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HomeMy WebLinkAbout079-060-065LP 93-2748 B' HEMSfAI,K,:�-LIL'L'IAN�"-"'' '2874 FOOTHILL;. OROVILLE ';?7,A REROOF/SF-' !t 04-3582 LASSEN SAVIN�S LOAN ASSN. 3753B CLAREY,' MICHAEL 2972P Y' , 2 IFOO 74 t or BLVD, 0 874 ]FOOTHILL C) ROVILLE" 36 -7 9 (0 — 0(a5 Cont: OIAWER 0 , u I - , REROOF" SIDJN(� WNDWSH' 2874 Foothill Blvd., Oroville VAC CONTR: Oscar Deakins, Oroville -log: TRANSFERRED FROM W.H. FRANKS 1793B 1446P & I nq w., single family) 1863E FRiNKS, W.H. .1794B. -17( 1446P s1s Foothill,at Pinedale, Oroville C/- X-C-e- jj -,a amok I NOTES I RESIDENTIAL 036-420-065 - 01-3583 JPERMIT %' Y M 04-3582 *'�AREY, MICHAEL ­ F2874 FOOTHILL BLVD, OROVILLE C . 67 Cont: OWNER REROOF, SIDING YTNDWS HT4VAAC 11 SPECIAL CONDITIONS 11 SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS. SUB -STANDARD HOUSING LETTER JOB FINALED (Da te)— Signature CHECKED BY q = OK 0 =/Not OK NotApplicable Not Ready 1 . MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 3. 1 . Zoning Req u irements-Setbacks- Easements Wood Awn.; Posts- Beams-Rftrs-Connectors Shthg-Frg-Bracing 2. Soils; Special MH Support Sketch 6. 3. Sewer; Location -Test -Fall -C/0 -Concrete Electric 4. Water; Location -Test- Easement Needed (Sketch) 9. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Roof; Shthg-Roofing 6. Gas; Location -Test -Wrap;-/ P' L 'ft. / P Nat. or/ P' L "ft./ PLPG 12. 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 Requ irements-Setbacks- Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test- Demand -Valve -Con nector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. 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 Req uirements-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. Verifv #s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except Vs 1 . Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-Depth-Spaci ng -Con nectors-Steel 3. Decks, Girders and/or Joists- Decking- Braci ng -Stairs- Rai Is 4. Wood Awn.; Posts- Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Colu mns-Connections-Splice-Decal- Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nai I i ng -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-GIFI 5. Elec.; Pool Lighting; 15 Volts-GF1 6. Elec.; Enclosures; Conduit Entries -Term i nals- Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures -Panel boards- Ins. to Main 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 4 = OK 0 = Not OK - = NotApplicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #s 1 . Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Sternwalls, Main; Steel- Blockouts-Wrapped 6. Sternwalls, Garage; Steel- Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #s Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 71. 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Card B-1 Date Card B-1 Date Elec. Outlets & Receptacles at Kit. Counter Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels- Motors- M ech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 87. Water Well, Disconnect, Electrical, Plumbing Date 88. Card B-1 Date Card B-1 Date 89. Ventilation Throughout House Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Aftic Date 96. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Card B-1 Date Card B-1 41. Sills Proper Materials & Anchors Card B-1 Date Card B-1 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purl in-Roff Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -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 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width- Headroom- Rise- Run -Land i ng-Fi re Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-UnderfIr. Access 59. Glazing Area -Glass Protection-Skyl ights- Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration-Walls-Winclows 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 -M ech. Protection 67. Bedroom Exiting 68. G.Fl. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, C learance- 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- Land i ng -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.Fl.)-Romex Protection 80. 1 nsu lation- Foam- Looked in Attic 81. Guard Rails & Deck Construction- Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor Q Yes 83. Following Instld./Drive 0 Yes 0 No/Walks D Yes 0 No/Planters 0 Yes 0 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.Fl. Receptacle -U nderg round 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: , j. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.neAdds 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 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Date: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of pedury 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 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 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 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).): 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 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.). 1. 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.). am Exempt under Article 3 of the Business 3 ssions Code 0/2 mom Dat //� wrier: 1% WORKERS'COMPENSATION DEC ARATION '1,1- I hereby affirm under penalty of perjury one of the following declarations: 0 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. 