HomeMy WebLinkAbout079-060-08436-42-c7-1
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2934 FOOTHILL BLVD ORM0 LEI
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CLARK, JOHN 310 - q it% - 6
FOOTIfILL BL�D: OR
CONT: PERFECTION PCIOU �kE
NEW POOL MASTER #0 1 -.501,
.036-420-084., �'�"05-2405
CLiXRKk.jOHN'1" t
',2934�FOOTHILL LV� PERMIT RENEWAL
B D, OROVILLE
Cont: OWNER DATE:.- t?—/ 4%,
REMODEL BP#_o E- Zt -
105
EXPIRES: 7
079-060-084
.05-3259
CLARK, JO.HN
2934 FOOTHILL BLVD OZOVILLE
Cont: OWNER
ELEC SERV
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION 9: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP052405
B. C. Building Permit 01-16-04 pg 1
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: 09/28/2005 APN: 036-420-084-000
the Business and Professions Code, and my license is in full force and
effect.
License Class License Number:
Site Address: 2934 FOOTHILL BLVD ORO
Map Index:
Date: Contractor:
Description: GAR CONV (462) REMODEL (2 00) ADDCOV
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
PORCH (67)
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
Owner: CLARK JOHN H & LINDA M
signed statement that he or she is licensed pursuant to the provisions of
2934 FOOTHILL BLVD
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
OROVILLE, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95966
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
Applicant: CLARK, JOHN AND LINDA
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
2934 FOOTHILL BLVD
provided that such improvements are not intended or offered for
OROVILLE, CA
sale. If however, the building or improvements are sold within one
95966
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
530-534-3068
sale.).
IZI 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,
Contractor:
.and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
EI I am Exempt under Article 3 f th Bu and Professions Code
o
Date: _q-_2_L-o5_wne
WORKERS'COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #:
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.
Architect:
EI I have and will maintain 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: 67 S. F.
Policy #:
I certify that in the performance of the work for which this permit is
Valuation: $1,072.00
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.
2—?_0_o!5_
Date:
Applicant:
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
(515 3 C141mvel
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
'? '.4ma", 4J2
CONSTRUCTION LENDING AGENCY
This permit is h reby issue under �"plicable provisions of the Butie County Code and/or
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Re I tions t o work indi4ated 6ove or which fees have been paid.
BY7 Date:
.
Name:
Address:
PERMIT EXPIRES ON:
(Date)
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.
El 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 owne'r or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purpo I ses.
Print Name: Signature:
Z -4a C>s
Date:
wrier El Contractor Q Agent for Owner E3 Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BALANCE OF FEES SHEET
DATE -
PERMIT if -
AS . SESSOR PARCEL 9- 0r7q-(AQ-0&i
OV�NERI S NANM:
FEES (Amount and Purpose):
BALANCE OF'FEES: S -
ADDITIONAL FEES:
REVISED PLAN CHECK:
SHERIFF FEE (commercial only):
SRA: $
COPY FEES (S1 or more) S
DRAINAGE S BASIN,
BC RESIDENTIAL IWACT
County Wide Chico Urban --
El Medio _ North Chico Specific S
WATERTENDERFEES BATTALION
FEMA S
SMIP S
OTHER AMW -OLk S
RECEIPT NUNMER(S)
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA §5965 Phone (530)538-7541 Fax �(530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: C� ASSESSOR, r,,CEL NUMBER
16 Proposed Building Use: Ck$ -qJrA"'� �erm'it Technician: Date:
Items required in order to apply for a permit. All boies MUST'be checked OR marked NA in order fo)apply-.
T� I . Site plans, 3 or 4 sets, signed by the preparer of the plans.
-t:D 2. Complete plans, 3 or 4 sets, signed by the Oreparer of the plans.
0 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
0 4. Engineered truss details and layouts in duplicate. No faxesl
0 5. Letter from Engineer or Architect for truss design review.
S 6. Energy compliance design and supporting documentation in duplicate.
0 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
0 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
0. 9. Metal bldgs: (A) Metal Bldg Plans, (B) Frid plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet-sicined by the engineer.
0 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
0 11. Letter of intent for non-residential buildings
0 12. Hazardous Material Form
e�jl 13. Acknowledgement of building permit application without required clearances.
0 14. Other
Borflain*e s needed to issue the permit. (May require additional plan review upon receipt of the following items.) T_
3- in itation and site plan approval from the Environmental Health Department in 0 Chico 0 Oroville, as applicable*
an
0 Fire Sprinklers .............................................................................................
.b, 17. - Agricultural ' Buffer clr and site plan apr from the Ag Commissioner Sent by-..
0 Soils Report and/or Engineered Foundation required ...........................................
0 Erosion Control Plan Required ..............
%E�10 Fees as shown on the attached Scheduleof
Of iCity of Chico Plumbing permit ........................................................................
22. Site plan and business license approval from th C*t f Biggs ..............................
'1y
Q-210117 23. California Department of Forestry plan approvalkpaoid. Sent by:
af-_ 24. Planning approval for (A) L (0 4B)Parking:
_L _(C) Parcel Check:
0 25. Contact Land Development about - Improvements, - Drainage ........................
26. NPDES Form ..................
0 27. Encroachment Permit for driveway from the Public Works Dept ...........................
0 28. Contractor's license information, (Number, Name Style, Classification) ...................
0 29. Worker's Compensation Cargier and Policy Number ..........................................
p 30. Owner -Builder Verification�/ Given to owner, -Mailed to owner) .....................
0 31. Letter of Signature authorization ....................................................................
0 32. Recorded copy of Agricultural Acknowledgment Statement .................................
0 33. Existing violations and/or expired permits .........................................................
0 34. Deed Restriction ......................................................... ..............
0 35. 0 Legal description, 0 M.H. Title, title search, registration o r MCO .........................
0 36. Other:
0 37. Other:
When issued Telephone and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applica!n"*
Date: -7-
1. Index permit applipation for oltHtew numbered:
Plan Check Letter
2. Additional iternsuequir 410M 4 )d
'ab
-2�
Contractor, clesign�n WZis-Zvisd 6f4e ove data by 12T phone, 0 mail, C3 counter,
Date'
Contractor, designer, owner, was advised of the above data by 0 phone, 0 mail, 0 c . , -Date:
_J
Contractor, designer, owner, was advised of the above data by 0 phone, 0 mail, 0 counter, by -
Plans reviewed by: - �� Date: Plans approved by: TP
Date:
Date. 9, To
Structural reviewed by: --Date: Structural approved by:
Date:
Note transfer by: Date:
Yellow: Building Division
13
E.H. USE ONLY
Flat Plan Attached
Roar Men Atuchad
Sent to S.D.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location A P#
Plan'Aporoved for: Sewage Dispos—a� W t r Supply: Put Private WelILN,_
Clearance for — dwelling. Other 'ALI AA
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health
8/96
cialist
k -Aj
A—
Date
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVELLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140
SCHEDULE OF RECEIPT OF FEES
Website: www.buftecountv.net/dds
OWNER CA
JPROSED BUILDING USE
1. BUILDING PERMIT FEES
-- Balance Due ..................... $ O -)n
--- FEMA Flood elevation review ... $
A.P. # 6'2 -?G - L06 - OV
DATE - I �C)
RECEIPT #
q -"b
,e,
--- Additional plan checking Fee .... $
SCHOOL DISTRICT FEES qlqb 5
(paid at School District Office) (form available after Plan Check)
3. SHERIFF FEES (paid at Building Division)
Commercial (sq. ftg.) ..... X $0.03 = $
Sq.Ftg.
