HomeMy WebLinkAbout038-170-04431
John Hanson
N/S Stanford d.,app.2 mi.E.of Hwy
99E, Durham
contr: Al Vial, Chico.- .�
Permit #4200-76B,P,E,M(add bathroom,
bedroom,carport,porch & deck - 3anodel
kitchen & elec.serv.change/SF)
7 38-17 --ZiaC)
Del ert Siems,.o_n,�
879/}Stanford Lanel,.Durham
"conte `Hol day•Po61's, -Chico
Permit #1827-78B,P,E(new private
sunnming pool) ,•�`�^_ _713/?g --
38-17-20
Contr; Servamatic Solar
Permit�k2079-83P(solar wtr ht/S )
�n
38-17---6 0yj
Con Ron Bunch
Permit7-85B(demolish/shed)
.R .
Contr: Ron Bunch Y
i Permit#1143-85B.;E� a.dd garage, reframe
garage dco opening, remove & replace
slum s=one veneer/SF)
B07-1662 038-170-,044
MISCELLANEOUS LPG Tank (AbvGmd)
} TANK SET,& GAS PIPING TO SF
8791 STANFORD LN
SIEMSEN,-_DELBERT & MARGARET
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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 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 8791 STANFORD LN
APN: 038-170-044
Owner:
SIEMSEN, DELBERT & MARGA
permit No: B07-1662
Issued Date: 08/01/2007 By KCG
Expiration Date: 07/31/2008
Occupancy: Zoning:
Permit type: MISCELLANEOUS
Subtype: LPG Tank (AbvGrnd)
Description: TANK SET & GAS PIPING TO SF
8791 STANFORD LN
DURHAM, CA 95938
(530) 345-4527
Contractor
Applicant:
Square Footage:
RELIANCE PROPANE SERVICE INC
RELIANCE PROPANE SERVI,
Building Garage Remdl/Addn
P0BOX 917
P0BOX 917
PARADISE, CA 95969
(530) 872-7740
PARADISE, CA 95969
(530) 872-7740
Other Porch/Patio Total
FEE INFORMATION
DBP Gas System (enter outlets) $58.00
Total Charged: $58.00 Fees Paid: $58.00
Balance Due: $0.00 Receipt No: B4088
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION. "
Contractor (Name) State Contractors License No. / Class / Expires
RELIANCE PROPANE SERVICE 734318 / B / 03/31/200$
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 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 such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractor's 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];
Please check one of the following:
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3/ the Business and Professions Code, and my license
is in full force
X 08/01/2007)
Contractor's Signature Date
❑ 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 License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are notintended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sale.).
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' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
,,���///
�/I I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
/L,Ct Section 3700 of 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: STATE FUND Policy Number. 316-0000185 Exp. Date:10/01/2006
(This section need not be completed if the permit is or one un red ollars ($100) or less.
❑ I, As OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
The Contractors License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
❑ I AM EXEMPT under Section B. & P.C. for this 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
X 08/01/2007
Owner's Signature Date
provisions.
X 08/01/2007
1 hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
prop wner r authorized to act on the property owners behalf.
�fP✓I.� ��ln 08/01/2007
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Namie. 07 NamP ee [SIGN] Print Date
❑ Owner ❑ Contractor OR. Agent for Owner MA@ertt for Contractor
FILE COPY
Lender's Address City State Zip
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 APPLICATION
OWNER
Name 0,1b,,,4-
e bei
dress
dress g 7 9/ 5 f -Rn 4e,, Z Rne
City p�rG
State
Zpg 593 0
Phone 3z/ �i5Z7
Fax
E-mail
PPLICANT SIGNATURE
X
For office use only:
CONTRACTOR
Name -
Address
6426 SKYWNY
� Same as Contractor
City RAD
Same as Contractor
State
Zip
PhoneFax
872-9200
Zip
Phone
E-mail
Fax
Lic. # 734318
1 Class
PPLICANT SIGNATURE
X
For office use only:
ARCHITECT/ENGINEER
Name
� Same as Contractor
Address
Same as Contractor
City
Subdivision Name
State
Zip
Phone
Lot #
Fax
E-mail
Date Approved:
State Ucense Number
PPLICANT SIGNATURE
X
For office use only:
APPLICANT NAME
Name
� Same as Contractor
Address
Sheriff
City
Subdivision Name
State
Zip
Phone
Lot #
Fax
E-mail
Date Approved:
PPLICANT SIGNATURE
X
For office use only:
-Bldg
Zoning
Flood Zone SRA I Yes No
Occ.