0 1 . 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: I . Carrier: 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 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 shZ forthwith comply with those provisions. Date: Z,%e Applicant: WARNING: Failure to securi/wwk.r.' Compensation co�erage 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 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.) Name: Address: PERMIT NO. BP043582 Issued Date: 12/20/2004 APN: 036-420-065-000 1 Site Address�: 2874 FOOTHILL BLVD ORO Map Index: Description: REROOF(23SQ),SIDING(150)WINDOWS(6)H VAC Owner: CAREY MICHAEL ALAN SR & DARINKA 2874 FOOTHILL BLVD OROVILLE, CA 95966 Applicant: CAREY MICHAEL ALAN SR & DARINKA 2874 FOOTHILL BLVD OROVILLE, CA 95966 Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. . Valuation: $0.00 Census Code: This permit is hereby issued under the applicable provisions of the Biitte CounfyC e ?7n r Rjesolutio 6 dQ work MIcal d 3, bo e for which fees have been paid. PERMIT EXPIRES ON: 0 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. 0 Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. 0 Attached are copies of the required E-P.A. notification forms. 0 I hereby certify that I'have read this application, that the, above information is correct, and that'l 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 hereb authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. 'Signature: Print Name. �%yz� g!� V - �Z oor Date: �� =,,-,0'0 9 /, Q Agent for Contractor EI Owner Q Contractor E) Agent for Owner 14 qk U NTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUIL'DING DIVISION , 7 Countf. Center Drive - Oroville, C61iffirnia 95,965 - Telephone (916)) 53 8 PERM t APPLICATIOWAND PERMIT ASSESSOR PARCEL NUMBER il _ * . 036 -420 -065 - ZONING BUILDING PERMIT OWNER Lillian Hemstalk TELEP*iONE 53"628 SQ. FT. OCC., BUILDING VALUATION 12 0 60 720.00 OWNER'S MAILING ADDRESS — t� 2900 Foothill Blvd., Oroville 95966 CONTRACTOR'S NAME Mer TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNI(NOWN Total Valuation J$720.00 Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $21.00 ARCHITECT OR ENGINEER NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE $41.00 2874 Foothill Blvd., Oroville PLUMBING PERMIT Filing Fee 20.00 Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF7J Duplex El Mobilehome El Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W 1 1 @20.00 Ji TYPE OF WORK New 0 Addition 0 Remodel 0 Utilities El Installation Q Other DescribeWork: Reroof w/Comp. I I PERMIT FEE J$ Coniractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service 2" OOV ORR LESS OA 0 LESS 23.00 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. & ACC. BLDS. 3.5 0 S(T. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, 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) 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) Q I am exempt under Sec. Business and Professions Code forthis reason NEW.CONST. MULTI -OUTLET NON RESIO. BRANCH- C IRCU ITS @7.50 POWER APPARATUS ( & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES 20 @ 1.0 -AL.@ .500 Ex. Occup. ( OFIXED APPLNS. OR UTLETS (RESID.) EA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): EI This permit is for $100.00 (valuation) or less. 0 1 have placed on file with the County of Butte Dept. of Development Services Building Division a Certificate 6f Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. � 0 Ishall not employ any person in any manner so asto become subject to the Worker's Compensation laws of California., _ , Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Co I de, you must forthwith comply with such provisions or this permit will be revoked. I PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this applij_ati'or�and s` ' tate thatthe above information is correct. 1 agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize i6p�eseniatives of the County of Butte to enter upon the above mentioned property for'inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X I!, J t Date Signature of Applicant - El Owner 0 Contractor 0 Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Energy Inspecti66 Fee . . I $ C C , �NST. TYPE I TOTAL FEE s 41.00 HAZ. I D. FEES I IMP FLOOD I CDF I PARCEL PD 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. DIRECTOR.OF-PUBLIC WORKS B Date CP/- PERMITEXPIRESON (Date) ReceiptNo. 148355 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLD ENRO O-APPLI CANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Callifornia 95965 - Telephone (916) 538-7544 PERM APPLICATON AND PERMIT ASSESSOR PARCEL NUMBER 036-420-065 ZONING BUILDING PERMIT Vft OWNER Lillian Hemstalk TELEPHONE 534-0628 SQ. FT. OCC. BUILDING VALUATION 19 @ 60 720.00 OWNER'S MAILING ADDRESS 2900 Foothill Blvd., Oroville 95966 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation J$720.00 Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $21.