4. RECREATION DISTRICT FEES
(paid at Recreation District Office) (form available after Plan Check)
5. RESIDENTIAL DEVELOPMENT IMPACT FEES
COUNTY WIDE (per dwelling) $
CHICO URBAN AREA (per dwelling) $
EL MEDIO FIRE DISTRICT (per dwelling) $
NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning
6. SRA FIRE INSPECTION AND PLAN CHECK FEE
$204.98 (paid at Building Division)
7. WATER TENDER FEES BATTALION #
$200.00'(Paid.at. Building Division)
8. SMEP-,
9. DRAINAGE FEE"
10. OTHER
11. OTHER
DATE REC.
_0
At time of per7nit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed duringAhe plan checkirj& process.
APPLICANT
DATE 1-7
Pursuant to Government Cocy Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You
have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. 'Me requirements for a
protest are specified in Government Code Section 66020(a).
Original -Building Division Yellow -Applicant Pink -Owner (rev. 7/05)
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District /* Building Department No.
A.P. Number Jurisdiction: -city X lCounty
Property Owner
5 1
P Location/Address
Sdkdivision
Lot No.
Residential Development
.......................................................................................
sq. Footage
No of Living
Mobile Home Additi,oaL,
:,,--'C_onveFsZ�riPermit
*Supplemental to
(Group. R)
Units
Installation
-------------
#
........................................................................................
(No foundation inspection)
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document),
Commercial/Industrial
New Addition
Building Department Representative
District Identification No. J&
V, a LI -e E(C_rn School District certifies that
^ _' a-dk -6 *', IF. - I I L 1�, 'i� t �)l
Sq. Footage
(including Exterior
/Roofed Areas)
Date
CA, 0��_ 1'� 1. , - —'
(Applicahtj�:'
(Phone Number)
C� Is Ct G
(City) (State) (Zip Code)
hasQrvl tilnied with the requirements of, Resolution' No. !D 7? —0 4- 04dnt of $
epres, (o 'I— square feet. $
r e g FB, 2926.
IVULL MIT16ATION $
School District
Paid by Check # 0 ( C_ —
Remarks:
*,--I -a S
Date
Z 0
Nofice: You may protest the Impiplitlon of the fees identified above by submitting a written protest to the District, In compliance with
Government Code Section 6602d(a),jw6!'n,9016js.from the date fen are paid. Failure to submit a timely wilttv protestwtil-prohiblit
you from challenging the Imposition of the fees In any court action.
ff. subs"uent to the School DistrictlRepresentadve signing this Butte County Schools Impact Fee Certification Form, the School District Is
notified by the applicable Local Planhing Agency ")tplis prject Is being rerviewe und�r/"CallfornlaEnvlronme Ity
; _ , r0LQuaij fAct (CEQA),
> 11, ---
this Prolect mav be sublect toldditionall school Ion to fully mitloate Its Invact on the 9dwool districre schools.
TeelormAn
orks
i of Public V)
\3 T
D.epartmen
f B L1 t t e
0
C o u n t Y
LAND DEVELOPMENT DIVISION
hael CrU
mp, Director s,,or-m Water Managen, ent Nograrn
C
k
7 County Center.Drive
'Oroville. CA 95965
0 (530) 538-7266
-7171
(FAX) 538
(NPDES) Phase
National Pollutant Dis . ch;�rge Elimination SYstern
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (sWPPP) Acknowledgement -HAN I A
Project Description: A-1?P i-r1or4
Project Location andlor Parcel Number:
By sigfiing below, L the project owner/owntr's agent, certify that this project WIELL NOT DISTURB
t) ly for a Construction Storm Water P erm't
i acre, or more of land and that L therefore, do not need to aPP based projects that contain
the State of California Regional 'Water Quality Control Board. P
f, 0M . subsequent phases total more
multiple site build -outs of Itss than one acre. but when combined with
than onf,- acre of disturbe�d soil will require a Construction Storm 'Water Permit from the State of
California Regional'Water Quality Control Boaxd.
truction
ffing false and/or inaccurate information or failure to apply for a.Cons
am aware that submi
Storm Water Permit from thf,- State of California Regional Water Quality Control Boa d for a proj ct'
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Si ped:
Title -
Date: 67 -7 — co 5-
. 10
Attention Property Owner:
An "owner-�uilder" building permit has been applied for in
signature. your name and bearing your
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 issueduntil this
verification is.received.
I personally plan to provide the"major labor and material forconstruction of this proposed
property improvement: YES >6] NO [ ].
2. 1 HAVE HAVE NOT signed an application for a building permit for the proposed
work.
I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:
4. 1 plaii to provide portions of the work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:
5. 1 will provide some of the work but I have contracted (hired) -the foll 6wing. persons to provide
the work indicated:
NAME ADDRESS PHONE
TYPE OF WORK
04 10) 0: 3-sm
PROPERTY OWNER:
WMI-3
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
ADMINISTRATION * BUILDING * GIS * PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2`140 Facsimile
Dear Property Owner:
An application for a building permit has been submitted in your nanne listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner-builde*r" 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:
6
• 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.
• 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.
• 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.
• 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 contractors is to secure an "owner -builder" building
pen -nit, 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, Califomia 95814.
Please complete and return the enclosed owneT-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.
I It
KV___1
MicVael C. Vieiri C.B.O.
Maqager, Building Inspection
NOTE: This Owner-Build.er Information is required by Section 19830 of the California Health and Safety Code.
Butte CountyDepartmen t of-Developinent Serw'ccs
13 r
7 County Center Drive
0 0
0 0
Oroville, CA 95965
0 0
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
BUILDING PERNUT APPLICATION WITHOUT REQUIRED CLEARANCES
I request and authorize the Building Division to process this building pen -nit applicat * ion through the plans
examination process WITHOUT first obtaining all necessary, related permits and clearances fr6m other
regulatory entities, including but not limited to, Planning, Environmental Health, Land Development,
County Fire, and Agriculture.
I hereby acknowledge:
* I n * eed to submit applications for septic andlor well to Butte County Environmental Health
immediately.
* I -ain required to bring the approved Environmental Health site plan and approved sanitation
clearance to the Building Division as so . on as clearance is obtained.
* I a . m responsible for notifying Development Services, in writing, to stop processing of the
application and to arrangefor disposition ofplans.