Sheriff
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
�0� �jCoCo�
BP
BIN #
2 G
LOCATION
�\
API V J O' -1 V _ &-2� O
Property Address
Cross Street
DUA4 C
WORKER'S COMPENSATION
Policy Number 1617722-02
Carrier-. State Fund
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:
lL 5e �- a,, 5
i -�,6
Sq. Footage
❑ Structure Built without Permits
O 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
'Received by r) 6 • Amount d '3
-Bldg
SRA
Receipt #: 14
Sheriff
SMIP
Page 1 of 2
1 -1 Other 0
Date: � J
5 g CIO Total
REV 4-30-04
1
48Q 7COZ35<L
April 10, 2002
Delbert Siemsen
8791 Stanford Lane
Durham CA 95938
Dear Mr. Siemsen:
Your property, parcel number 038-170-020-000 at 8791 Stanford Lane, Durham CA, is
located in a designated flood plain, zoned AE as shown on the map attached hereto. With
this zoning, an agriculture building is not permitted under current county regulations on
your property as it exists.
Sincerely,
y 1
8791 Stanford Lane
Durham CA. 95938
April 12, 2002
Department of Development Services
7 County Center Drive.
Oroville, CA 95965
Dear Sirs:
Enclosed is a proposed form of a letter, which I am requesting from your department.
The company from which I was to purchase an agricultural building is requesting this
information, in writing, in order for me to terminate the purchase agreement.
Sincerely,
Delbert Siemsen
p SCE WE
APR 55 2002
BUTTE COUNTY
PLANNING DIVISION
is Delbert Sfemsen `! `
t' y 8791 Stanford Ln.
Durham, CA 95938-9799
Department of Development Services
7 County Center Drive
Oroville, CA 95965
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Ed.
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Delbert Sfemsen
8791Stanford Ln.
Durham, CA 95938-9799 E
1
Delbert Sfemsen
8791 Stanford Ln.
Durham, CA 95938-9799
e
PERMIT NO. 1143-85B,E
' PERMIT EXPIRES -//C2_T, �lt&?
i.
OWNER DEL SIEMSEN
CONTR. Ron Bunch
ASSESSOR PARCEL 38-17-20
LOCATION 8791 Stanford Lane, Durham
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Temp. Power Pole
Called PG&E _
�i
. Temp. Elec. Service
Called PG&E
Temp. Gas Service /
r
Cal led PG&E
JOB FINALE[
• t
a
i
Signature
I:'
Y '= OK'
O = Not OK
Not Applicable
* = Not Ready
MOBILEHOMES
MISCELLANEOUS
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/O -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rflrs.-Connec.-Shthg.-Rfg.-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
Card -BI
Date
Date Card -BI Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except H's
Card -BI
Card -BI
Date
Date Card -BI Date
Date Card -BI Date
POOLS (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
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
8. 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 -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B-1
Date Card -BI Date
Card -BI
Date Card -BI Date
� ,w
= OK
= Nqt OK
= Noicable
= No[t Ready RESIDENTIAL (Single and Duplex)
Rea
Date NJDERFLOOR Plans OK except #'s
Date FR/cMLNG (Continued)
Y. Zoning requirements -Setbacks -Easements
romty Line Firewall & Openings
- el -Flet. Grnd.- / /" Ftg. Depth
0. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
. Ftg., Garage; Soils -Steel- / /" Ftg. Depth
th-Headroom-Rise-Run-Landing-Fire Protection
-4.._Ettg.iPorches & Decks; Soils -Steel- / /" Ftg. Depth
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
a--Slemwalts, Main; Steel-Blockouts-Wrapped-Slab
ailing -Veneer
temwalls, Garage; Steel-Blockouts-Wrapped-Slab
tucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
Piers -Fireplace Ftg.-Steel
lazing Area -Glass Protection -Skylights -Plastic
I7. D-W-V� Fall -Fittings -Test -2 way C/0 -Sewer Test
5K Shear Walls; Nailing -Bolts
?1�&es'Ptpe; Size -Anchors
10--Weter'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 Date 2 Card -BI Date
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Card -BI 7NDate Card -BI Date
Date FINAL,(Plans) OK except #'s
Card -BI Date Card -BI Date
.
Date P MBING (Permit) OK except #'s
&,. ,'Ext. Steps -Door & Sidelight Protection -Landings
-37-ftoke Detector
14 Water Ht.; Vent -Access -Combustion Air
-68,--Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15 Water Pipe; Test & Anchors -Nail Protection
16' D.W.V.; Test-Fttngs & Anchors -Nail Protection
-Bedroom Exiting
17 Shower Pan; Test, First Floor -Tub Access
•c.."T'.f.I. & Bath Fixtures & Tub Access
14, Test Tub & Shower, 2nd Floor -Tub Access
_G$,--Elec. Trim & Subpanel; Breaker Sizes -Labels
19. Gas Pipe; Size '& Anchors
62:-Vairs & Rails
62r--Ptreplace or Stove; Clearances -Hearth
Card -BI Date Card -BI Date
6#r-,L*fec. Outlets at Wood Panel; Int. & Ext.
6&r -Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI Date Card -BI Date
AP—E4ec. Outlets & Receptacles at Kit. Counter
Date E CTRICAL Permit OK except #'s
&?-,Garage Fire Door; Swing -Landing -Closer
.88:-A.C. Duct in Garage -Damper
Fixture & Transformer Clearance -Ins. Protection
•697- r. Htr.; Vents -Clearance -Comb. Air -Connector -P .V.-
Garage; Above Floor-Mech. Protection
Elec. Receptacles Spacing -Lights &Switches at Doors
Size Boxes & No. of Conductors -Stapled
b., Elec. & Mech. Equip. Listed for Lo
Romex Installed Close to Ed of Studs & C.J.
CNW Elec. Receptacles in Garage; (G.F.I.)- Prote .
Equip. Ground made up w ech. Fa and Gas & ater
X7.2 emulation-Foam-Looked in Attic El Yes
ircuits in Kitchen &Conductor Size
cto
78. --guard Rails & Deck Construction -Post Caps
26. Subfeed Wire Size / / ga. Cu or AI or At
7V-Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
/ ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes El No
75-7-ollowing instld.: Dri a Yes o; Walks ❑Yes o;
Planters Yes o
Service -Riser Conductors & Ground -Main Disconnect
$EK 76. Stucco; Br n-Fi'rrfsr(i
34. Equip. Clearances; Panels-Motors-Mech. Equip.
38.-&1e1 es Closet Light -Shower Light
��.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
.fig ents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
-e9- Water Well; Disconnect, Electrical, Plumbing
r80v--Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I P ft�_ Date 7 8$ Card -BI Date
Ventilation throughout House
Card B -I Date Card -BI Date
-82,-Glass Protection
Date r4ECHANICAL (Permit) OK except #'s
X83- Corrections from Previous Inspections
*4 -'Gas Test -Meters Tagged; Gas -Electric
31. A.C. Ducts; Insulation & Support
-6E- Water & Sewer Connected -C/O to Grade -HD Approval
-615- Energy Compliance Certificate -Other Certificates
3 . Vent Fan; Exhaust above Insulation
3 Condensate Drain & Overflow; Size & Grade
3 Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
Attic Access & Platform if Furnace in Attic
Card -BI Dat Card -BI Date
Card -BI Date ' 41 Card -BI Date
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Comments at Final:
Date FRA/NG(Plans)OK except
Sills; Proper Material An s
8Z S G4�4J
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
26 Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof)
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
Header & Beam -Size & Bearing
�/ Hangers -Post Caps -Anchors -Connectors
a
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnp_.-Rfn_g._ _
fireplace Ties or Type A Flue -Fireplace Throat
45•--AMic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
d6 "Bdrm-Windows or Exiting Doors -Sill Hgt. & Dimensions
Garage Fire Protection Framing
(NOTE: An entry must be made each time you visit job site)
000UNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 5344541
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
whe correction of work is completed. If you have any question pertaining to this
mat er, or need additional explanation, please contact this office imifiediately.
c�
Inspector Date
_ COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
//VT - CPs
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.
wv b+
l hro _orl ,w
cove. "
Inspector Date / '� r
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
/4/.f ` �'S-
A routine inspection indicates that the following violations of County Ordinance
ex
is at the above address and should be corrected. Please notify this office
wh n correction of work is completed. If you have any question pertaining to this
ma ter, or need additional explanation, please contact this office immediately.
Inspector J*V-X Date /��/
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
)PERMIT NO.
ASSESSOR PARCEL NUMBER
ZON G
BUILDING PERMIT
Ow R
aP
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
-
OWNER'S MAILING AD RES/
CON TOR'S 4T, 16
TELEPHONE
_ :a CE S t
CO A
I
Fireplace
CONSTRUCTION LSNFER UNKNOWN
(�
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
Q
LICENSE NO.
Plan Checking Fee
$
$
ARCHITECT OR ENGINEER'S MAILING ADDRESSPenalty
Permit fee
$
BUILDING DDRE s
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other `I El,
SPECIFY
Building sewer
5.00
Mobile Home S G W
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodll,_V Uti lities ❑ Installation ❑ Other
Describework: ► l`�'Y1
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP ORV OR LESS10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST.(DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
I
2/20sq ft
CONTRACTORS LICENSE LAW
I declare and r 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 ce and effect.
License No. /_3Classification
❑ 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. MULTI -OUTLET 2,50 ea
NON.RESID BRANCH CIRC ITS
NEW CONSTR. POWER APPARATUS &)
NON.RESID. (SINGLE OUTLET CIR.
20e50a
Ex. Occup(o TS OR FIXTURES BAL®30
FIXED PR
Ex. Occup. OUTLETS (RESID,)EA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Mi sc. 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.
ave 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 10.00
Heating
Cooling
Hood
3.00
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 County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities s, costs, and expenses which may in any way accrue
agains s u consequence of the granting of this permit.
%� Date di Z.3'-&S�
Signature of Applicant — Owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3st�orries in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ 00
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
ND
BsuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
D CTO F PUBLIC
By
PERMIT EXPIR $ D e
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date ' S
6LQ7Receipt No. 7 ! 7
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTT- DEPARTMENT OF PUBLIC WORKS
I 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
rAPERMIT NO.
ASSESSOR P RCEL NUMBER
/'
ZONI G
r
BUILDING PERMIT
OWIn
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWN 'S MAILING ADDRES
r
C RA TO •S NAME^ '
TELE HONE
/—I (n v,r
CONT A TO ING ADD SS
1
Fireplace
CONSTRUCTION ER
UNKNOW` N'
L/
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
r_-:1 9.1
PLUMBING PERMIT
Filing Fee 10.00
_-Ss��_rd
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE '
??��
SF [_1Duplex❑ Mobilehome❑ OtherRI b V11- ('"`@r
SPECIFY
Building sewer
5.00
Mobile Home S G W
10-00e
TYPE OF WORK
NewAdditi ❑ Remodel❑ Utilities Installation[] Other
Describe work: ��d% ��G`-^�'�('<i�;p _
/� 4 }.,�� 1
9I- 'b&Z r QQ.r%I n0 � 1\�O/111 UP�1 lam [
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELL` ACC. B exffyr.&) 21/2Q$q ft i
OR ADDNS. 1 eq
CONTRACTORS LICEN E LAW
I declare u r 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. 13 Classification l'
❑ 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
NON.RESIDR BRANCH CIRCTITS) 2.50 ea
&
NEW NON.CONSTR RESID, SINGLE OUTLET CIPOWER APPARATUS .&)
20�g0Q
Ex. Occu TS OR FIXTURES
p(o BAL®30
FIXXEEDD APP LNS, OR
EX. Occup. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 1
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
n T "ermit 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
FiIingFee 10.00
Heating
Cooling
Hood
3.00
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 County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to snify and keep harmless the County of Butte against
all liabi ' i fu e p1c osts, and expenses which may in any way accrue
against s d Co n equence of the granting of this permit.
X ��/.Z�.�,j —
Date
Signature of Applicant — Owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
OCCUP. GROUP
TYPE OF CONST.
i
PARCEL
PD HD
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF BLIC
By.
