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073-310-034
` GLASS,, G.D. .407-69B '73-31-3� Bldg. Permit # 407=69 f Welding. Shop n/w corner Oroville-F bestown Rd. ahnd Cha;1 z' cut doff, Forbestown '73-31=34 ( new welding shop) LOLA WALBURN 4' 5631 "FORBESTOWN RD,, FORBESTOWN- 1 PERMIT: #2622-91B,'E(DECK, _�AMP`ROOF; DOORS ; " REROOF RAMADA /MH)-,f;irna a /Q v Permit#37.12-91B(, g _ Permit#3713-91E(ele6ser & isc lec) 9� - , 073-310-034' , •. 0-0377 . ' WALBURN, LOLA': tiE 5631 FORI3EST0\\N RD., I'ORBcEs'TO WN CONT:-TATTON'CONST POWER POLE REPLACEMENT' 073-310-034 02-0545 WALBURN, LOLA 5; 5631 FORBESTOWN, A RBESTO REPAIRS TO RAMAD `� __ I �i iI COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7 41 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 02-0545 ASSESSOR PARCEL NUMBER 073-310-034 U ZONING BUILDING PERMIT OWNER LOLA WALBURN TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS P.O. BOX 120 FORBESTOWN CA 95941 contr e t. 3,,500 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 3 500.00 ARCHITECT OR ENGINEER LICENSE NO. $ 20.00 —FilingFee Permit Fee $ 63.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5631 Energy Plan Checking Fee $ PERMIT FEE $ $3.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 8 Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ® Describe Work: REPAIRS TO RAMADA OVER MH Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G I w 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service zaOA OR LESS 23.00 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: ❑ 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 Main Service 46.00 WEE200A NG CCU000A NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BLDS. SO 3.50FT: NEW T. R61p MULTI -OUTLET 97.50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 Q 1.00 BAL .50 FU(ED APPLNS. OR EX. Occup.ounErs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ 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, , LJ, d l ,%Date - C� Signature of Applicant - [A Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 83.00 HAZ. D. FEES IMP FLOOD CDF PARCEL I PD I HD ISSUE This permit is herebyissu rider the applicable provisions of the Butte County C de art, or Resolutions to do work indicated a ove for w Ich fee have been paid. y Date 3-14-2002 PERMIT EXPIRES ON 3-14-2003 pate ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF ,DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 P R�gIT 0. (Rev. 12/96) APPLICATION AND PERMIT —��°j " f ASSESSOR PARCEL NUMBER 073-310-034 ZONING BUILDING PERMIT OWNER IATA WAIBLW TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS P.O. Box 120 FORBFSTOWN CA CONTRACTORS NAME PATRON CONST. TELEPHONE 1692-0524 C0 ' T. sBOX 3+7,8 DOBBINS CA 95935 CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5631 FORB=WN CA 95941 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: POWM POLE REIAC vM Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 600V 0 R LES Main Service ZDOAORLESS 23.00 23.00 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 'n 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: ❑ 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 TO Main Service 200A 1000A 46.00 NEW CONSTDWELLING . CUP. WEWEE OCCU OR ADDNS. ( & Ace. BLDS. SO 3.5¢FT; MULTI -OUTLET CONST. BRANCH CIRCUITS QG 7,50 8 POWER APPARATUS SINGLE OUTLET CIR. EX. OCCU OUTLET OR FIXTURES 200 O 1.000 Ex. Occup. OF'EEDTB RES D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 PERMIT FET= $ 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 com I wA�oserovisions. X Date 2Z Signature of Ap ant - O ner ontractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. I D. FEES IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work of indicated above for which fees have been paid. By ate 1 �Z PERMIT EXPIRES ON D efe Receipt No. 3LL l7 (,R lLl� nn WHITE-D.-B.D. GANTRY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive' • Oroville, California 95965 •Telephone (530) 538-754 �JE RMIT NO. Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 93 n _ n V zommv BUILDING PERMIT OWNER TELEPHONE SO. FT, OCC. BUILDING VALUATION OWNER'S MAIU (7,ISB CONTRA C R'S NA 31� 0 T LFPHONE 2 - CO KESS In CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flirt Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Fc b as c Y � RV Energy Plan Checking Fee $ -)c $ PERMIT FEE S LOT NO. SUBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ emodel ❑ U#Jas ❑ I lation ❑ Other ❑ Describe Work: l Gas piping system 1- 5 outlets 15.001 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service OOOA OR LESS 2o0A OR LESS 23.00 *PERAIT FEE PAM s � � ,G� SRA-.-Misc. SHERIFF- ��•HEQ AAkbVNT RECEMb S RECEiFT NVM�ER W46" TOse PiT � co Main .Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. 3•5¢SO. OR ADDNS. & ACC. BLDS. FT. NEW CONST. MULTI.OUTLIET NofFREsID. 