The Building Division will process the application through the plans examination process, as submitted,
without input from other regulatory entities that could prohibit issuance of the building Rermit or rMuire
submission of amended building plans to the Building Division.' Once the plans examination process
begins, there will be no refund of plans examination fees. Any changes requiring submission of amended
plans to the Building Division will incur additional fees.
Within one year from the date of application for a building permit, all other required permits and clearances
from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances
will void the application.
Typically other required perm'its/clearances include, but are not limited to, verification the parcel. was
legally created, adherence to. all rilitigations and conditions imposed on the parcel at time of creation, as well
as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture
buffer zones, and habitat/species).
Please print:
Applicant Name: H t'l (2- tA R -K
APN:
Building site address: 'Z -17's4- /-_00-r9/ZW, RZ_V,0 Permit No.:
I have read, understood and accept the terms and conditions as expressed herein as indicated by. my
submission of the above -referenced building permit applicatibri and my signature below:
— �� a��
SIGNf�� OF APPLICANT
DATE
? - 7 -os -
...... I ICU rc:l- K:Forrri.-/BldvPcrmit%%ithoutClearances 020705
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE N: (530) 538-7541
A FEE WILL BE REQUIRED A T TIME OFAPPLICA TION
Welbsite: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
0
OWNER INFORMATION
Last . Name _T
rst Name
J o14 N
Address 12— C? r--00-rH/iL_ 5q.112.
City
State
CA
Zip
Phone
Fax
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT INFORMATION
ARCHITECTIENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X I�L. . .
For of yie use only:
Zoning
Property Address
S17341 -
Flood Zone
'Cross Street
/$�'O 4WII-VV
SRA
I Yes
No
Occ.
I Type Const.
Subdivision Name
Map Book
I Page
Planner
I Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldqADDISubRqmts.doc
PERMIT
W.
C,
BP
PROJECTLOCATION
AN
.62
Property Address
S17341 -
City
'Cross Street
/$�'O 4WII-VV
)
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:
6r /—f ef6AAV��Sf 6A1
o) 9 i;,) Few (P 7 &1�b4
)
Sq FT- Living Garage Open
Cov
0 Structure Built without Permits 66 sz,
t
0 Proposed Change of Occupancy
(Note previous use):
Paqe 1 of 2
EXPIRATION OF ATPLICATION
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.
Reg k"yed by: Amount: 9_5 Bldg
SRA
Receipt #:
'�SS -3
Date.91--7 � 65
Sheriff
SMIP
Other
STotaL_J.
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply fo� a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
0 1 . Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
0 -2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) PR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
0 3. Engineered truss details and layouts in duplicate (if required). No faxes!
0 4. Energy compliance design and supporting documentation in duplicate.
0 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
0 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
n 7. Metal bidgs: (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.
0 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
0 9. Site plan and business license approval from the City of Biggs.
0 10. Letter of intent for non-residential buildings.
0 11. Building Permit Application Without Required Clearances Form
0 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
0
1 .
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
0
2.
Impact Fees.
0
3.
California Department of Forestry plan approval (if required).
0
4.
NPIDES Form.
0
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupa ncy).
0
6.
Contractor's license information. (Number, Name Style, Classification).
0
7.
Worker's Compensation Carrier and Policy Number.
0
8.
Owner -Builder Verification (if required).
El
9.
Letter of Signature authorization (if required).
0
10.
Recorded copy of Agricultural Acknowledgment Statement.
0
11.
-0 Legal description from current recorded grant deed, 0 Copy of M.H. Title, Title transfer, or MCO.
0
.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 expiration, 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 of 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
K:\F0RMS\BU1LD1NG F0RMS\B1dgApp1SubRqmts.doc Page 2 of 2 REV 8-12-05
NOTES RESIDENTIAL(
03-2917
P ERMIT N '036-420-011
CLARIC, J011N �ROVTLLE
29 . 34 y;OO_rj_jjtLjLV.Dl
CONT. PERFECTIONpoOLS
NEW POOL 1,4AST . ER#()1-500
SPECIAL CONDITIONS'
CHECKED
BY,
— SRA
— FLOOD CERTIFICATE REQ.
— FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
/.7-
Z.
t
JOB FINAL ED (batei
Signature /4_4
4 = OK
0 = Not OK
- = NotApplicable
= Not Ready
Card B-1 Date Card B-1
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except Ws
1
1.
Zoning Req uirements-Setbacks- Easements
Footings; Size -Spacing- Marriage Line
2.
Soils; Special MH Support Sketch
4.
3.
Sewer; Location -Test -Fall -C/0 -Concrete
Drain; MH Test -Fall -Flex Connector�
4.
Water; Location -Test- Easement Needed (Sketch)
7. Wafer and Sewer Connectecl�C/0 to Grade -HD Approval
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
9.
6.
Gas; Location -Test -Wrap;-/ /" L 'ft.
/ P Nat..or / /!' L "ft./ P LPG
7. Well Clearance & Disconnect
8. Utilitv Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except Vs
1
. Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing- Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector�
6.
Water; MH Test- Reg ulator-Connector
7. Wafer and Sewer Connectecl�C/0 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 Requ irements-Setbacks- Easements
2.
Footing s; Size-Spaci ng -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 Ws with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
3o-frool Structure; Steel -Connections -Thickness
Wd Men -Lining.
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except.#s
e6.; Pool Lighting; 15 Volts-GFI
1.
Zoning Requirements -Setbacks- Easements
7.4ec.;
2.
Footings; Soils-Size-Depth-Spacing-i�6nnectors-SteeI
Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Rnypq anelboards-Ins. to Main Conduit
3.
Decks, Girders and/or Joists- Decking -Bracing -Stairs-Rails
.
10.
4.
Wood Awn.; Posts- Beams-Rftrs-Con nectors
Shthg- Frg -Bracing '
Niche
5.
Alum. Awn.; Col um ns -Con nections-Splice- Decal- Enclosures
Date !t- -Card
Date U
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nail i ng -Veneer -Stucco -M esh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps- Doors- Land i ngs
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card 8-1 Date Card B-1
Date
POOLS (Plans) OK exceDt #'s
3o-frool Structure; Steel -Connections -Thickness
Wd Men -Lining.
jio'Elec�.;
Receptacles and Lighting, Distance7GFl
5.
e6.; Pool Lighting; 15 Volts-GFI
Elep.; Enclos res;.Conduit Entries -Terminals- Listed
7.4ec.;
Bonding; Metal w/5' -Circulating Equip. -Heater
er/Ec.;
Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Rnypq anelboards-Ins. to Main Conduit
�,,Kealth
Department Approval
.
10.
Pt2p.; Cir. Test -Water Supply Test
I 04,416ht
Niche
nclosure; Fencing -Alarms
Date !t- -Card
Date U
B-1 - Date Card B-1
Card B-1 . Date Card B-1
4 = OK
0 = Not OK
- = NotApplicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date
UNDERFLOOR (Plans) OK except #s
I . Zoning -Setbacks -Easements -Flood -Slope
Hangers -Post Caps -Anchors -Connectors
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
48.
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
5. Sternwalls, Main; Steel-Blockouts-Wrapped
50.
6. Sternwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
Property Line Firewall & Openings
9. D.W.V.; Fall-Fifting-Test-2 Way C/0 -Sewer Test
54.
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
Stairs; Width -Headroom -Rise -Run- Landi ng- Fire Protection
12. Electric Underground
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
13. Plenums & Ducts; Clearance- Material -Support- Ins.
57.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
16. Insulation
59.
Glazing Area -Glass Protection -Skylights -Plastic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #s
17. Water Htr.; Vent -Access -Combustion Air Baffle
Insulation -Walls -Ceilings
18. Water Pipe; Test & Anchor -Nail Protection
63.
19. D.W.V.; Test Fittings & Anchor -Nail Protection
Date
20. Shower Pan; Test, First Floor -Tub Access
Card B-1 Date Card B-1
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
Date
23. Fire Sprinkler; Test
64.
Date
Card B-1 Date Card B-1
Date
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 El No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
Date
Card B-1 Date Card B-1
Date
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 Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #s
41. Sills Proper Materials & Anchors
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-Purlin-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 X -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run- Landi ng- Fire 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 -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63.
Infiltration -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 I
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor- Ducts- Mech. 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, 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 (FFI.)-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 0 Yes
83. Following InstId./Drive 0 Yes 0 No/Walks Q Yes Q No/Planters Q Yes Q 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 -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:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive 9 Oroville, California. �95965 & Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 03-2817
ASSESSOR PARCEL NUMBER 036-420-071
ZONING
BUILDINGPERMIT
OWNER JOHN & MARY CLARK
TEL&HONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
2937 FOOTHILL BLVD, OROVILLE
'ST.
CONTR. 1, 27,000.00
CONTRACTORS NAME
PERFECHON PWLS & SPA
TELEPHONE
895-0437
CONTRACTORS MAILING ADDRESS
172 E. 20TH STREET, CHICO 95928
CONSTRUCTION LENDER
LENDERS MAILING ADDRESS
Fireplace
Total Valuation $ 27-000-00
ARCHITECT OR ENGINEER
LICENSE NO.
—Fling Fee $
20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Permit Fee $
265.00
Plan Checkinq Fee $
23-00
BUILDINGADDRESS
29-34 Fumi4m. BLVD, DRO-VITI.E.
Energy Plan Checking Fee $
PERMIT FEE
inq_n
LOT NO.
SUBDIVISIONS NAME
I I
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex 13 Mobilehome 0 Other SPECIFY
—Each Trap
7.00
- Solar or heat pump water heater
23.00
Water piping
15-0015.00
Each gas water heater or vent
15.00
TYPE OF WORK
New 0 Addition 0 Remodel 0 Utilities 11 Installation 0 Other 0
Describe Work: NEW POOL MASTER # 01-500
—Gas piping system I - 5 outlets
15.00
Building sewer
15.00
Mobile Home IS I GI W1
@?20.00
PERMIT FEE $
35.00
ELECTRICAL PERMIT
Filing Fee 1 20.00
Main Service "'.ACR.::
1 23.001
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in fujiforce and effect.
License Class � 6�9 Lic. No. 6 6 4
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
0 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.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP,
OR ADONS. & ACC. BLDS.
so
3.50FT.
Ntw OUTLET
NON-RES`20." MULTH' CIRCUITS
97.50
POWER APPARATUS
SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FD(TURES
20 0 "00
BAL @ .50
_L
.=D.A LNS OR
Ex. Occup. PP ES,6.,
5.00
- Temporary Service
23.00
Mobile Home Facilities
20.00
- Misc. Wiring
23.00
D001 EI EMIC
10-0 nc
PERMIT FEE $
so - nc
WORKERS' COMPENSATION DECLARATION
1 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.
I have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compe ton insurance carrier and policy number are:
Carrier MOM
MECHANICAL PERMIT
Filing Fee 20.00
Heating
- Cooling
I
Hood
6.50
Ventilation
PERMIT FEIE $
Policy Number a-7,a_!S Ae - 0-3
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
0 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
,A=Ekers' compensakon provisions of section 3700 of the Labor Code, I shall
forth ith comply
X Date a-/6 3
SignVtur of Applicant - 0 Owner JR Contractor 0 Agent I
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories i eight.
:4
Mobile Home Installation Fee $
Energy Inspection Fee $
occ CONST. TYPE
TOTAL FE" 393.00
FLO
-1tP4
CDIF+LA�
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
By Date
— - -
PERMIT EXPIRES ON
1(&t.)
provisions
to do work
paid.
, q117 //57
'o—
I -
Receiptl`403as�z/ 171P
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT I
COUNTY OF BUTTE -DEPARTMENT OF DE�ELQRWENT SERVICES -BUILDING DIVISION
I
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: 3' L`VfQ�OA (luOrleAe- ASSESSOR PARCEL NUMBER -0
-Proposed Building Use:
Y, 0( re" f Counter Technician: Date: 3
Items required in order to apply for a permit. All boxes NWST be checked OR marked NA in order to apply.
Y41. Plot plans, 3 or 4 sets, signed by the preparer of the plans.
,2. Complete plans, 3 or 4 sets, signed by the 1preparer of the plans.
0 3. Engineered plans, 3 or 4 sets with wet signature on plans AND 2 sets of stamped and signed calculations.
0 4. Engineered truss details and layouts in duplicate. No faxes!
0 5. Energy compliance design and supporting documentation in duplicate.
0 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or
foundation plans, alt in d�plicate.
0 7.1 Metal bui . Idings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate.
(D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be
indexed and returned to the plan review line-up when required items are received.
Date Received By
0 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................
0 9. Plot plan and business license approval from the City.of Biggs ....................................
0 10. Letter of intent for non-residential buildings .........................................................
0 11. Detached Accessory Building Form filled out by the owner .....................................
0 12. Hazardous Material Form ...............................................................................
.13. Other
"'idditional plan review upon receipt of the following items.),
Remaining items needed to issue the permit. (May require
0 14. Fees as shown on the attached Schedule of Fees Due Sheet .......................................
tQ 15. Statement of Intent for Non -heated and A/C Buildings ......... .......... IV
VW16. Sanitation and plot plan approval from the Environmental Health Department in 0
0 17. City of Chico Plumbing permit .........................................................................
0 18. California Department of Forestry plan approval 0 paid. - Sent by: ......................
0 19. Planning approval for (A) Use: _(B)Parking: Q Parcel Check:
0 20. Contact Land Development about 0 Improvements, 0 Drainage ...............................
0 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
0 22. Pre -Inspection f�r` required ................
0 23. Contractor's license information. (Number, Name Style, Classifii�ation) ......................
0 24. Worker's Compensation Carrier and Policy Number ................................. I ............
0 25. Owner -Builder Verification (0 Given to owner, 0 Mailed to owner) .....................
0 26. Letter of Signature authorization ....................................................................
