HomeMy WebLinkAbout079-070-014.Lr
HAZEL CAWTHRA
120 Greeribank Ave, Orovi e
CAWTHRA, 4156B
HAZEL
Contr:,Oroviile PUMp & E ectric
8' _,� ____L _. , ___ __ _'. __. --33081
Permit#5627- OE(ele ser ch)SF
-AA-63ZLw .1 --3828P
a'A_ 92 oly
�AWTHRA, Hazel 110.
i20Greenbank,'-�Orov'ille e�&��, I Green.bank -Ave i Oroville
gas.'. -line/sf CONTR: Richa�d Woodq 1067 PoA6naL Ave.,iOro I v3_3
(,�ew osingle famidy)
3- 1
94-1225B
KIBBLE -1 HAZEL
110-GRE'ENB�NK AVE.-, ,OROVILLE%�r�':_
REROOF/SF W/O PERMITS
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036-430-U"_ /14
STEINSIEK, DON
I 10 GREENBANKAVE, OR 1�
Cont: OWNER' .7
ELEC (RELOCATE SERV)
03! 05-2108
STEINSIEK, DON
1.10 GREENBAN E,,OROVIL
Con't: OWNER
D
RE ROOF N 4w
A
-4
7
TP A 17 QL__rrp
3/8/94 RA+EE+
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W/O PERMITS
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HAZEL CAWTHRA
120 Greeribank Ave, Orovi e
CAWTHRA, 4156B
HAZEL
Contr:,Oroviile PUMp & E ectric
8' _,� ____L _. , ___ __ _'. __. --33081
Permit#5627- OE(ele ser ch)SF
-AA-63ZLw .1 --3828P
a'A_ 92 oly
�AWTHRA, Hazel 110.
i20Greenbank,'-�Orov'ille e�&��, I Green.bank -Ave i Oroville
gas.'. -line/sf CONTR: Richa�d Woodq 1067 PoA6naL Ave.,iOro I v3_3
(,�ew osingle famidy)
3- 1
94-1225B
KIBBLE -1 HAZEL
110-GRE'ENB�NK AVE.-, ,OROVILLE%�r�':_
REROOF/SF W/O PERMITS
J
r el-
ctrj4
e
036-430-U"_ /14
STEINSIEK, DON
I 10 GREENBANKAVE, OR 1�
Cont: OWNER' .7
ELEC (RELOCATE SERV)
03! 05-2108
STEINSIEK, DON
1.10 GREENBAN E,,OROVIL
Con't: OWNER
D
RE ROOF N 4w
A
-4
7
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county Assessors OffiCe
Orovi le, Cilifornia
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Type Boat: Houseboat Canoe Jet Ski Pontoon Sail
Boat Material: Fiberglas IF) Wood W. Metal IN 0
Length of Boat: —Feet Inches
Propulsion: Outboard (0) Inboard (1) Inboard/Outt
Motor Information: -
#1 Year - Manufacturer
#2 Year Manufacturer
Location of boat: Owner's Residence Other:
addres
Condition of boat and motor (considering age)
Excellent Good - . Average —Poor
(Any comments that would help us value the boat should
The boat and motor are taxable to the owners as of 12:01 AN
March 1, you are still liable for the taxes of that year.
I declare under penalty of per*lu!y, that these statements are I
(signature)
Date
A -, _ - . I
v Nil
I ig.
04
*401,
6^0010
famoc-,
COMPLAINANT:
ADDRESS: )acp
PHONE NUMBER:. so�a—
OTHER COMMENTS:
COMPLAINAN
ADDRESS:
PHONE NUMBER:
OTHER COMMENTS:
_�����...
NOTES
RESIDENTIAL
.'PERMIT NO.
0.5 --17-07
SPECIAL CONDITIONS
CHECKED'
BY
SRA
—FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS RE
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CO ' NDITIONS
SUB-STA.NDARD HOUSING LETTER
p
JOB FINALED (bate)