97.50 POWER APPARATUS 8 SINGLE OIRLET CIR. OUTLET OR FIXTURES @ I'� EX. OCCU BALL 9 .yo flxvriErs a) EA 5.00 Ex. Occup. OD Temporary Service 23.00 Mobile Home Facilities 20.00 Wiri 23.00 PE . IT FEE S MECHANIC L PERMIT Filing Fee 20.00 Heating Coolin Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ D`D CONST. TYPE TOTAL FEE $ 60 HAZ. D. FEES IMP FL000 COF pgRCEL• PO I HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date _ Dare ReceiptNo. j WHITE•D.D.S.•B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT +�i=i��-�.:;�,'w:.+.3r'+!`i..°'S?dL•. ��#•�'�"4'+-t..^�p+"'c'`�._�R'*rnr�r�i?�4.i4r-�2'.^e �T , .;Ys,,�„ �',Ysx •+.v.-...-++a•*r 4-��?�F� �� .r I�!.;'f'e�•i'`s�: J COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: bJA1 &I n L o LA ASSESSOR PARCEL NUMBER Q 73 Proposed Building Use: T�Dwer-Po �1�� I(°C°r►%PY]!� Counter Technician: Date: 1;�� Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ❑ 1.. Plot plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7.. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... . ❑ 12. Hazardous Material Form............................................................................... ..' 0) 13. Other . Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.). --"- 0 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. 0-46. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit......................................................................... ❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 19. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 221. Encroachment Pmt fqrdriy ay om the Public Works Dept. (construction approval prior to occupancy). EI 12. Pre -Inspection for 14 U?X1. required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: 1. Index permit application for the above items numbered: _ 2. Additional items required Contractor, designer, owner, was advised of the above data by Contractor, designer, owner, was advised of the above data by Plans reviewed by: Date: Structural reviewed by: Date: Note transfer by: Date: Date: ❑ phone, ❑ mail, ❑ counter, by ❑. phone, ❑ mail, ❑ counter, by _ Plans approved by: _Structural approved by: Yellow: Building Division Plan Check Letter _Date: Date: Date:_ Date: PRE -INSPECTION REPORT OWNER: LOCATION: CONTRACTOR:_ q X1710 re kl� }- PRE-INSPETION FOR: /?1j) to,/ �(� I e. 1�PnI�� e rr DATE TO INSPECTOR: PERMIT HISTORY:( ) NONE DATE: 2 A.P.#.Q'__� ZONING: V (,YA'S FOLLOWS: BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential/# of Units: Currently Occupied Abandoned/Vacant ` S Electric: / Yes No _ Electric currently On f Off Condition of Electric Z-Ojo�--- Gas:eNatural Propan' None Currently On Obvious Problems: Sanitation: ' Plumbing Working Well Working Obvious SewageProblems ` Potable Water ACTION RECOMMENDED: ISSUE: at . HOLD FOR , , ��'L f -h t '% S 5 � r ai Inspectoate - • ` I �+ 1 f Sketch buildings. on reverse and indicate location on ropertY � P k I . . ♦ I 0 Bldg. Permit # 407-69 Welding Shop 73-31-34 LOLA WALBURN 5631 FORBESTOWN RD, FORBESTOWN PERMIT #2622-91B,E(DECK, RAMP ROOF, DOORS, REROOF RAMADA/MH) /Q Permit#3712-91B(demo g ge) Permit#3713-91E(elec ser "isc lec -a V GLASS, G.D. 407-69B 406-69E i n/w corner Oroville-F bestown Rd. and Cha cut-off, Forbestown ( new welding shop) ' a ® r 3 0 RESIDENTIAL F J3-18-87-- 2622-91B,g - WALBURN, Lola j 5631 Forbestown Rd, Forbestown (deck, ramp roof, garage dors reroof - - --- - ramadag..mh . - -S� a JOB FINALE Signature J=OK O = No OK NotNot Ready RESIDENTIAL RESIDENTIAL (Single, & Date UNDERFLOOR (Plans) OK except #'s j 1. Zoning -Setbacks -Easements -Flood -Slope I 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg'Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support - Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except ti's -16. Water Htr.: Vent -Access -Combustion Air -Baffle ------------------- -------------------------- 17. Water Pipe: Test & Anchor -Nail Protection --------- ------ ---------------------- 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test. First Floor -Tub Access 20. Test Tub &_Shower. Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ti's 22. Fixture & Transformer Clearance -Ins. Protection ------------------------- -------------------- ------------ 23. Elec. Receptacles Spacing -Lights & Switches at Doors ------------------------ ---------------------------------------------- 24. Size Boxes & No. of Conductors -Stapled ---------- --------------------------------- ----------------------------- 25. Romex Installed Close to Edge of Studs & C.J. -------------------------- ---------------------------------------------- 26. Equip. Ground made 'up w/Mech. Fastners-Bond Gas & Water ------ -------------------------------------------- _ 27. 