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079-130-003
Dan Robertson ' 150 Fairhill Dr., Oroville Permit #6827-798,P,E,M(new single family) Permit # 20- OB, (add'l ft for er #6827-79) 663 93-1592 B,M REDFERN, EDWARD ,150 FAIRHILL DR, OROVILLE GAS LINE,.WTR HTR, FURNACE/SF 09 01-222.3 � REDFERN, EDWARD�J 150 FAIRHILL DR, OROVILLE REROOF �� 01-2542 R N, EDWA4-0 & SUS 150 FAIRHI b CONT: IMS CUSTO EL CHANGE HVAC � �• 1 03 69 - t , 03-0471 REDFERN, ED & 'TT" 150 FAIRHILL' OROVILLE ADDITION TO SF -STUDY 0 04-1627 REDFERN 150 FA RfnL DR, OROVILLE Cont: OWNER COMPLETE PERMIT 03-0471 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP041627 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: 06/07/2004 APN: 036-620-003-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 150 FAIRHILL DR ORO Date: Contractor: Map Index: Description: PERMIT TO COMP 03-0471 (2 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 INSPECTIONS) Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: REDFERN EDWARD E & SUSAN J JT signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 150 FAIRHILL DRIVE she is exempt therefrom and the basis for the alleged exemption. Any OROVILLE, CA violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 95966 LK 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 Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, Applicant: REDFERN EDWARD E & SUSAN J JT provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 150 FAIRHILL DRIVE proving that he or she did not build or improve for the purpose of OROVILLE, CA sale.). ❑ 1, as owner of the property, am exclusively contracting with 95966 licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ lam Exempt under Article 3 of the Business a Professions Code Contractor: Date: -_7 G 4 Owner: festa WORKERS' COMPENSATION DECLARA ON I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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 License #: is issued. ❑ I 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 Architect: - insurance carrier and policy number are: Engineer: Carrier: Policy #: 0 I that in the certify performance of the work for which this permit is Total Square Ft: 0 S. F. issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: is 0 Q 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 damages compensation; as provided for in Section 3706 of the Labor 4p (e? -c:? code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code anryor I hereby affirm that there is a construction lending agency for the Resolutio s to do work in ' ve Pr which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: BY� /''Date: Q4 PERMIT EXPIRES v Address: ate) ❑ 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. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. 1 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 -ith all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form o document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: U -9 E D N tjc" Signature: / /E' Date: caner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor OT BUTTE COUNTY oo DEPARTMENT OF DEVELOPMENT SERVICES 0 o BUILDING PERMIT APPLICATION 0 0 AND SUBMITTAL REQUIREMENTS 00 o -`�"-� ` 0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 cOIJOFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION APPLICANT NAME OWNER Name Eb E City Address 1§?2 0"el-fli L City ® v Fax Sta�aX Zip Phone gQ S,,_( gSZ Fax E-mail APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Lot # Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Lot # Fax E-mail State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X, For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS BPo¢t&4 BIN # LOCATION AP# D z o0 Property Address S x -f ore o Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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: 67 Amount: Z1 q R (1cl Bldg SRA Receipt #:'466,--Q5 Sheriff SMIP Date: �pq. Other Z I 'I • c% k Total 11 K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 1 of 2 REV 4-30-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND ININK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXESI). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to mobile or modular homes.) ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. ❑ 10. Metal Buildings: (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. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (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 -sighed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO (Rev. 12/96) APPLICATION AND PERMIT T—r ASSESSOR PARCEL NUMBER 036-620-003 ZONING A -R BUILDING PERMIT OWNER ED IS, SUSTE REDEIMN TELEPHONE —533--.6956-- SffFr.OCC. BUILDING VALUATION R 22,626 .OWNERS MAILING ADDRESS CONTRACTOR'S NAME 00M TELEPHONE IREMOD CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ 39 030. ARCHITECT OR ENGINEER LICENSE NO. Flirt Fee $ 2C.•00 Permit Fee $ 349.50 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 227.18 BUILDING ADDRESS 150 FAIR HILL DRIVE, MMEM ITIE Energy Plan Checking Fee $ 23.00 $ PERMIT FEE $ 619.68 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20 00 USEOFSTRUCTURE SFXK Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition IX Remodel IR Utilities ❑ Installation ❑ Other ❑ Describe Work: ADD STUDY & WALK—TN (710SFT AND RFMODET, Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ 7P po ELECTRICAL PERMIT Fling Fee 20 00 Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.P License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law r the following reason: will do the work, and the structure is not intended or offered for sale. cooI, as owner of the property, or my employees with wages as their sole compensation, I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. I am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service To ,000A 46.00 NEW CONST. OWEILC. OCCUP. 3.5Qs0. W: ( FT. OR ADDNS.NEW CONST. MUAiOTCou�rLET NO..ESID. @7.50 OWER APPARATUS a SINGLE OUTLET CIR. Ex. Occu OUTLET OR FDRURES 20 Q 1'00 s„u o .50 Ex. Occup. o�,EF°,SAPRRa _(RM°E. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20 ,00 Heating Cooling Hood 6.50 Ventilation FX= D11(7 19-00 PERMIT FEE $ 19-00 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ,I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. to 2 - Ig -D_� gnature of Applicant -X 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 $ 46.00 c T-3 3 CONSIOPE TOTAL FEE $ 836.3_':-' HAZ D IMP O CDF PARC Po HO 3S This permit is hereby issued under the applicable provisicns of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date �� PERMIT EXPIRES ON B D la ReceiptNo. 33 9S3 WHITE-D.D.S.-B.D. CANA Y.ASSESSOR PINKJPSPECTOR GOLDENROD -APPLICANT ,G %T Y OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING D VISION County Center rive • O oville California 95965 Telephone 5 3 - , ! -- PERIrIET NO 7 ty n D r T ph (30) 5 6 41 APPLICATION AND PERMIT 1 6 3 P ce-m ,R _ 2O1e7 _ BUILDING PERMIT n«rxm ZELEPMONE W. FT. OCC. BUILDING VALUATION -69 s o v Dxsaacrons weLE Ta. MO =tffPAv=,S MAL= ADDRSO r»rrtamah AMR= P.=w .T oR 6 MW= aR D=MMM UQ= ADDR= a, Drh= 14 cueDmsoxs mum 30-- 3 @ Lf O 8-I - COIFL-F-Y AC -2C5, USEOFSTRUCTURE 3FA' 1 Duelez D Mob8shome O Other TYPE OF WORK Nein O Addftn �) Remodel E3 U56Hes 0 Instakfion 0 Other 0 Describe Work Q � h ,Gi✓1 I-- LL c1'D 17 = X. L3'1 0 S 13azq *PSWT FEE PAlD .SRI si�.IFF . OTM. . "Ovw RRECE "m •PZMrM„Nmm �7/ X33 so ae nr� st�tro cow Fea heckh Plan 0.00 PLUMBING *PERMIT FMng Fee 20.00 Eseh . 7.00 Solar or h um water heater 23.00 Water p' . g 15.00 >r.to.D Each gas weir heater nt 15.00 Gas PIPIng 1 - 5 c u%E 15.00 sunding sewer 15.00 ►u -e., es___ S G w e_ee PERMIT FEE S TRJCAL PEWIT Service = oa Service 2MA •m Inn L,4� ' ( cuoeL=- omwP- . l 20.00 I.Er..Oc=p.ounce oR F= soL a-_;; Er Oezu FarmAPA1tS. oR ount�s tgEsm Ea 5.00 Tonparary ServL-8 2900 Mobile Home FacNes 20.00 M',- Wring 29.00 PERMIT FEE S MECHAN)CAL PERMIT Filing fee 20.00 HeaBng Coolnm Hood 6.50 l , ego 1 /J-- — PERMIT F -E k S 3 Dd Mobne Home Installa5on Fee S Energy Inspection Fee $ e 6 1)C% TO AL FEE $ 0.� 1 nAz C FES This peen@ Is hereby Issued 6nder the appticable provisions of the Butte County Code and/or Resohi5ons fa do work indicated above for which fees have been paid By . Date RexiptNa YYMITE-C' PERMIT EXPIRES ON .�s.