HomeMy WebLinkAbout079-260-007z Euripides Quiles Fi l`e-
7300 Lower Wyanodtte Rd., Oroville
Permit #5444-80B,P,E,M(addition &
remodel/SF)
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QUILES, ENRIQUE 05-2387
7300 LOWER WyANDOTTE RD
ORO VILLE
Cont: THOMAS E. WARNER
MC)
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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.
BP052387
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 09/06/2005 APN: 036-310-140-000
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.Site
3 3 67 25
Address: 7300 LOWER WYANDOTTE RD ORO
License Class : License Number:
Date_ Contractor..—L im_ i
Map Index:
Description: DEMO PORTION OF HOME (1020) KITCH,
OWNER -BUILDER DECLARATION
BA, BRK NOOK
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
Owner: QUILES, ENRIQUE
to its issuance, also requires the applicant for such permit to file a
263 S MAPLE AVE
signed statement that he or she is licensed pursuant to the provisions of
SAN FRANCISCO, CA
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
94680
she is exempt therefrom and the basis for the alleged exemption. Any
650-872-1556
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 1, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: THOMAS E. WARNER
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
105 SHELTERWOOD LN
such work himself or herself or through his or her own employees,
OROVILLE CA
provided that such improvements are not intended or offered for
95966
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
(530) 589-2068
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
Contractor: THOMAS E. WARNER
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
105 SHELTERWOOD LN
pursuant to the Contractors' State License Law.).
OROVILLE CA
❑ I am Exempt under Article 3 of the Business and Professions Code
95966
(530) 589-2068
Date: Owner:
License #: 330725
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
Architect:
is issued.
I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier: u
Total Square Ft: 0 S. F.
Policy fl: :2
Valuation: $0.00
Census Code:
❑ 1 certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
J
Date:
Applicant: C�&)�
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.
l�►1' ,j J
CONSTRUCTION LENDING AGENCY
This permit is hereby sued under the applicable provisions of the Butte Co ty Co and/or
I hereby affirm that there is a construction lending agency for the
Resolutions o indicated above for which fees have been paid. (���
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performance of the work for which this permit is issued (Sec 3097 Civ.)
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Name:
By: Date:
66
Address:
PERMIT EXPIRES
Date
❑ ' 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 & 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 above mentioned property for inspection purposes
�� )�/ f� Signature:
�Print Name:
`
(J ~ d
Date:
❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor
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 OFAPPLICA TION
Website: www.buttecounty.netldds
"*PLEASE PRINT CLEARLY"'
OWNER INFORMATION
Last NameFirst
N me
t
Address 6 So m -C ,oy e
City S� StateLo
t� a
SRA I
Phone
a.
E-mail
APPLICANT SIGNATURE
X SAI
For office use only:
CONTRACTOR
Name
0
NdA
Address
SRA I
City
No
Stat d
Zip S1
Phone `
d
Fax
E-mail
Planner
Lic. # 6 7
Class
APPLICANT SIGNATURE
X SAI
For office use only:
ARCHITECT/ENGINEER
Name
NdA
Address
SRA I
City
No
State
Zip
Phone
Book
Fax
E-mail
Planner
State License Number
APPLICANT SIGNATURE
X SAI
For office use only:
APPLICANT INFORMATION
Name
C�l A o�
Address
SRA I
City
No
State
Zip
Phone
Book
Fax
E-mail
Planner
APPLICANT SIGNATURE
X SAI
For office use only:
Zoning
Pro e,dy Address
/3�0vccr1
Flood Zone
Cross Street„�DD//i
SRA I
Yes
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgAPP1SubRgmts.doc
PERMIT
NO.
BP:-.
PROJECTLOCATION
AP#
Pro e,dy Address
/3�0vccr1
City
>^a
Cross Street„�DD//i
WORKER'S COMPENSATION
Policy Number v
//?
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
Sheriff
SMIP
'LENDING AGENCY
Name
Address
Description or Scope of Work:.
Sq FT- Living /p A Garage 'Open Cov
❑ 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.
Page 1 of 2
REV 8-12-05
eceived by:
Amount: Bldg
SRA
Receipt #:
l eJE5�) !l
Sheriff
SMIP
Date!✓ (,&SOther
o� Total
Page 1 of 2
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A1C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 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. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
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.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 A
Oct 11 02 08:45a
Demolition Permits
Asbestos Notification Statement
p.2
"Z J
Date
AP#
Pursuant to section 19827.5 of the California Health and Safety Code, all
demolition permit applicants are required to fill out this form.