2 Appliance Circuts in Kitchen & Conductor Size!GFI -------------------------------`------------------------- 28. Subfeed Wire Size/ r ga. Cu or AI-A.C. Wire Size! / ga. Cu or AI 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No ------------------------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect ------ - - - - ------------------------------ -- 31 Equip Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light ----------- ---------------------------------------------- ---------- -------- -- 33. Smoke Detector --------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 ------------------------------------ --------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except ti's 34. A.C. Ducts Insulation & Support -------------------------------------------------- - 35. Vent Fan Exhaust above insulation -- ------------------------- -- ----------- 36. Condensate Drain & Overflow: Size & Grade --------------------------------------------.-. ---------- -..- 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet---------------------------------------------------------------- 38 Attic Access & Platform if Furnance in Attic -------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 -------------------------------------------------------------- ---------------- Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except ti's 39. Sils. Proper Material & Anchors ---------------------------------------------------------------- 40 Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ----------- ---------------------------------------- ---- ---------------. 41. Bearing Walls over Girders & Floor Nailing - ------------------- ------- 42. Draft Stop in Walls (rat proof) ------------------------------- --------------------- 43. Fire Stops Furred Ceilings -Stairs -Chases -Tub ------------------------------------------ 44. Headers & Beam -Size & Bearing Duplex) Date FRAMING (Continued) - 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. AT Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51 Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. _Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access -- ----------_ ---- 57. Glazing Area -Glass Protection- Skylights- Plastic 58. Shear Walls: Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Card B-1 Date _ Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except ti's 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection ------------------ 64. Bedroom Exiting -------- ------------- - - 65. G F.I_& Bath -- Fixtures & Tub Access -Spa ----------------- 66. Elec. Trim & Subpanel: Breaker Sizes & Labels ----------------- 67. Stairs & Rails ----------------------------------- - 68. Fireplace or Stove: Clearances -Hearth -------------- 69. Elec. Outlets at Wood Panel: Int. & Ext. ---------------------------- -70.- --------------------------70. Kit.Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter -- ------ ------------ - -------- ---- 72. Garage Fire Door: Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Hlr Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection ------------------------------------ 75. Plb.. Elec. &Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection --- ----- ------------------------------- 77. Insulation -Foam -Looked in Attic ❑ Yes --------------------------- --------- ------------------ 78. - Guard -- Rails & Deck -Co onstruction-Post Caps ------------------------ --- 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth . Clearance Looked under Floor ❑ Yes 80. Following instld.: Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No: Planters -13 -Yes ❑ No 81. Stucco: Brown -Finish - - - - --- 82. A.C. Unit: Disconnect. Electrical, Plumbing 83. Vents Above Roof: Plbg -Appliance-Fireplace.-Clearance to Openings _ ______ 84. Water Well: Disconnect, Electrical, Plumbing ----------------------------------------- -- -- 85. Exterior Elec. Trim: G.F.I. Receptacle-Under9 round --------------------------------- ----- 86. Ventilation Throughout House - - - -- -- - -- ----------------------------- 87. Glass Protection ---------------- 88. Corrections from Previous Inspections ------------------------- 89. ----- ----------89. Gas Test -Meters Tagged: Gas -Electric - - - ---------------------------- -------- 90. Water & Sewer Connected -C/O to Grade-HDApproval ..---------------------------------- --- -- -- 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 -Date ---------------------- Date Card B-1 Date Card B-1 Comments at Final: J=OK O = Not OK =Not Applicable Not Ready MOBILE HOMES o ' = Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete MISCELLANEOUS Date CK OVERS, Q7RPORTS, GARAGES, (Plans)OK except #'s oning Requirements -Setbacks -Easements o ings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmq; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 1 ; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card 8-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 6. Gas; Location -Test -Wrap: / P L" ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch ' 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date CK OVERS, Q7RPORTS, GARAGES, (Plans)OK except #'s oning Requirements -Setbacks -Easements o ings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmq; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 1 ; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card 8-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ,��.