�a euuaRr-ASSESsoa PUIX-II�SPEGSOR GpLD�NaoD-APPUGANT �h,� 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: f4d4ASSESSOR PARCEL NUMBER 3 Proposed Building Use: Counter Technician: (-\,c7 Date: OL Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to appy. 1..Plot plans, 3 or 4 sets, signed,�y the preparer of the plans. Complete plans, 3 or 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. ,IT -4. Engineered truss details and layouts in duplicate. No faxes! 1�5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be, indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) {14YIT 'es as shown on the attached Schedule of Fees Due Sheet ....................................... - ""`Statement of Intent for Non -heated and A/C Buildings .......................... Sanitation and plot plan approval from the Environmental Health De art ent in L� 17. City of Chico Plumbing permit ... :........................................ a 18. California Department of Forestry plan approva 6 paid. Sent by. I D ................ ❑ 19. Planning approval for (A) Use: c))?,- (B)Parking: (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... ... ., ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone 9 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit Applicant: �a�t/. G` Date: Z —/J- ro. 3 1. Index permit application for the above items numbered: / Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised cf the above data by ❑ p e, ❑ mail, ❑ counter, by Date: Contractor, designe ,'own as advised of the above data by hone; ..❑ mail, ❑ counter, by ate: Plans reviewed by: Date: Plans approved by: ate: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: O Yellnw' Rnildinv nivicinn COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 SCHEDULE OF FEES DUE OWNER PROP SED BUILDING USE �. 1. BUILDING PERMIT FEES Balance Due ....................... A.P. # DATE RECEIPT # DATE REC. Additional Fees Due ................. $ Additional Fees Due ................. $ Revised Plan Checking Fee .............$ 2. SCH OL DISTRICT FERS / (p ' at s ce) ( a Ch 3. SHE F S (paid at Building Division) Residential ...................... x $360.00 = $ Units Commercial (sq. ft.) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... —x—=$ # Units Amt. Commercial (sq. ft.) ............ —x—=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) :37fD3�� j 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE 7— Pursuant Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 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 - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner ' (Rev. 6/00) School District A.P. Number Property Owner Property Location/Address Subdivision Residential Development BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) Building Department No. —061 115 ,, = City : County A 03-Oy7/ Lot No. [ Sq. Footage �g No of Living !Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # "(No foundation inspection): C Building Department Representative (Floor Plans reviewed liSchool District Personnel District Identification No. Sq. Footage (Including Exterior Roofed Areas) Date kte School District certifies that cS'uLS o�y� IZ'J -Pv n (Applicant) (Street Address) (Phone Number) ©v -o v: G'4 Q S `1 (a L (City) (State) (Zip Code) has complied with the requirements of Resolution No. 10 by payment of $ representing (-}SI, q square feet. 11AB 2926 $ FULL MITIGATION $ School District Repiesentative Date Paid by Check # All G Remarks:��— Notice: 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 fees 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 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 fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/98)dmm O.B.- I 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. personally plan to provide the major labor and materials for construction of thero osed P P (oproperty improvement: YES B'-- NO ❑ I HAVE SHAVE 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: PHONE: CONTRAC R'S LICENSE NO. 4..I plan to provide po of this wo , but I have hired the following person to coordinate, supervise, and provide the ma' ork: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LIC + ENO. 5. I will provi some of the work but I have contracted (hired) the fo g persons to provide the wor dicated: N ADDRESS PHONE TYPE F WORK SIGNED: PROPERTYOWNER g, SOCIAL S URTTY NUMBER: 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. OVER y OWNER BUILDER INFORMATION Dear Property Owner: D.B.-1 An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -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 California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. rely, �, 4 Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner. -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 1 CF -1R Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 Pro�ect Address 150 Fairh 11 D ' ******* i rive Oroville *v6.01* Documentation Author... Marty Runnells ******* Bui ng !� r t Energy Calculation Services /JIca 1907 Mangrove Avenue, Suite E Plan Check Date Chico, CA 95926 530-894-8466 Field Check/ Date Climate Zone........... 11 Compliance Method...... MICROPAS6 v6.01 for 2001 Standards by Enercomp, Inc. MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM CF -1R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition GENERAL INFORMATION Conditioned Floor Area..... Building Type .............. Construction Type ......... Building Front Orientation. Number of Dwelling Units... Number of Stories.......... Floor Construction Type.... Glazing Percentage......... Average Glazing U -factor... Average Glazing SHGC....... Average Ceiling Height..... 419 sf Single Family Detached Addition Alone Front Facing 315 deg (NW) 0.18 1 Raised Floor 16 0 of floor area 0.36 Btu/hr-sf-F 0.39 9 ft BUILDING SHELL INSULATION Component Frame Cavity Sheathing Total Assembly Type Type R -value R -value R -value U -factor Location/Comments Wall n/a R-13 R-n/a R-13 0.088 FRONT, LEFT, BACK Roof n/a R-30 R-n/a R-30 0.031 TO ATTIC Floor n/a R-19 R-n/a R-19 0.037 RAISED FLOOR FENESTRATION Over - Area U- Interior Exterior hang/ Orientation (sf) Factor SHGC Shading Shading Fins Window Front (NW) 3.0 0.350 .0.350 Standard. Standard Yes Window Left (NE) 7.0 0.350 0.350 Standard Standard None Window Left (NE) 2.0 0.370 0.390 Standard Standard None Window Left (NE) 7.0 0.350 0.350 Standard Standard None Window Left (NE) 2.0 0.370 0.390 Standard Standard None Window Back (SE) 40.0 0.360 0.400 Standard Standard Yes Window Back (SE) 6.0 0.370 0.390 Standard Standard _.,� Yes HVAC SYSTEMS Refrigerant Equipment Minimum Charge and Duct Type Efficiency Airflow Location Gas 0.780 AFUE n/a Attic ACSplit 10.00 SEER No Attic Test a Duct D a�� Thermostat R -value aTee Type R— 4 .s&:- No No — Setback R-4.2'";No No Setback CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 2 CF -1R Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM CF -1R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition REMARKS COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title -24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features Modeling Assumptions section. DESIGNER or OWNER DOCUMENTATION AUTHOR Name.... Company. Ed Redfern Owner Name.... Company. Marty Runnells Energy Calculation Services Address. 150 Fairhill Drive Oroville, CA 95966 Address. 1907 Mangrove Avenue, Suite E Chico, CA 95926 Phone... 530.533.6956 Phone... 530-894-8466 License. Signed.. Signed.. f 1/2�/�,� ate ate ENFORCEMENT AGENCY Name.... Title... Agency.. Phone... Signed.. ate MANDATORY MEASURES CHECKLIST: RESIDENTIAL Page 1 MF -1R Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 Project Address 150 Fairhill D , ******* ••.•••.. rive Oroville *v6.01* Documentation Author... Marty Runnells ******* Building Permit Energy Calculation Services 1907 Mangrove Avenue, Suite E Plan -Check / Date Chico, CA 95926 530-894-8466 Field Check/ Date Climate Zone........... 11 Compliance Method...... MICROPAS6 v6.01 for 2001 Standards by Enercomp, Inc. MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM MF -1R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition Note: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (*) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. BUILDING ENVELOPE MEASURES Design- Enforce- er ment *150(a): Minimum R-19 ceiling insulation. 150(b): Loose fill insulation manufacturer's labeled R -Value. *150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -factor in metal frame walls (does not apply to exterior mass walls). *150(d): Minimum R-13 raised floor insulation in framed floors. 