Sign,ature
4 = OK -
D = NOLOK
- N�tAppficable
= Not Ready MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #s
1 . Zoning Requirements -Setbacks -Easements
2. Soils; SpeciA MH Support Sketch
3. Sewer; Location -Test -Fall -C/0 -Concrete
4. Water-, Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ /" L'ft.
J P Nat. or/ r L"ftJ 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 #'s
1 . Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test-Deenand-Valve-Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water MH Test-Regulator-Connectoe
7. Water and Sewer.Connected-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 Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Une
3. Blocking
4. Gas; MH Test -Demand -Valve
5. Electricity; MH Test
6. Water MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
10. License Decals
11. Verify #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except Vs
1. Zoning Requirements -Setbacks- Easements
.2. Footings; Soits-Size-Depth-Spacing-Connectors-SteeI
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5. AJum. Awn.; Columns -Connections -Splice- Decal- Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except Vs
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Vofts-GFI
6. Elec.: Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Departmerd 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
= NotApplimable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #s
1 . Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /' Ftg. Depth
5. Stemwalls, 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-Frtting-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 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 Rue -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- Landing -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
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #s
Date
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
23. Fire Sprinkler, Test
70. Stairs & Railq
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except ff's
24. Fixture & Transformer Clearance -Ins. Protection
25. Elea. 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 KAchen & Conductor Size GFI
30. Subleed Wire Size/ Iga. Cu or AJ -A -C. Wire Sizet /ga Cu or Ad
31. Range Circle/ /ga Cu or AI -Oven Circ. /ga Cu or Al
Insulated Neutral 0 Yes 0 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
85. A.C. Unit Disconnect, Electrical- Plumbing
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. Fumace-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
Date
41. Sills Proper Materials & Anchors
Date
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
Date
43. Bearing Walls over Girders & Floor Nailing
Comments
44. Draft Stop in Walls (rat pr000
45. Fire Stops, Furred Ceiling s -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 Rue -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- Landing -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. Infittration-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 Proteation-Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Railq
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.; Elea. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood-Eartk
Clearance Looked under Floor 0 Yes
83. Following lnstIdJDTive 0 Yes 0 No/Walks 0 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.F.I. Receptacle -U nderg round
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Eleatic
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:
. BUTTE COUNTY.
DEPARTMENT OF; I DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 638-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BPO52108
B. G. BuHuing ruminui-tu-04 Py 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: 08/08/2005 APN: 036-430-014-000
the Business and Professions Code, and my license is in full force and
effect.
Site Address: 110 GREENBANK AVE ORO
License Class License Number:
Map Index:
Date: Contractor:
Description: RE -ROOF (20 SQ)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: STEINSIEK DON
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
700 STILSON CANYON RD
signed statement that he or she is licensed pursuant to the provisions of
CHICO, CA
the Contractors State License Law (Chapter 9 commencing with Section
95928
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
(530) 894-1918
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
Applicant: STEINSIEK DON
Code: The Contractors' State License Law does not apply to an
700 STILSON CANYON RD
owner of property who builds or improves thereon, and who does
CHICO, CA
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
95928,
sale. If however, the building or improvements are sold within one
(530) 894-1918
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
Contractor:
not apply to an owner of property who buildsor improves thereon,
,and who contracts for such projects with a.contractor(s) licensed
pursuant.to the Contractors' State License Law.).
El I am Exempt under Article 3 of the Busin and Professions Code
Date:Y—X-05 Owner
License #:
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
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
13 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:
Carrier:
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy #:
Census Code:
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 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
0
forthwith comply with those provisions.
Date:
35 0 1-7
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 the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutio s to do work indicated above or which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Date:
Name:
By:
0 G)
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 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.
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 But e County to enter upon the above mentioned property for inspection pur es
nJ4�411
Print Name: 5 1 Signature:
0,c4_q oe Md
Date:
;rOwner Ell Contractor El Agent I I or Owner IZI Agent for Contractor
B. G. BuHuing ruminui-tu-04 Py 1
'NOTES
RESIDENTIAL,
PERMIT NO.
—0-36 _05�2074
0 4
STErNSIEK, DON
I 10 GREENBANK AVE, OROVILLE
Cont: OWNER
ELEC (RELOCATE SERV)
7
0�_ )IJoy
A
SPECIAL CONDITIONS
CHECKED'
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITION S
SUB -STANDARD -HOUSING LETTER
OFFICE COPY
Address
GAS
Meter By Date
ELECTRIC
Meter By Date
JOB FINALED.(Date)
Signature -ool
4 = GK
0 = Nrd. OK
- - AtApplicable
. = Not Ready
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1 . Zoning Requirements -Setbacks -Easements
2. Soils; Speciad MH Support Sketch
3. Sewer Location -Test -Fall -C/0 -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Locatiori-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ /" L'it.
/ P Nat or/ /" L"ftJ P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except Ws
1 . Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Une
3. Gas; MH Test-Deenand-Valve-Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water MH Test-Regulator-Connectoe
7. Water and Sewer.Connected-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 Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Une
3. Blocking
4. Gas; MH Tesi-Demand-Valve
5. Electricity; MH Test
6. Water MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
10. License Decals
11. Verify #s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except Vs
1 . Zoning Requirements -Setbacks- Easements
2. Footings; Soils-Size-Depth-Spacing-Connectors-SteeI
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Beams-Rftrs-Connectors
Shthg- Frg- Bracing
S. Alum. Awn.: Columns -Connections -Splice -Decal- Enclosures
6. Carports; Winclows-Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #Is
1. Setbacks -Easements
2. Soils, Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men-Uning
4. Elec.; Receptacles and Ughting, Distance -GA
5. EJec.; Pool Ughting, 15 Vofts-GFI
6. EJec.; Enclosures; Conduit Entries-Termina)s-Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test.
11. Light Niche
12. Enclosure; Fencing -Alarms
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
= OK
= Not OK
= Not Appricable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1 . Zoning -Setbacks-Easements-Rood-Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, 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. Girclers-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 PLUMBING Wermit) 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
23. Fire Sprinkler, Test
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 A)-A.C. Wire Size/ Iga Cu or AJ
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral 0 Yes 0 No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels- Motors-Mech. Equip.
34. Clothes Closet Ught-Shower Ught-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. Fumace-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 proo�
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 Rue -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- Landing -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-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-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.El.)-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 13 Yes
83. Following InsfldJDrive 0 Yes 0 No/Walks 0 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.F.I. Receptacle- Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
%03 T
0 DEPARTMENTO,F DEVELOPMENT SERVICES
0 BUILDING PERMI I
0 24 HOU I R INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
_0 OFFICEM (530) 538-7541
P
DIM
PERMIT NO.
BP052074
.. 1. � U . . 1�0 1. 1. � V�
LICENSED CONTRACTORS DECLARATION,�
I hereby affirm Undei penalty of perjury that I am 'licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 08/03/2005 AIPN: 036-430-014-000
the Business and Professions Code, and my license is in fu 11 force and
effect.
'" ' 1. , i
. Site Address: 110 GREENBANK AVE ORO
License Clais,: License Number:
Map Index:
Date: �.Contractor:
Description: RELOCATE ELECTRICAL SERVICE
OWNER-66ILDIEWDEtLARATION
I hereby affirm under penalty of perjury that I am 'exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: DON STEINSIEK
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires,the ap plicant' for such permit to file a
700 STILSON CANYON RD
signed statement that he or she is licensed pursuant to the provisions of
CHICO CA
the Contractors State License Law (Chapter 9 commencing with Section
95928
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
I
(530) 894-1918
violation of Section'7031.5 by any applicant for a permit subjects the
dcs97@hotmail.com
applic I to a civil, penalty of not more than five hundred dollars ($500).):
, I
71, as . ow ner 76f ti�le . pro"Oprt , y, or my employees with wages as. their
sole , compensafion, will do the work, and the structure is. not
intended or.o4ered,for"sale (Sec. 7044, Business and Professions
Applicant: DON STEINSIEK
Code: The Contractors'. State License Law does not apply to an
,
700 STILSON CANYON RD
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or herbwn employees,
CHICO CA
provided that such improvements are not i ntended or offered for
95928
'
sale. If however, the building or improvements are sold within one
(530) 894-1918
year of completion, the owner -builder will ha ' ve the burden of
proving that he or she did not build or improve for the purpose- of
dcs97@hotmail.com
sale.).
I, as owner of the property, am 'exclusively contractin-g with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
Contractor:
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.).
El I am Exempt un?r Articl usiness altsonsC de
/1-A
Date: Owne :
License M
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
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
IZI I have and will maintain workers' compensation insuran i ce, 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:
Carrier:
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy
Census Code:
I I certify that'in the perf6rmance of the work for which this permit is
N
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 shall
forthwith comply with those provisions.
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 the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit s ereb ssued under the applicabl provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
of the work for which this permit is.issued (Sec 3097 Civ.)
Resolutions to do k indicated aOLbove o hi fc have been paid.
1 <2-,
performance
Name:—
By: Date:
PERMIT EXPIRES ON:
Address:
(Dbte)
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.
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
Bu
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the supillance of any official form or docu Butte ounty. I hereby
authorize re��atives of Butte CouS ei r upon the above mentioned property for inspectioA purpose
77
e,,% in z_)
Print Name:! Signature:
Date: V— C)
19/Owner a Contractor Q Agent for Owner El Agent for Contractor
.. 1. � U . . 1�0 1. 1. � V�
^" � ��a '' � ,r.-� .,. • �' �. + y.!'hetk}+V `'7�+s17��+.1' '� -�.� v�.t.+�ir:�= .wr.:- 'F:-..7:-+�:.t.;+ras -.
• ;
OUNTY 0 , F BUTTE -'DEPARTMEWT OF#DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, Califok.1 95965 - Telephone (916) 538-7541^. PERMIT NO.