"19827.5. A demolition permit shall not be issued by any city, county,
city and county, or state and local agency which is authorized to issue
demolition permits as 'to any building or structure except upon the receipt
from the permit applicant of a copy of each written asbestos notification
regarding the building that has been required to be submitted to the United
States Environmental Protection Agency or to a designated state agency, or
both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to that part. The permit may be issued without the applicant
submitting a copy of the written notification if the applicant declares that
the notification is not applicable to the scheduled demolition project. The
permitting agency may require the applicant to make the declaration in writing,
or it may incorporate the applicant's response on the demolition permit appli-
cation."
Attached is a.copy of my written asbestos notification to the United States
Environmental Protection Agency for the demolition project located at
Lq
Signature of Applicant
6R
I hereby declare that a written asbestos notification to the United States
Environmental Protection Agency is not applicable to this demolition project.
-
Signature of Applicant
2/19/91
r
P o,. 54444'80B,P,E,M
PERMIT EXPIRES zwn
OWNER
Euripi�s Quiles
CONTR. owner
ASSESSOR PARCEL36-31-31
LOCATION 7300 Lower Wyandotte Rd., Oroville
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Temp. Power Pole
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Called PG&E
Temp. Elec. Service
S�
Called PG&E
Temp. Gas Service
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Cal led PG&E
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JOB FINALED (Date)
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Signature
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1
V = OK ,
0 = Not OK
=Not Applicable MOBILEHOMES
Not Ready
MISCELLANEOUS
Date
MOB(LEHOME UTILITIES (Plans) OK except p's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'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)
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
4, Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; LocatiorrTest-Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec. -
Card -Bl
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/O to Grade -HD Approval
7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater , ^,
B. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. `
Boxes -Enclosures -Panel boards -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-1
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B-1
Date Card -BI Date
Card -BI
Date Card -BI Date
A
J = OK
0 = Not OK
= Not Applicable
* Not Ready RESIDENTIAL (Single and Duplex)
Date A ANDERFLOOR Plans OKex:;e t#'s
Date
FRAMING (Continued)
Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
_Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
A& Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
_
50
St ' s; Width -Headroom -Rise -Run -Landing -Fire Protection
FA., Porches & Decks; Soils -Steel- / /" Ftg. Depth
'Sr
Djywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
gi2l
Siding -Nailing -Veneer
6. Stemwalls, Garageteel-Blockouts-Wra ed -SI
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fire a Ftg.-Steel f'
54.
55.
Glazing Area -Glass Protection -Skylights -Plastic
Shear Walls; Nailing -Bolts
V.: Fall-Fittings-Tes -2 way C/O -Sewer T t
G Pipe; Size-Anchors 1
1 ater Pipe; Test -Anchors -Regulator -Service Test _
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Card -BI
Card -BI
Date Card -BI Date
Date Card -BI Date
Date Card -BI Date
Card -BI Date / Card -BI Date
Date
FINAL (Plans) OK except N's
Card -BI Date Card -BI Date
/�..r lr
Date PLUMBING (Permit) OK except q's
56.
Ext. Steps -Door & Sidelight Protection -Landings
57.
Smoke Detector
4. fflater Ht.; Vent-Access-ConSustion Air
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
Water Pipe; Test & Anch 21SA!, P o
4Fjjqj/&6. *15W.V.; Test Fttn nc ors -Nail Protection
59.
Bedroom Exiting
17. Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
U6 T Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
1 Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI Date 6 Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI Date Z 1/ Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date ELECTRICAL Permit OK except N's
67.
Garage Fire Door; Swing -Landing -Closer
_ 68.
A.C. Duct in Garage -Damper
20. Fixture & Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
lec. Receptacles Spacing -Lights & Switches at Doors
70.
Plb., Elec. &Mech. Equip. Listed for Location
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
le-RDmex Installed Close to Edge of Studs & C.J.
E ip. Ground made up w/Mech. Fasteners -Bond Gas &Water
72•
Insulation -Foam -Looked in Attic E] Yes
2 Appliance Circuits in Kitchen &Conductor Size
73.
Guard Rails & Deck Construction -Post Caps
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor El Yes
. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
7. Range Circ. / / ga. u or AI Oven Circ. / / ga. Cu or AI,
Insulated Neutral ❑Yes pfio
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes ❑No
28. Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29. Equip. Clearances; Panels-Motors-Mech. Equip.
77.
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30. Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I Date Card -BI Date
81.
Ventilation throughout House
Card B -I Date Card -BI Date
82.
Glass Protection
Date MECHANICAL (Perrr,iq OK except #'s
-
83.
C9rre2!!jsn�from Previous Inspections
T65r-Meters Tagged; Gas -Electric
31. A.C. Ducts; Insulation & Support
85.