0 27. Recorded copy of Agricultural Acknowledgment Statement ....................................
0 28. Manufactured home utility clearance ...............................................................
0 29. Existing violations and/or expired permits .........................................................
0 30. 0 Grant Deed, 0 M.H. Title/Statement of Facts, 0 Letter from Legal Owner, 0 Check to H.C.D. $
0 31. Other:
When issued Telephone J 2 -le It and hold for pickup.
I have been informed of the above qtems and requirements for obtaining a building permit.
Ap . plicdnt: P Date: 9[403
1. Index permit application for the above items numbered:
2. Additional items required
Contractor, designer, owner, was advised of the above data by
Contractor, designer, owner, was advised of the above data by
Plans reviewed by: Date:
Structural reviewed by: Date:
'Note transfer by: Date:
Yellow: Building 1�ivision
Plan Check Letier
• phone, El mai * 1, 0 counter, by _Date:
• phone, 0 mail"" 0 counter by -4 Date:
Plans app r oved by: Z Z Date: Qt& 1/72
Structural approved by: 409" Date: 81' 7 �,�
EA. USE GAILY
F402 Plan AtlacfiaW I/
Raw Pftn Atuchad
sent to S.D. 9-10
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for — dwelling. Other
Hold final for:
Final clearance O.K. for:
NOTE: /"\
E6vironmental Health
8/96
ialist
,:�V6
/ 0, .00w,5
Date
Butte County Department of Development Services -
7 County Center Drive, Oroville, CA 95965'
N 0 T E S
530) 538-7601 vfww.�qqojco�unty netidds
R E SI'D E N T I A L-
APN: Permit No.
-3 50
Owner. 9-060-084 Is. 0 5
A CLARK
LLE
Site Address: 2934 F60THILL BLVD, OR&I
Cont: OWNtK
Contractor
-ELEC SERV
Type of Permit:
0 FICE COPY
Address
GAS
Meter B y
ELEC Date
TR
Meter By. C
Dat';)
---------- --
I
OK
0 Not OK
MANUFACTURED HOMES
MiS.CELLANEOUS
DATE Lj PERMANENT FOUNDATION SOFT -SET
1. Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Loctn-Test; FalUC/0-Concrete
4 Wtr; Loctn-Test-Easement Needed-Re§ulator
5 Elec Loctn-Clrncs-Grnd Amp -Concrete
6 Yard Gas; Loctn-T6st-Wrap Nat L_j or LPF-1
Inch Sz Ft Lngth
7 Blckng; Sz-Spacing-Marriage Line
8 Gas; MH Test-Demand-Valve-Cnnctr
9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -C/O to Grade
12 Gas and Electricity Tagged
13 Tie Downs D Foundation ID
14 Exits
15 Cert of Occupancy
16 HUD Label/insignia Numbers Serial Numbers
DATE ID E C K S -C 0 V E R S -C A R P 0 R T S -G A R A G E S
I Zoning -Setbacks -Easements
2 Ftgs; Soils-Sz-Dpth-Spacing-Cnnctrs-SteeI
3 Decks. Girders/Joists-Dcking-drcing
Stairs-Guard/Handrails
4 Wood Awn; Posts -Beams -Rftrs -Cnnctrs -S hthg
Frmg-Breng
.5'Alum Awn; Columns-Cnnctns-Splice-Decal-Enclsrs'.
6 Carports; Wndws-Doors
7 Electric
8 Frmg; Si I Is -An chrs-Stu ds-Rftrs -Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof, Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnis.
41 0
DATE IPOOLS
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel -C n nctns-Thickn es s
Dead Men -Lining
Elec Rcptcls/Lting; Distance-GF1
5 Elec Pool Lting; 15 volts-GF1
6 Elec EncIsrs; Conduit Entries -Terminals -Listed
7 Elec Bonding; Metal w/5'-Crcitng Eqp-Htr
8 Elec Grndng; Eqp w/5' CrcItng Eqp-Pool Ightg
Bakes-Encisrsmprilboards-Insultri to Main Conduit
9 Health Dept Apprvl
10 PImb; Cir Test-Wtr Supply Test
11 Lt Niche
12 EncIsr; Fencing -Alarms
13 Bonding, Diving board or Slide
41
401*
Pool Drawing
OK
I RESIDENTIAL (SIngle. &Duplex) - I
DATE JUNDERFLOOR
UAlt
IPLUMBING
I Zoning -Setbacks -Easements -Flood -S lope
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-E le c Grnd Ftg Dpth.
55 DWV; Test Fittings & Anchr Nail Prtctn
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth�
56 Shwr Pan; Test First flr-Tub Acc
5 Sternwalls Main; Steel -Blockouts-Wra pped
57 Test Tub & S hwr, 2nd fir - Tub, Acc
6 Sternwalls Garage; Steel-B(ockouts-Wrapped
58 Gas Pipe; Sz & Anchrs
6a Hold Downs and Special Anchrs
59 Fire Sprinkler; Test
7 Slab, Steel Wrapped
60 Yard Gas Piping
8 Piers-Frplc Ftg-Steel
9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
1:1 Wtr Pipe; Test-Anchrs-Rgitr-Service Test.
__FM
12 Elec Undrgrnd
DATE
E C H A N I C A L
13 Plenums & Ducts; Cirnc-Material-Support4nsultn
61 AC Ducts lnsultn & Support
14 Girders -Sills-Anchr BoltsJoists-Vnts-Cripples
.62 Vent Fan, Exhaust abv lnsultn
15 Acc & VntItn
63 Condensate Drain & Ovrflw, Sz & Grade
16. Insulation
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & PItfrm if Furnace in attic
DAT� IFRAMING
17 Sills Proper Materials & Anchrs
DATE
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-CImc-Comb, Air-Cnnctr
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
In Garage; abv-flr-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-Truss-Shthg
71 GF] Arc Fault
25 Frplc Ties or Type A Flue-Frplc Throat CImc
72 Elec Trim & Subpnl, Breaker Sis & Labels
26 Attic Acc; Sz & Rmx: Prtctn-Draft Stop -Ins Baffles
73 Stairs, Guard/Handrails
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
74 Frplc or Stove, Clmc-Hearth
28 Garage Fire Prtctn Framing -RC Channel
75 Elec Outlets at Wood Prill, 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-CIrnc-Com Air Cnnctr-PRV; abv fir
34 Stucco Lath -Weep Screed-Fridtri Vnts-Undrflr Acc
Mech Prtctn; LPG AppInce Undr House 3" drain
35 Glazing Area -Glass P rtctn-SkyLts-P las tic
81 PImb; Elec & Mech Eqp Listed for Loctn
36 Shear Walls; Nailing -Bolts
82 Elec Rcptcls in Garage (GFQ Romex Ortctn
37 Brace Int/Ext Wall pnls
83 lnsultn-Foam-Looked in Attic
38 Insultn-Walls-Ceilings
84 Guard Rails & Deck Cnstrctn-Post Caps
39 Infiltration-Walls-Wndws
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Clrnc DrngePlanters. Yes [—] No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
8§ Vnts abv Roof, PImb-AppInc-FrpIc-CImc to Opngs
DATE JELECTRICAL
90 Wtr Well, Dscnnc% Elec, PImb
40 Fxtr & Trnsfrmr CImc4ns Prtctn
91 Ext Elec Trim, GFII Rcptcl-Undrgrnd
41 Elec Rcptcls Spacing-Lts & Switches at Doors
92 VntItn thru House
42 Sz Boxes & No Of Cndctrs Stapled
93 Glass Prtctn
43 Romex Installed Close to Edge of Studs & CJ
94 Corrections from previous lnspctns
44 Eqp Grnd made up w/Mech Fstnrs
— 95 Gas Test -Meters Tagged, Gas-Elec
45 Grndng Electrode Bond Gas & Wtr
96 Wtr & Sewer Cnnctd-C10 to grade -HD Apprv]
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 ga [:] CU or AL
99 Fire Sprinkler
48 Range Circ ,. [::ICU or AL
Oven Circ
_00cuorFIAL
Insulated Neutral 0 Yes 0 No
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
41
BUTTE COUNTY .