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE $41.00 2874 Foothill Blvd., Oroville PLUMBING PERMIT Filing Fee 20.00 Trap 1 7.00 —Each Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF)p Duplex 0 Mobilehome Q Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S7FG7W @20.00 TYPE OF WORK New 0 Addition Q Remodel 0 Utilities 0 Installation 0 Other CX DescribeWork: Reroof w/Comp. PERMIT FEE $ Cont'ractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service 2'0" OR LESS OOA OR LESS 23.00 Main Service 200A TO I OOOA 46.00 NEW CONST. DWELLING OCC UP. OR ADDNS. & ACC. OLDS. 3.50 ST0._ CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) 0 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. — Classification 61 1, as the owner, or my employees with wages as their sole compensation, wilFd—o- the work, and the structure is not intended or offered for sale. (Sec 7044) 0 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) 0 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON -RESOD. 13RANCH CIRCUITS @7.50 POWER APPARATUS ( & SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @ 1.00 BAL. @ .50 Ex. Occup. OFIX ED APPLNS. OR UTI FTS (RESID.) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): 0 This permit is for $100.00 (valuation) or less. 0 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. W Ishall not employ any person in any manner so asto become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certifythat I have read this applicationand state thatthe above informationis correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to entei 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, es which may in any way accrue against said County in ponse I O� e�reaxpenngsof this permit. Date Contractor 0 Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee s Energy Inspection Fee s oc CONST. TYPE TOTA L FEE$ 41. 00 LE11HAZ. I D. FEES I IMP I FLOOD I C;TRCEL I PD This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have DIRECT9JL.OZ_P_UBLIC r, By /464Zfj�r PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. WORKS I Date tie ReceiptNo. 148359 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTME��T OF,6E\V 15LOPM ENT SERVICES - BUILDING DIVISION W 7 COUNTY CENTEiibRIVE - OROVI LLE,CALIFdk A;965-TE1LEPHONE(916)538-7541 PERMIT APPLICATIOISIDATA SHEET OWNER 0 3 Proposed Building Use Building Inspector Date 4 At time of permit application, I was advised the following data -must be submitted prior to permit processing and/or issuance: I/ DATE RECEIVED By I . All items have been submitted . ....................... * ... * * * * ......... 2. Plot plans, 3/4 sets, signed by preparer of plans. , ......................... 3, Complete plans, 3/4 sets, signed by preparer of plans. .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................. 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). 9. Mobilehome data and manufacturer's installation instructions, 2 sets . ........... 10. Fees of $ . ......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees ......................... 13. Flood elevation letter (1100 year flood) by California Engineer ................... 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley . ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development.about (A) Improvements (B) Drainage ............ 19. Driveway permit (construction approval required prior to occupancy) ............. 20. . -1 Pre4nspection request Pre -inspection for required. to Building lnsPector�_(Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23, Owner -Builder Verification (Given to owner Mail to owner ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ......................................... 26. Copy of recorded deed of parcel creation and 60 right of way to a public road ...... 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . ............... 29. Documentation of legal access . ...................... ; .................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . .................................................... 33. When you issue the permit, process as follows: L," -Mail to owner. Mail to contractor. Telephone and hold for pickup at office. 7 Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. _ Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone - mail Counter by Date Contractor, designer, owner, was advised of above required data by _ phone - mail Counter by Date Plans checked by Date Plans appioved by Date Sets of plans on hold in File cabinet AP foldeC Copy - Department of Public Works COUNTY OF BUTTE - Deoartment of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder'.' building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building.permit. No building permit will be issued until this verification is received. 1. 1 personally plan to.provide the major labor and materials for construction of the proposed property improvement (yes or no) \Ic5 r 2. 1 (have/have not) ia-oe nc)-i— _ signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4: 1 plan to provide portions of this work, but I have hired -the following person to coordinate:, supervise, and provide the major work: Name Address City Phone Contractors'Liddnse No*., 5. 1 will provide some of the work.but I have contracted (hired) the following persons to ptovidethe work indicated: Name Address Phone Type of Work Signed: Property Ow��er! Social Security Date /,9 &4,C_ NOTE: This owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit.