HomeMy WebLinkAbout079-120-005HAROLD FARELICK
220 Fairhill Dr , Oroville
Contr: Waibel AC
Permit #k5293-76E,M(inst. .heat
pump & 200 amp elec. ser)_S_P
5 93-2525 B,M
-FROELICH, ARDIS •�r
220 FAIRHILL DR', OROVILLE y�"I
CONTR: ARTIC AIRE
GAS LINE & ,HVAC/SF �� .
bo
RYAN, MICHELLE& JOHN 05-2381
220 FAIRHILL DR., OROVILLE
Cont: GREENE ROOFING
ADD-ROOM/BATHRM
R-29.06
'vZ ) L�u '
KLEIN, JERI 4147B
4.Vent-3345P 3319P �'
4134E �;
��S �
W7!�j/y-v. AP'`
Lot 56. - 220 Fairhill br. ,. Copley Acres,Oro
CONTR: Harmony Builders, P.O.•Box 578 -Oro
( new s ingle-family_. re s ..) ., -
t
DUNCAN, Woodrow H. 3145E
Lot 56,. F&drhi11.Dt.,Copley .Acr`.e"s,Oroville
CONTR: New Trend Corp., 2605 Foothill Blvd.-
(nengle family) '
Or villa
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NOTES RESIDENTIAL
F
PERMIT NO'. �� ✓ ��� �—�
jJ37 DS Q�h s�L�! pd "'o ",a," d-�t,SS 036-610-005.,.,, OS -2381
RYAN, IVMICHELLE & JOHN
220FAIRHILLDR.,`OROVILLE
Cont: RICK STOKES
ADD-ROOMBATHRM
1�
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
fUSE PERMIT CONDITIONS
1 '1 SUB -STANDARD HOUSING LETTER
Iz
JOB FINALED (Date)
Signature !!J®y"'A %7
I= OK
r = Not OK AppGa
= Not tde
= Mt Ready
RESIDENTIAL
date
UND LOOR (Plans) OK except #'s
-Setbacks-Easements-Flood-Slope
. tg., Main; Sols-Elec. Gmd. // Ftg. Depth
3. Ftg., Garage; Sols-Steel-Elec`Gmd.-/ i Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ r Ftg. Depth
S. Stemwalls, Main; Steel-Blockouts-Wrapped
Stemwalls Garage; Steel-Blockouts-Wrapped
old Downs and Special Anchors
Slab, Steel -Wrapped
8.Pi uepface Ftg.-Steel
10-13-05-
.W.V.; Fall -Fitting -Test -2 Way C/O -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
(Single & Duplex)
Date Card B-1 Date Card B-1
Date Card B-1 . Date Card B-1
Date PLUMBING (Permit) OK except #'s
17, Vter Htr.; Vent -Access -Combustion Air Baffle
V06r Pipe: Test & Anchor -Nail Protection
V.; Test Fittings & Anchor -Nail Protection
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 t/ 'p . Card B-1 Date Card B-1
Date.Card B-1. Date Card B-1
Date ELEC�PlICAL (Permit) OK except #'s
X. Fusture & Transformer Clearance -Ins. Protection
Receptacles S
3oxes & No. of
27. Romex Installed Close to Edge of Studs & C.J.
28 quip. Ground made up w/Meth Fasteners -Bond Gas & Water
pliance Circuits in Kitchen & Conductor Size GFI
-7T-30Med Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral 0 Yes O No
"3�S r ice -Riser Conductors & Ground Main Disconnect
3 ui . Clearances Panels -Motors -Meth. Equip.
Clothes.Closet Light -Shower Light -Spa Light
jV Smoke Detector
Date 111%,A Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ME ANICAL (Permit) OK except #'s
K. C. Ducts Insulation & Support
Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Furnace -Vent Access -Comb. Ait-Retum Air Vent 115 Outlet
40. Attic Access & latform if Furnace in Attic
Date j Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRA NG (Permit) OK except Vs
s Proper Materials & Anchors
Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. aring Walls over Girders $Floor Nailing
44' Draft Stop in Walls (rat proof)
45.,,P6 Stops, Furred Ceilings -Stairs -Chasers -Tubs
Headers & Beams -Size & Bearing
Date FRAMING (Continued)
ers-PostCaps-Anchors-Connectors
. Cling. Joist-Rftr. Ties-Purfin-Roll Brac: Truss-Shting.-Rtng.
vep ace Ties or Type A Flue-F'treplace Throat Clearance
""30 tic Access; Size & Romex Protection -Draft Stop -Ins. 60;-s
-
,54"- Bdmti Windows or Exiting Doors -Sill Ht & Dimensions
c-6:j5rage Fire Protection Framing -.RC Channel
roperty Line Firewall & Openings
Ext Doors -One T -Check Garage 3rd Story, 2 Exits
':airs; Width -Headroom -Rise -Run -Landing -Fire Protection
Sd_Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
53r. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
5,9'.' GI 'ng Area -Glass Protection -Skylights -Plastic
�ar Walls; Nal'utg-Bolts
Brace In 'or/Exwe rbr Wall Panels
62. Insulatio -Walls-Ceflings 7y4,yj
63. lnfiltration-Walls±Lhclo m r
Date 3 e/ d rd B-1 Date . Card B-1
Date Card -1 : Date Card B-1
Date Fl la K except Vs
teps-Door & Sidelight.Protection-Landings
Smoke Detector A, Ifoo't-
;:umace Vents -clearance Comb, Air -Connector -
In Garage; Above Floor -Ducts -Meth. Protection
J?YBecjroom Exiting
fi&."G.FI. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails y;
71: Fireplace or Stove. Clearance -Hearth t
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 -Meeh. Protection
jfl/P(b.; Elec. & Mech. Equip: Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 13 Yes
83. Following InslldJDrive 0 Yes O No/Walks 0 Yes O Wa Planlers O Yes O No r
84. Stucco Brown -Finish
85. 9,C. Unit Disconnect, Electrical -Plumbing
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. tOerior Elec. Trim, G.F.I. Receptacle -Underground
Yprt6lation Throughout House
Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
5ergy Compliance Certificate -Other Certificates
25/ Address Posted
96. Fire Sprinkler
Date --7-U Card B 1 (, Date Card B-1
Dat 1 ard B-1 (,,, 1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
J=OK
p = Not OK
. cable
= Not ReNot ady 99110BII LE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Easements
2. Soils; Specidl MH Support Sketch
3. Sewer, Location-Test-Fall-C/O-Concrete
4. Water, Location-Test-Easement Needed (Sketch)
5. Electricity; Location-Clearances-Gmd-/ /Amp-Concrete
6. Gas; Location-Test-Wrap;-/ P L'ft.
/ P Nat or/ /" L'ftJ P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Easements
2. Footings; Size-Spacing-Marriage Line
3. Gas; MH Test-Demand-Valve-Connector
4. Electricity; MH Test-Crossovers-Breakers-CAearances
5. Drain; MH Test-Fall-Flex Connector
6. Water, MH Test-Regulator-Connectot
7. Water and Sewer Connected-C/O to Grade-HD Approval
S. Gas and Electricity Tagged
9. Tie Downs-Type-Installation Cert
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
Date Cana B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PERMANENT END SYSTEM (ONLY)
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Biockirig .
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 Cann B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
S. Alum. Awn.; Columns-Connections-Splice-Deca6Enctosures
6. Carports- Windows -Doors -
7. Electric
8. Frng.; Sills-AnchorsStuds-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext; Steps -Doors -Landings
12. Braced Wall Panels
Date Card B-1 Date Card B-1
Date . Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure StabTity
3. Pool Structure; Steei-Connections-Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting. Distance-GFI
5. Elec.; Pod Lighting; l5 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elea; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elea; 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
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive * Oroville, CA - (530) 538-7541
CORRECTION NOTICE, -,,,-
y!57,_ -Z S T N
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 call for re -inspection when correction of
Work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
Date
Inspector k7
'REV 4/05 Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
insulation Certificate
BUILDING OWNER: Dr l s
BUILDING LOCATION:
Description of Installation
ROOF
Material
Thickness (inches)
�1 BUILDING PERMIT #:
Brand Name
Thermal Resistance (R -Value)
CEILING Brand Name
Ban or Blanket Type Thermal Resistance (R -Value) 3
Thickness ('inches) Brand Name
Loose Fill Type lb Minimum thickness inches
Contractor's minimum installed weight/ft
Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value)
EXTERIOR -WA
Thickn&ss Cinches)
RAISED FLOOR
Material
Thickness (Cutches)
SLAB FLOOR
Material
Thickness (inches)
Width (inches) _
FOUNDATION WALL
Brand Name _ -
Thermal Resistance (R -Value)
Brand Name
'IhermalResistance (R -Value)
Brand Name
Thermal Resistance (R -Value)
Brand Name
Material :T;�-zermalResistance (R -Value)
Thickness (inches)
Declaration
I hereby certify that the above insulation was r newd in �re bdential builduilding at ings contained in Titl conformance above location in 4 ofthwith
the current Building Energy Efficiency Stand
ards California Administrative Code.
G ntrar wilder)
C:Z�ignature and Ti
Sub -contactor (Insulation Installer)
Signanue and Title
TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION
WTTTIN THE BUILDING.
L'c a Numb r
Date
License Number
Date
THIS CERTIFICATE MUST^BBT PROVIDED T
.e
BUTTE COUNTY PERMIT NO.
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT BP052381
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
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: 09/29/2005 APN: 036-610-005-000
the Business and Professions Code, and my license is in full force and
effect.
Site Address: 220 FAIRHILL DR ORO
License Class : License Number:
Map Index:
Dale: Contractor:
Description: ADDITION TO SF' (480)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' Slate License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: RYAN JOHN & MICHELLE
permit to construct, alter, improve, demolish,.or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
220 FAIRHILL DR
signed statement that he or she is licensed pursuant to the provisions of
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95966-9504
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
ZI, 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: RYAN JOHN & MICHELLE
Code: The Contractors' State License Law does not apply to an
220 FAIRHILL DR
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
OROVILLE, CA
provided that such improvements are not intended or offered for
95966-9504
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will. have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
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.).
Cl I E t under Art�eeand Professi ns Code
�ODateO
License #:
WORKERS' COMPENSATION DECLARATION—/
I hereby affirm under penalty of perjury one of the following declarations:
❑. 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
Architect:
is issued.
Engineer:
❑ 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: 480 S.F.
Policy a:
Valuation: $31,200.00
Census Code:
I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
— 0
Date
Applicant: lt_AG
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.
_ _
7 72-_ _ ts�3-� . q�
CONSTRUCTION LENDING AGENCY
This permit is h reby issued and he appllcable provisions of the Butte County Code and/or
1 hereby affirm that there is a construction lending agency for the
of the work for which this permit is issued (Sec 3097 Civ.)
Res lulions t o work in icat a ove for which fees have been paid.
d
performance
By' Date:
Name:
PERMIT EXPIRES ON: 6Z
!
Address:
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Not in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter t substance of any official form or document o County. I hereby
authorize represen(ttattiiiv/els of/Butte County to enter a n the above mentioned property for in ection purposes.
Print Name: l (l.N 1L t L✓
��/ —act
Date:
Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP052381
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: 09/29/2005 APN: 036-610-005-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Site Address • 220 FAIRHILL DR ORO
Map Index:
Date: Contractor:
Description: ADDITION TO SF (480)
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: RYAN JOHN & MICHELLE
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
220 FAIRHILL DR
signed statement that he or she is licensed pursuant to the provisions of
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95966-9504
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
licant to a civil penalty of not more than five hundred dollars ($500).):
Z
I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: RYAN JOHN & MICHELLE
Code: The Contractors' State License Law does not apply to an
220 FAIRHILL DR
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
OROVILLE, CA
provided that such improvements are not intended or offered for
95966-9504
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will. have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
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.).
❑ 1 Exem t under Article 3 f the Business and Prole si ns Code
Dater
License #:
WORKERS' COMPENSATION DECLARATION---'
I hereby affirm under penalty of perjury one of the following declarations:
❑. 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
Architect:
is issued.
Engineer:
❑ 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:
rotal Square Ft: 480 S.F.
Policy#:
Valuation: $31,200.00
Census Code:
I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date.
Applicant G
WARNING: Failure to 'secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
Ree # /M q Y&/1
' ��� �ll
compensation, damages as provided for in Section 3706 of the Labor
I
code, interest, and attorney's fees.
_
y,3 M4;; • q�
CONSTRUCTION LENDING AGENCY
This permit is h reby issued and he applicable 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.)
Res tutions t o work in scat a ove for which fees have been paid.
d
4
performance
BY� Date:
Name:
PERMIT EXPIRES ON: �' �/�
Address:
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that 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 t e4ubstance of any official form or document o� County. I hereby
authorize representatives of Butte to enter n the above mentioned property for in ection purpos s.
�County
///
ICN Si
Print Name: r t IZ `' L tare
Date:
�wner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER INFORMATION
Last Name
F t tn� I�
Addr
K,2
City C l /
Stat
Z�lJ7 (Lc0
Phon 2g q
Fax
E-mail al Y - C -n DSI C&-)ro s�f - r?
� v
APPLICANT INFORMATION
CONTRACTOR
Name ' C
Address
City b., u i l I
l
City
1
l
State
State
Zip
Phone
Fax
Fax
E-mail
State License Number
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
Address l r
Address
City b., u i l I
l
City
Zip/, J� �/
�/
�l CO
State
Zip
Phone
Ci me s4
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name nM a
e- / e- n
Address l r
r �
l
City b., u i l I
l
Slate,�]_
/�
Zip/, J� �/
�/
�l CO
Phone p - �t� l
Fax
E-mailrutin
Ci me s4
APPLICANT SIGNATURE
Pt 4z�_�6
For office use only:
Zoning
Property Addfess
K l( I
I Flood Zone
X I
SRA
Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
]
PERMIT
NO.