DEPARTMENT OF DEVELOPMENT SERVICES
- BUILDING PERMIT
24 HOUR MPECTION 4: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICEM (536) 538-7541
PERMIT NO.
BPO53259
B. C. Building Permit 01 -16-04 pg 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
12'/13/2005 APN:
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date:
the Business and Professions Code, and my license is in full force. and
079-060-084-000
effect. 0— .
License Class License Number:
Site Address: 2934 FOOTHILL BLVD ORO
Date: Contractor:
Map index:
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
Description: ELECTRICAL SERVICE UP -GRADE (NEW
Business and Professions Code: Any city or.county which requires a
BOX)
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
Owner: CLARK, JOHN H. LINDA M.
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
2934 FOOTHILL BLVD.,
she is exempt therefrom and the basis for the alleged exemption. Any
OROVILLE CA
violation of Section 7031.5 by any applicant for a permit subjects the
95966
applicant to a civil penalty of not more than five hundred dollars ($500).):
(530) 534-3068
0 1, as I 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,
Applicant: CLARK, JOHN H. LINDA M.
provided that such improvements are not intended or offered for
2934 FOOTHILL BLVD,
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
OROVILLE CA
proving that he or she did not build or improve for the purpose of.
95966
sale.).
(530) 534-3068
0' 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)'Iicensed
pursuant to the Contractors' State License Law.).
Contractor:
0 1 am Exempt under Article 3 of the Business and Professions Code
Date: 12�-051"Owner:
WORKERS' COMPENSATION DECLARATION
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
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.
0 1 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 M
Total Square Ft: 0 S. F.
1_1KI 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.
0� —0
Date:_
Applicant:
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 tha Labor
code, interest, and attorney's fees.
e -C)
CONSTRUCTION LENDING AGENCY
This permit I h b Issu undernapplicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Res to o work ind�idtated for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
By. Date:
Name: -
PERMIT EXPIRES ON:
Address:
(Date)
0 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health an! Safety Code, which regulate the storage,
handling and use of hazardous materials.
0 Notification in accordance with Section 1 9827.5 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.
I .. hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon theabove mentioned property for inspection ppl�o;es�
--s A
Print Name: Signature
Date: 0�
E3 Contractor 0 Agent for Owner El Agent for Contractor
B. C. Building Permit 01 -16-04 pg 1
Department
C o u n t y
J. Michael Crump, Director
Warner C. Phillips, Asristant Director
September 11, 2003
John Clark
2934 Foothill Boulevard
Oroville, CA 95966
Re: Lot Line Adjustment
AP 036-420-071 / 036-430-048
Dear Mr. Clark:
of Public Works
o f B u t t e
LAND DEVELOPMENT DIVISION
7 County Center Drive
Oroville, CA 95965
(530) 538-7266
(FAX) 538-7171
BUTTE
COUNTY
SEP I Z 2003
DEVELOPAlENT
SERVICES
On September 11, 2003, the Department of Public Works made the finding that the Lot Line
Adjustment on the above referenced property is exempt from environmental review, and
approved the project subject to the conditions on the attached page.
Should you appeal the decision of the Department of Public Works, please submit your appeal,
in writing, with the appeal fee of $50.00, to the Clerk of the Board of Supervisors, 25 County
Center Drive, Oroville, California, prior to 4:00 p.m., September 22, 2003. -
The conditions of approval must be met within thirty-six (36) months from the date of approval
by the Department of Public Works or the approval will be'considered null and void.
If you have any questions concerning this matter, please contact this office at (530) 538-72.66,
Monday through Friday,.8:00'a.mi to 4:00 p.m.
Sincerely,
Stuart Ede I
Manager, Land Development Division
SE/kp
Attachment
cc: E vironmental Health Department
vruilding Division
Michael Mooney.
Michael Evans
IZ
3ohn Clark,, Lot Line Adjustment AP 036-420-071 / 036-430-048,, modifying
the common boundary line between two parcels located on the West side of Foothill.
.Boulevard, 500 feet South of Mountain View Drive, Oroville area. Engineer: Michael
Mooney.
1. New lot or parcel lines shall comply with setback requirements of applicable
zoning and building ordinances'.
2. Deeds and plats (if required) shall be submitted to the Department of Public
Works, Land Development Division for checking and approval prior to recordation
and shall contain the notes specified below.
3. Provide documentation from a title company of the applicant's choice verifying
that any deed of trust affected has been. partially re -conveyed or modified to
reflect the lot line adjustment and to prevent the creation of any additional lot or
parcel.
4. Prior to recordation of deeds, - provide documentation verifying payment of taxes
as required by Subsection (b) of Section 20-95 of the Butte C ' ounty Code and as
specified in Article 8 of Chapter 4 of Division 2 of Title 7 of the Government
Code, commencing with Section 66492.
Deed Note
(To be placed on any deed to effect lot line adjustment)
The purpose of this deed is to effect a lot line adjustment as approved by the Butte
County Director of Public Works on The above described lands are to be
combined with and become a part of those lands as described in the deed to
as filed for record in Butte County Official Records at Serial Number Book
at Page No additional lots or parcels are created hereby. � The scope of review
of. said lot line adjustment.was limited as specified in Government Code Section
66412(d), and approval of it does not constitute assurance that -future applications for
building permits or other land use entitlements on the modified lots or parcels will be
approved by the County of Butte.
Plat Note
(To be placed.on any required Plat)
This plat does not constitute a legal description of the lots or parcels depicted and does
not show all easements of record on or affecting said lots or parcels.
