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HomeMy WebLinkAbout005-396-004a 4113-90P,E,M HALLGREN, Lynn 788'Colorado St,"Chico .,(elec,serv,,gas line, v.iall heater/sf) 0? !005-3976-004%-93-652,.BPEM HALLGREN, LYNNE,." C 788 COLORADO, 'CHICO .-.F ROOF,.FURNACE,-ELEC,.'GAS LINE/,SF • 005=396-004: PERMIT#96-2438•. • ,HALLGR,EN,,- Ly-nne 788 Colorado., Chi -co Reroof,furnace,Ele,Gas Line/SF 05-39-9-334 ��00--2238---""' - (11 .1 .. DAVENPORT;Cecill- 788 Colorado St., Chico -200'AMP Upgrade 005-3 9 -6-064 00*2263 DAVENPORT, CECU-JAC-��� 788 COLORADO STREET, CHICO CONTR: OWNER Q, w-� WATER HEATER, GAS LINE I � - V6 CA wra5�,, 60 - ::14 -S�Clke, P24c- )o-z)A 5 t r4 • L e COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754101.PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT C 3 19 ASSESSOR PARCEL NUMBER` — — .3 1OWNER �(•J\ BUILDING PERMIT 72oNIN JLEP NE 3p 9 O SO. FT. OCC. BUILDING VALUATION OWNER'S I DRESS CONTRACT NAME TELEPHONE 891-5S CONTRACT R ADDR S n / ?Eq -.-3 rq ^../y3 /�" •IL Y/J CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS oq Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE S Oo,Z238 00 - 2240 93-690T 47�„ay30 ELECTRICAL PERMIT Fling Fee 20.00 7,T —F Main Service 20.A. aOOV . S 23.00Q3 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 To 46.00 NEW CONST. DWEW EE NG OCCUCUP. OR ADONS. ( a ACC. BLDS. SO 3.5aFT; ULT 0.OUTLEr No RESDT JM UL @7.50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occu OUTLET OR FDRURES Q 1.00 20 BA @ .e0 Ex. Occup. oUT ED AaID.°E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t 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 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 0 1 should become subject to the o kers' compensa ' rovisions of section 3700 of the Labor Code, I shall fo hwith c ply i se provision . �7 / X at � � !.� y Si nature of Ap nt - ❑ Owner ❑ Contractor Agent An OSHA permit i quired for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ p� l�c3kAL TYPE TOTAL FEE $ 3.67 HAZ. O FEES FLOOD CDF I PARCEL PD TH7E This permit is hereby issued under the applicable provisions of the Bu County Code and/or Resolutions to do work indicat above for which fees have been paid. e By l,('X!� Date PERMIT EXPIRES ON Da Receipt No. WHITE-O.D.S.-G.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT NH " JJILo I 'S S"d0.LOW 2197l�a a3z'so"Inv cGi14,V'�i TIME & JOB SHEET Name: Date: Job# & Name: Must be filled out at job site. Labor Code # hrs. Description t .`� `� °�� .'! V. t�o gym' F., •,•°�i� AI •i�,'��. l' Materials installed on job: Completed: Truck Check turned in: If you need more room please us the back for more description... woo dwndpartia}orn rnr :a}{sgaM £6L0-168 WES) xod • S4SS l68 (0£Sl �", -O -008-1 aa�d 00I ..," , o F uowoios Row 5-396-04 4113-90P,E,M :�K.-': .,..;w;�, .•s<;,,r.;.:��_.:'.'� : `• 1 HALLGREN, Lynn , 788 Colorado St, Chico (elec sere, gas line, wall heater/sf) 9" 4 005-39-6-004 93-652 BPErl HALLGREN, LYNNE 788 COLORADO, CHICO ROOF, FURNACE, ELEC, GAS LINE/SF 005-396-004 PERMIT#96-2438 HALLGREN, Lynne 788 Colorado, Chico Reroof,furnace,Ele,Gas Line/SF uup - J 7'• v -w- DAVENPORT, Cecilia 788 Colorado st_, Chico 200 AMP Upgrade 005-39-6-004 00-2263 DAVENPORT, CECELIA 788 COLORADO STREET, CMCO CONTR: OWNER WATER HEATER, GAS LINE '. .'.'�— , 3s.y �;. �.,,�_.�yv`\.FxL,(•t"�'�r�"t•ti�c"a�'j�.i'C�_" ;.1�..��3C:.La �Y„ } � �; , . ,,v, _ �_ �_ ,; •.. '005=396=004 PERMIT#;96-2438h HALLGREN, iLynne 's }, '7& 7&-y Co1rdo�,'. xa x Reroof,furnace,Ele,Gas Li e`/lkS f t C_ • , t ! 't L•1� \ i r ! ^r 1 t . r kz_"O a --co - A j its COUNTY OF BUTTE- DEPARTMENT OF PMENT SERVICES - BUILDING DIVISION �PERMIT NO. 7 -County Center Drive - Oroville, Ca rnia '85965 - Telephone (9"16)' :538-7541�,/� APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 005-396-004 ZONING AR BUILDING PERMIT OWNER �' LYNNE HALLuREN TELEPHONE 89'--6287 SO. FT. OCC. - BUILDING VALUATION 600 OWNERS MAILING ADDRESS 788 COLORADO ,.- CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS ' ' Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation $ Filing Fee $ 20.00 LENDERS MAILING ADDRESS Permit Fee $ 17.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 788 COLORADO CRICO PERMITFEE $ 37.