HomeMy WebLinkAboutB16-2203 041-410-023v
BUTTE ;COUNTY AREA
DEPARTMENT OF DEVELOPMENT SERVICES 3
INSPECTION CARD f4UST BE ON JOB SITE
24 Hour Inspection Line (IVR) : 530.538.4365 (Cut off time for inspections is 2pm)
Development Services cannot aarantee inspections on the date requested
Office: 530.538.7601 Fax: 530.538.7785 www.ButteCounty.net/dds
Permit No: B16-2203 Issued: 11/1/2016
APN: 041-410-023
Address: 3767 STEAMBOAT ROCK. RD, BUTTE
VALLEY
Owner: SOUTHWORTH KEVIN R. & SMALL APRIL
Permit Type: LIMITED AG
Description: LTD AG BLDG (2112) W/ELECTRIC
1 Flood Zone: A SRA Area: Yes
SETBACKS for Zonine. G W
Front: 20 Centerline of Road:
Rear: 10 SRA:
Side: 10 AG:
Other: 10
t Total Setback from Centerline of Road:
k
ALL PLAN REVISIONS MUST BE APPROV!, D BY THE COUNTY BEFORE. PROCEEDING
Insvection Type
IVR INSP DATE
Setbacks
131
Foundations / Footings
111
Pier/Column Footings
122
Eufer Ground
216
Masonry Grout
120
:F:
Setbacks
-
Do Not Pour Concrete Until Above are Sign d
Pre -Slab
124
Gas Test Underground/floor
404
Gas Piping Underground/floor
403
Underfloor Framing
149
Underfloor Ducts
319
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Manufactures Name:
Date of Manufacture:
Do Not Install Floor Sheathing
or Slab Until Above Signed
Shearwall/B.W.P.-Interior
134
ShearwallB.W.P.-Exterior
135
Roof Nail/Drag Trusses
129
Do Not Install Siding/Stucco or Roofing Until Above Signed
Rough Framing
153
Rough Plumbing
406
Rough Mechanical
316
Rough Electrical
208
4 -Way Rough Framing
128 .
Gas Piping House
403
Gas Test House
404
Shower Pan/Tub Test
408
Do Not Insulate Until Above Signed
Inspection Type
IVR INSP DATE
T -Bar Ceiling
145
Stucco Lath
142
Swimming
Pools
Setbacks
131
Pool Plumbing Test
504
Gas Test
404
Pre-Gunite_
506
Pre -Deck
505
PooFFencing/AlarmsBarriers
503
Pre -Plaster
507
Manufactured Homes
Setbacks- _ �,--------------"
Blocking /J V OFFICE COPY
Tiedown/S ,Bfdg'Permit: W
Permanent r:1r . f M
Under roti Address'
Sewer �' _ `._ _
Undergroli :.. • ' M
Manomete -GAS By: - Date:'
Continui Electric By: Date:
Skirting/Si
Coach Info
Manufactures Name:
Date of Manufacture:
Model Name/Number:
Serial Numbers:
Length x Width:
Insignia:
Mechanical Final
809
Plumbing Final
813
Fire Sprinkler Test or Final
702
«—
i, Env. Health Final 538.7281
►t Sewer District Final
t
1{ "PROJECT FINAL 1
,1 *Project Final is a Certificate of Occupancy for (Re identi 1 On )
PERMITS BECOME NULL AND VOID I YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY rR A 1 YEAR
RENEWAL 30 DAYS PRIOR TO EXPIRATION
j
1
tIsUalys�Iyl t, tr U
LICENSED CONTRACTOR'S DECLARATION 4
- OWNER/ BUILDER DECLARATION- _.
Contractor (Name) State Contractors License No. / Class / Expires
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for
OWNEWBUILDER
the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section
_
7031.5, Business and Professions Code: Any city or county that requires a permit to construct. alter,
improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she Is Iicensed.pursuant to the provisions of the Contractors'
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter g
(comment ng with Section 7000) of Division 3 of the Business and Professions Code, and my license i
State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
in full force and effect.
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption.'
X-
Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
not more than five hundred dollars ($500).):
I, as owner of the property, or my employees with wages as their sola compensation, will
Contractor's Signature r Date
correct.
do U all of or U portions of the work, and the structure is not intended or offered for sale
(Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who, through employees' or personal effort, builds or Improves the
property, provided that the improvements are not intended or offered for sale. If, however, the
building or improvement is sold within one year of completion, the Owner -Builder will have the
WORKERS' COMPENSATION DECLARATION
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'
burden of proving that it was not built or
improved for the
compensation, issued by the Director of Industrial Relations as provided for by Section
purpose of sale.).
3700 of ale Labor Code, for the performance of the work for which this permit is issued. Policy
No.
_
I, as owner of the roe `
p p rty, am exclusively contracting with licensed Contractors to
El
authorization form ,
construct the project (Section 7044, Business and Professions Code: The Contractors' State
I have and will maintain workers' compensation insurance, as required by Section 3700 of
License Law does not apply to an owner of property who builds or improves thereon, and who
the Labor Code, for the performance of the work for which this permit is issued. My workers
contracts for the projects with a licensed Contractor pursuant to the Contractors' State License
compensation insurance carrier and policy number are:
Law.). .
Cartier. Policy Number. Exp. Date:
❑ I am exempt from licensure under the Contractors' State License Law for the following
reason:
I certify that, in the performance of the work for which this permit is issued, I shall not
-
employ any person in any manner so as to become subject to the workers'
_ compensation laws of California, and agree that, if I should become subject to the workers
`
Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
_
provisions.
Owner's Signature,Date
X
PERMIT APPLICANT DECLARATION
Signature Date
By my signature below, I certify to each of the following:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
I L) California licensed contractor or Uthe property owner' or U authorized to
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
act on the property owner's behalf**.
ct a
I have read this construction permit application and the information I have provided is
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN
correct.
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
I agree to comply with all applicable city and county ordinances and state laws relating
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
to building construction.
I authorize representatives of this city or county to enter the above -identified property
CONSTRUCTION LENDING AGENCY DECLARATION
for inspection purposes., California' Licensed Contractor, Property Owner* or
Authorized Agent": `requires separate verification form "requires separate
hereby affirm under penalty of perjury that there is a construction lending agency for the
authorization form ,
performance of the work for which this permit is, issued (Section 3097, Civil Code).
'
Lender's Name and Address
V - - -
Lenders Name & Address City State zip
FEE INFORMATION '
Total Fees: $1,520.65 ' Fees Paid: $1,520.65
Balance Due: (None) Job Value: $53,000.00
BUTTE COUNTY AREA
DEPARTMENT OF DEVELOPMENT SERVICES 3
INSPECTION CARD MUST BE ON JOB SITE
24 Hour Inspection Line (IVR) : 530.538.4365 (Cut off time for inspections is 2pm)
Development Services cannot guarantee inspections on the date requested
Office: 530.538.7601 Fax:530.538.7785 www.ButteCountv.net/dds
Permit No: B16-2203 Issued: 11/1/2016
APN: 041-410-023
Address: 3767 STEAMBOAT ROCK RD, BUTTE
VALLEY
Owner: SOUTHWORTH KEVIN R. & SMALL APRIL
Permit Type: LIMITED AG
Description: LTD AG BLDG (2112) W/ELECTRIC
Flood Zone: A SRA Area: Yes
Front: 20 Centerline of Road:
Rear: 10 SRA:
Side: 10 AG:
Other: 10
Total Setback from Centerline of Road:
ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING
Insvection Type
IVR INSP DATE
Setbacks
131
Foundations / Footings
111
Pier/Column Footings
122
Eufer Ground
216
Masonry Grout
120
Setbacks
131
Do Not Pour Concrete Until Above are Signed
Pre -Slab
124
Gas Test Underground/floor
404
Gas Piping Underground/floor
403
Underfloor Framing
149
Underfloor Ducts
319
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Blockin nde inin
612
Tiedown/Soft Set System
611
Do Not Install Floor Sheathing
or Slab Until Above Signed
Shearwall/B.W.P.-Interior
134
Shearwall/B.W.P.-Exterior
135
Roof Nail/Drag Trusses
129
Manometer Test
605
Do Not Install Siding/Stucco or Roofing Until Above Signed
Rough Framing
153
Rough Plumbing
406
Rough Mechanical
316
Rough Electrical
208
4 -Way Rough Framing
128
Gas Piping House
403
Gas Test House
404
Shower Pan/Tub Test
408
Do Not Insulate Until Above Signed
Permit Final
802
Electrical Final
803
Mechanical Final
809
Plumbing Final
813
Fire Sprinkler Test or Final
702
Swimming
Pools
Inspection Type
IVR INSP DATE
T -Bar Ceiling
145
Stucco Lath
142
Swimming
Pools
Setbacks
131
Pool Plumbing Test
504
Gas Test
404
Pre-Gunite
506
Pre -Deck
505
Pool Fencing/Alarms/Barriers
503
Pre -Plaster
507
Manufactured Homes
Setbacks
131
Blockin nde inin
612
Tiedown/Soft Set System
611
Permanent Foundation System
613
Underground Electric
218
Sewer
407
Underground Water
417
Manometer Test
605
Continuity Test
602
Skirting/Stens/Landings
610
Coach Info
Manufactures Name:
Date of Manufacture:
Model Name/Number:
Serial Numbers:
Length x Width:
Insignia:
Public Works Final 538.7681
Fire De artment/CDF 538.6226.
Env. Health Final 538.7281
Sewer District Final
**PROJECT FINAL
*Project Final is a Certificate of Occupancy for (Residential Only)
PERMITS BECOME NULL AND VOID I YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR
RENEWAL 30 DAYS PRIOR TO EXPIRATION
BUTTE COUNTY AREA
DEPARTMENT OF DEVELOPMENT SERVICES 3
INSPECTION CARD MUST BE ON JOB -SITE
24 Hour Inspection Line (IVR) : 530.538.4365 (Cut off time for inspections is 2pm) '
Development Services cannot guarantee inspections on the date requested
Office: 530.538.7601 Fax: 531
Permit No: B16-2203•. Issued:.l1/1/20.16 .
APN: 041-410-023
Address: 3767 STEAMBOAT ROCK RD, BUTTE
VALLEY
Owner: 7SOUTHWORTH KEVIN R. & SMALL APRIL '
Permit Type: LIMITED AG ,
Description• LTD AG BLDG (2112) W/ELECTRIC
ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY.BEFORE PROCEEDING
Inspection Tyve
www.nurret-ounry.neuoos
Flood Zone: A ,' SRA Area: Yes
SETBACKS for Zononp. AG. SRA- PW
Front:
20 Centerline of Road:
Rear:
10' SRA:
Side:
10 AG• ..
Other: •
'10
Total Setback from Centerline of Road:
ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY.BEFORE PROCEEDING
Inspection Tyve
IVR INSP DATE
Setbacks
131
Foundations / Footings
111
Pier/Column Footings
122
Eufer Ground
216 .
Masonry Grout
120
Setbacks
_4
Do Not Pour Concrete Until Above are Signed .
Pre -Slab
124 .
Gas Test Underground/floor
404
Gas Piping Underground/floor
403
Underfloor Framing
• 149
Underfloor Ducts
319
Shear Transfer ' .
136
-Under Floor Plumbin
412
• Under Slab Plumbing
• 411
Blockin nde inin
612 `
Tiedown/Soft Set System
611
Do Not Install Floor Sheathing
or Slab Until Above Signed
Shearwall/B.W.P.-Interior
134 '
Shearwall/B.W.P.-Exterior
135
Roof Nail/Drag Trusses
129
Manometer Test
605
Do Not Install Siding/Stucco or Roofing Until Above Signed
Rough Framing
.153
Rough Plumbing
406--
06••Rou
h Mechanical,
Rough
316
Rough Electrical
208
4 -Way Rough Framing
128' .
Gas Piping House
'.403
Gas Test House
404- -
Shower Pan/Tub Test
408
Do Not Insulate Until Above Signed
Inspection TVpe
IVR INSP DATE
T -Bar Ceiling
145
Stucco Lath
142
Plumbing Final
813.
Fire Sprinkler Test or Final
702
Swimming
Pools
Setbacks
131
Pool Plumbing Test
504
Gas Test
404
Pre-Gunite
506
Pre -Deck
505
Pool Fencing/Alarms/Barriers
503
Pre -Plaster
507
Manufactured Homes
Setbacks
131
Blockin nde inin
612 `
Tiedown/Soft Set System
611
Permanent Foundation System
613
Underground Electric
218
Sewer .
-407
Underground Water
4171
Manometer Test
605
Continuity Test
602
Skirting/Steps/Landings
610
Coach Info
Manufactures Name:
Date of Manufacture:
Model Name/Number:
Serial Numbers:
Length x Width: •.
Insignia:
7'.,--=-7777
, d h7 , u' r, , u' Finals! 's .' 7. 7
Permit Final
802 -
Electrical Final
803
Mechanical Final
809
Plumbing Final
813.
Fire Sprinkler Test or Final
702
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR
RENEWAL 30 DAYS PRIOR TO EXPIRATION . .