Water & Sewer Connected -C/O to Grade -HD Approval
32. Vent Fan; Exhaust above Insulation
_ 33. Condensate Drain & Overflow; Size & Grade
86,
Energy Compliance Certificate -Other Certificates
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 Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI Date Card -BI Date
Card -BI
Date Card -BI Date
Date FRAMING Plans) OK except q's
Comments at Final:
. Sills; Proper Material & Anchors
:1314alls; Studs -Nailing, Spacing & Bracing -Plates -Sound
r�_ 34,;"Bearing Walls over Girders & Floor Nailing
3� aft Stop in Walls (rat proof)
. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
/yeader & Beam -Size & Bearing
4Q1 angers -Post Caps -Anchors -Connectors
CIng. Joist-iiftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfnp.
4fireplace Ties or Type A Flue -Fireplace Throat
/Attic Access', Size & Romex Protection -Draft Stop -Ins. Baffles
4lie Bdrm. windows or Exiting Doors -Sill Hgt. & Dimensions
_
a7!Garage Fire Protection Framing
oeT e u made each time you visit jobsite)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
P R IT10
.
JJA
A55 5 R_PAP CkE L NU ER ZON G
BUILDING PE
OWNER3ELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S NTAILINq ADDRESS
(Aw
- ^
CONTRACTOR'S NAME
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TELEPHONE
V
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
UNKN w
Fireplace ,
Total Valuation $
LENDER'S MAILING ADDRESS
`
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
�IT�T OR NGINEER'S MAI LINA ADDRESS '
) '�/,�JePermit
49—
fee
$
DIN
ADD 55� ` t I (9-"-!C 14
PLUMBING PERMIT
FilingFee
r 'R1 _
Each Trap
2.00
Repair drainage or vent piping
2.00
z
r le-
Water piping
SIDO
OT NO.
SUBDI VISION NAME
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
^
USE OF STRUCTUR -
SF Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
2.00
WORK
—,/ TY;-7ut
New❑ AdditionU Remodellities❑ I stallation❑ Other❑
Describe work: —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 0
Main service 100 AMP ORV OR LESS5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLI OOt
OR AODNS. ACC. B
22 Sq ft
��
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and 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 CON5TR MULTI -OUT LET 2.50 ea
NON-RESID, BRANCH CIRC ITS
NEW CONSTR. POWER APPARATUS .&)
NON RES D. SINGLE OUTLET CIR.
EX..00CU 50 @L �
P�o Ts OR FIXTURES BAL�10¢
(FIXED
Ex. Occu FIXED TS (REAPPLNS. OR
Occup. (RESID.) EA,) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6,25
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.
otice 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 noo
Heating
00
Cooling
Hood
p
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, co ts, and expenses which may in any way accrue
agai said County i co eq ence of th ranting of this permit.
X Date
Signatyre o pplicant — caner Contractor ❑ Agent
An OSHA permit is required fo ovations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE
OCCuP, GROUP
R- 3
I TFY!PE o�f �° NST.
VIVO
®V
PARCEL
PD
HD
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREC '6 OF PUBLIC
ByDate
PE IT XPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
_/I—
Receipt No. O
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
. Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing permit. No building permit will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction
of the,proposed property improvement (yes or no) �.
2. I (have/have not) �igned an application for a building
permit for the proppgeld work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
N e
Ad sus City
$h a 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:
AddkOs City
Ph Contractors License No.
5. Iit provide some of the work but I have contracted (hired) the following
per ns to provide the work indicated:
e Address Phone Type of Work
S igned :
Prop
Soci
"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
permitted to issue the permit,
I
OWNER
Proposes ........,..y
Permit fee based upon:
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS — BUILDING DIVISION
7 County Center Drive — 0roville, California 95965 — Telephone: 534-4541
PERMIT APPLICATION DATA SHEET
�_ Complete Contract Price
Permit No.
A.P. No.
DPW Valuation
a Utner le plain
Building Inspector - Date —
At time of permit application, I was advis the following data must be submitted prior to permit processing and/or
issuance:
DATE RECEIVED APPROVED
1.
All items have been submit ed...................................................................
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.
�elephone.S�9
--SD- 3 and hold for pickup at (� ►^?1 office. Deliver w/inspection.
Other
0 d H S
' Applicant Date
Copy of plans sent Health Dept., iA
Fire �Dep.' Other
During the plan checking process, the following data must be submitted prior to permit
(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
Plans approved
OTHER:
Copy/DPW
Telephone
Mail
Other
ance:
Date.
NOTE:—All Mateticls $r Worlmanship'Be in
Accordance with Recognized Good Practices and
of a quality prescribed for she Specified use in the � 3
Uniform Building, Plumbing � & Machanical es and ! `
the National �lectricbl .ode.
A setback of 15 ft. from the
property line's and a setbat �E
of 50ft. froffi the road
centerline S all be cleatbf
structures cff— quipment 0:000
for q 2 ft. eave dverhang..__. Ak ..
f
V/ ✓�
!ns}all s nke detectowp
Provide adequate bracing.
3
2f X
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9.0 .