E Lot Line Adjustment Conditions of Approval - Butte County E
036-420-071 99-2422
CLARK, LINDA &JOHN
2934 FOOTHIELL BLVD., OROVILLE
CONTR: OWNER
LAWN SPRINKLERS
lk
. Q::�t
COUNTY OF BUTTE - DEPARTMENT OF DEVffLOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive 9 Oroville, California 95965 9 Telephone (530) 538-754 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
,ASSESSOR PARCEL NUMBER
/I -D R7
Q LIE !� P, Xul�. CLJ (
ZONING
BUILDINGPERMIT
OWNER
UAWILL-, 0� 951L,53
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
CONTRACTORS NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Fee
$
ARCHITECT OR ENGINEERS MAJUNG ADDRESS
—Permit
Plan Checking Fee
$
BUILDiNGADDRESS 9 ;31X0.
Energy Plan Checking Fee
$
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF .0, Duplex 0 Mobilehome 0 Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
—
TYPE OF WORK
New 0 Addition 0 Remodel 0 Ublities 0 Installation 0 Other [3
Describe Work:
piping system 1 - 5 outlets
15.00
—Gas
Building sewer
15.00
Mobile Home I S I G I IN
920.00
PERMIT FEE
ELECTRICAL PERMIT
Filing Fee 20-00
a00V OR UE:SS
Main Service .A OR LE
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law f r the following reason:
V1, 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.
/0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
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 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
f one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X, Date J�� .
Sign aturia(wbf A�61icgnl - 0 - Owner 0 Contractor 0 Agent*
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 2WA TO 1000A
46.00
NEW CONST. P. so
OR ADONS. %WZCSU 3.50FT.
NEW CONST
NON-RESID. muLT,'Oc= 97.50
'P.0r AP= US
. . CIR.
Ex. Occup. OUTLET OR FIXTURES 20 @ 1.00
BAL @ .50
O.OXED APPUNS OR"
Ex. Occup. CRES,6.) E
5.0
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
I
PERMIT FEE
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTALFEE$
HAZ.
t. FEES IMP
I FLOOD
I CDF
PARCEL
PDT;3
'S
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By L
7- tj
PERMIT EXPIRES ON i
I
the applicable provisions
Resolutions to do work
been paid.
il)/20/
Date
iWIVX�;:)
(Date)
ReceiptNo.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 9 Telephone (530) 538-7541z71_7 PERMIT NO.
W., - "")
(Rev. 12/96) APPLICATION AND PERMIT fzqrn
0JgSS&y6CEL7fI1ER
_0 LINDA & JOHN CLARK
ZONING
BUILDINGPERMIT
2= FOMILL BLVD., OROVILLE, CA 95966
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
� OWNERS MAJUNG ADDRESS
OWNa
CONTRACTORS NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
UCENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
SUILDINGADDRESS 2934 FOMIU BLVD., OROVILLE
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF V Duplex 0 Mobilehome 0 Other
SPECIFY
Each Trap 1
7.00
-
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New 0 Addition 0 Remodel 0 Utilities 0 Installation 0 Other 0
Describe Work: LAW SPRINKLERS
piping system 1 - 5 outlets
15.00
—Gas
Building sewer
15.001
Home ISI GI W1
1@20.00
—Mobile
I SPRINKLERS
19.00
_J_Aj,;,,JN
PERMIT FEE
35.00
ELECTRICAL PERMIT
Filing Fee 20-00
Main Service o".
23.00
LICENSED CONTRACTOR'S DECLARATION
1 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 Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law f r the following reason:
K71 as owner of the property, or my employees with wages as their sole compensation,
�ill do the work, and the structure is not intended or offered for sale.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00
NEW CONST DWELLING OCCUR
OR ADONS. & ACC. EILDS.
3.50SO
FT.
NEW CONST. MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS
97.50
POWER APPARATUS
& SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FocrURES
20 @ 1.00
BAL @ .50
O.FIXED APPM. OR.
Ex. Occup. (R J E
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE $
WORKERS' COMPENSATION DECLARATION
l 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.
[3 1 have and will maintain workers' compensation Insurance, as required by Section
3700 ofthe Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
C a ! rier
VPolicy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
f rt with comply with those provisions.
�O%
Date VJ 4 0
ig n u P�K�af—Agplpgfi'canl - 0 Owner 0 Contractor 0 Agent'
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Filing Fee— 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEIE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTALFEE$ 35.00
HAZ.
I D. FEES IMP
I FLOOD
HD
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 h e been paid.
10/20/99
I B,&�. ) Date
k_4_r_ 10/20/2000
PERMIT EXPIRES ON .11 J
pate)
ReceiptNo._ 280472
WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
_1/
Attention Property Owner:
An "owner-bufldee' budding 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.
I personally plan to provide the major labor and materials for construction of the
proposed prope, improvement: YES[L-J'NO[ ].
V-2. I HAVEjA'��HAVE NOT[ I signed an application for a building permit f6r the
proposed work.
3. 1 have contracted with the following person (firm) to '-provide -the -proposed
construction:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S 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: CONTRACTOR'S LICENSE NO.
5. 1 will provide. some of the work but I have contracted (hired) the followirip,-per'sons to
provide the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNTD:
81—OROPERTY OWNER:
SOCIAL SECURITY NUMBER:
-0 01ci 0
�,,T,DATE:
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health and Safety Code.
May 1995
This verification must be completed and returned to our office before
we are permitted to issue the permit.
2.26
O.B.- I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified.
For your protection, you should be aware that as "owner-buildee, 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 nam. e.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all permits
for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract� you
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any'persons other than your immediate family, and the work (including
materials and other costs) is $300 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments as an employer and. you. are
subject to several obligations micluding state and federal income tax withholding, federal social security t i axes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be financial risks'for "you if you do not carry out these obligations, "and these risks are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about YOU' r
obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial.
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees, without a licensed contractor or subcontractor, only
under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuildee,
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 ow'n"'
work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned.
Sincerely,
Michael C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
May 1995 2.27
2689-76B,P,E,-M
PERMIT NO.
PERMIT EXPIKES-
North Sierra Const.
OWN E R
��CONTR.q owner -
LOCATION (A.P 36-42-71
2934 Foothill Blvd., Orovilld
Temp. Powe Pole
I/
Called G&E
c.
Temp. El . Serv.. 92
/Temcall PG&E
Cal d
. as Serv.
p
C I
lied PG&E -5-71
J B
INALED
(DatV'—
(Si6-na
fu r 4)
COUNTY OF BUTTE — -DEPARTMENT OF PUBLIC WORKS
i
BUILDING INSPECTION ReCORD
BUILDING� BUILDING (Cont'd) PLUMBING
S a I b a c k z,- — Firewall 7- 76- Soil Piping
Forms Pairapets Ist Floor
Main Bldg. Restroom Flnlsf�� 2nd Floor
Footings Windows 9- 7- --7-Z 3rd Floor
Stemwa I 1 "-7-2-74. Sidina — Topout 71—
Slab Roof Sheathing -"7 —J4 --7.4-- Water Plpl'ng 49 -
P!ers Roofing G - 2--7L Sewer
Garage Fdn. Vents 9-7-74- Fixtures -7- '71
Footings 77 Garage Vents Water Htr. 74:-
Stemwa I I Insulation * eq- 7 �:-79 Heaters Z -
Slab -76 Prov. for p� Appliances
handic ppe Isichily
Carport
Conformance of ex. Gas Piping & Test a-3rc &Z
Footings structure Temp. Gas
Slab -Final Sanitation
Patio FIREPLACE Final 7
Footings Footing 4 ELECTRICAL
Masonry Walls Throat Rough
ReInf. Steel Final Fixtures
Bond Beam FiRt SPRINI�LERS Motors
Framing Test Water Htr.