150(1): Slab edge insulation - water absorption rate no greater than 0.30, water vapor transmission rate no greater than 2.0 perm/inch. P A 118: Insulation specified or installed meets insulation quality standards. Indicate type and form. 116-17: Fenestration Products, Exterior Doors and Infiltration/ Exfiltration Controls 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. 2. Fenestration products (except field fabricated) have label with certified U -factor, certified Solar Heat Gain Coefficient (SHGC), and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. 150(8): Vapor barriers mandatory in Climate Zones 14 and 16 only. N/A 150(f): Special infiltration barrier installed to comply with Sec. 151 meets Commission quality standards. ►.�,� 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. MANDATORY MEASURES CHECKLIST: RESIDENTIAL Page 2 MF -1R Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM MF -1R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition SPACE CONDITIONING, WATER HEATING AND PLUMBING SYSTEM MEASURES Design- Enforce - 110 -113: HVAC equipment, water heaters, showerheads and er ment faucets certified by the Commission. 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACOA. ✓ 150(1): Setback thermostat on all applicable heating and/or cooling systems. 150(j): Pipe and Tank insulation 1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. 2. First 5 feet of pipes closest to water heater tank, non - recirculating systems, insulated (R-4 or greater). 3. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or R-16 combined internal/external insulation. 4. All buried or exposed piping insulated in recirculating sections of hot water system. 5. Cooling system piping below 55 degrees insulated. 6. Piping insulated between heating source and indirect hot water tank. N *150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and in- sulated, to meet the requirements of the 1998 CMC sectons 601, 603, and 604, and standard 6-3; ducts insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape, aerosol sealant, or other duct -closure system that meets the applicable requirements of UL181, UL181A, or UL181B. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used. Building cavities shall not be used for conveying conditioned air. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber addhesive duct tapes unless such tape is used in combination with mastic and drawbands. 2. Exhaust fan systems have backdraft or automatic dampers. 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 114: Pool and Spa Heating Systems and Equipment 1. System is certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System is installed with: a. At least 36 inches of pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spas. 3. Pool system has directional inlets and a circulation pump time switch. 115: Gas-fired central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously burning MANDATORY MEASURES CHECKLIST: RESIDENTIAL Page 3 MF -1R Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM MF -1R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition pilot light (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr). LIGHTING MEASURES 150(k)l: Luminaires for general lighting in kitchens shall have lamps with an efficacy of 40 lumens/watt or greater for general lighting in kitchens. This general lighting shall be controlled by a switch on a readily accessible lighting control panel at an entrance to the kitchen. 150(k)2: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumens/watt or greater switched at the entrance to the room or one of the alternatives to this requirement allowed in Sec. 150(k)2.; and recessed ceiling fixtures are IC (insulation cover) approved. Design- Enforce- er ment COMPUTER METHOD SUMMARY Page 1 C -2R Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 Project Address 150 Fairh'll D 4******* i rive Oroville *v6.01* Documentation Author... Marty Runnells ******* Energy Calculation Services 1907 Mangrove Avenue, Suite E Chico, CA 95926 530-894-8466 Climate Zone........... 11 Compliance Method...... MICROPAS6 v6.01 for 2001 Standards by Enercomp, Inc. MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM C -2R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition MICROPAS6 ENERGY USE Building Permit Plan C ec Date Field Check/ Date Compliance Method...... MICROPAS6 v6.01 for 2001 Standards by Enercomp, Inc. MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM C -2R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition GENERAL INFORMATION Conditioned Floor Area..... Building Type .............. Construction Type ......... Building Front Orientation. Number of Dwelling Units... Number of Building Stories. Weather Data Type.......... Floor Construction Type.... Number of Building Zones... Conditioned Volume......... Slab -On -Grade Area......... Glazing Percentage......... Average Glazing U -factor... Average Glazing SHGC....... Average Ceiling Height..... Floor Area Volume Zone Type (sf) (cf) 419 sf Single Family Detached Addition Alone Front Facing 315 deg (NW) 0.18 1 ReducedYear Raised Floor 1 3768 cf 0 sf 16 % of floor area 0.36 Btu/hr-sf-F 0.39 9 ft BUILDING ZONE INFORMATION # of Dwell Cond- Thermostat Units itioned Type ADDITION Residence 419 3768 0.18 Yes Setback Vent Vent MICROPAS6 ENERGY USE SUMMARY Leakage Energy Use Standard Proposed Compliance (kBtu/sf-yr) Design Design Margin Space Heating.......... 18.65 18.01 0.64 Space Cooling.......... '13.60 13.93 -0.33 Total 32.25 31.94 0.31 *** Water Heating not calculated *** GENERAL INFORMATION Conditioned Floor Area..... Building Type .............. Construction Type ......... Building Front Orientation. Number of Dwelling Units... Number of Building Stories. Weather Data Type.......... Floor Construction Type.... Number of Building Zones... Conditioned Volume......... Slab -On -Grade Area......... Glazing Percentage......... Average Glazing U -factor... Average Glazing SHGC....... Average Ceiling Height..... Floor Area Volume Zone Type (sf) (cf) 419 sf Single Family Detached Addition Alone Front Facing 315 deg (NW) 0.18 1 ReducedYear Raised Floor 1 3768 cf 0 sf 16 % of floor area 0.36 Btu/hr-sf-F 0.39 9 ft BUILDING ZONE INFORMATION # of Dwell Cond- Thermostat Units itioned Type ADDITION Residence 419 3768 0.18 Yes Setback Vent Vent Air Height Area Leakage (ft) (sf) Credit 2.0 Standard No COMPUTER METHOD SUMMARY Page 2 C -2R Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -FORM C -2R User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition OPAQUE SURFACES Area U- Insul Act Solar Form 3 Location/ Surface (sf) factor R-val Azm Tilt Gains Reference Comments ADDITION - New 1 Wall 159 0.088 13 315 90 Yes None FRONT 2 Wall 198 0.088 13 45 90 Yes None LEFT 3 Wall 116 0.088 13 135 90 Yes None BACK 4 Roof 419 0.031 30 n/a 0 Yes None TO ATTIC 5 Floor 419 0.037 19 n/a 0 No None RAISED FLOOR FENESTRATION SURFACES Area U- Act Exterior Shade Interior Shade Orientation (sf) factor SHGC Azm Tilt Type/SHGC Type/SHGC ADDITION - New 1 Window Front (NW) 3.0 0.350 0.350 315 90 Standard/0.76 Standard/0.68 2 Window Left (NE) 7.0 0.350 0.350 45 90 Standard/0.76 Standard/0.68 3 Window Left (NE) 2.0 0.370 0.390 45 90 Standard/0.76 Standard/0.68' 4 Window Left (NE) 7.0 0.350 0.350 45 90 Standard/0.76 Standard/0.68 5 Window Left (NE) 2.0 0.370 0.390 45 90 Standard/0.76 Standard/0.68 6 Window Back (SE) 40.0 0.360 0.400 135 90 Standard/0.76 Standard/0.68 7 Window Back (SE) 6.0 0.370 0.390 135 90 Standard/0.76 Standard/0.68 OVERHANGS AND SIDE FINS Refrigerant System Minimum Charge and Duct Type Efficiency Airflow Location ADDITION Gas ACSplit 0.780 AFUE n/a Attic 10.00 SEER No Attic REMARKS Left Fin Right Fin— Dpth Hght Ext Dpth Hght n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Tested Window—. Overhang Duct Duct Manual Area R -value Left Rght Eff Surface (sf) Wdth Hgth Dpth Hght Ext Ext Ext ADDITION - New 1 Window 3.0 n/a 1 2 0 n/a n/a n/a 6 Window 40.0 n/a 6.67 8 2 n/a n/a n/a 7 Window 6.0 n/a 1 8 1 n/a n/a n/a HVAC SYSTEMS Refrigerant System Minimum Charge and Duct Type Efficiency Airflow Location ADDITION Gas ACSplit 0.780 AFUE n/a Attic 10.00 SEER No Attic REMARKS Left Fin Right Fin— Dpth Hght Ext Dpth Hght n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Tested ACOA Duct Duct Manual Duct R -value Leakage D Eff R-4.2 No No 0.737 R-4.2 No No 0.645 HVAC SIZING Page 1 HVAC Project Title.......... The Redfern Addition Date..01/28/03 14:04:23 Project Address 150 Fairhill Dri e ******* Oroville *v6.01* Documentation Author... Marty Runnells ******* Energy Calculation Services 1907 Mangrove Avenue, Suite E Chico, CA 95926 530-894-8466 Climate Zone........... 11 Compliance Method...... MICROPAS6 v6.01 for 2001 Standards by Enercomp, Inc. MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -HVAC SIZING User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition GENERAL INFORMATION Floor Area ................. Volume ..................... 