�� y �"++'_i�^; i :'i�r;l.._ . s ti�i---,yi1F�a�r� r'� � �;a';� a_e3� _,�:�5.�.Tr'�. e.� :�,-•;:;.. y -a iaiii:-�-= `-" COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile - Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE /-3a )W ER PERMIT NO. 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 corre ion of work is completed. If you have any question pertaining to this mat or need additional explanation lease contact this office immediately. R-ozr � 6(, 147- 7�< �C A -o- -b 57A1, 2s Date tg///9r Inspect COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION ANCI VERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 073-180-087 ZONING U BUILDING PERMIT OWNER LOLA WALBURN TELEPHONE SQ. FT. OCC. BUILDING VALUATION p /� 48 C 624 OWNER'S MAILING ADDRESS 5631 FORBESTOWN RD., FORBESTOWN, CA 95941 240 0 1,680 CONTRACTOR'S NAME OWNER TELEPHONE 19 @ 60 1,140 EST 500 CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ 3,944 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 44.50 ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 22.25 Energy ecg Ener Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5631 FORBESTOWN RD. FORBESTOWN Permit fee $ 76.75 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping - 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G 1 10.00 ea TYPE OF WORK New ❑ Addition U Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: NEW DECK UNDER EXISTING ROOF, NEW ROOF OVER RAMP, GARAGE DnORS, AND REROOF RAMADA Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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. 1, as the owner, or my employees with wages as their SOIe 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 CONST. ( DWELLING OCCUP.m) OR ADDNS. ACC. BLDGS. , /20sgft NEW CONSTNON-RESID R. BRANCH CIRCUITS 2.50 ea POWER APPARATUS (IN) OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES BAL0ALO303o FIXED APPLNS. OR EX. Occup. OUTLETS (RESI D.) EA.� 2.00 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 :L I Permit Fee $ 12.00 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. f� I shall not employ any person in any manner so as to become subject I� 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabi ' ies -' dgments, costs, and expenses wh' h may in any way accrue again aid britof,tf>te g t g of is permit. jpce,Gf/ �j X Date / g atur9 of Applicant — Owner Contractor ❑ Agent ❑ OSHA permit is required for excavations over 5'0" deep and demolition or construct- 'on of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ - 88.75 HAL. I CUAPARK SCHL FLD CDF PAR PD 1 ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County.Code and/or resolutions to do work indicated abov for which fees have been paid. LIC WORKS DI O 7��.Date .... �.r BY �/ VS PE MIT EXPIRES ate Lam. Receipt No. 96977 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance 73 le- J-) 7. Owner Loq&tibn AP# Plan Approved for: Sewage Disposal 'Rater Supply Water Supply Hold final for: ^anal clearance O.R. for: Wer Supply Clearance for bedroom mobile home. Other NOTE *** _ Sanitarian COUNTY OF BUTTE - DEPARTMENTT ONPUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVIL_LE, G L FORNiA 95965 - TELEPHONE: 916/538-7541) PERMIT APPLICATION"DATA SHEET ., C�Q/'`!j OWNER o. Permit No,,,—, ( �Q P. No. ,,,,//�� Proposed Building UseAJd/f l Building Inspector Gj Date / At time of permit application, I was advised the following data must be submitted prior to permit:processing and/or issuance: 1. t _ DATEIRECEIVED All items have been submitted. ...................... ?............ . APPROVED 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. 14. 1 hool Disjoict fees paid ............... Sanitation rO U i E.. approval from -Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway..permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... Pre-Inspec. request to Building Inspector (Date 21. Contractor's license information (No., Name Style, Classifications ... 22. 23. Certificate of Workmans Compensation Insurance ............ Owner -Builder Verification (Given to owner ❑, Mail to owner ..... — F 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. 54 Mail to contractor. Telephone and hold for pickup at QieD office. Deliver w/inspector. Other A p p I i c a n t Date of Hdz-Mat form sent Health Dept. —Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date The following data must .be submitted prior to permit`issuance 1. Index permit for above items No. 2. Additional items required: By (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone---nail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mai I—counter by date Plans checked by I�w Date 24 519 Plans approved by RW Date S (55191 Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AND -PERMIT PERMIT NO. ASSE S !F ARCEL UMBER Q /,_ ZON:ryG / BUILDING PERMIT OWNS ,^ Z_B fn TELEPHONE SO. FT. OCC. BUILDING VALUATION OWN- S MAI LINy.DA.