HomeMy WebLinkAbout005-391-003WILLIAM E. THOMPSON THOMPSON, Chas. 485-66B +T
780 Wisconsin St, unit #3, Chico r` ' _ 372-66E
ermit #4377-78P(repair ga Tine) 1 �`t"�---Q 8-6
duplex _t MGI��o.l_ _Gj_%,.
780 Wisconsi St
005-391'-003 � ''''` {94-0799E, , , Y' + n • � Chico
(cI nverting 2 residences to duplex lby add�in
THOMPSON; WILLIAM {
ci Dr , halls & baths) / r'
-780V ISCONSIN ST UNITS "1� 6, CHICO `,r k
CONT : ' TIrI JOHNSON►:'=
iNEWELE-SERVICES/MFS`
0
F
PRE—INSPErTION (�
OWNER: e�! I%�114 y D �^ DATE -3 A
LOCATION: 780 t:s r oA)s,4i 5 i [ % CO A.P. # aO S •- -' 9' li- ave
CONTRACTOR: 17^1 -�--0 4 /uso to _ ZONING
PRE -INSPECTION FOR: 6a) s61zu1 C6:g
DATE TO INSPECTOR.
3/,;?- 9 / 9 y
PERMIT HISTORY: NONE AS FOLLOWS: 7,9
A N �eye2 Z /1 es"�1PN�cs to ��l'c�C ,b y ��y�:vcP C�4 pQ� Grp ��s 4 ti�
TYPE OF OCCUPANCY
BUILDING USAGE:
TENNANT :
6 5,5;curr"�
FIELD - INFORMATION
Q OCCUPIED HAS ELECTRIC HAS GAS HAS SANITATION FACILITIES
Q HEATED -COOLED PERSON CONTACTED
OTHER COK1,MNTS :
ACTION COMMENDED:
'ISSUE Q HOLD FOR
OTHER:
16/
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7£ounty Center Drive — Oroville, California 95965,
Tel eph,1.ne: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X
Signature of Permitee or Agent
Date
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 Date
Building permit expires Date
BUILDING
. "� ! ,
Owner - J Ir
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor
Mailing Address `
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address =�, '/�� ' - r '
Plan Checking Fee Vor Penalty
Permit Fee
`
' • _;- -
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
r
(�! �f iI.
Repair drainage or vent piping 1.50
A. P. NO. �• ! 1 f • - ` j
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
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. Plans Recd .
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER/❑
Permit Fee $ ��-U
$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family ❑ Duplexio Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
OV AMPP OR LESS O
Main service OVER 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW
OR ADDNST ( ACCONSCLBLDGS.CCUP. &+) rLPSgft
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:
NEW CONSTR BRANCH
NON-RESID (MULTI BRANCHH CIRCUITS) 2.50ea
NEW CONSTRPOWER APPARATUS &
.
NON-RESID. (SINGLE OUTLET CIR.
EX. OCCUP(OUTLETS OR FIXTURES BAL@10Q
FIXED APPLNS,
Ex. Occup. (OUTLETS (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 Noi @ 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.
❑I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
Land Development Fee
is
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X
Signature of Permitee or Agent
Date
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 Date
Building permit expires Date
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
Telephone: 534-041
APPLICATION AN PERMIT
spy -7 p12
authorize representatives of the County of Butte to enter upon the
above-mentioned property/For inspection purposes.
-157 ��- Date Zd
re of Permi , or Agent
Receipt No. -I / a ay 1P
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.
?ZR EC OF PUBLIC WORKS
B Date
_74-6 Z7 IF
Building permit expires Date 1v b
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address SO
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each TraD 1.50
•
Repair drainage or vent piping 1.50
A. P. No. �— — 3
Zonin &Planning
Water piping 1.50
Each gas water heater or vent 1•.50
F
Seni-�
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
I Parcel Map
60' R/W
I Improvements
Each additional outlet 30
Building sewer 5.00
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
is
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3,00
00V OR LE
Main service 100 AMP ORSLESS 5.00
Single Family ❑ Duplex Mobil Home ❑ Others ❑
Main service EA. ADD•L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service/ EA. ADD'L 100 AMP 1.00
NEW CONSTOR ADDNS. \ ACCLBLDGS.DWELINGCCUP 711 22sgft
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
st le of:
y
T
NEW RESID,CONSTBRANCH CIRCUITS
NON -REBID � BRANCH CIRCUITS 2.50ea
NEW CONSTR. POWER APPARATUS 6
NON.RESID, SINGLE OUTLET CIR,
Ex. Occur){OUTLETS OR FIXTURES B L@1
Ex. Occu FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA) 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 $
$
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.