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISIONSNAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF D Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 TYPE OF WORK v New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Otherd❑ Describe Work: REPAIR ROOF, WALL FURNACE, ELEC SERVICE* — MISC) WIRING, GAS LINE Mobile Home S G W 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20.00 ( Main Service ( 200OR ESS ) 23.00 200AA LESS SS 23.001 Main Service ( 200A TO 1000A ) 46.00 i LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensgd 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 foNthe following reason: QII, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions, Code for this reason NEW CONST. DWELLING OCCUR SO. OR ADDNS. ( 6 ACC. BUDS. ) 3.52 FT. NEW CONST.MULTI-OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 WER (aPs NG E OURETTUS C R. ) Ex. Occup. (OUTLET OR FORURES ) BAL @'.50 Ex. Occup. ( OUTLEEDrA P sE S. EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 PERMITFEE = 66.00 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating. Cooling Hood 6.50 Ventilation PERMITFEE $ 3-9,00 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation ,etf 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 rovisions. X i�' '� i f %!� . i7bw. Date /)% ,Signature of Applicant'- El 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 $ 173.00 HAZ. D. FEES IMP FLOOD COF PARCEL PD 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. B �._ Date 4VJ ? PERMITEXPIRESON /b/2/ %7 (Date) Receipt No?0625 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OFOEVELOPMENTSERVICES -BUILDX5417 7 County Center Drive - Oroville; -California 95965 - Telephone (916) PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 005-396-004 ZONING AR B ING PERMIT OWNER LYNNE HALLGREN TELEPHONE 891-6287 SO. FT. OCC. BUILDING VALUATION 600 OWNERS MAILING ADDRESS 788 COLORADO CONTRACTORS OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 17.00 ARCHITECT OR ENGINEER .LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 788 COLORADO CHICO PERMITFEE $ 37.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF W Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other )b Describe Work: REPAIR ROOF, WALL FURNACE, ELEC SERVICE, — MISC WIRING, GAS LINE Mobile Home S G W @20.00 PERMITFEE $ . Contractor ELECTRICAL PERMIT Filinq Fee 20:00 ^ Main Service 200OR LESS MiS ( zooA OR LESS ) 23.00 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION 1 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 f9y1he following reason: IV I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING oCCUP. SO. OR ADDNS. ( a ACC. BLDs. ) 3.50 FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. EX. Occup. ( OUTLET OR FIXTURES) 20 @ I•00 BAL 0 .50 Ex. Occup. OUTLETS APPLNS. OR PES D.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 PERMITFEE $ 66.00 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 g Heating 15.00 Cooling Hood 6.50 Ventilation PERMITFEE $ 3500 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation f one hundred dollars ($100) or less.) 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 thoseprovisions. /y 1�2 'I 1111191111A,Date –�2 _ OE Of( ntractor ❑ Agen er a#,f_Ap;3Iics(nf_ff Co An OSA permit is required for excavations over 60" deep and demolition or constructionAr of structures over 3 stories in height. Mobile Home Installation Fee $, Energy Inspection Fee is occ CONST. TYPE TOTAL FEE $173.00 HA2. I D. FEES I IMP I FLOOD I CDF PARCEL PD I HD I 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. B Date l® f PERMITEXPIRESON �d/7.( 57% I (Date) ReceiptNo206281 WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �'.,'1+ .'i•'�^r�Ss;�-''L'-'"s'': � •�'�t^,�i^re.. .,�.�+c...�'tK,"?•��w'y j. ia,,,�f=t`[•k• �.+��.. _C.;�� .w. ..UE:•:rz�.y �,,, .�.�y�,j:�t�✓'4""ijl': yy�K3.'�i.:ir'S•��•►;»=• t�+irA... f -,y :(,,A0�s.,,;,_•wiswt Y' f' X005 39 6.004 938652' P: f' ` HALL`GRER, t LYNNE r , 788 COLORADO, * CHICO :y►`sw� FURNACE, ELEC GAS LINE/SF+ i • lily • ^ FcAx &-a j -2- --(0 Z WRP l COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. jj 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7 41 ' APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER �" ZONING a BUILDING PERMIT OWN R Z Y "N/r./ C `� - fn/ TELEPHONE 5. %� �_l e (� SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'SNAME - (RdNF.R TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER - UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS - • ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 15,00 Permit Fee $ 6 50 Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS �f r Penult fee ! 0 PLUMBING PERMIT Filing Fee 1 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 [n Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5,00 Building sewer15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[--] Other ® Describe work: REPAIR ROOF: WAII FITRNACF, E FV( SFRVL_ MISC WIRING• GAS LINE Permit Fee $ 20. nn Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200V OR LESS 00A OR LESS 18.50 18.50 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, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200ATO1000A) 37.50 NEW CONST. / DWELLING OCCUP.