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HomeMy WebLinkAbout079-130-028JOHN M. HANDLIN r; njj _ Ogg 35 Audui:a Circl6,- lot 2_53, Orovil e Permit#1695 ?( 1,3 -85B,P,E,M(new single family) [ HANDLIN, JOHN 05-1470 , 15 AN RA 5 ANDORA CIR., OROVIL�LE 0 t. 0 Cont: OWNER 00 RE -ROOF w laef r 1CnI NOTES r " RESIDENTIAL PERMIT NO. 036-620-025 OS 1470 HANDLIN, .JOHN 35 ANDORA CIRN, OROVILLE Cont: OWNER RE -ROOF SPECIAL CONDITIONS CHECKED; BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER i JOB FINALED (Date) Signature J=OK 0= Not OK . = Not Rbte . =Not Readyeady MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Cana B-1 Date 1.' Zoning Requirements -Setbacks -Easements Date 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 1. Zoning Requirements -Setbacks -Easements 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ P' L "ftJ P LPG 3. Blocking 7. Well Clearance & Disconnect 8. Utility Clearance 5. Electricity; MH Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 9. Exits 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 11. Verify #'s with Office 6. Water, MH Test-Regulator-Connectot 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged Card B-1 Date 9. Tie Downs -Type -Installation Cert. Date 10. Exits; Insp.-Sketch Card B-1 11. Cert. of Occupancy Date Card B-1 Date Cana B-1 Date Cana B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK -except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-Depth-Spacing-Connectors-StBel 3. Decks, Girders and/or Joists -Decking -Bracing -Stair -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns-Connections-Splice-Decal-En:losures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. g; Nailing -Veneer -Stucco -Mesh Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date (0-_J6_CL5 Card B-1 Date Cana B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. -Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK = Not OK = Not Applicable " = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows; Date Cana B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Win Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Stec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive 0 Yes 0 No/Walks 0 Yes 0 WRanters 0 Yes 0 No 84. Stucco Brown -Finish 85_ A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 0' 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, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Profession& Code Date: �-50wner: t aA__4� WORKERS' COMPENSATI N DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit 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 insurance carrier and policy number are: Carrier: PERMIT NO. BPO51470 Issued Date: 06/07/2005 APN: 036-620-028-000 Site Address: 35 ANDORA CIR ORO Map Index: Description: re roof 31 squares Owner: HANDLIN JOHN M & WESLIE M JT 35 ANDORA CIRCLE OROVILLE, CA 95966 Applicant: HANDLIN JOHN M & WESLIE M JT Contractor: License #: Architect: Engineer: Policy u. Total Square Ft: el I certify that in the performance of the work for which this permit is Valuation: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: and agree that if I should become, subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 6 Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. 35 ANDORA CIRCLE OROVILLE, CA 95966 0 S. F. CONSTRUCTION LENDING AGENCY This permit is he y issued under. e' appti a provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions t tlo work ' ic5f above for hic es have been paid. _ performance of the work for which this permit is issued (Sec 3097 Civ.)�� Name: BY: ///GGG///��` Date: Address: PERMIT EXPIRES ON: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5.of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the abovermentioned property for inspection purposes. f � 1 f Print Name: L, 6 ii ' / 9 c r" 11y� Signature:�r Date:, ❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01.16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO51470 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/07/2005 APN: 036-620-028-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 35 ANDORA CIR ORO License Class: License Number: Map Index: Date: Contractor: Description: re roof 31 squares OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: HANDLIN JOHN M & WESLIE M JT permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 35 ANDORA CIRCLE the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 95966 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): /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 anHANDLIN Applicant: JOHN M & WESLIE M JT owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 35 ANDORA CIRCLE sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of OROVILLE, CA. proving that he or she did not build or improve for the purpose of 95966 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does 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.). Contractor: ❑ I aim Exempt Article 3 of the Business and Profession& Code /under S Owner: Date: 1 A —L WORKERS' COMPENSATI N DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy #: I certify that in the performance of the work for which this permit is . Valuation: $0.00 O issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �) Date: l• S Applicant: WARNING: Failure to secure workers' compensation coverage is Cnr unlawful, and shall subject an employer to criminal penalties and one VVV hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is he y issued u} e e applipaVe provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions t o work ' ie� above for hic es have been paid. Name: By Date: !J PERMIT EXPIRES ON: Address: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19627.5.of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the abovermentioned property for inspection purposes. l �dMI6ti J VkS6V) �� -91 Print Name: ' , a 8r1� Signature: Date: / — ❑ Owner ❑ Contractor /Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER Last Name. A L First Jame c S Lpc Address . Sr A N o©RA Ll R C c_ City �<Q p f (LCG State C R zip9S Phone 3 ,3, 6 Fax E-mail / �/ CONTRACTOR Name City b RQ r LrL6 Address Zip�S City Fax State Zip Phone Address Fax E-mail Lic. # Class / �/ ARCHITECT/ENGINEER Name City b RQ r LrL6 Address Zip�S City Fax State Zip Phone Address Fax E-mail State License Number APPLICANT NAME Name L.._ C o (� F C d r t V1S tJ ✓\ Address -S-3,0W D"fla ra C'G l City b RQ r LrL6 State C± Zip�S Phone Ci q �rI l 1 Fax E-mail APPLICANT SIGNATURE X1 / For office use only: Zoning Flood Zone SRA Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIr NO. 5`tf7 BIN # LOCATION _ \� API,_(),5 Property Addre s 7' don 'f I ►' fit! y 'cOv Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker a compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: ' Jf� Wr'-'f_3/'Sa 3 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. 5� Received by- � Amount: Bldg l� SRA Receipt #: qI� I Sheriff SMTP Date:Other. � � � �]� Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 June 7, 2005 Lloyd F. Parkinson is given my permission to sign and represent John (deceased) and Wesley Handlin on my behalf as my agent on Parcel #036-620-028 at 35 Andora Circle, Oroville, CA., 95966. �.v Iva Wesly Handlin 35 Andora Circle Oroville, CA., 95966 PERMIT NO. 1695-85B,P,E,M PERMIT EXPIRES 0 OWNER JOHN M. HANDLIN CONTR. owner ASSESSOR PARCEL 36-62-28 LOCATION 35 Andora Circle, lot 25, Copley Acres,, Oroville V, <-+o, fi r. 4 OFFICE COPY Address GAS Meter By Dat,14-14 i ELECTR Meter By Date 1 30 Temp. Power-vue, Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service CailedPG&E JOB FINALED (Date) Si V = OK O = Not OK Not*qi�plicable Not Ready RESIDENTIAL (Single and Duplex) i Date UNDE LOOK Plans OK except #'s Date FRAprrrvc, (Continued) ni requirements -Setbacks -Easements 41al P perty Line Firewall & Openings F ., Main; Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 4 Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 4. Ftg., Garage; Soils -Steel- / /" Ftg. Depth Ft orches & Decks; Soils -Steel- / /" Ftg. Depth 51,-'P Idth-Headroom-Rise-Run- Land ing-Fire Protection ood on Roof Overhang -Attic Vents -Rafter Outriggers t alls, Main; Steel-Blockouts-Wrapped-Slab 5 Sidin -Nailing-Veneer IIs, Garage; Steel-Blockouts-Wrapped-Slab Mesh -Drip Screed-Fdn. Vents-Underflr. Access ers- U Mg. -Steel 5 lazing Area -Glass