APPLICATION AND PERMIT 1-f V - / _� *7 !�7
ASSESSOR PARCEL NUMBER 36-430-014
ZONING .'AR
BUILDING PERMIT
OWNER HAZEL KIBBLE
T�TA564
SQ. FT. 6cc. BUILDING VALUATION
20 (a 60 1.2M.00
OWNER'S MAILING ADDRESS 110 GREENBUK AVE 0R*ILLE, 95966
1
CONTRACTOR'S NAME UMINN
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER 41
UNKNOWN
Total Valuation Is
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
29.
ARCHITECT OR ENGINEER
CENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 110 GREENBAW AVE
PERmrr FEE s
49AX
OROVILLE, 95966
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
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
SF 9 Duplex 0 Mobilehome 0 Other
SPECIFY
Gas piping system 1 5 outlets
15.00
sewer
15.00
—Building
Mobile Home S G I W
@20.00
TYPE OF WORK
New Q Addition 0 Remodel 0 Utilities El Installation El Other J
DescribeWork: RERWF
(W/O PwaT)
PERMIT FEE
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service '20 OOV ORR LESS
OA 0 LESS
23.00
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCC Up
OR ADDNS. & ACC. BLDS.-
3.50 s0T.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
Q 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)
El 1, as the o w-ner, 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.RESID. BRANCH CIRCUITS
@7.50
POWER.APPARATUS
& SINGL. OUTLET CIR. I
Ex. Occup. ( OUTLET OR FIXTURES
B 20 @ 1.00
AL. @ .50
Ex. Occup. ( OFIXED APPLNS. OR
UTLETS (RESID.) EA. 1
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
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 66tte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
V'ertificate of Consent to Self -insure.
I-1hall not employ any person in any manner so as to 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 certify that I have read this application and state that th6 above information is correct.
1 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.
1 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 4 Date
Signature of Ao�licant - Owner Q Contractor C) Agent
7L.
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 $
I
Energy Inspection Fee I $
C
CONST. TYPE
LTOTAL FEE $ 49.00
HAZ.
-
I D. FEES
IMP
I
-
FLOOD
I CDF
PO
I PARCEL I —
fHO
IZ;UE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
y
__V_
PERMIT EXPIRES ON— V-3/
e [Dat�)
provisions
to do work
paid.
Date
4 e
/
162630
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLD ENRO D-APPLI CANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, CaOorinia 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT qq-
ASSESSOR PARCEL NUMBER 36-430-014
ZONING AR
BUILDING PERMIT
OWNER HAZEL KIBBLE
Tff—"�564
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAJUNG ADDRESS 110 GREENBANK AVE OROVILLE, 95966
20 0 60 1,200.00
CONTRACTOR'S NAME
UNKNOWN 77�
ONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
—Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 110 GREENBANK AVE
PERmrr FEE $
OROVILLE, 95966
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
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
SF 4 Duplex 0 Mobilehome Q Other
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G I W
@20.00
TYPE OF WORK
New 0 Addition 0 Remodel CI Utilities 0 Installation 1:1 Other (I
DescribeWork: REROOF
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
(W/O PERMIT)
Main Service "' O.R LESS
�..A 0 LESS
23.00
Main Service 200A TO IOOOA
46.00
NEW CONST. DWELLING OCCUP.
ADDNS. & ACC. BILDS.
3.5, so
FT.
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.
XLicense 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)
El I am exempt under Sec. Business and Professions Code
forthis reason
—OR
NEW.CONST. MULTI -OUTLET
NON RESID. BRANCH C IRCUITS
. _
@7.50
POWER AP PARATUS
( &-SINGUE OUTLET CIR..
Ex. Occup. OUTLET OR FIXTURES
8 20 @ 1.00
AL.@ .50
Ex. Occup. OFIXED AP"S. OR
UTLETS (RESID.) EA.
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
0 This permit is for $100.00 (valuation) or less.
El I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
V'ertificate of Consent to Self -insure.
ilhall 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 application and state thatthe above information is 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.
1 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 � �_L 14 9 1 � 1111axl- Date
Signatidre df A&Iicant - wner Q 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
C
CONST. TYPE
TOTAL FEE $ 49.00
HAZ.
1 0. FEES
IMP
I RLOOD
I COF
PARCEL
I PO
HD
ISSUEj
I/
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
B
PERMIT EXPIRES ON
I "(Dato
provisions
to do work
paid.
/
Qate Y,
V
Receipt NO. 162630
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD-APPLIC ANT
Z4 6 -6)
CO-UNTYOF BUTTE - DEPARTMENT6F DEVEGOPM ENT SERVICES - BUILDING DIVISION
few-
7C60NITYtENTER DRIVE - OROVILLE,CALIFORNIA95965 -TELEPHONE (916)538-7541
PERMITAPPLIC ATION DATASHEET
OWNER 4Z -3 1-j al Z
A B - 0.
Proposed Building Use Building Inspector Date
At time of per A-5-prplication, I was advised the following data must be submitted prior to permit processing an&or issuance:
DATE RECEIVED BY
�71.'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 (160 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) .............
-in Ireln,ecti n request
20. Pre spection for required. to Building lonspector
21. Contractor's license information. (No., Name Style, Classification). . . . . . . . . . . . . Date)
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 authorizatiori . ........................................
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
I and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
.34.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. 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. 11 1
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 approved by 4#1 Date
Sets of plans on hold in File ca�inet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE
Department of Devel6ment Services
Building Division
Oroville: 7 County. Center Dr., Oroville CA 95965 Ph: 916-538-7541
Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751
OWNER -BUILDER VERMCATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your nam� 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 property improvement
0'r no)
2. IqEe,�Ive 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 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 following per -sons to provide the work indicated:
Name Address Phone Type of Work
Signed:
Property Owner
Social Security Number J
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California
Health and Safety Code.
Thi's verification must be completed and returned to our office before we are permitted to issue the
permit.
I
VNW,
7- 1!
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lomo -4' Sb
All
CAWTHR AJ :16 HAZC-L
Pr 6: t1i y- AVG. oeo.'
(REPAIPRO C,-nqs u 1%4
OFFICE COPY,.
Datew_md�
NI -t Bs
ELECTRIC
Meter- By Date
10
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS PERMIT No
7 County Center Drive - Oroville, California 95965 -* �8-7541
Telephone: 916/53
APPLICATION ANnPFRMIT
ASSESSOR PARCEL NUMBER
016-430-014 1
ZONING
AR
BUILDING PERMIT
OWNER Hazel Cawthra (Kibble), -
TELEPHONE
5 3=:��,
SQ.FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
110 Greenhank Ave, Oroville 95965
CONTRACTOR'S NAME
ITELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER JUNKNOW
UNKNOW
Total Valuation Is
LENDER'S MAILING ADDRESS —
Filing Fee $ 15.00
Permit Fee $
ARCHITECT OR ENGINEER
EII N 0.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $
1.2n Greenhonk Ayfa.. Oroville
PLUMBING PERMIT FilingFee 1 15.00
Each Trap 1 5.001
Solar or heat pump water heater 1 20.001
LOT NO.
SUBDIVISION i�AME
1 1
PARCEL MAP
Water piping 1 7.001
Each qas water heater or vent 7.001
USE OF STRUCTURE
SF FKI DuplexF� Mobilehome[] Other
SPECIFY
Gas piping system 1 - 5 outlets 1 5.001 5.00
Building sewer __7 15.00
Mobile Home S I G J W @ 15.00
TYPE OF WORK
NewEl AdditionD RemodelE] UtilitiesD Installation[:) Other[:]
Describe work: Repairing Gas line
I —
Permit Fee $20.00
Contractor
ELECTRICAL PERMIT FilingFeeF 15.00
Main service 600V OR LESS
200A OR LESS 18.501
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one): I
0 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and e ffect.
License No. Classification
R -k 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
0 1, as the owner, am exclusively contracting with licensed C0I1LI01,L_
ors. (Sec. 7044)
1-1 1 am exempt under Sec.—, Business and Professions Code
for this reason
Main service 200A TO 1 OOOA) 37.501
NEW CONST DWELLING OCCUP.5d) 3.54 sq.ft.1
OR ADDNS. ACC.BLDGS.
NEW CONSTFL MULTI -OUT LET
NON.RESID. BRANCH CIRCUITS) @ 5.00
PO ER APPARATUS 1%)
SINWGLE OUTLET CIR .
20 @ 791
Ex. OCCLIP(OUT LETS, OR FIXTURES F AL� C& 46
Ex. Occup. FIXED APPLNS. OR
OUTLETS- I _RESID.) EA.) 3.00
Temporary service 15.00
____F_
Mobile Home Facilities 15.00
Misc. Wiring -15.001
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
F-] The permit is for $100.00 (valuation) or less.
F� I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become su.)
to the W. C. provisions of the Labor Code, you must forthwith comply with su'c'h'
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Fi I ing Fee 1 15.00
Heating
Cooling
Hood 6.50
Permit Fee $
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County 01
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 I n any way accrue
against said County in consequence of the granting of this permit.
X Al Date
Signature of Applicant - Owner El ContractorEl Agent n
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
I
Energy Inspection Fee $
occ
CO ST TYPE
TOTAL FEE $ 20.00
_TAZ
I D FEES I
IMP
I FLOOD
I CDF=
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or,,resolutions to do
work indicated abo fd` h' " ."
, r, w ich fees'have been paid.
blRECTORJOF PUBLIib WIDERKS
By D . I e
PERMIT'EXPIRES Date
Receipt No. 1296W
WHITE-O.P.W., YELLOW-ASSfSSOR. PINK -INSPECTOR. GOLDENROD-APPL I CANT
COUNTY OF BUTTE DEPARTMENT OF PUBLIC W PERMIT NO.
7 County Center Drive - Orovlllle, California 95965 - Telephone: 91 /538-7541
APPLICATION AND PERMIT r
ASSESSOR PARCEL NUMBER
036-430-014
ZONING
AR
BUILDING PERMIT
OWNER
Hazel Cawthra (Kibble)
TELEPHONE
533-4564
SO. FT. OCC. BUILDING VALUAT19 I
OWNER'S MAIL-ING ADDRESS
110 Grppnbank Ave, Oroville 95965
CONTRACTOR'S NAME
lTnk-nc)wn
TELEPq—ONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total valuation Is
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
Permit fee
$
120 Creembank Aire 0—mi 11 e
PLUMBING PERMIT
FilingFee 1 15.00
Each Trap
1 5.001
,
Solar or heat pump water heater
1 20.001
LOT NO.
I
SUBDIVISION NAME
MAP
Water piping
1 7.001
Each qas water heater or vent
1 7.001
—
USE OF STRUCTURE
SFE DuplexF-1 Mobilehorreo Other
SPECIFY
Gas piping system 1 - 5 outlets
11 5.001 5.00
Building sewer
15.00
Mobile Home S I G
@ 15.00
TYPE OF WORK
NewF� AdditionEl Rerrodel[] UtilitiesEJ InstaliationE) Othero
Describe work: Repairing Gas line
Permit Fee
$20.00
Contractor
ELECTRICAL PERMIT
FilingFee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
I am exempt under Sec._, Business and Professions Code
for this reason
Main service 200A TO 1 OOOA)
37.50
NEW CONST DWELLING OCCUP.ad
OR ADCINS. ACC.BLOGS.
3.64 sq.ft.
NEW CONSTR- MULTI -OUTLET
ESID,
NON -R BRANCH CIRCUITS)
@ 5.00
( POWER APPARATUS.&)
SINGLE OUTLET CIR
Ex. Occup(OUTLETS OR FIXTURES
F 20 @ 75o
AL. @) 4F;
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESIO.) EA.)
3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
-15.001
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
F] The permit is for $100.00 (valuation) or less.
E] I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Fi i rig Fee 15.00
Heating
Cooling
Hood
6.50
Venti lation
Permit Fee
Contractor
—
I certify that I have read' this appli"cation and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County Ot
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 Date /D — -29—g-9—
Signature oJA`p`p1icant Ownerw Contractor El AgentEl
An OSHA permit is required for exc , ovations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
Energy Inspection Fee $
occ
CONST TYPE
i
TOTAL FEE $20.00
IHAZIDFEESI
IMP
I FLOOD
ICOF
I A—RCEU
I PD
I HD
I
This permit is hereby issued under the
sions of the Mitte County Code Jano
work in a b 0 f r �hich f e
f
IREJ8FF L
L /�
By 59
PERMrr EXPIRES Date
applicable provi-
esolutionstodo
ave been paid.
i
RKS
Receipt No, 129616
WHITE-D.P.W.. YELLOW -ASSESSOR. PiNK-INSPECTOR. GOLDENROD-APPL I CANT
COUNTY OF BbTTE Department.of Public.'Works
7 County Center Drive, Oroville, CA 95965 Phone: 9.16-.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*personally 'Plan to provide the major labor and materials for construction,of
the proposed property improvement (yes or no) UXA:::�'
2. 1 av'have'nod UZIAL signed an application for a building -permit
f4!!!�e' propos.ed worka
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 T have hired the follo0ing person'
to coordinate, supervise, and provide the major work:
-..Name.
Address. City
Phone Contractors License No. -
5. 1 will provide some of the work but I have contracted (hired) the following
.persons to provide the work indicated:
Name Address Phone Type of Work
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.
'COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
OWNER /1 o 1 12- 0 C r e- e -p% 60-1A 4,1c- PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
plea e contact this office immediately.
Z J—
NrU=51
doxy -W ".04ma
Date V1121941 Inspector
REV 10/92
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747- Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
(kibLie-) /,Tdfz—P 3 6 - 51,30 -
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
P.—jt�4-'s jr( 4e-)Qc�rlk"
'?2— 392—P
Q
Date Inspector
REV 1 W12
COUNTY OF BU -E
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt Road,, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
cln�- t4j-T 0-0"7.
OWNER PERMT NO.
A routine inspection indicates that the following violations of Butte County Ordinances eiffstat
the above address and should be corrected. Please notify this office when caFrectian at work
is completed. If you have any questions pertaining to this matter, or need additional exptanafion6
please contact thi office immediately.
'Pfz* VT
�JA—T
Date / 6/ 001�' inspector
REV 11/91
77,t- 'W'
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, Cali ornia 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT I
ASSESSOR PARCEL NUMBER
I Z?NING
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER's MAILING ADDRESS
CONTRACTOR'S NAME
ITELEPHONE
CONTRAC_T�R'S MAILING ADDRESS
CONSTRUCTION LENDER _'____JUNKNOWN
Fireplace
Total Valuation $
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER's MAILING ADDRESS
Permit fee
$
BUILDING ADD I RESS
PLUMBING PERMIT
FilingFee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.
Su BDIVISION NAME
L MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF [_1 DuplexR Mobilehomef-I Other SPECIFY
Building sewer
Lawn sprinkler system
2.00
_71
TYPE OF WORK
NewF] AdditionE:1 Remodel El uti iities 0 InstallationF_ Other F]
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 3.00
Main service 6001 OR L.ESS
100 AMP OR LESS
5.00
Main service EA. ADD -L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&)
ACIRNS- ACC.BLDGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and e ffect.
License No. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
F� I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
F] I am exempt under Sec.—, Business and Professions Code
for this reason
_2R.
NEW.CONSTR MULT.--.T LET
NON RESID. BRANC H _CIRCIJITS) 2.50 ea I
NEW CONSTR. POWER APPARATUS &
NON-RESID. SINGLE OUTLET CIR .
25,t
Ex. OCCUP( OUTLETS OR FIXTURES PBOA L @ I CC
OCCUP.(FIXED APPLNS OR
Ex. OUTLETS (RESI'D.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee
$
Contractor
MECHANICAL PERMIT
FilingFee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
I—] The permit is for $100.00 (valuation) or less.
F-] I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
Heating
Cooling
Hood
2.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 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 Date
Signature of Applicant — OwnerEJ ControctorEl Agent F—I
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE
$
occUP. GROUP
I TYPE OF CONST.
F
PARCEL
PD
HD
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPL I CANT
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 534-4.541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE -
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspecto Date—
_,7
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORK' PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-454/1
APPLICATION AND PERMIT 111� A
ASSggoR P -L q -R
_7
'0,
F F
-SMILDING PERMIIII�
i
0 C__ CAW 7W P_ A
�111 PM
W
SQ. FT. OCC. BUILDING VALUATION
OW71q,R-S MAILING ADDRESS
70 6 14VA-11, AVE. � 04111U,4 m,
Ce�r&TOR'S NAME
_ITELEPHONE
CpTeCTOY ADDRESS
�AILING &f�
I X 7-7 1 0 A9 1//
CONSTRUCTION LENDER I
"-S, 411�
UNKNOWN
1
Fireplace
Total Valuation $
—
LENDER'S MAILING ADUFAL—.Sv
Permit Fee
$
ARCHITECT OR ENGINEER
aad:��_
ENSE NO.
Plan Checking Fee
$
Penalty
$
— —
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
131�1_20 A?
PLUMBiNG PERMIT
FilingFee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.
UBDIVISION NAME
is
ARCEL MAP
1P
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
S F R?"�D`u p I e xF� MobilehomeF-1 Other
SPECIFY
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
NewF� Add i t i on [:] Remode I [:J Utilitie [:1 Ins.talliationC Other k;_
Describe work:
Permit Fee
$
--contractor
ELECTRICAL PERMIT
FilingFee /0.00
main service 600V OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD -L 100 AMP
2.50
NEW CONST. ( DWELLING OCC up -81)
OR ADDNS. ACC.BLDGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Busines S
and Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NEW CONSTR. ( MULTI -OUTLET
NON.RESID, BRANCH CIRCUITS) 12.50 ea,
NEW. CON,STR. (POWER APPARATUS &)
NON -RES D. SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 50 @ 25C
FIXED APPLINIS OR __.BAL@10t
Ex. Occup. (OUT LETS -(RE-SI*D.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring
Permit Fee $
Contractor
MECHANICAL PERMIT
Fi I ing Fee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
[–] The permit is for $100.00 (valuation) or less.