�D/Rn55 �� ^ �Jf11C 1 C R CTOR'S N T LEPH NE LA SO i CANT CT 'S MAILING ADDRESS _ Fireplace CO TRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee ; '9. A C ITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADORES Permit fee $ PLUMBING PERMIT FiIingFee 10.00 Each Trap 2.00 Solar or heat pump water heater. 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeN Other SPECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mob le Home S G W 10.00 ea TYPE OF WORK New ❑ AdditionX Remodel ❑ Utilities ❑ Installati nOther ❑ Describe work: k" f +J D ✓e r 4 ( Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 -1Main service 6011 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penaltyof perjury (check one): F -1I 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. 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 CONST.(DWELLING OCCUP.ad OR AODNS. ACC. BLDGS. • , 2/20sgit NEW CONSTR.MULTI-OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20.950¢ eAL131 FIXED APLNS Ex. Occup. OUTLETS PR IRESID )EA.) pq{ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ ,Q Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): F1The 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. ❑ 1 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 7 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 liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X 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 $ Energy Inspection Fee $ occ CONST TYPE n TOTAL FEE $ on,/ HAZ. CUA I PARK I SCHL I FLD I COF PAR PD HD. ISSUE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. "NNITE•O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE -.Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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) / v,4 2. av /have not) �,��p� signed an application for a building permit fo�"fhe proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone 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: Name Address City Phone Contractors 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 OwnerG�y�/ Social Security`Number Date 91 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 per- mitted to issue the permit. _ $1 �2!SY...i?' '• :7"FT . "+itC�R;'! .'�.. , t:•a�ti n ,n.t w•'- . •«' r,"-11.tti,. ,>�+'^+.«�., ti'(.i : 1 �,� .r.,.,• � T ,''1'r, � ,+;Ijn, � �-w • ar- Y..: w.�, � `t' 4 �1' rJ si 'rl 4a,�,.•t�.•s.:lbY . :.� :�•k%v' w.$`c -moi ;rf 1 1 Al/ S k ;;SCO 'N,TYF BUTTE -DEPARTMENT OF PUBLIC WO.F3K` _t'� PERMIT NO:', s i 7,(vqu Center Drive-.Oroville, California 95965 -Telephone:,'916% -7641, I ' APPLICATIONIt AND PERMIT ASSESSOR PARCEL NUMBER �� 073-180-087 7 ZONING DING_ -PERMIT OWNER -? LOLA WALBURN TELEPHONE- SO. FT. OAC, ¢...t BUILD NG VALUATION ' OWNER'S MAILING ADDRESS 5631 FORBESlTOWN RD ftRBESIMN 95941 - CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS i Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. "� Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5631 FORBESTOWN RD EMESPOWN 95941 Permit fee $ PLUMBING PERMIT Filing Fee 15.00 k Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL' MAP L Water i.ping 7.00 Each pas water heater or vent 7.00 USE OF STRUCTURE 4 SF ❑ Duplex❑ MobilehomeXI Other I SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other [X Describe work: REPLACE MAIN SERVICE AND MISC ELECTRIC FOR GARAGE Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 50 Q� 200A OR LESS 18. 18.50 Main service 200A TO I000A, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I 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 ZI 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- i. ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason ; _37.50 NEW CONST. ( DWELLING OCCUP.9- 3.64 sq.ft. OR ADONS. l ACC, BLDGS. / NEW CONST R. ULTI-OUTLET NO N•RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS b (SINGLE OUTLET CIR. 20 76 Ex. Occup(OUTLETS OR FIXTURES Al - Ex. Occup. our LE PRESID ID APLNS.REAJ I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 15.00 Permit Fee $ • — 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. Notice to Applicant: If after making this statement, should you becomesubject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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, osts, and expenses which may in any way accrue against said' County i ,c sequence of the granting of this permit. 