Stucco Final Subpanels
Mesh -7 MECHANICAL Grd. Fault Prof.
Scratch Heating e-lve �7-14 - 74 Service '7
Brown _7 c/- Cooling cl —�2 — -X_ Temp, Pole "Z
Finish 0 Ducts Underground
Interior Lath e_e Ventilation Permanent
Door Closer 7-- Final 7-74: FI nal 2—
DATE REMARKS OR CORRECTIONS
C;d
61�`
0/0 1! 17 1 _/0 0
9 - I - -7
0
d",4 lxlfe_�
t
el
(NOTE: An entry must be made on this form each time you visit the job site.)
Fiber GlassIp'sUla'tion
BUILDERS INSULATION STATEMENT '
BLOWN INSULATION I _t
Manufacturer's min -mum thickness to provide the level of insulation
resistance (R) Values as shown-
R Values are determined in accordance with ASTM C-687 and C-236.
Conforms to Federal Specification HHI-1030A.
This insulation has been installed'in conformance with the above recom-
mendations to provide a value of R -using -bags of insula-
tion to cover ----square feet of area. _ 11,
Insulation Contract , or (Sign) -
Company Name
BATTS AND BLANKET
R
INSULATION,
R
INSULATION
VALUE
THICKNESS
VALUE
THICKNESS
R-22
61/2
R-1 3
351stt
R-19
6"
R-1 1
31/2 "
Builder (Sign)
Company Name
--Date
Meets Federal
Specification HHI-521
Fiber glass batts or rolls have been installed in accordance with the
manufacturer's recommendation t id a R -Value of in th4
.6 exterior walls,
ceiling', in, ih ails, in the floor or crawl space
Oerime�e A
A
2 In lation Co t t (Sign) B derign)
1/
Company Name Gn y a L�
C7. a
Date I
CSG -32-1 1 -C
CERTAIN -TEED PRODUCTS CbRPORATION. �O. BOX 860, VALLEY FORGE' PA. 19482
CEIRAINTEED
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS
7 County Center, Drive%��- QNPvi Ile, California 95965
Telephone: 53�-4541
76
APPLICATION AND PERMIT
OU " IVII�V 1UPIVOU11LOLIVU� UJI Ult: UUU[ILY Ul DULIV tu t�nter upun ine
above-4ritioned prop�rty f or ins pection purposes.
_Z
Date z-6 7
i�-r t rmlt Agent
416 4_5_s�_
Receipt No. ?/r;
White-D.P.W. - Yellow -Assessor - Pink -inspector - Goldenrod-Appli cant
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.
DIRECT R OF PUBLIC WORKS
By Date ej
Building permit expires Date
BUILDING
Ownerk,b/2-r-k ��J E& ft a (6.Ai 5-r–
SO. F T. OCC. BUILDING VALUATION
_r _7z
11
Mailing Address OL,vE Hy
.
6�& I- J 4
ca V,�, I I ap. ix-
R�JgIqA_z_
Fireplace I
Contractor A4 47—
Mai I Ing Address
Total Valuation
Permit Fee
Plan Checking Fee&/orPenalty
ITelephone
No.
Permit Fee
$
$
Building Address F60741*11 zfzl/a/
PLUMBING
No.1
@
FEE
PERMIT FILING FEE $3.00
S.00
Each Trap 1.50
L.&V
Repair drainage or vent piping
1.50
Water piping 1.150
/ "s -b
Each gas water heater or vent 1.50
1.0-
A. P. No. 3(o —q2- —:7/
I Zoning & Planning
Gas piping system 1 - 5 outlets
1 .50
1
Each additional outlet . 30
__
Fteesl
L�_
W.C.
kSZ �t
Fire Dept.
I FireZone
I Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
I Declaration
Parcel Map
60' R/W
I Improvements
Lawn sprinkler system 2.00
L�_
Bldg. Plans Rec'd____]
PcrceI(<P_0Pr`aVcII
—
Plansi4fp"roval
Permit Fee
$
$
NEW P2-- ADDITION UTILITIES OTHER
ELECTRICAL
No.1
@
FEE
PERMIT FILING FEE J$3.00
Main service 6110*OvAMOF.R LESS 5.00
OR LESS
Main service EA. ADD -L tOO AMR
2.50
Single Family [ff--Duplex Mobil Home OthersE]
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADD -L 100 AMP 1.00.
NEW CONST. DWELLING
OR ADDNS. ( ACC. BLDGsoc.; 7',0
e
20sq ft
NEW CONSTIL -.UT-LI-T '2.50ea
NON.RE�'D. (MULTI
BRANCH CIRCUITS)
NEW CONSTFL ( POWER APPARATUS &)
NON-RESID. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
1 am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
�_rh/
D 254t
Ex. Occup(OUTLETS OR FIXTURES) P.OACL @ I(%
FIXED APPLNS. OR
Ex. Occup. (OU TLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No__,7 -7- Classification -P>
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
I have piac�d on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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 Workmen's Compensation Laws of
California.
MECHANICAL
No.
@
FEE
PERMIT FILING FEE $3.00
3-00
Heating 35WO G7 -Q
. �,-D
Coo I AW? CodleX e *&D
4�vv
Ventilation
Hood 2.00
4,6,-0
Permit Fee $
I L
$ 7
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. S.tate Laws relating -to building construction, and hereby
L TOTAL PERMIT FEE
OU " IVII�V 1UPIVOU11LOLIVU� UJI Ult: UUU[ILY Ul DULIV tu t�nter upun ine
above-4ritioned prop�rty f or ins pection purposes.
_Z
Date z-6 7
i�-r t rmlt Agent
416 4_5_s�_
Receipt No. ?/r;
White-D.P.W. - Yellow -Assessor - Pink -inspector - Goldenrod-Appli cant
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.
DIRECT R OF PUBLIC WORKS
By Date ej
Building permit expires Date
a ILM M R MMV M V
Sales, Service, Installation Uc. #566654
e . I L,,u ic
R04
'i
'j, 11' -
�Jtjy
NIS110N
BUILDI p O\IFD
E
0 10 20 so 40 so
GRAPHIC SCALE
ORIGINAL SCALE: 1" 30?
Assessor's Parcel Number: Fol Size (Acres)
Owner Name /Address/ Phone No._ a�w S Lto-bA 0--t-4p
Site Location 3 4 OTf-4 IL -C I-Vf> 0
CA
Zoning General Plan
Contact: Name RICL Phone —(6� 0 - 74 F 4