F-1 I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
Heating
Cooling
Hood
2.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said Courity in con quence of the t t is perml
, , f )�ng o h
X Date /Fo —
Signature . f Applic�Vt Owner LJ Contractor LJ AgentH /
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
Land Development Fee $
TOTAL PERMIT FEE $ roo
OCCUP. GROUP
I TYPE OF CONST.
PA.Crl
PC
D I
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECT F PUBLIC
PERSKT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
ate 1/_1 Z__
I Z_
Receipt NO. $N�2z 2
WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPL I CANT
db
UNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 County Center Drive — 0 roville, Galifornia 95965 — Telephone: 5 / 3'4 -4 5 4 1
PERMIT APPQ!�A, T40N DATA SHEET
Permit No.
0 W N E R A.P. No.
Proposed Building Use
Permit fee based upon: Complete Contract Price 4 --"DPW Valuation
�1 QhE r xplain)
Building Inspector _ff&V Date . //ZZOZ
At time of permit ap-pli6ati—on, I was advised the following data must be submitted Oriorito permit processing and/or
issuance: D�TE RECEIVED APPROVED
1. All items have been submitted ...................................................................
2. Plot plans in duplicate/triplicate ................................................................
3. Complete plans in duplicate/triplicate ...................................................
4. Complete engineered plans and calcs . ....................................................
5. Plans with Energy Design'Compliance Statement . ...........................
.6. State Energy Forms No. ....................
7. Statement of Intent for Non -Heated & AC Buildings . ..................
8. Fees of $
9. Letter of signature authorization .............................................................
—10. Sanitation approval from Health Dept....
11. Planning approval for, .............
7
12. C rt ; e orkmen's -Compensation Insurance ........................
Wt.of V"
0,
si g__Icee(-n e-1
nt�a. Gon-tnaert or- s nformation (no., name style,
classif ication) .................. ............
14. Improvements may be required. Contact Land
Development Section of Dept. Public Works (see
address below) ........ . ............. f
.......... ........... * ..........
Pre-insiYec. request to
5. Pre -inspection f'oA_iW ... required. bldg. inspector— (date�
16. Other
When you issue the ermit, proces - follows: —Mai I to owner —Mail to contractor.
LI -11 Telephone 3 sas ancChoid for pickup at 1 -f -W —office. —Deliver w/inspection.
Other
cant
Appli* &/,Mate
Copy of plans sent —Health Dep�., Fire Dept., —Other Date—
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time of application, circle item.)
1 . Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Tele'phone
Mail
Other
By Date
Plans checked by Date
Plans approved by Date
Copy/DPW
COUNTY OF BUTTE Department of Public Works
7 County Center Drive, Oroville, CA. 95965. Phone: 916-534-4541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your nameand bearing
your signature.
Please complete and return this information in the envelope provided at your
.earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing permit. No building permit'will be issued until this verification is received.
1. 1 personally plan to provide the major labor and materials for construction
of the proposed property improvement (yes or no)
2. �e_(_h�a;3 signed an applica.tion for a building.
0SM-ft, ��e pro_pos�ed w rk.
3. 1 have contracted with the following person (firm) to provide the proposed
construc ion:
Name
Address 7 City
Phone Contractors Licens6�No. J A 474�7 a
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 License No.
5. 1 will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed:
Property- Owner
Social Security numbei/'
Date /17
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
permitted to issue the permit.
Complainant:
Address:
Phone Number.
other Comments:
Building Inspector must draw a plot plan wfth all buildings and violations:
Additional comments from Building lhspector.
OVER
BUTTE COUNTY DEVELOPMENT SERVICES
Complainant:
,�
Address:
S-0
Phone Number:
Other Comments:
Inspector must draw a plot plan with all building locations:
Additional comments fi7om' I�spector:
or
*
rle ��
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form Per Building)
School District
A.P. Number
Property Owner
Property Location/Address
Subdivison
Residential Development
Commercial/Industrial
Jurisdiction = city
Building Department No.
= County
Lot No.
Sq. Footage
No. of Living MHI Addition (Group R)
Units
= Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Building Department Representative Date
(Floor Plans reviewed by School District Personnel)
District Identification No. .
School District certifies that
(Street Address)
(City)
has complied with the requirements of Resolution No.
representing square feet.
School District Representative
Paid by Check Number
Bank Number
Paid by Cash
(State)
Remarks:
r
(Applicant)
(Phone Number)
(Zip Code)
by payment of $
Date
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to
additional school fees to fulIV mitigate its imoact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.wki (4/92)