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0
--� 4;
�+1
M
BUTTE COUNTY
PUILDING DEPARTMENT
"Pot.C,/, ��2�¢v0C-• APPROVED
The mi imum STATE RESIDENTIAL ENERGY REQUIREMENTS for this building q'�}
ft•.�L�cl�-�!?DGijegree Days, and Design Temp. are:
S W D G 1�---- --�-•
t
P2oV/DE A, -,OD EX7E-RVCZ-
Insulation:
S,'_:b C -4w.... _ . .,� $__
c; <` :'ic..v-f•
/
11L
.A''X/2;x F A9
, _ ... s�, .�,—,,...
F:c ;rs - - - . - . - i ----.-11_
I
%q.
Ro S%7��
��d`�3 - ^ - - - - - - //stoo.: -
�YX�ap
n��z
Ceilir�cf2oc* - - - - . = /7,0�.-
��,,` .?arsi�r .
r�s reg.�ired
-
2ifx(P iF-AFTr-&S
►.+, ;, iz nrs.
- ce;t. & leb�sledj
2f X
-2. W, p.CG•
9.0 .
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0
--� 4;
�+1
M
BUTTE COUNTY
PUILDING DEPARTMENT
"Pot.C,/, ��2�¢v0C-• APPROVED
The mi imum STATE RESIDENTIAL ENERGY REQUIREMENTS for this building q'�}
ft•.�L�cl�-�!?DGijegree Days, and Design Temp. are:
S W D G 1�---- --�-•
t
P2oV/DE A, -,OD EX7E-RVCZ-
Insulation:
S,'_:b C -4w.... _ . .,� $__
c; <` :'ic..v-f•
/
sq. ft. -1--
AT7�/.(1<i
, _ ... s�, .�,—,,...
F:c ;rs - - - . - . - i ----.-11_
�:-•: rctiF::.=e�
S�. �Y. `
Ro S%7��
��d`�3 - ^ - - - - - - //stoo.: -
• '-
Ceilir�cf2oc* - - - - . = /7,0�.-
��,,` .?arsi�r .
r�s reg.�ired
This set of plans and specifications MUST be
/GCivcui,4;i,c -,��; _ ,�/l /VUR_
►.+, ;, iz nrs.
- ce;t. & leb�sledj
the job at all times and it is to
kept on cr
Ducf^,rs^?k �; i.= -
�`
CcorsP.:i'i7�9f53r1�F�ea}_--
ma.4e any' hanges or alterations on same without
Htg. & A.-
E, ° • -.. �3115
back dampered
written permission from the Department of Publij -
Type X/S 77 Al Cf
U: s Kc is
intermiffent ignitio
Works, County -of 'Butte.
BTU Max. _' At /A
WI Appliances
certified pp
Wtr. Hir. Type &X+I577A/4;..`_
Other:
_
-
. � 0
ti n c��P Il,I
1
f
F.
{j 1
8
P�
BUTTE COUNTY
BUILMNG DEPARTMENT
APPROVE!
70
7.
m
ill ,,�.
J11�L11_�-
r 7 IT I- U),7/
I
1-7
N-
Aza
Owner:
Addres
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT .
Tenant:
Building Location: 3.Q
Type of Inspection requested:
1. Housing 2. Financing
4.- Other (specify)
A.UU
Date of Inspection
10,
Inspector r.•{�!/.
'Present use. of building:
A. Sanitation (Housing)
1. Water closet: ,,.
2. Lavatory:.
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
.6. Heating facilities:`
7. Natural light and ventilation:
8. Room and space requirements:
9.. Bedroom window or door for second exit:
10. Infestation of insects, vermin, or rodents:
11. Connection to sewage disposal:
12. Connection to water'supply:
13. Rubbish and garbage facilities:
14. .Comments: -
B. Structural
1. Piers and footings:
2.- Floor construction:
3. Wall construction:
4. Ceiling and'roof construction:
5. Fireplaces:'
6. Comments:..
C. Electrical,
1. Service and ground:
2. Receptacles:
3. Fusing:
4. Comment s:
D. Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4.. Comments:
t
(enntinvF+ri nn hnrlr.l
E. Other
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Co►nments
F. Commercial Buildings
1. Roof covering:
2. Distance to property lines:
3. Physically handicapped:
4. test -oom floors and walls:
5. Exits
6. Improvements:
7. Zoning:
8. Comments.
G. Field Problemis or Violations
1. Problep�_ -violation (give comp_lete descriptic,n) :0��, L,
w .
2. ' What action taken (give complete. ;I.escrillt� ) :
/.fes ��./�lY/s �/i/1f�.L.�J /ilil�ra . �i .� ✓ !
3. What action reccimmended:
77A. A.A. infor ation only - filLe.
F-. B. Hold for ten (10) days, then write letter.
% I C-. Waite_ letter.
/7D,. Other:
2-S
t40`