'Front Orientation.......... Sizing Location............ Latitude ................... Winter Outside Design...... Winter Inside Design....... Summer Outside Design...... Summer Inside Design....... Summer Range ............... Interior Shading Used...... Exterior Shading Used...... Overhang Shading Used...... Latent Load Fraction....... 419 sf 3768 cf Front Facing OROVILLE RS 39.5 degrees 30 F 70 F 104 F 78 F 37 F Yes Yes Yes 0.20 HEATING AND COOLING LOAD SUMMARY 315 deg (NW) Heating Building Permit Plan Check Date Field Check/ Date Compliance Method...... MICROPAS6 v6.01 for 2001 Standards by Enercomp, Inc. MICROPAS6 v6.01 File-03022ADD Wth-CTZ11S92 Program -HVAC SIZING User#-MP1333 User -Energy Calculation Servic Run -419 SF Addition GENERAL INFORMATION Floor Area ................. Volume ..................... 'Front Orientation.......... Sizing Location............ Latitude ................... Winter Outside Design...... Winter Inside Design....... Summer Outside Design...... Summer Inside Design....... Summer Range ............... Interior Shading Used...... Exterior Shading Used...... Overhang Shading Used...... Latent Load Fraction....... 419 sf 3768 cf Front Facing OROVILLE RS 39.5 degrees 30 F 70 F 104 F 78 F 37 F Yes Yes Yes 0.20 HEATING AND COOLING LOAD SUMMARY 315 deg (NW) Minimum Total Load 6501 4993 Note: The loads shown are only one of the criteria affecting the selection of HVAC equipment. Other relevant design factors such as air flow requirements, outside air, outdoor design temperatures, coil sizing, availability of equipment, oversizing safety margin, etc., must also be considered. It is the HVAC designer's responsibility to consider all factors when selecting the HVAC equipment. Heating Cooling Description (Btuh) (Btuh) Opaque Conduction and Solar...... 2805 1608 Glazing Conduction ............... 962 625 Glazing Solar .................... n/a 669 Infiltration ..................... 2143 880 Internal Gain .................... n/a 0 Ducts ............................ 591 378 Sensible Load .................... 6501 4161 Latent Load ...................... n/a 832 Minimum Total Load 6501 4993 Note: The loads shown are only one of the criteria affecting the selection of HVAC equipment. Other relevant design factors such as air flow requirements, outside air, outdoor design temperatures, coil sizing, availability of equipment, oversizing safety margin, etc., must also be considered. It is the HVAC designer's responsibility to consider all factors when selecting the HVAC equipment. _ . COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 89172751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE 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 notice 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 161 Inspector REV 1 2 oh f L f 9i C04 "t Dl`s f - a • ��. � l c - _ � i 17 • � �,� ' .� y 1� _ _ . ' ' _ 1 � . .� � '' `� � f{ ,� .. 1� y 1� _ _ t ,� '� ,I ,� `� � _ ' �� .• !� ' i�� � y _ . ; . S �� _ - � • `� /, r nY r .-n Tw, a. rr 5 ' 036-620-003 01-2542 REDFERN, EDWARD & SUSAN 150 FAIRHILL DR, OROVILLE CONT: IMS CUSTOM STEEL CHANGE HVAC 61 aaa ..-. Y..syn..�yLT'�tl"f/`^._.'�-.r-..-.�- r -..-. .y .. .r._ ... .--•--..r-_...---••-�-r_.swvr.-•.+w-+...sw..+. y� \�+-+�i;V�v,C�.Si�.•yN:�i,�'F� h COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION". ,7 County Center Drive • Oroville, California 95965 • Telephone (530)'538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCELN(U'�MIBEERR_�/�� 036-620-M ZONING AR BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS = FAUML ER. 0QRW=0 CA 95%6 CONTRACTOR'S NAME11��� �� DE CLIS ,11,7 Sim la��rr LEP�HOONE TTE�. y M - - - _ CONTRACTORSMAILING ADDRESS .IMO MMM, 4F CA 95%5 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS - Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS FAIN= 2 50 M. CA 95%6 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL,MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE I , SF = Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or. vent 15.00 TYPE OF WORK I New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation 9 Other ❑ Describe Work: � �� HVAC, �^ Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ I F ELECTRICAL PERMIT ' "" Fling Fee 20.00 - - - `v OR LESS Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION , I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfessionsTCOde, and my license is inIl force and effect. .�+� '' {� License Class Lic. No. / �•'--I ti� I � OWNER-BUILDER DECLARATION` J- I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: j v ❑ 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 salee .4' ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business'and'Professions Code for this reason I WORKERS' COMPENSATION DECLARATION 1 ereby affirm under penalty of perjury one of the following declarations: ; I have and will maintain a certificate of consent to self -insure for workers' .. r compensation; ,as provided for by section 3700 of the +Labor Code, for the performance of the work for which this permit is issued. �Q I have and will maintain workers' compensation Insurance, as requirediby Section �( 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are. Carrier � 1Ft. 1.-11 Policy Number I,.� - a I 'i d" rs'$. (The above sections need no be completed if the permit is foT wo(,k of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall fort comply with those provisions. -- ��/�/ / r� %� X •'•�„�''�• Date (C,/ / � Signature of Applicant - caner Contractor ❑ Agent f An OSHA permit is required for excavatjr,ions over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46,00 NEW CONST. DWELLING OCCUP. 3.5QSO. ADDNS. ( AC . BLDST FT. NOR EW CONST. AAI ULT PIPµ RESip.BRANCH CIRCUITS @7.50 POWERAP 8 SINGLE OUfLEi CIR. 20 @ 1.00 EX. OCCu OunETOR FIXTURES SAL Q .50 OR EX. Occup..oFIXE' APPINS.vnETs RESID. En 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating 15.00 Cooling 14 15,00 -, Hood 6.50 Ventilation PERMIT FEI: $ • Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 50.00 HAz p FEES IMP I FLOP' I CDF PARCEL PD HD I ISSUE This permit is hereby issued under the applicable provisions in ica Butte a my Code and/or Resolutions to do work indicated ab 4e for hich ees have been paid. �I By ��%17KVWA?0_ PERMIT EXPIRES ON v Wq" ReceiptNo. -�C�_i '60 50.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION �i 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541,PERMJT NO. (Rev. 12/96) APPLICATION AND PERMIT�a- ASSESSOR PARCEL NUMBER 036-620-003 ZONING AR BUILDING PERMIT OWNER EDWARD & Susan Redfiern TELEPMONE 533-6956 SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 150 FAIRHILL DR. OROVILLE CA 95966 CONTRACTOR'S NAME IMS CUSTOM STEEL METAL TELEPHONE 533-8088 CONTRACTORS MAWNG ADDRESS .1700 MYERS-ST. OROVILLE CA 95965 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 150 FAIRHILL DR. OROVILLE CA 95966 Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF XI Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation 5 Other ❑ Describe Work: CHANGE OUT HVAC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800VOR LESS Main Service z0OA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license i 1 II force and effect. �` (�Q .License Class gu Lic. No. C7� le 1 ( OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00NEW CONST. DWELLING OCCUP. so OR ADDNS. ( a ACC. eros. 3.50FT: NON-peSlp MULTI.OIlTLET @7,50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @'.00 BAL @ .50 FLIED Ex. Occup.oin Aa DORS 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION I er by affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' c mpensation insurance carrier and policy number are: Carrier Z- E N ' Policy Number -- b i (The above sections need not be completed if the permit is for wo& of a valuation of one hundred dollars ($100) or less.) [II certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forth ith comply with those provisions. X Date �0 Signature of Applicantwrier KContractor ❑ Agent I An OSHA permit is required f xcavations over 5'0" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating 15.00 Cooling Hood 6.50 Ventilation PERMIT FEt S 50.00 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 50.00 HAZ D FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of Butte my Code and/or Resolutions to do work indicat d ab a for hich Jess have been paid. By Date D/ PERMIT EXPIRES ON �[J/ % / `D—a]e—� Receipt No. So.t77 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96)' APPLICATION ANn PFRIu1T ASSESSOR PARCEL NUMBER .3 (0-(�� - �j G � `& — I SAL a .50 ZONING BUILDING PERMIT OWNER waf (1 (r^ 4- SIU Ate/ eek- el -,l Service TELEPHONE 33"G95� SO. FT. OCC. BUILDING VALUATION OW NIRS MLARJlID AD 98 L 5e) .