BPO.523$
BIN #
�=3
PROJECT LOCATION
A ID
Property Addfess
K l( I
,rr 11
Vll��
Cros et
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 PW rk:
rn DV-)
Sq FT- Livi g Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
Page 1 of 2
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: u:7.
Receipt #:1� 35 �Q2
entc�
Date.q -6 - (SCJ
Amount:,, � W P4 Bldg
2_0 i • 9 S SRA
SMIP
Other
511 C
J - 92- Total
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
O 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
O 10. Letter of intent for non-residential buildings.
O 11. Building Permit Application Without Required Clearances Form
❑ 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.)
❑ 1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2.
Impact Fees.
O 3.
California Department of Forestry plan approval (if required).
❑ 4.
NPDES Form. .
❑ 5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6.
Contractor's license information. (Number, Name Style, Classification).
❑ 7.
Worker's Compensation Carrier and Policy Number.
❑ 8.
Owner -Builder Verification (if required).
❑ 9.
Letter of Signature authorization (if required).
❑ 10.
Recorded copy of Agricultural Acknowledgment Statement.
O 11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑ 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
KAFORMSOUILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
00523%
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION'
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: -1 ASSESSOR PARCEL NUMBER o36 - (6.10- cbs
Proposed Building Use: AAA S Permit Technician: 6 • Date: 71-w- 05
Rep required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
`QY XN 1. Site plans,1 3 or 4 sets, signed by the preparer of the plans.
TN 2. Complete plans, 33 r 4 sets, signed by the preparer of the plans.
❑^/ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
Q/XN 4. Engineered truss details and layouts in duplicate. No faxesl
❑ 5. Letter from Engineer or Architect for truss design review.
1/-afJ6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 9. 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.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
❑ 11. Letter of intent fog non-residential buildings=
❑/ 12. Hazardous Material Form
`�' Zvj 13. Acknowledgement of building permit application without required clearances.
❑ 14. Other
Rema nIng items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
Sahitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable
❑ 16. Fire Sprinklers............................................................................................
❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 18. Soils Report and/or Engineered Foundation required ........:..................................
0 / 19. Erosion Control Plan Required.......................................................................
Fees as shown on the attached Schedule of Fees Due Sheet........'.*.'.*.*.'.*.'.*.'.'.*.'.*.'.'.'.'.*.'.'."
heet .............................. GS
❑ .. 1. City of Chico Plumbing permit........................................................................
❑ 22. Site plan and business license approval from the City, of Biggs ..............................
23. California Department of Forestry plan approval id. Sent by: K47 . ....... .
® Planning approval for (A) Use: �-(B)Parking: (C) Parcel Check: ..........
..
_❑ // 25. Contact Land Development about _ Improvements, _ Drainage .......................
.
"aw 26. NPDES Form.....................................................................:.......................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Contractor's license information. (Number, Name Style, Classification) ...................
❑ 29. Worker's Compensation Carrier and Policy Number ..........................................
30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
❑ 31. Letter of Signature authorization....................................................................
❑ 32. Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 33. Existing violations and/or expired permits.........................................................
❑ 34. Deed Restriction..........................................................::..............................
❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO .........................
❑ 36. Other:
❑ 37. Other:
When issued �Telephone t53o) rJ 3 D - 9 0 1 5 pw1'tPY` and hold for pickup.
I have -been informed of the above items and requirements for obtaining a building permit.
/�, r
Applic n : G Date: C.1/ _ 6
1. Index permit application for the o e'tems num re : t i _ >J �. )t P, Can Check Letter
2. Additional items require f:6A
Contractor, designercaner of thea ove data by ❑phone, ail, ❑counter, by _ ate: 7
Contractor, designer,"owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner, was advised of the abo eataxy ❑phone, ❑mail, ❑counted by Date:
Plans reviewed by: j o Date: a Plans approved by: -, a jo . Date: to
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: Date:
Yellow: Building Division
E.H. USE ONLY
'Plot Plan Attached
Flow Plan Attached
t' Sent to G.D. /
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
-&( f,A*1 & le4A
Owner Location AP#
Plan Approved for: Sewage Dispos Water Sr ply; Publi Private Well
Clearance for dwelling. Other
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist Date
8/96
COUNTY OF BUTTE (�5sl
DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140
SCHEDULE OF RECEIPT OF FEES
Website: www.buttecounty.net/dds
OWNERV Q�
PROPROSED BUILDING USE Add J-0 t,��P
Id 1. BUILDING PERMIT FEES C e
-- Balance Due ..................... $ ,) • -l'
--- FEMA Flood elevation review ... $
--- Additional plan checking Fee.... $
A.P.# O__JCp—CQIO- 0
DATE (?—00-c6
RECEIPT k DATE REC.