'This X <..! Y� rr�_lr� 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEES 48 SO • HAz 0FEES IMP FLOOD C111 PARCEL PD HD ISS permit is hereby issued under the applicable rovi- P Y PP P cions of the Butte County Code and/or resolutions to do work indicated:abd� for which fees have been paid. �2 RE OR O� PUE IC WORKS BY, f' j /�, Date /(.,0 PERMIT EXPIRES—Date �- Receipt No. 101429 WNITC-D.P.W., TELLO W-A99[990R, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER -- 073-180-087 ZONING _ U" BUILDING PERMIT OWNER LOLA WALBURN ' T ELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 5631 FORBEST014N RD FORBESTOWN 95941 CONTRACTOR'SNAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5631 FORBESTOWN RD FORBESTOWN 95941 Permittee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: RFPT,AC E MAIN SERVICE AND MTSC: FLEC:TRTC FOR GARAGE Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service R LESS 200AORLESS 18.50 18.50 Main service 200ATO1000AI 37.50 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 CONST. ( DWELLING OCCUP.y\ OR ADDNS. ACC. BLDGS. // 3.6psq.ft. NEW CONSTR ULTI-OUTLET NO N.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occ Up(OUTLETS OR FIXTURES 20 76 Ex. Occup. OUTLETS IIRESID IFIXED APPLINIS REA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ — 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. ,Qj�.l shall not employ any person in any manner so as to become subject 6to 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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 liabilit' jud ent st , and expenses which may in any way accrue against Co i nce of the grant' of this permit. X-�� Dater – �� �� re of Applicant — Owner g ❑ Contractor ❑ A ent ❑A permit is required for excavations over 5'0" deep and demolition or construct - fn2fS.�tructuresover 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 48.50 RAz I DFEES I IMP I FLOOD I coFPARCEL PD HDIssu This permit is hereby issued under the sions of the Butte County Code and/or for which fees O PU IC work indic:K4R PEI BEXPIREDate _ applicable provi resolutions to do have been paid. WORKS Date /0-'�2'R/ – Receipt No. 101429 WNITE-D.P.W.. YELLOW-A58[930R, PINK -INSPECTOR. GOLDENROD -APPLICANT a. a I,it,.�, .. �i0'lT T-.,S,�q +. Y.. Ztx� �i�lY-' �06i��iYl .�7, �F 1?�714�'�✓'i.Tr!-,lJN"t'"v�,'+..'. ` r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLt=, .CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMMRPRP 4,CATION -DATA SHEET _ Permit No. OWNER ZaIA (Q148' l�4011vl A. P. No. 073—/SO�D��l Proposed Building Use Building Inspector Date to 7- 1/ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. ......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ......................................... . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent, for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13• School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking:.' 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner t3l� /..... /0- 7-5/ 24. Recorded copy of Agricultural Acknowledgment Statement ......... 5. Letter of signature authorization . 26. 27. When you issue the permit, process as follows: / Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w./inspector. Other Applicant F nate/0-/7 '91 Copy of Haz-Mat form sent Health Dept. Vre Dept.'Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Others 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: Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by -.date Contractor, designer, owner, was advised of above required data by—phone —mai I—counter by date 1 Plans checked by Date Plans approved by V Date Sets of plans on hold in File cabinet AP.folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916,'538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER pmt p �73 - 1&-dO 7 ZONING BUILDING PERMIT OWNER,( , V /- • V TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING AD E55 3�bPSTo��/ 1y CONTR OR'S NAME TELEPHONE CONT ACTOR'S/ MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS - / � .S � �La�s /�✓� /%/'1 Permit fee $ PLUMBING PERMIT Filing Fee 1 15.00 IPS �GGd sfL Each Trap I 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex[]Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 1 15.00 Mobile Home IS1G W @ 15.00 TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities❑ Installation[] Other Describe work: _- ���Le- �1,V .SffVAf- �iyo 1/'/.�( Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 1 18.501 , S Q Main service 20GATO 1o0OA, 37.50 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 CONST.( DWELLING OCc N3.6Q sq.ft. OR ADDS. ACC. BLDGS. I NEW CONSTP_ ULTI.OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS.5 (SINGLE OUTLET CIR. 20 76d Ex. Occup(OUTLETS OR FIXTURES 5AL EX. Occup. OUTLETS PRESIFIXED APL.NS. O IREA.� 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ — 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. ❑ 1 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Si nature of Applicant - Owner g pp ❑ Contractor ❑ Agent ❑ An OSHA ion of struc urestoverr34stories ineheL/igg!httions over 5'0" deep and demolition or construct- Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAz 1 0FEEs I IMP I FLOOD COF PARCEL PD I HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. IDI `72T WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oreille, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phones 916-538-7541. ' An 'owner -builder" building permit has been applied for in your name and bearin& your signature. y • 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) 2. I (have/have not)_igned an a ` lication for a building permit for the proposed wor .