-• ' �' ( Pit 23.001 1 CONTiLLCTO '9 CONTRAC CONSTRUCTION LENDER LFi,,lace LENDER'S ►WUNO ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS NAUNG ADDRESS Permit Fee $ Plan Checkin Fee $ BUILDING ADDRESS Energy Plan Checking Fee b S PERMIT FEE i SOT NO. SUSON610NS NAME PARCEL NAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF t� Duplex ❑ Mobilehome ❑ Other /` 9PEc� Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 New ❑ Addition ❑ Describe Work: TYPE OF WORK Remodel ❑ Utilities ❑ Installation ��j stir ,�— Other 13-- �%`l�dcC Each as water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W X20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service OOOV OR LESS x0A OR LESS 23.00 *PERAAIT FEE PAM SRA • SHERIFF OTHER AMOUNT RECEMb Dam 5ervlce i zoaA TO s—A 4e.00 NEW CONST. ( DWELLI G DecuP. ) 3.5¢R OR ADONs. i ACC. SLOB. tX. UCCU . OUTLET OR F0RURE9 `& — I SAL a .50 Ex. Occup. APPlA6. OR ovn.E�s EsiD. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.001 1 PERMIT FEE i MECHANICAL PERMIT Filing Fee 20.00 Heating160 1 S Qp Coolin ,,,)�-" , 00 Hood 6.50 Mobile Home Installation Fee $ Energy Inspection Fee $ ocD CONST. TYPE TOTAL FEES 50.p8 NAZ• D. FEES I IMP 70 [COF I PARCEL PO HD 6SUE S • 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. *RECaPT W114 t * TO BE PVT INTO COMPVM By PERMIT EXPIRES ON Date 117-r? wq';g45vp.' :'Fr+ V . � .,- "`"`T�':F � : ��nfStkrvL'�I'•,�j'i�,'i�,if�',,..'���'•rb`vt7:r�+ F 20-003ERN, EDWAS2223 AIRHILL DR, OROVILLE OF r, r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 195965" • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT Cil - DDL26 ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER WARD PIMFIM TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERSMAILING ADDRESS 50 JWFAMM DR 29160 CONTRACTOR'S NAME TELEPHONE cwtyo CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 3t6W. ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ WOW ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 250 FAIRML DR. ORVII.t.E Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF T9 Duplex ❑ Mobilehome ❑ Other SPECIFY I Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK i i New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 3 jp Describe Work: RE -R" W/C5am. & new/ pbggddMI Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home Kai W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 aoOVOR LESS Main Service zoo. oR LEN 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contracto s License Law for the following reason: O'~I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am 'exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWE OCCUP. OR ADONS. ( 8 ACC. BLAS. SO 3.5¢Fr. N CONS MULTI.OUTLET NDN.RESID. @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. EX. OCCU OUTLET OR FIXTURESIR t20 O 1.00 FIXED APPLNS. OR Ex. Occup. OUTLETS ESID.) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 151-1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X — r, , `l rI >�! `+ .�� Date y'—/ In / Signature of Applicant - ❑ Owner ❑ Contractor 13 Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. �..--.� \ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $83.00 HAz. D Fe ES IMP FLOOD CDF PARCEL PD HD SSUFr 1�/ This permit is hereby issued under of the Butte County Code and/or indteateda6 v or wbfees have By . PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paidr �1 Date l D to Receipt No. r' WHITE-D.D.S.-B.D. CANARY -ASSESSOR INK -INSPECTOR- GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES - 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE FPO (261 6, O NER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice 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. z iJ � Date - ZZ 161 Inspector REV 1 2 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75AI R MIT NO. (Rev. 12/96) tAPPLICATION AND PERMIT ASSESSOR PARCEL NUMBER -620-091 ZONING BUILDING PERMIT OWNER EDWARD RMEMN TELEPHONE -695 SQ. FT. OCC. BUILDING VALUATION ��� . OWNERS MAILING ADDRESS 150 FAMILL DR., OROVILLE, CA 95966 CONT�NTT�RRA7A�77C�TT.O.��R�'S NAME OWNER TELEPHONE cont.,. 1 00 1 9. JVD/ CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ 3,660.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20 00 Permit Fee M $63.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 150 FAT72Hrr 7 - DR. OROVITT.F Energy Plan Checking Fee $ , $ PERMIT FEE $ .6O LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF X3 Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other N Describe Work: RE -ROOF w CgM. & new sheathing Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.P License Class LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: C?"'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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. eLDs. So 3.5¢FT; qUIp MULTI.OLTTLET 97.50 OWER APPARATUS 8 SINGLE OUTLET CR. Ex. Occup. OUTLET OR FIXTURES BAL ® 1. o APP Ex. Occup.,OUTLEETS (RRES D.DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ WORKERS' COMPENSATION DECLARATION 1 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 is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed the permit is for work of a valuation of one hundred dollars ($100) or less.) 111-11 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date 9—G— 2_41y Signature of Applicant - Owner ❑ Contractor ❑ Agent An OSHA permit is require for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.30 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 83.00 HAz. D FEEs IMP FLOOD COF PARCEL Po HD VLSU{y / This permit is hereby issued under the of the Butte County Code and/or Resolutions inted v or w ich fees have By PERMIT EXPIRES ON applicable provisiois to do wank been paid Dat D to Receipt No. 775 77 75 77 775— WHITE-D.D.S.-B.. CANARY -ASSESSOR INK-INSPECTO GOLDENROD -APPLICANT aev.12ro6) 4.vuty 1 Y vF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATInu AND PERMIT PERMIT NO. AaapsOR rARCEL Nyyaa i � nDMuO OWNER BUILDING PERMIT OwNa? WAJM AOOREft r / `/v ��� SO OCC. Rt ru n�u,..,... _ OON/TRNCn0m LeOEr1 IENDER's ►w1HO ADOMS ARf:NrtFCT-OR eMNEER WusTl� OR e1oNIMI "11UNO ADDRFes aUIDNOAOOREte IOTNO. sUEDIVOKMIMkW USEOFSTRUCTURE SF O Duplex O Mobllehome ❑ Other New O Addition O Describe Work: _ `! TYPE OF WORK O Udid s O Insulation *PERMIT FEE PAID SRA -- SHERIFF OTHER AMOUNT RECEINEb *RECaPT NVMBER " TO BE PUT INTO COAAPVI'ER Total Valuation I,' Fhn FeePermit FeePlan Checkn FeeEnergy Plan Checking Fee i PERMIT FEE t rLUM81NG PERM Each Trap Solar or heat pump water Water piping Each gas water heater or Gas piping system 1 - 5 of Mobile Home PERMIT FEE I i ELECTRICAL PERMIT Main Service °O0V °R LEss �ooA oR LEss Main Service 20" TO 1000A NEW CONST. DWEi11MO OCCUP. OR AOONs, a AOC. aws. NOIiNE4i0. MULTLOUTLEr aPDWE71 APPAMTIAI Cut i Ex. OCCU ofmET OR FVmjAea Elf. Occup. FS�Ns O AP. OR 1 OVTIE�y evo. EA 1 Temporary Service 1 Mobile Home Facilities PERMIT FEE i MECHANICAL PERMIT PERMIT FEIE S Mobile Home Installation Fee S Energy Inspection Fee = J' oce COMT. Tri TOTAL FEE $ I 20.00 11 �1ung ree 20 00 _7.00 23.00 15.00 15.00 15.00 15.00 it3"i20.00 Fee 20.00 23.00 49.00 23.00 20.00 23.00 9.50 20.00 11AZ 0. FEES OMP ftWO COW PARC NO Esu 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. I By Date PERMIT EXPIRES ON v 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 ajor labor and materials for construction of the proposed property im vement : YES 13 NO ❑ I HAVE HAVE NOT 11 signed an application for a building permit for the proposed work. 1 have contracte �� the f 11 perso�(firm) to provide the proposed construction: NAME: ADDRESS: /57 CITY: � • Z --/l I ?S-Alr ' PHONE: x.33 6 9 Q6 CONTRACTOR'S LICENSE NO., 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: CITY: 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 PROPERTYOWNER:% DATE_Q - 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. F I_ ; OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible parry of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. r rely, Mic el C. Vi iia, C.B.O. M ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER 0 !� 77- 9 PERMIT NO. 6b-80B,E PERMIT EXPIRES OWNER Dan Robertson owner CQNTR., ^LOCATION (A.P. 36-62-3 w, 150 F. -d&11 Dr., lot 46, Oroville E. ( 1 i 4, 1 f• Temp. Power.Pole Called yyi(G& E Temp. EI�'c. Serv. SJ �v k Call.eHHd PG&E ltd Temp as Serv. Gafffffflled PG&E B INALED (Date) r 5 (Signatur COUNTY.OF BUTTE — DEPARTMk-1 OF -PUBLIC WORKS .BUILDING INSPECTION RECORD BUILDING I IBUILDING (Cont'd) I PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Sidina To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for ph sically handica ed Conformance of ex. siyt2fe/7-I Appliances Gas Piping &Test i TemD. Gas Patio *IREPLACE in Footings Footing ECT ICAL Masonry Walls Throat Rough Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr- mean MECHANICAL Grd. Fault Prot. Scratch Heating Service Frown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation anent Door Closer Final Fina Z MOBILEHOME UTILITIES ------------------ Elec. Service ec. Pedestal - Water Piping Sewer Gas Piping O11LEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS r 3 (NOTE: An entry must be made on this form each time you visit the job site.) I / � 6827-79B,P,E,M PERMIT NO. PERMIT EXPIRES OWNER Dan Robertson CONTR. owner 36-62-3 :'LOCATION (A.P. ) 150 Fairhill Dr., Oroville • s . i �r J '1 Y Temp. Power Pole Called PG&E Temp. Elec. Se/i� . A/, --7 f 7 Called PG&E Temp. Gas Serv. a Called PG&E JOB�/ FN ED �l .(Date) j, (Signature i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING Setback Forms Main Bldg. Footinas Slab Piers Garage Stemwa I I Slab Footings Slab Patio Footings isonry Walls Reinf. Steel Mesh / Brown Finish Interior Lath Door Closer MOBILEHOME UTILITIES Water Piping BUILDING (Cont'd) Firewall Q1410, Z Z / 9- Parapets Restroom Finl Windows Siding Roof Sheathing 15-79 Roofing Fdn. Vents Garage Vents Insulation Prov. for phy Cally handica ed Conf-canance of ex. Footin final F r Test Final Heating Cooling Ducts V %— do nal ---------------- ec. Service Sewer ON -------------- Support 4-2- Z— 2- Z 2— Soil Piping 1st Floor 2nd Floor 3rd Floor Topout Water Piping Sewer kEv Fixtures Z I Water Htr. Heaters Appliances Gas Piping & Temp. Gas Prot. Tema. Pole Vic. Pedestal Gas Piping Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS yu o 100, a ty PLUMBING (NOTE: An entry must be made on this form each time you visit the job site.) L PLUMBING --Above Floor 1. ater Heater--Vent--Access--Combustion-Air ater,Pi a --Test & Anchors --Nail Protection rain Pipe--test--Fittings & Anchors --Nail Protection iShower Pan --Test, First. f loor--Tub Access Z 4� kU Test Tub & Shower, second floor --Tub Access Gas Pipe --Size & Anchors Permit No. t" Test !� -3- ELECTRICAL --Above Floor /,Clearance & Insulation Protection at Flush Light Fixtures Permit No., lec. Receptacles Spacing --Lights & Switches at Doors Size Boxes & No. of Conductors --Stapled omex Installed Close to Edge of Studs & C.J. ui . Ground made up w/Mech. Fasteners 2 Appliance Circuits 'n Kitchen & Conductor Size Sub Feeders --Wire siz a. Cu or Al, Breaker Size Q Amp.-- Insulated Neutilal Yes No 8. Range Circuit JZW ga. Cu or Al, Breaker Size Amp.= -Oven "Wreaker Size M Amp, Circuit ga. Cu or Al, Service --Riser Conductors & Ground Bond Gas & Water Pipes Clothes Closet Light --Shower Light 12 Sign Job Card ALL OF ABOVE COMPLETEDEXCEPT Si n d• ABOVE LISTED CORRECTIONS COMPLETED Date: Date: 7�P0• . ......................... ........ -•--- MECHANICAL --Above Floor Y .C. Ducts --Insulation & Su ort :....... . Permit No. ent Fan --Exhaust Above Insulation - -Condensate Drain & Overflow --Size & Grade Furnace--Vent--Access-Comb.Air--Return Air Vent --115V Outlet Attic Access & Platform if Furnace in Attic 6. Sign Job Card ALL OF ABOVE COMPLETED nj EXCEPT Signed: ABOVE LISTED CORRECTIONS COMPLETED Date: Date: 2 l 6 -3- FINAL Permit No. 1A �rmnfn Ste s Door & Sideli ht Protectionke Detector nace--Vents Clearances Combustion Air :Connecto Garage -Height & Mech.Protection Bedroom Exiting . I. & Bath Fixtures Electric Trim & Sub Panel --Labels -8:= Stairs & Rails F re lace or Stove --Clearances Hearth Electric Outlets at Wood Panel --Int. & Ext. F xtures & Appliances in Kitchen--Grounded--Air Gap --Cooking Clearance 1 ec tical Outlets & Receptacles at Kitchen Counter 1 G e Fire Door --Swing & Landing, C1 ser Duct in Garage --Damper Water Heater --Vents, Clearances, Combustion Air, P.R.V., Connector Garage -Height & ech.Protection 'rewalls & Openings --Area Se aration Walls X -7'. -Electrical Receptacles in Garage G.F.I Romex protect . Insulation--Foam--Looked in Attic Yes • Steps at Ext. Doors & Landings I 46,'.(G and Rails and Deck Construction oundation Vents &.Crawl hole Door --Drainage & Wood-Earthearances-- oked Under Floor -7—% Yes 2k'.Following Installed: Drive Yes L/ No; Walks Yes No; Planters or _1#�ing Walls %�/ Yeso---Creatin Drainage Problems 7'7 Yes 1 �7 No .C. Unit --Disconnect Clearances Breaker & Conductor Size --115V Outlet Vents Above Roof --Plumbing, Appliances, Fireplace --Clearance to Openings A7r. ater Well -Disconnect Electrical Plumbing xterior Electrical Trim& G.F.I. Rece tacle Ventilation Throughout House lass Protection 2 • Corrections from Previous Inspections -(has & E1 tic _,Water Supply & Sewage Connected 3T..E,pergy Compliance Certificate Sign Job Card ALL OF ABOVE COMPLETED / / EXCEPT ABOVE LISTED CORRECTIONS COMPLETED -4- P L U M B I N G lLe.L T ;ter ❑ Permit ❑ Under. oor. Stage D.W.V.: (1) Sizing. (2) Materials. (3) Fittings. (4) Grade & Support. (5) Cleanouts & Accessibility. (6) Clearances. (7) Rough -in Locations. ❑* (8) Wrapping. (9) Test - including "Ts". (10) Additional test not requ ired .* ❑ Water: (1) Sizing. (2) Materials. (3) Support. (4) Test. (5) Wrapping. (6) Dissimilar metals. (7) Service regulator installed or not required.* ❑ Gas:' (1) Sizing. (2) Materials. (3) Support. (4) Log Lighter. (5) Wrapping. ❑ Framing Stage (Top Out D.W.V.: (1) Size. (2) Vent Area & Termination. (3) Materials. (4) Fittings. (5) Grade & Support. (6) Cleanouts. (7) Traps. (8) Nail Protection. (9) Plumbing Access. (10) Toilet Clearances. (11) Shower size. (12) Shower Pan Test. (13) Vents - turns, horiz., runs, loop, wet, etc. ❑ (14) Additional 2nd floor test not required.* ❑ Water: (1) Pipe Test. (2) Mixer Valves. (3) Support. (4) Roof drains. ❑ Gas: (1) Size. (2) Materials. (3) PR Valve Drain. ❑ Water Heater: (1) Vent. (2) Location. (3). PR Valve Drain. ❑ F inal D.W.V.: (1) Connected to sewer system. (2) Special systems. ❑ Water: (1) Water Source. (2) Shut-off. (3) Anti -siphon Valves. ❑ Gas: (1) Test. (2) Connectors. ❑ Water Heater: (1) Location. (2) Accessibility. (3) Clearances. (4) Stability. (5) 18" Garage Floor. (6) Mechanical protection. (7) Combustion Air. (8) Draft Diverter. (9) Vent Connector. (10) Vent. (11) Shut-off and connector. (12) PR Valve & Drain. ❑ Fixtures: (1) Approved. (2) Stability. (3) Clearances. (4) Trapped. (5) Connections. (6) Cross -connections. (7) Dishwasher Air Gap. 5/79 1' - -A - M E C H A N I C A L l�L .... 1. T .,- ❑ Permit ® Underfloor Stage ❑ Underfloor Supply Plenum: (1) One-story. (2) Clearances. (3) Combustible material. (4) Insulation and vapor barrier. (5) Access. (6) Catch, receptacles and registers. (7) Fire -stopping. (8) Boots. (9) Supply ducts. (10) Gas lines and plumbing cleanouts. Eucts: (1) Size. (2) Materials. (3) Support. (4) Fittings. (5) Wrapping. �! (6) Insulation. (7) Clearances - ground, crawlspace, cleanouts., plumbing, etc. ❑ Combustion Air: (1) Size. ❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (4) Insulation. ❑ Framing Stage ❑ Heating: (1) Approved appliances. (2) Accessibility..(3) Clearances. (4) Combustion air. ❑ Vent and Connector: (1) Approved. (2) Size. (3) Clearances. (4) Cap. (5) Termination. ❑ Ducts: (1) Materials. (2) Size. (3) Support. (4) Fittings.. (5) Insulation. . (6) Fire Damper. ❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (4) Insulation. (5) Condensate drain. Final Heating: (1) Accessibility. (2) Combustion air. (3) Safety controls. ❑ (4) Electrical connection. (5) Fuel shut-off. ❑ Cooling: (1) Accessibility. (2) Support. (3) Controls. (4) Pressure- relief valves. (5) Class 2 refrigerant. 5/79 FRAMING Permit No. I Z� C�_40 Plans @! Si11s--Proper Material and Anchors. ,x/Walls--Studs--Nailing & Spacing & Bracing --Plates" Bearing Wall s & ire Stops --Furred Ceilings--Stairs--Chases--Tub (& Header & Beam --Size & Bearine Bz Lo -I— i ers--Post Caps--Anchors- iling Joists, Rafter Ties Roof Bracinc. Trusses. S Fireplace Ties or Type A Flue --Fireplace Throat Attic Access --Size & Romex Proteci i 12'*.� Bedroom Windows or Exiting Doors --Sill Hat. & Dimensions Garage Fire Protection Framing Separation Walls --1 hr. Fire --2 hr. Fire W. Ext. Doors --One 3' - Check Garage 4. Stairs --Width, Headroom, Rise, Run, Landing --Fire Protection --Attic Vents --Ra --Nailing--Veneer. lA: Stucco Mesh, Drip Screed & Foundation Vents & Underfloor Access Glass Protection ob Card Ny ABOVE LISTED -2- Signed: �j J Date: 2 ( SIGN JOB Date: c -1- RESIDENTIAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMA4CE WID�A CU RRE ENERGY CONSERVATION REGULATIONS AT % S D �G�ti Z 42,- J (location)/ BUILDING PERMIT NO.�'�'2%— 62 d -SU A. P. N0. �"e --3 THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge. Fdn. Walls Floors Walls Ceiling/Roof .-/9 Ducts �,v��• Circulating Pipes cam✓ APPROVED HEATER 1� APPROVED WTR.HTR. GLAZING: Single Glazed Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. WEATHERSTRIPPED DRS. vsC�J BACK DAMPERED FANS_ INTERMITTENT IGNITION UEVICEST CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name Signature of (please print) Insulation Applicator State Contractors License No. General Contractor/Owner Name Vn0//1 J- Aoi3e�^�4t�rl Signature of (please print) �% General Contractor/Owner r Date State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. ng Address Contractor 0a Mai I i ng Address Building Address ANNW COUNTY OF BUTTE -. DEF_ARTMENT OF PUBLIC WORKS 7 County Center DFive - brovIrle" California 95965 Telephone: 534-4541 APPLICATION AND PERMIT C / d a Tele one No. Telephone No. �i�v sz1 1 C/o A. P. No'."' fp zj -� Zoning 8 F'r5nn g F �I.c. Fire Dept. Fire Zone Use Permi EQA I Parking I Parcel 60' R/W I Improvements Pians Declaration P Bldg. Plans Rec'd I Parcel Approval I Plans Approval NEW W ADDITION ❑ UTILITIES ❑ OTHER ❑ Single Family 19 Duplex ❑ Mobil Home ❑ Others ❑ 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: _ BUILDING Ij SO. FT. I OCC. I BUILDING V Fireplace ' Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1-- 5 outlets Each additional outlet Building sewer Lawn sarinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP N BRANCH CIRCUIT EX. OCCUDIOUTLETS OR FIXTtIRE. EX. Occup.(FIXED APPLNS. OR OUTLETS (RESID.) EA Temporary service Mobile Home Facilities Misc. Wiring License No. Classification I am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT FILING FEE I am aware of the provisions of Section3700 of the California Labor Heating G�/(ti 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 'Cooling 5 Workmen's Compensation Insurance. I 'f h $3.00 5.00 2.50 25.00 1.00 ?¢sq ft ?.50ea 2.00 10.00 15.00 6.25 $3.00 FEE .DU 15401 cert) y t at In the performance of the work for which this Ventilation permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of Hood 2.00 1 Z.dd California. Permit Fee $ . b7J $ � I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X v G` ✓ Date "� Signature of Permitee or Agent % t,\ Receipt No. White-D.P.W. —or — Pi k -Inspect r —Golden Land Development Fee $ TOTAL PERMIT FEE This permit is hereby issued under the applicable provi °s0� the B County Code and/or resolutions to do work 'r c7Wq abov f which fees have been paid. 0,70 )IR OR OF UBLIC WORKS BY K Date-t/—Z)U " Building permit expires Date I • `� IF TY OF BUTTE — DEPARTMENT.OF"PUBLIC WORKS — BUILDING DIVISION 7 County Center Drive — Oroville. California 95965 — Telephone 534-4541 I --0,q1j 4�erz Building Use_ fee based upon: PERMIT APPLICATION DATA SHEET Complete Contract Price Other (explain) Permit No. A.P. No. L•"DPW Valuation Building Inspector ( ' ` Date ///%�/ 71 At time of permit application, I waasdvised the following data must be submitted priorfto permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted................................................................... ?j Plot plans in duplicate tri licate............................................................... Complete plans in du ica /triplicate................................................... 4. Complete engineered plans and calcs..................................................... K 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 lv�'j Health Dept.... 11. Planning approval for ............. 12. Certificate of Workmen's Compensation Insurance ........................ 13. Contractors License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec. request to bldg. inspector (date) 16. Other When you issue the permit, process as follows: Mail to owner Mail to contractor. Telephone and hold for pickup atoffice. Deliver w/inspection. Other Applicant/G�c., r�//�"� Date Copy of plans sent Health Dept., Fire Dept., Other Date— During ateDuring the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above 1. Index permit for above Itl 2. Additional items required: (Contractor, Designe ,Owner was advised of above required data by Telephone S Mail Other �Y Date Plans checked by Plans approved by OTHER: I — - / - ;W,1 1A " V Conv/DPW 970 7 v� Date Date // — O — O' l.; COUNTY OF &T -T) '=c-DE•PARTMENT Of PUBLIC WO 1 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X✓ Date o?' /� a" ignature of Permitee�ent _ Receipt No. S 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 ByDatePZ-1 if—, wilding permit expires Date ��� q Pe BUILDING Owner n4-4/ 006607 0A SQ. FT. OCC. BUILDING VALUATION Q�=0a Mai Iing Aded'ress 210 FA ( I?— U, T> s, 0C> Contractor (,U /V ��_ Mailing Address Fireplace Total Valuation •V 0 Telephone No. Permit Fee "DO Building Address 1 %o ;UI� 'L> tom- l PIanCheckingFee &/orPenal ty , 00 4 Permit Fee ,Oa 0 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 TW OP y� -0 Repair drainage or vent piping 1.50 �y Z_2 A. P. No. (0 J Zani Planning Water piping 1.50 Each gas water heater or vent 1.50 F s Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans ParcelParcel Declaration Ma p 60' R/W Im rovements p Each additional outlet .30 Building sewer 5.00 Bldg. Pla Recd I Parcel A r of I Plans Appro al Lawn sprinkler system 2.00 +_ NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ permit Fee $ ELECTRICAL No. @ FEE is Ir-7op — — �O?I PERMIT FILING FEE $3.0000V OR L Main service 100 AMP ORSLESS 5.00 Single Family ©/ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 ' Main service OVER 600 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. I DWELLING OccU M OR ADONS. ACC. BLDGS. 22sgft V 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: MUL NEW CONSTR BROUTL T NON•RESID ( BRA.ANCCH CIRCUITS) 12.50ea Jr NEW CONSTR. POWER APPARATUS 8 NON•RESI D. SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXTIIRES g 0251'01 FIXED APPLNS. OR Ex. Occup.(oUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 or I am exempt from the Contractors License Laws of the State of California. Permit Fee $ .70 $ (� MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of y(orkmen'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. PERMIT FILING FEE $3.00 Heating Cooling 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 Land Development Fee $ TOTAL PERMIT FEE $rJZ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X✓ Date o?' /� a" ignature of Permitee�ent _ Receipt No. S 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 ByDatePZ-1 if—, wilding permit expires Date ��� q Pe COUNTY OF BUTTE — lJ PA MENT,i7_F�PUBLIC WORKS — BUILDING DIVISION 7 County Center Drive — O.rov�il'le', California 95965 — Telephone 534.4541 PERMIT APPLICATION DATA SHEET j Permit No. OWNER RAId TaoSEkj A.P. No. ?)G-G�'Z'" Proposed Building Use , , ADD Z X07-44, C. r2e Permit fee based upon:1;1 �1 % Complete Contract Price DPW Valuation /thper�(e•xplain)Building Inspector ���'X Date 2 - "�' — c� At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE 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 ............. 