PERMIT IRE; Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
� / l
Receipt NO. -87627
WHITE-D.P.W., YELLOW-ASSFSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
a
UA7 NOTE: --All Materials! & Workm Lst
DN P'
_7 Accordance with Rec - gnize"id G4od
of a quality prescribre- for the S�eci
Uniform Building,'Plunl6jjig Mechani
the National Electrical 'i
Fode�
This set of plans and specfficNflnns! MUST by
kopton the io6 at all; and it is ' ri
I Cwtto
MCIL charges or alterations on sap; wit'. Ouf
make any
written permission from the Deparfme�,F of Pb6lic
Works, County -pf Butte.
Z) I
V
V
CIO I
L4se in f
�04 gas
�-.ietback of 5 ft. f rain the
C71'property lines akt! a -jetba'kC
1 of 50ft. from the road
1centerline shall eclearof. t.
structures or eqp ipm, ).nt e) COPt
for a 2 ft,,eave Over 09.
BU TEICOUN-Y
BUILD \JG DEARENT
OIV
D
Tt-
F 7S,
-7
d
LIP
I
ic""Wo
fee
CCUN Y I
DEFIARtm NI
V E D
7..
7Xp .
1,
4�'•
G
Gr'ct
dj, I
--r.
LI
I/ I
cs�vS- 5C5 a 7
(�,�Tru cfory
PON BUNCH
9 B* Ct.
Chico, CA 95928
I0
14
Submit engineered detail of trusses
• , �.. for approval prior to erection. o
0
t
w f�
77 e I
BUTTE COUNTY
�U f LDE NG DEPARTMEN1
APPROVED+
I I
� I
er. Submit engineered gietaii of truoses
ror�avpr�val prior f ere tion��
4
roti '
o z
4412 a
►1 is - @ 6'i O.C�`max.land
0 ;clots.
v
>z
Fs ;.
I
11
BU TEC UN Y
ILD( G DE AR M NT
!Af POCV L -D
I z-
A co
PERMIT NO. 420 , 0-76B,P,E,M
8,41
PERMIT EXPIRES
OWNER John Hanson
CONTR. Al Vial, Chico
LOCATION (A.P. 38-17-20
NIS Stanford Rd.,app. mi.E.of wy 99E urham
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED_
(Date)
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
Setback %
Forms
Main Bldg.
Footings
Stemwall-/ 6, &-D--
Slab
Piers W-77 ?6
Garage
Footings
Stemwa I I
Slab
Carport
Footings- /-
Slab7 4�(i'
Patio
Footings/ ',=�f - 24 -
Masonry
4-
Masonr Walls
Reinf. Steel
Bond Beam
Framing f ,2 ! s
Stucco
Mesh Z2- 7�J
Scratch
Brown
Finish Z
Interior Lath 2
Door Closer — l •-
BUILDING (Cont'd)
Firewall
Parapets
Restroom Finish
Windows
Siding
Roof Sheathing—/2
Roofing /,
Fdn. Vents /.2
Garage Vents
Insulation
Prov. for physically
handicapped
Conformance of ex. �—
structure
Final
FIREPLACE
FootingcSF% i
Throat
Final ,- /2--77
FIRE SPRINKLERS
Test
Final
MECHANICAL
Heating
Cooling
Ducts
Ventilation \�
Final
PLUMBING
Soil Piping
1st FloorSu-
2nd Floor
3rd Floor
To p out 12,'
Water Piping 2 -i
Sewer /2-7,7
Fixtures /2—
Water Htr.
Heaters .
Appliances.
Gas Piping & Test
Temp. Gas
Sanitation —-%
Final
ELECTRICAL
Rough
Fixtures ��' —7-2
Motors r7 -/z,-27
Water Htr.
Subpanels
Grd. Fault Prot.
Service 7 7
Temp. Pole
Underground
Permanent
Final 3
DA _ 7 /� REMARKS OR CORRECTIONS
�pvL! P��T� G1934T•sa2. �'O cSh�Oul �. iG_
5A-�oo'� �Dtc,J7.0 •S1 trLS
1,2-2-76
Oil 17 -
(NOTE: An entry must be made on this form each time you visit the job site.)
ERSET
COMPANY
LICHNQED CONTRACTOR
Insulation — Weatherstripping — Accoustical Tile
Toae K&I
(Purchaser)
(No. and Street)
P. 0. Box 3506
Chico, California
Phone 342-4764
Date—
(City
ate
(City and State)
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH
THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, -TITLE 25,
STATE,OF CALIFORNIA, IN THE BUILDING LOCATED AT:
Street () Lmliftaftber Tract No.
EXTERIOR WALLS
Manufacturer Thickness/Typee� �- R Value L�
CEILINGS
Batts: Manufacturer /�/� � Thickness R Value
�%
OL
Blown: Manufacturer Thicknessss)/) `LNo. Bags Wt./Bag
Sq. Ft. Covered 1L(/ R Value
FLOORS
Manufacturer Thickness/Type R Va!ue
SLAB ON GRADE
Manufacturer Thickness/Type R Value
Width of Insulation � Inches
FOUNDATION WALLS
Manufacturer.
GENERAL CONTRACTOR I
BY A11 " ObOU ,�//
INSULAIION CONTRACTOR E
( DATE)
ACCEPTED
Thickness/Type R Value
LICENSE NUMBER 2 ZIP2t7
,TOWE DATE 1'� — ? ,— -2
LICENSE NUMBER v
TITLE O /� 1&J"4 DATE �~
SAVE ENERGY - INSULATE)
ERSETH COMPANY
(Authorized Representative)
COUNTY OF BUTTE — D'EPARrTMENT OF PUBLIC WORKS
7 County Centerve — Oroville, California 95965 -176
Tele one: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
n
X Date
Signot a of Permiteeforr�Agent -
Receipt No. / % / � �2!
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 OFA5bBLIC WORKS
ding permit expires Date �e—l ^ 77
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
A7u0�L T 3- 0 0 0 °
Mailing Address
Gz) 5 Yap oa
Telephone No.
'360 i O
�v
Fireplace D AM Ar 7-16.
Contractor L
Total Valuation 7fO °
Mailing Address .
9' 1114 PIC 10olV C
wee ry r- VA Lv • i 0 o
Plan Checking Fee&/or Penalty
G'7-
Telephone No.
_ /
Permit Fee 6,.00
Building Address /j/ s T,�S/�/Tp2 /�
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00 3 V 0
v,e 11byy 99,67
Each Trap 1.50 ,a;3
Dvlel Sr�l
Repair drainage or vent piping 1,50
Water piping 1.50 A S
Each gas water heater or vent 1.50
A. P. No. 7—ZZoni
Zoning 8 Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
FeJW
SO_ on FIreDept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im rove me s
P
Lawn sprinkler system 2.00
Bldg. Plans Recd
Parcel App al
Plans Approval
Permit Fee $ .S
C
NEW ❑ ADDITION UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 -3.00
/� . c4lePv27' /
TH m (/ P��� GAC.
600V OR LESS �1
Main service 100 AMP OR LESS 5.00 �f c v/O�
Fm�DEL k�tc Sim A��t/� E�'��•sem_
f� Oh4A.4,
Main service EA. ADD'L 100 AMP 2,50 7,90
Single Family Duplex ❑ Mobil Home ❑ Others ❑
OVER 600V
Main service 100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00NEW
CON S T. DWELING �7
OR ADDNS. ( ACCLBLDGS.0 O P &) 2¢sgft 20,2_0
NEW CONSTR. (MULTI -OUTLET
NON•RESID. BRANCH CIRCUITS) 2.50ea
•
NEW CONSTR. (POWER APPARATUS &)
NON-RESID, (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
/�/�
Ex. Occup(OUTLETS OR FIXTURES)/BAL@@1 ' V
EX. OCCU FIXED AP LNS. OR
p•(OUTLETSP(RESID.) EA) 2.00 .00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.cR 7492�7_ Classification 461
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ ' IN
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 Wor men's Compensation.
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00 3.00
Heating /00 000 l3rro. 00
Cooling 31-0 N Gj/ vQ
Ventilation
Hood 2.00 Z •f�0
Permit Fee $ /3 �o
$ f3 OC
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
n
X Date
Signot a of Permiteeforr�Agent -
Receipt No. / % / � �2!