- 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone 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: Name Address City Phone Contractors 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 Securii 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 per- mitted to issue the permit. ��'y�.�'f+�'.~Ri`$r%k���"'� ,. - r i�.i�vgr',FA'Y�wilYrx;�Kg*�1M^. �'•-,S v,�•v witi%e; +� >.'—w'eh*r F,w ���ryti�'!.: x'."Kwr,�i'�i��: -�`�y`,�i{r�l"`�� a����t�''�l�i";�:.' ti _ 91-,37f12"•'' W4 B r •1 ` CONT,R: OWNER, :. . ` FORBESTOWN 5631 , FORBESTOWN RD, DEMO GARAGE G s- i s,,. , t 1 • ,, Til COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS , PERMIT NO. 7 County Center Drive- Oroville, California 95965 - Tel.ephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 073-180-087 ZONING U BUILDING PERMIT OWNER �� WAT,�RN TELEPHONE OCC. BUILDING VALUATION /�S/O�.FT. T CONT1 200.00 OWNER'S MAILING ADDRESS 5631 FORBESTOW'N ROAD FORBESTOWN 95941 CONTRACTOR'S NAME ` TELEPHONE CONTRACTOR'S MAILING ADDRESS -" Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5FORBESTOWN ROAD FORBESTOWN 95941 permit fee $ 30.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other DET GARAGE SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other J] Describe work: DEMO 24 X 24 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 200A TO IOOOAI CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one,): F -1I am licensed under provisions oP-04, t. 9, Div. 3 of the BuslnesS and Professions Code and my license is in full force and effect. License No. Classification ,F,1 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 orfs. (Sec. 7044) ,�as the owner, am exclusively contracting with licensed !contract- ❑ I -..am exempt under Sec. , Business and Professions Code I for this reason NEW CONST. / DWELLING OCCUP.f\ OR ADDNS. \ ACC. BLDGS. // _37.50 3.6daq.ft. NEW CONSTR.ULTI.OUTLET NON -REST BRANCH CIRC ITS @ 5.00 POWER APPARATUS h ( SINGLE OUTLET CIS. Ex. Occup(OUTLETS OR FIXTURES 20 8 750 Ex. OCCUp. OUTLETS PIRESID )REA.) 1 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring -15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.0 (valuation) or less. �i ❑ I have placed on file�iit the( -County of Butt\Building Department a Certificate of Workmert\s� nsation Insu�, qpe or a Certificate of Consent to Self -Insure. w� ' ` ❑ I shall not employ any person in any m�qt's to become subject to the W. C. laws of California�1 ia. ` Notice to Applicant: If after making4h ata((� nt, should you become subject to the W. C. provisions of the Labor Col you`fauA forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 Ventilation permit Fee r $ Contractor I certify that I have read tis I•'oa '\h' ooh ,vd . to thaf� t e above information is correct. I agree to comply fo III �o�nty OPdinanc.es and State Laws relating to building construction, and her .y authorire:.repreaent t�'Ivjes of the Countyot Butte to enter upon the above men ironed property for in�spt tion purposes. I also agree to save, indemnify an keep harmless the County of Butte against all Iiabi l,ities, j9dgmepts,_ costs, and expenses which may in any way accrue against said County .i�,,cronsequence of the granting of this permit. X !�z i T ' _' / -�.- ' Date ��� i'/ 5; ncrure of Applicant - owner 9 pp 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 Instpll ; ' e.e- S Energy Inspectkon"Fee $ occ CONST TYPE TOTAL FEE $ 3O 00 • HAz I DFEES I IMP I FLOOD cDF PARCEL I PO HD IS E This permit is hereby issued under the sions of the Butte County Code and/or Work indicated- abo'e for hich fees I OR O PU IC By c -' ( PERMIT EXPIRES ate applicable provi- resolutions to do have been paid. WORKS Date/c) 1 G.`>r �. Receipt No. ` WHITE-D.P. W., YELLOW-ASSC3SOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P RMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT / ASSESSOR PARCEL NUMBER , 073-180-087 ZONING . U _ BUILDING PERMIT OWNER LOLA WALBURN TELEPHON SO. FT. OCC. BUILDING VALUATION CONT EST 200.00 OWNER'S MAILING ADDRESS 5631 FORBESTOWN ROAD FORBESTOWN 95941 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5631FORBESTOWN ROAD FORBESTOWN 95941 Permit fee $ 30.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF [:1 Duplex❑ Mobilehome❑ Other DET GARAGE SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ® Describe work: DEMO 24 X 24 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600VORLESS 200A OR LESS 18.50 Main service 200A TO 1000AI 37.50 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) El I, 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 CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 3.6asq.ft. NEW CONST R. ULTI.OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 /POWER APPARATUS e (SINGLE OUTLET CIR. EX. OCCUp(OUTLETS OR FIXTURES 20 76 FIXED APLNS*A Ex. DCCUp. OUTLETS (PR ,OR Er )A.