12. Certificate of Workmen's Compensation Insurance ........................ 13. Contractors License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec. request to bldg.inspector (date) 16. Other When you issue the permit, process as follows: Mail to owner Mail to contractor. Telephone t53` /��1z--' and hold for pick-up at A?"R a office. Deliver w/inspectior. Other Applicant 14f _4 J � , a Date Copy of plans sent Health Dept., 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 Telephone Mail Other By Date Plans checked ity1214 1—Date Plans approved Date 2 —1440 OTHER: Coov/DPW N F 036-62=0-003 93-1592 B,M: REDFERN., EDWARD 150 FAIRHILL DR, OROV ILU. GAS LINE, WTR HTR, FURNACE/SF P, OFFICE COPY Address GAS Meter By Dat'e4a ELECTRIC. M—ef—er-gy — — — — — — D_ale- 7 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone., 916.'538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S T G W @ 15.00 TYPE OF WORK New Addition _ Remodeli Utilities ❑_ JnstallationC Other E]Permit Describe work: _ Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS Main service 200A TO 1000AI CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ^7 J 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 ,J 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 _37.50 NEW CONST. / DWELLING OCCUPM 3.54sq.ft. OR ACDNS. \ ACC. BLDGS. NEWCONSTR.ULTI-OUTLET NON -RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS5) (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES20 @ 760 FIXED APLNS. Ex. Occup. OUTLETS P(RESID.)REA.T I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 15.00 Heating 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 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 County in consequence of the granting of this permit. X Date Si nature of Applicant - Owner g pp ❑ Contractor El ❑ 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 $ Ener Inspection Fee $ Energy P OCC CONST TYPE TOTAL FEE $ HAz 1 0FEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi- sions 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 Date Receipt No. WHITE-D.P.W.. YELLOW-ASSC3SOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PU WORKS PERMIT NO. 7 County Center Drive - Oroville, ralifo�nia 95965 -Tel h ne: 6.'538-7541 �9 2— APPLICATION AND PERMIT c� ASS SSOR PARCEL NUMBER 036-620-003 ZONING AR BUILDING PERMIT OWNER EDWARD REDFERN TELEPHONE 533-6956 S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 150 FAIRHILL DR., OROVILLE CA 95966 CONTRACTOR'S -NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Ener Plan Checking Fee Energy g ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 150 FAIRHILL DR., OROVILLE Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.001 7.00 USE OF STRUCTURE SFNI Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.001 5.00 Building sewer15.00 Mobile Home S G W @ 15.00 TYPE OF WORK,, New ❑ Addition Lj Remodel L Utilities LJ InstallationC Other ❑ Describe work: ADD NATURAL GAS LINE/REPLACE WATER HTR & FURNACE Permit Fee $ 27.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS Main service 200A TO 1000A1 37.50 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 [YI, 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 CONST. DWELLING 0CUP.& 3.6Q sq.ft. OR ADDNS. ( ACC. BLDGS. NEW CONSTR. MULTI -OUTLET @ 5 00 NON•RESID BRANCH CIRCUITS) POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 20 76[4 FIXED APLNS OR \ EX. Occup. OUTLETS P(RESID,) EA./ I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. P/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 Filing Fee 15.00 Heating FORCED AIR 9.00 Cooling g Hood 6.50 Ventilation Permit Fee $ 24.00 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 co sequence of the granting of this permit. X � Date .5 - Z F-' 93 Signature of Applicant - owner (�7� g pp L� Contractor ❑ Agent ❑ 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $51.oa HAz I DFEES IMP J FLOOD I CDF I PARCEL PD HD I ISSUY This permit is hereby issued under the applicable provi sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IC WORKS By PERMIT EXPIRES Dat Date Receipt No. 143906 WNITE-D.P.W., 7ELLOW-ASS[SSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT �• .. .. ♦-i { � v • � � • .. ^"ty.:IN. i, : � �• .?S r�"..X'.1R,+w. :';'" M 1 j,a.�r •�`�'f�: � .�..tti� .�..�.-.� _ . , f �-'�:4� „fir -• 'v .. C.QUNTYOF BUTTE - DEPARTMENTOVLOPMEN RVI ES - BUILDING DIVISION S /7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 9596 -TELEPHONE(916)538-7541 PERMIT APPLICATION DATASHEET OWNER�/D �/1�--�"' A. P. o.� Proposed Building Us ding Inspector Date At time of perm pplication, I was advised the following data must be submitted prior to permit processing and/or issuance: / DATE RECEIVED BY 11 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. 1" 10. Fees of $......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . 15. City of Chico plumbing permit . ......................................... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). . . 20. Pre -inspection for required. o Building 6A r6e o� (Date)+ 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................................... . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ........................................ . 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. .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 'e� g Acreage Applicant G Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916 '538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PA CEL NU BER 1 ZONIN BUILDING PERMIT o ����� TELEPHONE SO. FT. OCC. BUILDING VALUATION OW ER'S ILING A0013ESS, K /Z_L_ ((�11 C NT A TORSINAM TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING AD Ess Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each pas water heater or vent 7.00 C3 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 -5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW 1 615.00 TYPE OF WORK New, Addition;_ Remodel[ Utilities[] Installation❑ Other/❑ Describe work: f/ L /V ��PZ,lf � F Permit Fee $ 9 Z1262 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO IOOOA1 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the Bu$Ines$ 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 CONST./ DWELLING OCCUPM oR ADDNS. l ACC. BLDGS. 3.64sq.ft. NEW CONST R. MULTI -OUTLET NON.RESID BRANCH CIRCUITS) POWER APPARATUS &) (SINGLE OUTLET CIR. 276cl Ex. Occup(OUTLETS OR FIXTURES 20 AL. 460 Ex. OCCUp. OUTLETS PIRESID IFIXED APLNS. REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Iyirin g 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. Ej 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 Filing Fee I 15.00 Heating+' IC/100 Cooling g Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. 1 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 County in consequence of the granting of this perr1 . Q- X Date o Si nature of Applicant - Owner Signature pp ❑ Contractor ❑ Agent An OSHA ion of structures t�ovverZ3,gstoriess in height.Ions over 5'0" deep and demolition or construct- Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE f� TOTAL FEES V HAz I DFEES IMP I FLOOD CDF PARCEL P HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable prov - resolutions to d� have been paid - WORKS Date Receipt No. 1 /7QS� WNITE•D.P.W., TtLLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7.County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) T� s 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 City Phone Contractors License No. 4: I 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. 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 Owner ,, Social Security Number _-' Date 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. u — 5 I . 1 i .p� F r n L, n I 1 y • � �.p li �'1 �lr I 1 r L rz r. yy t r Y ,r �r ° I L , 1 , , i r , I r 4 11 , t' I F 4 t p f , {r L r, a M % f�ifiiiio_lli, fi[i % 42 �tl R)!�y lit I Tqqq V kiff 10 19PRTM T111IT1111ir E 2 4 UG ACCURA01 T, 0 Y, F - CUT -H E �J,,4,,GR PHY. Cj.p RA , C t` Ile 'Pre T, y9v V, �i% V $51 " f f6r the best, In P&PER ond,i�t .4 1 UVI),�-1;'�,' 94 06 ,94 U 104 ;�Zj ula.L L 98 09 Z4 Oz V.1 �!Y V T -t 40 4 41 '44 67 Z L 7 44 Ire profecfion,�a nd C! 4!' AM HA;L%. 1 It L 1I YYA ........ . 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