/or resolutions to do work i dicated' above for which fees have been paid. i3 DIRECTOR OF PUBLIC WORKS By 'v� Date 07-0-1/ PERMIT EXPIRES Date �'-- Receipt No. WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 196 C;unty of Butte Merylor-1-al DEPARTMENT OF PUBLIC WORKS 891-.276'/ Way 695 eleande, ., Chico – 943 4211, Ext. 70- 7 County Center Dr., Oroville – 534-4541 Skyway and Elliott Rd., Paradise – 474-4414155.. CORRECTION NOTICE z I I 4e. 46 ................. 1! ... ............... ding 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 immediatelv— ............................ Z ........... !. ....... Y' ? Ji�F Inspector Date.(A. Do Not Remove This Tog (400-4) COUNTY OF. BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, California 95965 - Telephone 916/534-45 APPLICATION AND PERMIT - Pte. MI N0. ASSESSOR Fr EL�l�ya�B'ER 1p v LJ • - Z°"'NG - - ILDING PERMIT . 0 7 ) n� V& V T LEPHONE r SO. FT. CC. BUILDING VALUATION OWR'S MAILING ADDRESS /Cj/(JO•/ be. D ^t11� COJRAC QR'S M TELEPHONE, CONTRRAA,/CTT/(O/ '''S MAY 2-3 /" l/✓(/ -_. Fireplace CONSTRUCTION LENDS/ UNKNOWN _ Total Valuation $ -Filing Fee - $ 10.00 LENDER'S MAILING ADDRESS - rr Permit Fees $ ARCHITECT OR ENGINEE LICENSE NO. Plan Checking Fee r ,$ ' Penalty - $ • '- ARCHITECT OR ENGI EER'S MAILING ADDRESS - Permit fee $ BUILDINAIyD`&RESS './ ��,PLUMBING PERMIT Filing g Fee 10.00 - Each Trap 2.00 Repair drainage or ventpiping5.00 ,/ D v�� Water Diping - 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 ❑P Remodel ❑ Uti li les nst Ion ❑ Oth,.ef Describe work: J�L��i � �' �/ ' Permit Fee $ ,>D-Od Contractor -ELECTRICAL PERMIT, Filing Fee 10.00 Maini service 6001 OR LESS 100 AMP OR. LESS 5.00 , Main service EA. ADD'L 100 AMP 2.50 NEW CONST. / DWELLING OCCUP.E11 OR ADDNS. _ ACC. BLDGS. / 20 sq ft CONTRACTORS LICENSE LAW I de lar ,under penalty of perjury (check one): _ I am licensed under provisions of Chapt. 9, Div.3 of the Business and Professions Code and y license is in f force and eff License No: Classification �- Sr' ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) 1 ❑ 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 CONSTIR MULTI -OUTLET 2.50 ea NON.RESID BRANCH CIRCUITS NEW CONSTR. /POWER APPARATUS 61 NON-RESID, l SINGLE OUTLET. CIR• / Ex. Occup OUTLETS OR FIXTURES ggL09j FIXED APPLNS. OR Ex. Occup.(ouTLErs (RESID•) EA.� 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 iMisa Wiring 7.50 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 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, ' dg ents, costs,.and expenses which may in any way accrue against I • C ty n onsequence f the granting of this permit. %� ^a - /9/-te Signature of Applicant — 04ner E Contractor ❑ Agen -k 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 $ occ5P. GROUP I TYPE OF CONST. PARCEL PD HD ISSUE "Th)s permit is hereby issued under the applicable provi- si of a Butte County Code and/or resolutions to do w di ate above for which fees have been paid. ECTOR OF PUBLIC WORKS Date' IZ"'17—Y PERMIT EXPIRES Date • Receipt No. SD� ' WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT