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Home My WebLink About047-300-115a ' 4 47-30`•115 MacDONALD, A.W.479 . -69B, NORMAN A. "SMITH _ _ -42L,-69P - ,__ SIS Kathy Lane, app - 1100'W of Garner— - Cj 468-x6 E _ Lane, Chico _— Permit #4874-79P(lawnt-ss S sYs Kathi Lane 2nd ouse, east .of Garner iNr i _ Chico -- 047-300-115 • _ PERMIT#95-032 -v- ( swimming pool) j GonD, Wilburn & Alpha f 4289 Kathy Ln. , Chico `a1/ 0�6�dG ( O Reroof/SF c L ------------ ' 4 r i 3 v i I . .er' �P zi 01-7 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS r 7+County Center Drive — Oroville, California 95955 Telephone: 534-4541 , , • �/� / / f. APPLICATION AND PERMIT ++ BUILDING Owner • [ J 1 SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor �, +�,�; Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address r i f, + � �, P I an Checking Fee &/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 =� Each Trao 1.50 (' i I ✓ Repair drainage or vent piping 1.50 A. P. No. [ Zoning 8, Planning Water piping 1.50 Each gas water heater or vent 1.50 Fees W. C. Sanitation Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans I ParcelParcel Declaration Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg.-Plans•Rec'd Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHEREI` Permit Fee $ 7 _- $ Ll ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 5.00 100 AMP OR LESS Single Family Q Duplex E] Mobil Home ❑ Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVERe0ov 25.00 100 AMP OR LESS Main service EA. ADD•L 100 AMP 1.00 NEW CONST. DWELLING OC Cup- �) 20sgft OR ADDNS. ACC. BLDGS. 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: NEW CONSTR. (MULTI-OUTL T NON-RESID ` BRANCH CIRCUITS) 2.50ea NEW CONST R. POWER APPARATUS e NON-RESID. SINGLE OUTLET CIR. g 25 Ex. Occua(OUTLETS OR FIXT11RES) 0 1 Ex. Occup. (OUTLETS P(RESID)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. lecertify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE J$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 $ authorize representatives or the County or t3utte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By r Date Building permit expires Date .1j_ e . COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 f/ I/� APPLICATION IND PERMIT BUILDING Owner Doom A4 A S'MrlTt+ SQ. FT. OCC. BUILDING VALUATION Mailing Address P -T 4 5•0x %ZC, 5 L- 14-1co , CA Contractor Mai I i ng Address N srz- Telephone No. Building Address r;/S V—AT i A IPP P00' W. CAZAIEIZ Lill, d- r 1 60 A. P. No, ,4 f — ✓o ^ 1 15 Zoning & Planning esW.C.&Mtetiolr Fire Dept. Fire Zone Use Permit EQA I Parking I Parcel parcel Ma 60' R/W I Im rovements Plans Declaration P P Bldg*-Mens—ReetidI Parcel Approval I Plans Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER L- -) 5Pi-14CEi� Single Family 11"Duplex ❑ Mobil Home ❑ Others ❑ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: License No. Classification U'J1 m exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. LJcertify 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. 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-me4tioned property for ins ` ction pu oses. X Date '7 $ignatureQf Per�ea�or�gent Receipt No. /CJS Y19 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Fireplace $ S1'1 -V Total Valuation @ FEE PERMIT FILING FEE Permit Fee Main service 600V OR LESS 100 AMP OR LESS Plan Checking Fee &/or Penalty Main service EA. ADD'L 100 AMP Permit Fee Main service OVER eoov 100 AMP OR LESS PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 ,Q.0 Each Trap 1.50 MULTI.OUTL T CIRCUITS) Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Building sewer 5.00 Lawn sprinkler system 2.00 2.0-0 Permit Fee $ S1'1 -V ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Main service OVER eoov 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST OR A.D.S. ACCLBLDGS.CCUP. 4) 22sgft NEW CONSTR. Nn N.RESIO_BRANCH MULTI.OUTL T CIRCUITS) 2.50ea Ex. OCCUD(OUTLETS OR FIXTURESB'L@ BAL"1 FIXED APPLNS. OR EX. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ MECHANICAL No. @ PERMIT FILING FEE J$3.00 Heatina Cooling Ventilation Hood 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE Is Sj &V This permit is hereby issued under the applicable provisions of u to County Code and/or resolutions to do work indicated above or which f es have been paid. I TOR OF PUBLIC WORKS y Date Building permit expires Date $ — 9r8O _ + 1�,: � �� r .•r�� >•.o+ erg � iµil� -q�,.rn Ji, r t T �f • ��J�t t.w� T . ♦ '-' `• Sir i r •x•,. .. !+7-300=115 t° 'aPERMIT#95-0329:=,I !� ' COULD,' Wilburn 4289 .Kathy Ln:, Chico 4 Reroof/SF. r �� `� c - F c: - �• a �. � ..,.• t. : � ��"' �t � . � � •'mss � �. COUNTY OF BUTTE - DEPARTMENT OF DVVELOPMENT SERVICES - 7 .County Center Drive - Oroville, California 195965 - Telephone APPLICATION AND PERMIT BUILDING*,pNISION (916) 5�8-7541 PERMIT NO. i/ C�t��- O3� ASSESSOR PARCEL NUMBER 047-300-115 ZONING AR, UILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS L 1.980_ CONTRACTORS NAME tJ�1RNOW11 TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER a UNW40WN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAIUNG ADDRESS Permit Fee $ 45.00 ARCHITECT OR ENGINEERLICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS KATHY LANE, CHIf,'0 PERMITFEE $ 65.004289 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other �""�"'.� Describe Work:��1 /�� e �� Mobile Home S G W 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT FilinQ Fee 20.00 w Main Serwice ( 200A OR LESS ) 23.00 Main Service ( 206A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: j VL I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR ADDNS. ( a. ACC. BLDS. ) SO. 3.50 FT. NEW CONST. / MULTI -OUTLET NON-RESID. \ BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) d SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL Q .50 Ex. Occup. ( OUFIXED APPLNS. OR TLETS(RESD.)EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) XSI I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. G X Date _ Z° 2 Signature of Applicant - �Vat ❑Contractor ❑ Agent V An OSHA permit is required f xions over 5'0" deep and demolition or constructionof structures over 3 stories i heig Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 65.00 HAZ. 1 D. FEES I IMP I FLOOD CDF PARCEL PD HD SSUE 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. j By Date PERMITEXPIRESON (Date) )*, Receipt No. rr%t7 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING ISION 7 .County Center Drive - Oroville,"California' 95965 - Telephone (916) 5 -7541 PERMIT NO. APPLICATION AND PERMIT �� ' ASSESSOR PARCEL NUMBER 047-300-115 ZONING AR UILDING PERMIT " OWNER TELEPHONE SO. FT. OCC, BUILDI V LUATION OWNERS MAILING ADDRESS adv � CONTRACTO S NAME UNKNOWN TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 45.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS /� 4289 KATHY LANE lii�ICO PERMITFEE $/ 65.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF gX Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other �Id t Describe Work: i�-' Mobile Home I S I G1 W I @20.00 PERMITFEE g Contractor Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service EOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO l000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 110. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ( 8 ACC. BIDE. ) So. 3.50 F7. CNS. NEW CONST. MULTI -OUTLET NOWRESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) d SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES ) BA2L @ + 50 L .SO Ex. Occup. (OFIXED UTLETS (RE IS . OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE S Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X __ Date _ 2 2 �� Signature of Applicant n ❑ Contractor ❑ Agent An OSHA permit is required f x ations over 5'0" deep and demolition or construction of structures over 3 stories i heig t. Mobile Home Installation Fee $ Energy Inspection Fee is occ CONST. TYPE TOTAL FEE $' 65'00 HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date Date) Receipt No. �%� �3 y WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Fre kz;oor+ OWNER: LOCATION: a ? q DATE 2� -a 3-/ A. P. # (moi - 3 Q - I/S CONTRACTOR: ZONING -------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------- DATE TO INSPECTOR S PERMIT HISTORY :NONE [ ] AS FOLLOWS: Lv l i� l yK i K Op j % o ' - 'a0 laa TYPE OF OCCUPANCY FIELD - INFORMATION BUILDING USAGE: TENNANT: OCCUPIED HAS ELECTRIC HAS GAS '-[4 HAS SANITATION FACILITIES 0 HEATED -COOLED F-1 PERSON CONTACTEDc��✓ OTHER COMMENTS: ACTION RECOMMENDED: ISSUE HOLD FOR �rf3 •�C-f C'.1 A.7, -.A C-//_. d ., /%.LZ> i_ ✓/.fry/ 4A2A -A PAGE � OF CDF / BUD DAILY INCIDENT LOG DAY/DATE FROM 0800 / /�y / Z - DAY/DATE TO 0800 INC It I3 2v FIRF # NAMF TVDG ''lin n 14 # A/V D CAUSE: ENGINES: CDF BCFD / CO# OFFICER: DAMAGE: so WT D Z CREW AA AT HC SAVED: OTHER EQUIP: MEDICS LAND USE: ACRE/TYPE TOTAL OW/TENANT WRA O R.P. - o -C! / B I MISC.: INC # 13$5 FIRE # 41 NAME 55+ PN F TYPE Ssl Z) t REPORT TIME 00 3 1 START TIME h 13 CONTROL TIME R.O. STA. LOCATION: I 5 - U- )L) /d BAT. CAUSE: 0 ENGINES: tDF B FD CO# OFFICER: DAMAGE: SQ WT DOZ CREW AAL AT .4 HC SAVED: OTHER EQUIP: MEDICS --� 0)* V MISC.: INC # FIRE # NAME SSSS POP TYPE REPORTTIMEW40 START TIME 8 1 ONTROL TIME R.O. STA. .. LOCATION: a` VC 0 ® s 3 4 01 N /9 BAT. CAUSE: ENGINES: CDF BCFD CO# OFFICER: DAMAGE: Sn WT DOZ CREW AA AT 3 HC SAVED: OTHER EQUIP: MFnirc f4� INC# I BE37 FIRE # 44 NAME, S2,S PQ P TYPE REPORT TIME TART TIMEql,5iqV CONTROL TIME R.O. STA. L ATION: � 584 1 7-3 BAT. CAUSE: ENGINES: OF B FD CO# OFFICER: � DAMAGE: SO WT DOZ CREW AA AT J HC 4i S) SAVED: OTHER EQUIP• MEDICS LAND USE: ACRE/TYPE TOTAL OWNER/TENANT WRA p._ R.P. B I MISC.: **�tt#itirir,►��r#t###t`� tt#####+########ttttttttttttttt##t*##tt#*_#:+kttt*ttttttt uwiwa111If) 9rr_ AG�mlty" It, if M 1 (!)q? --300— COUNTYOF BUTTE - DEPARTMENT OF D.E�PMENTSERVICES -BUILDING DIVISION P 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMITAPPLICAttTION DATA SHEET OWNER 0116 -OKI) 6 0--)1 Z A. P. No. / Proposed Building Use 91 •�I�� Building Inspector Date 2-3 ,:t - At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECENED BY 1. All items have been submitted............I............................. 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ........................................... . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 1 Contact Land Development about (A) Improvements (B) Drainage. .......... . Driveway permit (constructi ap roval required prior to occupanc Pre -inspection for k �' i,$ q Deg nsp QOr Z Zj reUlre . to Buildin In edoto 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . ........................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... Existing violations/expired permits . ...................................... Plan check list. ..................... .......................... 34. When you issue the permit, process as follows: (/Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant 71 Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: r Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE ftartment of Development Services Building Division Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 'S . 2. I (have/have not) signed an application for a building permit for the proposed work. ICS I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractor's License No. 4. I plan to provide portions of this work, but I' have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractor's License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: ' Property Owner Social Security Number — ro Date�,�i/,�� /�S 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. n PRE—INSPECTION OWNER: W R `L) 4Aj LOCATION: CONTRACTOR: DATE rtl 2,5 1,9$— A. P. A.P. #`7— 3o—/lS ZONING ------------------------------------------------------------------------------------- ---------------------------------`---------------------------------------------------- PRE—INSPECTION FOR: � IQ.A/ f I . DATE TO INSPECTOR ------------------------------------------------------------------------------------- PERMIT HISTORY: JL�rNONE Q AS FOLLOWS: Z fof TYPE OF OCCUPANCY ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ FIELD — INFORMATION BUILDING USAGE: TENNANT: 0OCGiIPIED _--HAS— ELECTRIC MJHAS_GAS HEATED—COOLED ��- ERSON CONTACTED OTHER COMMENTS: 4� t l ACTION COMMENDED: !�—J,' IISSR�SUE HOLD FOR Q S'SAAN TATION FACILITIES, k I OTHER: DATE