2. SCHOOL DISTRICT FEES QY_QVt I Ie [7I t Mf-n+(ary �q (�ob`'t''� ��/6'-t�gkctlO
(paid at School District Office) (form available after Plan Check) K(�.
3. SHERIFF FEES (paid at Building Division)
Commercial (sq. ftg.)..... X $0.03 = $
Sq.Ftg.
4. RECREATION DISTRICT FEES �Q�l�r C1�2g165
(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
95Q NORTH
SRA FIRE INSPECTION AND PLAN CHECK FEE
$204.98 (paid at Building Division)
7. WATER TENDER FEES BATTALION #
$200.00 (paid at Building Division).
J;e& SMIP ?® 19-
9.
?
9. DRAINAGE FEE
10. OTHER
11. OTHER
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed during the plan checking process.
AP T DATE VCQ w
Pursuant to Government Code Section 66020, you are hereby notified at 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. The requirements for a
protest are specified in Government Code Section 66020(a).
Original -Building Division Yellow -Applicant Pink -Owner (rev. 7/05)
... .fifly
,/c -.i
;.�;,
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.
L I personally plan to provide the major labor and material for construction of this proposed
property improvement: *YES CA NO [ ].
2. I HAVE [� ] HAVE NOT [ ] signed an application for a building permit for the proposed
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME: _
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME: _
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTY OW� •
DATE:
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.
Butte County Department of Development Services
ADMINISTRATIO14 t BUILDING ` GIS `PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile
�" +'• R<�6�� .'}%w rC 4 .5.�..0 s���"�'-Y,i^ cc'-�i_�,iti.�-'`1.:�_: •..iL:'i:'a`�.'•
111 il
Dear Property Owner.
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their own
work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of Califomia and to have a business license
from the city or county. They are also required by law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government as an employer and you are subject
to several obligations including state and federal income tax withholding, federal social security taxes, workers'
compensation insurance, disability insurance costs, and unemployment compensation. contributions.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, Califomia 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
i%v�
Mic el C. V ieir+ C.B.O.
MaTlager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
-- Works
Y3{= Department of P�btic
.0 o u n t y Ll
1� ';'_ ✓ �� 2 LAND DEVELOPMENT DIVISION
0 J. Michael Crump, Director
.4 Storm Water Management Program
0 7 County Center Drive
�y / Oroville, CA 95965
a �15 (530) 538-7266
�'-CtC WOF (FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase 44
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (sWPPP) Acknowledgement(LESS THA11! I ACRE
Project Description:
Project Location andlor Parcel Number:
Cho m �-% d ✓'
Flo
By signing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that L therefore, do not need to apply for a Construction Storm Water Permit
fron the State of California Regional Water Quality Control Board. Phased projects that contain
multiple site build -outs of less than one acre but when combined with subsequent phases total more
than one acre of disturbed soil.will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board
I am aware that submitting false andlor inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project.
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Signed:
Title: n "�
Date:
Butte County Department o.f-Developine12tSe,
vzces
°
7 County Center Drive
Oroville, CA 95965 o
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES
I request and authorize the Building Division to process this building pennit application through the plans
examination process WITHOUT first obtaining all necessary, related permits and clearances from other
regulatory entities, including but not limited to, Planning, Environmental Health, Land Development,
County Fire, and Agriculture.
I hereby acknowledge:
• I need to submit applications for septic and/or well to Butte County Environmental Health
immediately.
0 I wit required to bring the approved Environmental Health site plan and approved sanitation
clearance to the Building Division as soon as clearance is obtained-
® I am responsible for notifying Development Services, in writing, to stop processing of the
application and to arrange for disposition of plans.
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 permit or recluire
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 permits/clearances include, but are not limited to, verification the parcel was
legally created, adherence to. all mitigations 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: 0 � I C El i
cL.n APN: D La I D 0 � -
I-ejQ
Building site address: I kc ( I Permit No.: d 5 iq'8 I
I have read, understood and accept the terms and conditions as expressed herein as indicated by my
submission of the above -referenced building peimit application and my signature below:
l 1(,N A I I I K h'. t) r A r r l,ll.tlly l
DATE
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM TRA Oq J—Cod
(One form 1per.Buildlng)
School DistrictOrovi Building Department No. 0 ro
N
A.P. Number _D&N-410 805 Jurisdiction: City County
Property Owner Qvin 4:
OrProperty Location/Address 20 501P611 Dov lit. OAp.
Subdivision s Lot No.
................ ...... ............. ......
Residential Development 0:Sq. Footage
0
No of Living Mobile Home Addition/ *Supplemental to (Group. R)
Units Installation Conversion Permit#
.(No foundation inspection)
.....................................................................................
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility docurr'kent),
Commercial ' /.Industrial 0 Sq. Footage
New Addition (including Exterior
Roofed Areas)
Building Department Representative Date
A"
`:'iDistrict Identification: No.- - - �:s
Z�
School District certifies ID at q 8`_ V1
tt (Applicant)
of C1�1 V -
(Street Address)
(Phone Number)
Oro
(City) (State) (Zip Code)
has complied with the requirements of Resolution No. by payment of $
representing 4 AL0 -square feet. 1�13 2926 $
ULL MITIGATION $
School District Reprepktative Date
Check # Col Remarks:
Paid by Che 03" (40 l 0 CD 0 S
�
Nodco: . You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with
Government Code Section 66020(a), within 90 days from the date fen are paid. Failure to submit a timely written protest will prohibit
you from challenging the Imposition of the fees In any court action.
if, subsequent to the School District Representative signing this Butte County. Schools Impact Fee Certification Farm, 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 fan to fully midgate Its Impact on the school distrIcra'schools.
White (school district), Yellow (building department), Pink (applicant). feeform.xis (310SXIMm
BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM
,KFEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD)
❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD)
❑ PARADISE RECREATION AND PARK DISTRICT (PRPD)
0 DURHAM[ RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Number (s)(�'_ - jJ ) Building Permit Number
Property Owner (s)
Project Location /Address
Subdivision Name
H
Assessable Sq. Ftge
Type of Residential Development (check one)
New Development Single Family -Detached Single Family -Attached
Alte'ration/Addition(s) Non -Residential to Residential Multi -Family Dwelling
Mobile home Mobile home replacement verified by Assessor Department
Demo Permit (date issued ) verified by Building Department
Comments:
Rn;1A;9T)v %rtmPnt RPnrP a tntive Date ..
❑ FRRPD ❑ CARD ❑ PRP 0 DRPD certifies that:
1'///M, aalc_ a -r) Q� oc�)
Applicant �� one Number <,
(� dut-C � t. ( (.
Mailing Address city State Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment of:
Dwelling Units @ $
Square Feet @ $ _
Remarks:
Paid by Check No: Paid by Cash:
Recreation and Park District Representative
-1 —_ ora.. imm fnnn rev I.doe
per unit for a total of $ 0
per sq foot for a total of $
Receipt No:
...�..." , �T.• w':-. :. �,a:a1r":.-n+..•_+F •: ..-:.m .._ric $Ti `*4n
w' Ci#•"'eQ_++"i. :S yy'i '.ir^ ` .
r, f036-61-0-005 y. 93-2525 B,M
FROELICH, ARDIS•
`. 220 FAIRHILL DR, OROVILLE
CONTR: ARTIC AIRE ,
G•AS.LINE & HVAC/SF
t
a
J •
OFFICE COPY
Address
GAS
t Meter By DateW
} ELECTRIC
Meter By Date
'
r
COUNTY OF BUTTE - DEPARTMENT OF;)EVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California'95965 - Telephone (916) 538-7541 PERMIT NO�
APPLICATION AND PERMIT 9-�- —*-r
ASSESSOR PARCELNUMBER
n r,_ _AR
ZONING)
BUILDING PERMIT
OWNER
TELEPHONE
3_
SQ. FT. OCC. BUILDING VALUATION-*'
OWNER'S MAILING ADDRESS
220 r
CONTRACTOR'S NAME
Artie P
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
9R13 Hwy 32, rhico 9502A
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS i
j
Penalty $
BwLDu�c/.gDR 8irhill Drive, Oroville
SGV
PERMIT FEE $
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 AP
j
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF Q{ Duplex ❑ Mobilehome ❑ Other ;
•
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G 1 W
@20.00
TYPE OF WORK j
New CI Addition ❑ Remodel CI Utilities
Utilities ❑ Installation ❑ Othet)p
Describe Work: replace furnace W/ HVAC & g89 piping
FEE g14
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BOON OR LESS )
200A OR LESS
23.00
Main Service( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCC P.
OR ADDNS. ( 6 ACC. SLOB. )
3.50 'FT'.'
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
�l am a licensed under provisions of Chapter 9, Division 3 of the Business and
yfC
Professions Code and my license is in full force and effect.
License No. 62 3 q I 'k Classification tC 81
❑ I, as the owner, ormymy employees with wages as their s6le compensation, 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 contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
•NONRESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
a SINGLE OUTLET CIR.
Ex. OCCU OUTLET OR FIXTURES
P• ( )
20 @ 1'00
BAL. 50
Ex. Occu FIXED OR
p' ( OUTLETS (RESIDRESID.) 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):
❑ This permit is for $100.00 (valuation) or less.
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
Certificate of Consent to Self -insure.
O 1 shall 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.9
PERMIT FEE S
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
15.0-0
Cooling
Hood
6.50
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 Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgmgnts, costs, and expenses which may in any way accrue against said
County in con quence the granting of this permit. 1
` Date 7- 30 — �
nature o Applicant - ❑ Owner 7�Contractor CI Agent
+11n OSHA permit is required for excavations over 5"0" deep and demolition or
i
construction of structures over 3 stories in height.
Mobile Home Installation Fee Is
Energy Inspection Fee Is
DCC
CONST. TYPE
TOTAL FEE $ 85.00
HAZ.
I D. FEES
IMP
I FLOOD
I COF
PARCEL PD
I HD
I ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
J/r--
Date 7/30/93
J 7/30/94
PERMIT EXPIRES ON
(Date)
ReceiptNo. 148052
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
_ _-'.,-.41J'�^-,.=��'y"-.yv-v*�,..car+?sa..�.w�ir,v�•�.-.-....•t-.r w'�-+--.��.-+i1-•.-.--^ra.`S� n�;..�.••_,.. _,y),,,� ..Y.,.. -
_t ,
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (9.16) 891-2751
7 County Center Drive, Oroville, CA (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
`L3Lti
PERMIT NO.
A routrneinspection indicates that the following violations of Butte County Ordinances exist at
theabove address and should be corrected. Please notify this office when correction of work
is,corr;pleted.Ifyou have any questions pertaining to this matter, or need additional explanation, "
p'le �e tact this office immediately. —
1
rr '
Date " t D Inspector
Pz
REV 10!92
a
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
ER 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.
Date Inspector.
REV 10/
/ COUNTY OF BUTTE - DEPARTMENT OF DEVFl OPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 ff RMIT NOO..`�,
APPLICATION AND PERMIT
ASSESSORPARCEL NUMBER
6-61-0-005
ZONING
AR
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATIO .
OWNER'S MAILING ADDRESS
220
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
9WIR 14wv '19. Chi cc) 95926
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
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 $
1UIL1I23JffRrSairhill Drive, Oroville
PERMIT FEE $
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 CX Duplex O Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New O Addition ElRemodel 1:1Utilities O Installation El Other]
Describe Work: replace furnace W/ HVAC & gas piping
PERMIT FEE $
35.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( '2"vORLESS
200A OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLDS. )
SO.
3.5C FT,
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
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.Z: L,<q) 3 Classification G 3:yUTLETS
O I, 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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
BA20 @ 1.0000
Ex. FIXED APPLNS. OR
Occup. (O (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):
O This permit is for $100.00 (valuation) or less.
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
Certificate of Consent to Self -insure.
O I shall 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
15 1210
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
50. 00
I certify that I have read this application and state that the 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
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, judg nts, costs, and expenses which may in any way accrue against said
C in con quence the granting of this permit. r�
t-- Date I 30
nature o Applicant - O Owner Contractor ❑ Agent
n OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
ocC
CONST. TYPE
TOTAL FEE $
85.00
HAZ.
1 0. FEES
IMP
I FLOOD
I CDF
PARCEL
in
HD ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
DIRECTOR OF PU WORKS
By. , Date 7/30/93
PERMIT EXPIRES ON 7/30/94
IDetel
ReceiptNo. 148052
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
�6-13-
COUNTY OF BUTTE - DEPARTMENT OF DEVQLOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER/_? / O _ 60
ZONING
BUILDING PERMIT
OWNER e � L ��
`
PHONE
TELE -3 6qZ
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILUyJ_\/ 9"gD RESS
,/�/} ^ / /t H
CONTflACTO S(N
CONTRAC�S AILI G AD ESSP ' J - / ��,�� 1 C��Gy
(/T(///V/ l•/J (�T v
Fireplace
CONSTRUCTION LENDER
UNKNOWN/
Total Valuation $
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 *
02 aQ L
PERMIT FEE $
-t-
CA 91f9 Cr
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 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00 Q
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other
Describe Work:
PERMIT FEE $
Contractor
ELECTRICAL PERMIT Filing Fee 20.00
i
Main Service ( 'OVOR LESS )
200A OR LESS
23.00
Main Service ( 200A TO t000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. BLDS. )
SO,
3.50 FT.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force and effect.
License No. Classification
❑ 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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
.NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
B200
@1:00 60
Ex. Occu FIXED APPLNS. OR
p' ( OUTLETS IRESID.I EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
❑ I shall 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
155'0
CoolingSO
Hood
6.50
Ventilation
PERMIT FEE $
tq
Contractor
I certify that I have read this application and state that the 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
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
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and/demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEES
HAZ.