Protection -Skylights -Plastic Fall -Fittings -Test -2 way C/0 -Sewer Testear lls; Nailing -Bolt Pipe; Size -Anchors I_.,IX 0 1 Water Pipe; Test-Anchors-Regulator-Servic st 11. Electric; Underground 12. enums & Ducts; Clearance -Material -Support -Ins. 1V Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -!I Date rd -BI Date I Card -BI Date Card -BI Date Datea If_'C'Card-131 Date Card -BI .Z Date / Card -BI Date Date FINAL tans) OK except N's Card-BIDate Card -BI Date Date PLUMBING (Permit) OK except q's 5 ri,Steps-Door & Sidelight Protection -Landings 5 moke Detector !J=',14J Water Ht.; Vent -Access -Combustion Air ce_ Vents -Clearance -Comb. Air -Connector - I ar ; Above oor-Ducts-Mech. Protection Fater Pipe; Test & Anchors -Nail Protection .V.; Test-Fttngs & Anchors -Nail Protection Bgdroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 6 - F.J.,VBath Fixtures & Tub Access 18. Testjub & Shower, 2nd Floor -Tub Access 61 ec. Trim & Subpanel; Breaker Sizes -Labels La, -,Gas Pipe; Size & Anchors s r tove; Clearances -Hearth E Outlets at Wood Panel; Int. & Ext. Card -B Date y �s�. I31 Date 6 Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance BI DateCard-BI Date 6 Elec. Outlets & Receptacles at Kit. Counter Date ELECT L Permit OK except q's Swing -Landing -Closer e- Damper F i x t yA4 Transformer Clearance -Ins. Protection 6 tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In_Cd'rage; Above Floor-Mech. Protection7 ec. Receptacles Spacing -Lights &Switches at Doors oxes & No. of Conductors -Stapled Ib lec. &Mech. Equip. Listed for Location ex IIled Close to Edge of Studs & C.J. 714,efec. Receptacles in Garage; (G.F.I.)- x Protec. 2 ip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation-EseRr-Eooked in Attic 0 Yes 21L lance Circuits in Kitchen &Conductor Size �T9-9aard-Aei+s & Deck Construction -Post Caps bfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents &Crawl Hol D -Drainage & Wood -Earth Clearance Looked under Floor s �2fi—Raric. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Iosulaled Neutral ❑Yes El No 75. Following instld.: DrYes o; Walks ❑Yes o; ivePlanters ❑Yes No 28. -Riser Conductors & Ground -Main Disconnect ZG St n- finish Equip. earances; Panels-Motors-Mech. Equip. lothes Closet Light -Shower Light 7 Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 7$e—'Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. e ; isconnect, Electrical, Plumbing CApd'8rior B -I to p�7 -BI Date Elec. Trim; G.F.I. Receptacle -Underground g ilation throughout House Card B -I Date Card BI Date 8 ss Protection Date MECHANICAL (Permit) OK except k's Corr ctions from Previous Inspect' 84. s t -Meters Tagged; G--ElectricL7- 31. A.C. Ducts; Insulation &Support Wa & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation nergy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Card -BI Card -BI ate _L _ Card -BI Date Date_ Card -BI Date to Card -BI Date Card -BI Date Card -BI Date Date FR" IN OK except q's Comments at Final: ,,-�W Proper Material & Anchors 3 alts; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing 39 raft Stop in Walls (rat proof) o s; Furred Ceilings -Stairs -Chases -Tub Bader & Beam -Size & Bearing 4 ngers- Post Caps -Anchors -Connectors 4 Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq_.-Rfn_g_._ _ ire a Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4 Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 4 Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) J = OK. _ = Not OK = Not Applicable MOBILEHOMES MISCELLANEOUS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -.Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rig.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enc losures- Pane lboards- Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date i COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534A541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. X -SCi ; r G „mac S 2L �i ov; Z� c't7r-�,C ra-1 er-Aru. 1411 I 'r-0- V., Lt / NA e 'i L-cevJ 6{ lr r Inspector�� Date ___ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 / S� �L-op APPLICATION AND PERMIT ASSESSOR _P`RC L NUMB �J{BUILDING ZONIN PERMIT owN TELEPHONE SQ. FT.OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS v ` CONTRACTOR'S NAME 1^ TELEPHQNE li l CONTRACTOR'S MAILING ADDRESS Fireplace CONSMUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 1.00 LENDER'S MAILING ADDRESS Permit Fee $ tI ARCH ECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ $ A-1 60 ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS " — PLUMBING PERMIT Filing Fee 1.00 fiC d V- (2' le Each Trap 8T 2.00 14.00 Solar Water Heater 20.00 J Water piping 5.00 °;100 LOT NO. ds SUBDIVI ION 11ME PARCEL MAP p y Each qas water heater or vent 5.00 L- 00 Gas piping system 1 -5 outlets 5.00 S.00 U E OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W 10.00 e TYPE OF WORK NewAddition ❑�QRemode1 ❑ Utilities F-1InstallationOther ElContractor Des ibe work: 6 �k Permit Fee $ 119,10 ELECTRICAL PERMIT Filing Fee 1).00 Main service 100 AMP ORV OR LESS10.00 Main service EA. ADD'L 100 AMP 2.50NEW ' OR ADDNST ( ACCLBLDGS.LING CC i 21/20sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ElI 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 I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR ULTI.OUTLET 2.50 ea NON.RESID BRANCH CIRC ITS NEW CONSTR POWER APPARATUS & NON.RESID. SINGLE OUTLET CIR. Ex. Occu 2D@SOt P OR FIXTURES 9AL®30 FIXED APP LNS. OR Ex. OCCUp. FIXED A OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 E d 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. ❑ 1 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 1C.00 Heating Q'A FUy11,Ze__& Cooling nQ ( O� Hood 3.00 Ventilation J 3,120 permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue again sai aunty in consequence of the granting of this permit. nn %� Date -� ai— S' ature of Applicant — Owner LJControctor ❑ 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 $ _ LN` p .0 TOTAL ERMIT FIR/E $ occuP. GROUP 33 TYPE o�oNST. PAj;1, ,V/ PD HD ISSUE •t// This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC BY - � PER T EXPIRES Date _ the applicable p-ovi- resolutions t:D do fees have been paid. WORKS Date J -!-,'G Receipt No. SDI? WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OPrPU LIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,10_CA LI &NIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET 5 Proposed Building Use Permit Fee Based Upon: Building Inspector Complete Contract Price Other (Expolain) Permit No. A. P. No. U/o r/� `oy _DPW Valuation Date 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 and AC Buildings. 8. Fees of $ , . . . , , , Letter of signature authorization. . . . . . . . ,Sanitation approval from /l%/,�i��%1 Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner0, Mail to owner ❑.) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . •Pre-Inspec. request to 1 Pre -Inspection for Required. Building Inspect (Dare) M141" Recorded copy of Agricultural Acknowledgment Statement. (���c�-S 19. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone 5_99- 01>1 and hold for pickup at Dia office. Deliver w/inspectcr. Other Applicant )444 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 by Date Plans approved by Date Other: Copy—DPW Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT OF °UTT s,• Section 26-8.1 C''�U••I t•CALI O;NWA of the Butte County Code requires this acknowledgement AT7NER uC'IESq OF be recorded prior to issuance of a building Permit. The•property described herein is adjacent to land or included 1365 JUN I within an area zoned for agricultural purposes, and residents of this 2 P14 4• property may be subject to inconveniences or discomfort arisingfrom CLERK -RECORDER the use of agricultural chemicals, including,�I_C/�•FIU,� I I• y-EEir;•�' and fertilizers; and from the pursuit o but not limited_o herbicides,pesticides, Fcc"es, to cultivation f agricultural operations including, pesticides, , plowing, spraying, pruning,al but not limited ;�,q smoke, noise, and odor. Butte County has established sagriculturalwhich czones nai priority use for productive agricultural purposes; and residents within s y generate dusrt, adjacent property should be prepared to accept such inconvenience o which have as a necessary farm operations. said zones and ron m r disconform