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 OFA5bBLIC WORKS
ding permit expires Date �e—l ^ 77
57al4l,
711Y/7
�r�w.w`i .���-w�1l�+O�le .-..ilk- .✓�+r.nF .-. -.-.+� q�e.+.r1�s• x..�w.: +y .�... .,F -. j
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSESSOR P CEL NUMBER
0
ZONING
BUILDING PERMIT
OWN R
w1(�r ti, 1
TELEPHONE
��.
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
7 " / .S� in -_(QCJ
CONTRACT OR'S NAMjL r^
�5er)iIoiiT • f,)r , 4- . i
TELEPHONE
?,/.
CONTRACTOR'S MAILING ADDRESS "
�(%. /�• i/I f. r L t
Fireplace
CONSTRUCTION LENDER
UNKjNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS /
/t � t cl I
PLUMBING PERMIT
Filing Fee 10.00
_
Each Trap
2.00
Solar Water Heater
20.00-!
�0
Water piping
5.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF / Duplex❑ Mobilehome❑ Other
/ SPECIFY
Building sewer
5.00
Mobile Home S G W
10.00e
TYPE OF WORK
New ❑ Add ition:.�J/ Remodel F-1Utilities ❑ Installation[:] Other ❑
i
Describe work: rir 1(f! �iih �rt C �I I I _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6001 OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. / DWELLING OCCUP.&
OR ADONS. ( ACC. BLDGS.
2t/20sq 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 Professiorts-.Code apd my license is in full, force and effect.
�%// ( ` f FIXED
License No. V_� /0 ' / J Classification i ). �/ (/
❑ 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 ULT' -OUTLET 2,50 ea
NON-RESID. BRANCH CIRC ITS
NEW CONSTR. / POWER APPARATUS &1
NON.RESID. (SINGLE OUTLET CIR.
20@60C
Ex. Occup(O OR FIXTURES OALeaOQ
APP LNS, OR
FIXED A
EX. Occup. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities
15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
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
,2r'
� 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.
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
1 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 IiabiLities, judgments, costs, and expenses which may in anyway accrue
agaitrs# sat"d Coountyy in consequence/;of the granting of this permit.
X r 4,, f �` Kl e� l/ ( Date / ?
Signature of Applicant — Owner ❑ 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
$
TOTAL PERMIT FEE
$ .� C
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
I ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
IR CTO OF PUBLIC
By
PERMIT EXPIRES Da e
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date��^�
Receipt No. () L 1-1.
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
e
no
W, 71A 0 w5ir
ASSESSOR PA CEL N MBER
3 - - 2�
ZONING
BUILDING PERMIT
owN
e /
TELEPHONE
s -
S0. FT. OCC. BUILDING VALIUATION
OWNER'S MAILING A7DDJRESS
I? d
CO ACTOR'S NA E,
yna
TE E HO E
CO T AC OR• MAILING ADDRESS
r at
Fireplace
CON TRUCTION LENDER •
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS ti
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile Home JSJGJWJ
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodel tilities ❑ Installation❑ Other ❑
Describe work:SC�t" fh✓)
Permit Fee
$ •OC7
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
t
2hQSgft
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 Professi Code a d license is in f force and ffect.
License No. Classification
El 1, 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 CONSTFL ULTI.OUTLET 2,50 ea
NON RE BRANCH CIRC ITS
NEW CONSTR. POWER APPARATUS &
NON -REST D. (SINGLE OUTLET CIR. 1
Ex. Occup(o SALO 0C
OR FIXTURES BAL®30Q
IXEDTs
EX. OCCUp. OUTLETS P(RESID.)REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
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.
Heating
Cooling
Hood
3.00
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 liab' ' •es, judgments, costs, and expenses which may in any way accrue
agai sa• County'n c s uence of the granting of this permit.
Date �?&`sions
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-(6iR-CTO
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ 0Z)
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
HD
SSOE
This permit is hereby issued under the applicable provi-
of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
OF PUBLIC WORKS
y ~� T
PERMIT EXPIRES D e— 4 - r
Receipt No. o I I � �''
WHITE-D.P. W.,YELLOW-ASSCSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
PERMIT NO. 1827-78B,P,E
PERMIT EXPIRES
OWNER Delbert Siemson
CONTR. Holiday Pools, Chico
LOCATION (A.P. 38-17-29 ,
876 Stanford Lane, Durham
i Temp. Power Pole
Called PG&E _
Temp. Elec. Serv..
Called PG&E _
Temp. Gas Serv. _
Called PG&E _
JOB
FINALED
IYABVSteel --7 •- ? 1-& Final J Fixtures
beam 6 7 FIRE SPRINKLERS I Motors
aiucco
COUNTY OF BUTTE — DEPARTMENT IOF PUBLIC WORKS
BUILDING INSPECTION RECORD
Subpanels
BUILDING BU I LDING .(Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water PipingCp
—7 2
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Elec. Continuity
Footings
Stemwal I
Garage Vents
Insulation
Water Htr.
Heaters
Gas Piping
Slab
Carport
Footings
Slab
Provfor physically
handica ed
Conformance of ex.
Aftucture
Final
Appliances
Gas PipingTest
Temp. Gas
Sanitatio
Patio
FIREPLACE
Final
Footings
Footing
ELECT AL
IYABVSteel --7 •- ? 1-& Final J Fixtures
beam 6 7 FIRE SPRINKLERS I Motors
aiucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
I Final -7-
MOBILEHOME UTILITIES
Elec_ Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
MOBILEHOME INSTALLATION .............. Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE
REMARKS OR CORRECTIONS
�� " 7�
A
(NOTE: An entry must be made on this form each time you visit the job site.)
.F a _COUNTY OF BUTTE — OEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
Telephone: 534-4541 '
APPLICATION AND PERMIT
r
auinorlce representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes. a
X Date
Sign re of ermitee or Agent
Receip No. �7� 23�
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 O"UBLIC WORKS
By Date c%—z F 7
wilding permit expires Date
BUILDING ir
Owner j67_
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
GC/ Gt,
Telephone No.
Contractor pL L
Mailing Address LASSAME
Fireplace
Total Valuation G )'pp,
p ,3q
Tele ho a No..
-yy
Permit Fee
Building Address 5rANF0Rb ZA1.
Plan Checking Fee &/or Penalty
Permit Fee
0 caG
&IRWAAAPLUMBING
No. @ FEE
PERMIT FILING FEE $3.00 c1d
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. V — !�- �D
Zonis & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fbei
VIC&J
Salt'yj1[.on
I Fire Dept.
FireZone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking Farces
Plans Declaration
I Parcel Map
1 60' /W
Improve ents
Each additional outlet .30
Building sewer 5.00
Bldg. Plans Recd
Parcel A roval
Plans'Approval
Lawn sprinkler system 2.00
NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑
permit Fee $
$ S
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 3 cf-
Single Family ❑ Duplex E]Mobil Home ❑ Others ®
Main service 600V OR LESS
10o AMP LESS 5.00
-L
Main service EA. ADD100 AMP 2.50
i�
* /Y' Afl
Main service OVER 25.00
100 AMPP O OR LESS
Main service/ EA. AOD'L 100 AMP 1.00
OR A.D.S. ACCNEW CONST. LBLDGS.CCUP. &) 20Sgft
C
CONTRACTORS LICENSE LAW
1 am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
yDL /0 N }/ %100OL .S
NEW RESID,CONST/ BRANCH CIRCUITS)
NON-RESID l BRANCH CIRCUITS) 2.50ea
NEW CONSTR 1POWER APPARATUS 8
NON-RESID. SINGLE OUTLET CIR.
Ex. OCCup(OUTLETS OR FIXTURES 1 5 250
L�
Ex. Occu FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA1 2.00
Temporary service 10.00
Mobile Home Facilities 15:00
License No. 20 c1 32?�! .S3
Classification
Misc. Wiring ,ftt %4///?,f 6.25
AME7-.41n(1,iVC rG PocL�
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
,2
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 I have placed on file with the County of Butte a certificate of
1� Workmen's Compensation Insurance.
❑I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 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
$ 3 /
7
auinorlce representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes. a
X Date
Sign re of ermitee or Agent
Receip No. �7� 23�
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 O"UBLIC WORKS
By Date c%—z F 7
wilding permit expires Date