1 D. FEES
I IMP
I FLOOD
CDF
PARCEL PD
I HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY Date
PERMIT EXPIRES ON
(betel
Receipt No. �/ (/
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
NN
-1 11 —,
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Uroville, California 95965
_ TegEphone:, 534-4541
APPLICATION AND PERMIT
41
u .c[+icoolflo V.0 UI UIV I�UU11 y VI OUILC [U tllllef UpUn [ne
above-mentioned property for inspection purposes.
X Date
Signature of Permitee or Agent
Receipt No.�� i'�--'
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY Date
Ekd_-k t i9 permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address,r
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address i
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee
Building Address
PLUMBING No.1 @ FEE
PERMIT FILING FEE J$3.00
-
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. �� ; . 4-
A.
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
Wip,�
hi fl
I Fire Dept.
Fire Zone
Use Pen -nit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
provements
Lawn sprinkler system 2.00
-34,49:-Wb n -s fRwt'bd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES OTHER'14
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
`
Main service 600v OR LESS
100 AMP OR LESS 5.00
Main service EA. ADD -L 100 AMP 2.50
�
Single Family El Duplex ❑ Mobil Home ❑ Others ❑
OVER
Main service 1100 AMP OR LESS 25.00
Main service EA. ADD- 100 AMP 1.00
NEW CONST. DWELING
OR ADDNS. ( ACCLBLDGS.OCCUP, &) 22 sq ft
NEW CONSTR. MULTI.OUTLET
NON.RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTSL POWER APPARATUS &
NON•RESID. (SINGLE OUTLET CIR,
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
Style,Of;��
., a
Ex. Occup(OUTLETS OR FIXTURES)( - C25¢1
BAL
. FIXED APPLNS, OR;
OCCU EX
Occup. (RESID.) EA) 2.00
Temporary service 10.00
/--
Mobile Home Facilities 15.00
License No. `L l_i ' Classification
L
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
I 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 placed 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 em
P employ y an y person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
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
MECHANICAL No.1 @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
TOTAL PERMIT FEE
$
u .c[+icoolflo V.0 UI UIV I�UU11 y VI OUILC [U tllllef UpUn [ne
above-mentioned property for inspection purposes.
X Date
Signature of Permitee or Agent
Receipt No.�� i'�--'
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY Date
Ekd_-k t i9 permit expires Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Uroviille, California 95965
Tel ephonef."534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X ate
Signature of Perm' ee or Agent
Receipt No. /.$ _�?_ 2—G 9
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
JR IRECT OF PUBLIC WORKS
Rv Date `1 — 7,1— 7i�
permit expires Date % ` 2-1-77
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address oSlz 0 '
Telephone No.
Fireplace
Contractor •
Total Valuation
Mailing Address ,
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
�-3gl,�p SyPermit
Fee $
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. �G "'G l - O —ArGas
Zoning & Planning
piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
WP
n'S3'i
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im provements
Lawn sprinkler system 2.00
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ADDITION ❑ UTILITIE OTHER
❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
12
Main service 100 AMP OROR LESS5.00 �.
Main service EA. ADD•L too AMP 2.50 —
AO
�7( Duplex Mobil Home Others
Single Family IbJ ❑ ❑ ❑
OVER soov
Main service too AMP OR LESS 25.00
Main service( EA. ADD•L 100 AMP 1.00
NEW CONST.DWELING
OR ADDNS. \ ACCLBLDGS.CCUP. &) 2¢sgft
NEW CONSTR. (MULTI -OUTLET
NON.RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS &
NON-RESID, (SINGLE OUTLET CIP..
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
Sty
Ex. Occup(OUTLETS OR FIXTURES) 50 BAL21
FIXED APPLNS, OR n
(OUT LETS (RESID.) EA) 2.00 1„• (/
Ex, OccupTemporary
Temporary service 10.00
Mobile Home Facilities 15.00
License No. -2, Classification (7— e
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.
l�fI have placed on file with the County of Butte a certificate of
I 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. @NEE
PERMIT FILING FEE $3.00
Heating �'
Coolingo 7
Ventilation
Hood 2.00
Permit Fee $
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
TOTAL PERMIT FEE
$ �Q
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X ate
Signature of Perm' ee or Agent
Receipt No. /.$ _�?_ 2—G 9
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
JR IRECT OF PUBLIC WORKS
Rv Date `1 — 7,1— 7i�
permit expires Date % ` 2-1-77
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