from norma!, All that real property situate in the County of Butte, State of California as follows: as Lot25, as shown on that certain Map entitled which Map was recorded, in the office -of the Recorder of Acres theSCounty sofnButte, State of California, on August 1, 1963 in Book 30 of Maps, at pages 38, 39, and 40, Date: State of Calif ) County of .Butte ) SS. games®tate®��s9mm�eao®®tats�a® KELLY J. WHITE no NOTARY PUBLIC -CALIFORNIA Butts County . P My Commission Expires May 3, 1988 O pts®�®waeame�ols■®�sto®o.sles� . PRO ERT OWNERS: On this the 1_ 2 _ day of June me, the undersigned Notary Public 19 85 before personally appeared ******JOHN M. 1iANDLIN**** / Personally known to me. LXX Proved to me on the basis to be the of satisfactory evidence. the withinpinstrumenthand acknowledged one subscribed to that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I..hereunto set my hand and official seal Present A.P. No. N It y, Public Telephone '533-2000 North Burbank Public Utility District 1960 Erin Street OROVILLE, CALIFORNIA 95965 DISTRICT APPROVAL AND 40-85 VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North Burbank Public Utility District, must be submitted to Butte County. Applicant: JOHN M. & WESLIE M. HANDLIN Applicant Address: 5250 Olive Hwy, Space 1020, Oroville Applicant Phone No.: 589-0171 Property Location (s): Andora Circle Copley Acres Subd., Lot 25 A. P. No. (s): 36-62-28 Fees Paid: $200.00 Annexation, $35.00 Connection, $900.00 SC -OR Regional Facility Charge Due i Application for service approved: North Burbank June 12, 1985 Public Utility District Inspection(s) made and successful test(s) observed: Location: Date: By: North Burbank Public Utility District release to close permit: Date: By: Owner: ROOF Pernft No. ENERGY CERT IF ICAT ION Lot 25, 35 Andora Oroville, CA 1..0CATION - A. P. No. DESCRIP'T'ION OF INSULATION Material _ Brand Name Thickness(inches) Thermal Resistance (R,Value) EXTERIOR WALL Material Fiberglass Brand Name CertainTeed Thickness (inches)_ Thermal Resistance(R Value)_ - 17 CEILING Batt or Blanket Type Brand Name Thickness(inches)`_ _ Thermal Resistance(R Value) Loose Fill Type erg ass Brand -Name CertainTeedInsulSafeIII Minimum Thickness(Inches ���— ii Number'of Bags Wt. per bag Area covered (ft.2) Thermal Resistance(R Value) R-3 O �LOOR, ELEVATEE�iberglass CertainTeed Material Brand Name Thickness(inclies) 34 Thermal Resistance(R Value) R-19 FLOOR, SLAB Material Brand Name _ Thickness(inches) Thermal Resistance(R Value)________ Width(inches) FOUNDATION WALL Material Brand Name_ Thickness(inches) Thermal Resistance(R Value) I hereby certifys ^hat the above insulation was installed in the above building in conformance with the State of Calif y Requirements. QIiaael�. ns O'n-sl lation Co/Inc. 37F 4a7 _ 10 — STATE CONTRACTOR'S LICENSE N0, 21318 TURE OF INSTA TION A DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and.materials are of the quality prescribed or are specifically approved by the State of C.ali.fornia. FIRM NAME/OWNER (Please print) SIGNATURE OF QENERAL CONTRACTOR OIJIdiER STATE CONTRACTOR'S LICENSB NO, DATE TRIS CERTIFICt1T4f3S>T BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INS_P) C'rION APPRQY II, '`AN'b A COPY SHALL BE POSTED WITHIN THE BUILDING. January 1984 ��, _, +.•'len.Rix.Alr^+d'^^.�""igpW°�y7�y.4iF^`,y��a'dY'!t'(vT,in,' .�..�."`.•�'-„* 'r'. Telephone l� 533-2000 North Burbank; Public. Utility District 1960 Elgin'Street OROVILLE, CALIFORNIA 95965 DISTRICT APPROVAL AND - 40-85 ` VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North Burbank Public Utility District, must be .submitted to Butte County. Applicant: JOHN M..& WESLIE M. HANDLIN Applicant Address: 5250 Olive Hwy, Space 1020, Oroville Applicant Phone No.:. 589-0171 Property Location (s): Andora Circle Copley Acres Subd., Lot 25 A. P. No. (s): 36-62-28 Fees Paid: $200.00 Annexation, $35.00 Connection,. $900.00 SC -OR Regional Facility Charge,D� e Application for service approved: North Burbank June 12, 1985 Public Utility District Inspection(s)_m e and successful test(s) observed: Location: Date: Do By: North Burbank Public Utility District release to close permit: Date: D By: G