B�f certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
Land Development Fee
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property/For inspection purposes.
-157 ��- Date Zd
re of Permi , or Agent
Receipt No. -I / a ay 1P
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.
?ZR EC OF PUBLIC WORKS
B Date
_74-6 Z7 IF
Building permit expires Date 1v b
��'�y;�.i=-i�.${�rK'.-+7..y..F;,vi%c`-,}','i'''. oaf"'.`. r,"F:':;7iyis'�`'�.F 5'v^;q; Li. +za'�ia+rnb'n7+ti.Y"a d+t::'�'j"..'•+_^F.f *'f'`i�.f+� � •7• �a„r� - .Gy, f�...�'C'�
005-391=003 '
• � j`" _ � '".THOMPSON,•.WILLIAM
t
-'780 :WISCONSIN ST., UNITS 1K6., CHICON
- CONT: 4TIM JOHNSON '`"-
^ NEW .ELE SERVICES/MF`+`'� • {
C(3UNIY.4F BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
¢7 County Center Drive - Oroville, California 95,965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT f-7 7 `�-
ASSESSOR PARCEL NUMBER
005-391-003
ZONING
A8
BUILDING PERMIT
OWNER
WILLIAM THOMPSON
TELEPHONE
343-0508
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
E ROAD CHICO 95928
4 79 DAYTON WEST
CONTRACTOR'S NAME
TIM JO N
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee $
20,00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
780 WISCONSIN STREET CHCIO
PERMIT FEE $
jjjQl'j'S 1
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SFO Duplex ❑ Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
U Installation O Other ❑
New ❑ Addition ❑ Remodel ❑ Utilities y
Describe Work: 6 NEW SERVICES (ELECTRIC)
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 2OOA0 LESSR LESS ) 6
23.00 138.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUR
OR ADONS. ( 8 ACC. BLDS. )
S(.
3.5C FT.
NEW CONST. MULTI -OUTLET
.NON-RESID. ( BRANCH CIRCUITS )
@7.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
Oil 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ I am exempt under Sec. Business and Professions Code
forthis reason
( POWER APPARATUS )
a SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.000
BA0
Ex. Occup.FIXED APPS. OR
(OUWTLETS IRESID.1 EA. )
5.00
Temporary Service
23.00
Mobile Home FacilitiesL23.00
Misc. Wiring
_RRVI INSPE MON
23,
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
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 Butte County Ordinances and California 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
liabilities, judgments, costs, and expenses which may in any way accrue against said
County in consequence of the granting of this permit.
X /ff � - Date —�? - ti Y
Signature of Applicant* 'ElOwn r ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 181.0
HAZ•
I D. FEES
IMP
I FLOOD
I CDF
PARCEL PD
HO
I ISSUE
Nor
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for hich fees have been paid.
`
By Date 3 3/ q
PERMIT EXPIRES ON 33�
lDetel
Receipt No. 156702-43.00// 0 -•
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PIN -INSPECTOR /GOLDENROD -APPLICANT
J/to/ COUNTY ;OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville,, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
005-391-003
ZONING
AR
BUILDING PERMIT
OWNER
WILLIAM THOMPSON
TELEPHONE
343-0508
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
4 7 DAYTON WEST ROAD, CHICO 95928
CONTRACTOR'S NAME
TIM JOHNSON
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEER
ucENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
780 WISCONSIN STREET CHCIO
PERMIT FEE $
UNITS 1-6
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7,00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF O Duplex 0 Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
FG
15.00
Mobile Home TS W
@20.00
TYPE OF WORK
New O Addition ❑ Remodel O Utilities Ili Installation O Other ❑
Describework: 6 NEW SERVICES (ELECTRIC)
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BOOV OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONS. ( & ACC. BLDS. )
S0.
3.50 Fr.
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full farce and effect.