� I 3.00 Temporary service 15.00 Home Facilities 15.00 Misc. byirin 9 15.00 Permit Fee $ — 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. &—1 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. Contractor MECHANICAL PERMIT Filing Fee 1 15.00 Heating Cooling g Hood 6.50 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 Ito 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 liabil' "es, judgme s o and expenses ch may in any way accrue again id C Int �ience of the gran ' of this permit. X Date �g/ S' ature of Applican — Owner ❑ Contractor ❑ Agent ❑ A OSHA permit is required for excavations over 5'0" deep and demolition or construct - 'on of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 30.00 HAz OFEES IMP FLOOD CDF PARCEL PD HD Iss E This permit is hereby issued under the sions of the Butte County Code and/or work i ate abo for w ich fees R OF U C By PE IT EXPIRES 66ate applicable provi- resolutions to do have been paid. WORKS Date/ Receipt No. 101429 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER�Ij r OC D?� U [ZONING BUILDING PERMIT OWNER TELEPHONE SO.FT. OCC. BUILDING ^VALUATION G ADDR ESJS.• OWNER'S Mx` CONTRACTOR'S NAJ.AE TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ s Oo ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 2 J Permit fee $ _�v PLUMBING PERMIT Filing Fee 15.00 G/ kes DwA) Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE /� SF❑ Duplex❑ Mobilehome❑ Other O�� GLIA-GZ SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W 615.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Instal lation ❑ Other [ Describe work: aPifll jQ zk Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 200A TO IOOOAI 37.50 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 .Jo. Classification FlI, 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 CONST./ DWELLING OCCUP.✓f) OR ACDNS. 1 ACC. BLDGS. 3.6Q sq.ft. NEW REST 0. RANCH CIRCU NO N•R ESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup( OR FIXTURES 20 76d FIXED EX. OCCUp. OUTLETS PIRESID IgEA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): F] 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. 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. Contractor MECHANICAL PERMIT Filing Fee 1 15.00 Heating Cooling g Hood 6.50 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, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Si nature of Applicant - Owner g pp ❑ 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 S Energy Inspection Fee $ DCC CONST TYPE TOTAL FEES �— HAz 1 0FEES I IMP I FLOOD COF I PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. ( ! 7 WHITE-D.P.W.. YELLOW-ASSE»OR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT.gF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE„CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET L��/T----�/� Permit No. / 61, OWNER_ A. P. No. 073""J�� —4067 Proposed Building Use 4eMO 6-'4/tvUC Building Inspector 40 Date 04-17— q/ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED - APPROVED 1. All items have been submitted. .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ......... 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ........ . 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance �.................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... Letter of signature authorization ............ ...........O�. A:5Ae,-%Qs 17- 9/ 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other 1152 z-2 Applicant ate I i�—✓7 ��% a 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: Contractor, designer, owner, was advised of above required data by_phone----rnail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mai l—counter by date Plans checked by Copy—DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder Date COUNTY OF BUTTE - Department of Public Works 7 County Center -Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. b 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.p.lan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) signed an pplication for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. J 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 Contractors 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 Securi Number Date ter/)- / 17OW 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 per- mitted to issue the permit. Demolition Permits Asbestos Notification Statement / / rw Date l ®� 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 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 ro'ect. Signature of Applicant 2/19/91 us�Npx Dr Aso 0 6'� 0 F� (Gpy 42(,Z2- 91