O I, as the owner, or my employees with wages as their sole compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
I am exempt under Sec. Business and Professions Code
forthis reason
NEWCONST. MULTI -OUTLET
.NON-RESID. ( BRANCH CIRCUITS )
@7.50
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
B20AL. .50
FIXED APPLNS. OR
Ex. Occup. UTLETS IRESID.) EA. )
(O
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PRE !NSPECTION
PERMIT FEE $
93 0
181 0C
WORKER'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
O This permit is for $100.00 (valuation) or less.
O 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
jL I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
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 Butte County Ordinances and California 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
liabilities, judgments, costs, and expenses which may in any way accrue against said
County in consequence of the nting of this permit.
Date c� %� f� — !r
Si nature of Applicant7QOw r O Contractor O Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 181 .0
HAZ•
1 D. FEES
I IMP
I FLOOD
I CDF
PARCEL PD
HD
I ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
in above for which fees have been
(A
By
PERMIT EXPIRES ON Y-9/Ak
)Date)
provisions
to do work
paid.
Date all Q
Receipt No. 156702-43.00// IS(o_731 139,0
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PIN -INSPECTOR GOLDENROD -APPLICANT
..,T•q,ev��:.x"7,�.-y-��•�'+iti.a��-�cr�Y7 f,,,w-'�^nr'w�"`�,�,,,y.,�,ArC}•r�NQ1*iF"'.+wFvr1"}ax}2,..n.-snv+;'�,.;:^.:.<."vcY�7•ilryr'+¢.'�"'i`^-\rT �'t..-..�_,..-....n��- ..�w1.TM....�.. ^r:#�r. .. �,.. .. .�,.. �.. ..
COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE (916) 538-7541 V
PERMIT APPLICATION DATA SHEET
OWNER V ( / /11
Proposed Building Use
6M
A. P. No. &Lt- - 39 i - OCZ3
�?
Building Inspector t I o Date 3 S
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ........................................
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 sup rting 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 ata and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ /Jl8s'-.........................................
1. 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:
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). ...Preanspe'ction rags
20. Pre -inspection for We1A(,VA4'441 !t Y-427WI-Ps' ITC, required. .. to Building lnepela-r30 4� -696--Date)
(
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 . ......................................... Ff
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30.f Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When you issue the permit, process as follows: mailtoiowner. Mail to contractor.
c,"'Telephone,3Y-3 �cf and hold for pickup at %< < office. Deliver with inspector.
Other
Parcel Creation_
Acreage Applican i0-ez�'r ate 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 _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
tans 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 - DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION
7 County Center Drive - Oroville,, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER �s OO ^
'dl
ZONING -1511F
BUILDING PERMIT
OWNER
W,-1114114 G1 Sd
TELEPHONE
343-05`
SO, Fr, OCC. BUILDING VALUATION
OWNER'S MAILINd ADDRESS
O (!�
CONTRALTO NOWE
rlk
TELEPHONE
CONTRAC OR'3 MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20,00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
BUILDING ADDRESS
Penalty $
PERMIT FEE S
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAMEPAR
CEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
S Duplex O Mobilehome O Other
sPECIFr
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New ❑ Addition ❑ RemodelO Utilities Installation O OtherElContractor
Describe Work: � � It eW 5feulif6:S
PERMIT FEE $
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BGOv OR LESS )
2WA OR LESS
23.00 8�
Main Service ( 200A TO IOOOA )
46.00
NEW CONST. DWELLING OCC P.
OR ADONIS. ( a ACC. BLDs. )
SO.
3.50 FT.
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
O I am a licensed under provisions of Chapter 9, Division 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 compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST,
.NON•RESI
ID. I BRANCH CIRCUITS )
@7.50
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
Bn2 @ I.w
Ex. Occu p' (FIXED APPLNS. OR
OUTLETS iRESID.i EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20,00
Misc. Wiring
28,00
c
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
O This permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
O I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
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 Butte County Ordinances and California 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
Signature of Applicant - O Owner O Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" 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
I COF
PARCEL PO
HO
ISSUE
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.
By Date
PERMIT EXPIRES ON
lOetel
y
Receipt No. 1%11e+1 �� rCG S "jU I Sr�j L
WHITE-O.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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