&) 3.64sq.ft. OR ADDNS. l ACC, BLDGS. // CONSTR.NEW CIRCUITS)U NON -REBID BRANCH @ 5-00 APPARATUS aI (W SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 20 0 76 FIXED APPLNS Ex. Occup...OUTLETS ((RESID,)REA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring -15.00 S Permit Fee $ G 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 �f Consent to Self -Insure. YrCI� 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 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ 24.00 Contractor f 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 consequencethe granting of this permit. Date _ / rr // -S ignature. of Applicant — Owner' Contractor ❑ Agent ❑ An OSHApermit 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 124.00 HA z OFEES IMP I FLOOD I CDF PARCEL PD I HD I ISSUE This permit is hereby issued under the applicable provi sions of the Butte County Code and/or resolutions to do work indicated pove,fdr which fees have been paid. ,r DIRECTOR OF PUBLIC WORKS BY Date / 9? PERMIT EXPIRES Date "r /, lrav � � . Receipt No. p 13 5-la6 �ayDu WNIr[-D.P.W., YELLOW-A$e[;93OR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95955 =velephone: 916/538-7541 APPLICATION AND PERMIT A PERMIT NO. ASSESS P EL/N UMBE �— ZONING BUILDING PERMIT ovyNE n/h/ 1� Q// !' e� 9 �; 9 % 2� / SQ. FT. OCC. BUILDING VALUATION OW 'S MAILING ADDRESS 600 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 15.00 Permit Fee $ 16.50 Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 31.50 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(J Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ® Describe work: REPAIR ROOF; WALL FURNACE; ELEC SERV; MT WIRTN ; GAS LINE Permit Fee $ 20-00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 1_18-50 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under El p provisions of Cha t. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. Icense 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 Main service 200A TO IOOOA1 1 .37.50 NEW CONST. DWELLING OCCUPM 3.64sq.ft. OR ADONS. ACC. BLDGS. I NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS &) SINGLE OUTLET CIR. EX. Occu 20 76 Occup(OUTLETS OR FIXTURES Ex. Occup. FIXED OUTLETS (PR ESID )REA.) 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 $100.00 (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 Consent to Self -Insure. 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 9.00 Cooling Hood 6.50 Ventilation Permit Fee $ 24.00 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 IiabiIit' judgments, cost ,and expenses which may in any way accrue a s I C unty in cons ence the granting of this permit. / %� Date (D Signatur of Applicant — Owne 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 FEE $ 124.00 HAz DFEES IMP FLOOD CDF PARCEL PD HD IssuE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work IndIC d ove r which fees have been paid. OF PUBLIC WORKS BY Date PER I: EXPIRES Date / p �� S�1®S �. Receipt No. ?/do r WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT e • f' COUNTYOF BUTTE - DEPARTMENT OF DEVELOPM€tITSERVICES - BUILDING DIVISION t --7COUNTY CENTER DRIVE -OROVILLE, CALIFORNIA 95965-TELEPHON!(916)538-7541 PERMIT APPLICATION DATASHEET OWNER 0 An A. P. No. (155- e Proposed Building se (g.-3 Building Inspector Date 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 supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy). .. .. .. . 20. Pre -inspection for Prea"�°" request required. .. to 9.'Iding �nsped°r (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 parcel4 creation and 60 right of way to a public road. .... . 27. 'Letter of intent on building use . .......................................: . 28. Mobilehome utility clearance . ..................:...................... . 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ..............". 31. Existing violations/expired permits . ....................................... 32. Plan check list . ..................................................... 33. When you issue the permit, process as follows: Mail to owner. Mail to contractor. 1,o,#�`hone g9j-1jQ X -4- and hold for,pickup at �o �,c �� office. Deliver with inspector. Other Parcel Creation Acreage Appli ant /�2k/21 Date Copy of Haz-Mat form sent Health Dept. Fire Dept. " Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder - Copy - Department of Public Works r b; 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) 6411110) 2. I (have/have not) _ signed an appl cation fora 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. 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 Ow er 74v��w Social Security Numger _ 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. �v^,,..y r�T.-. T .._ _ - ;r-•.-«n ;� 'W/.>�-rre�4wer _�.�w:h"+aL�';Td.t.A^u,`•`aFiy l..�,.�.,.�r,."'�*s-.:r,.e�+r.+o.a.,a.^�;+!._'f�ai�o�!'r''Yf �' ",x'*n'ky�:`'isM%w���"'€+ :4`.• Vin it .: n''.s�! ` I Tr ff' i-� 7 ' c`: !- y •u��,,.•7 r ti; •r� t L238 is / i � ill - 005-39 6-004 ` 00- u ' DAVENPORT,~ Cecilia r : 788 Colorado St. Chico a . 200.AMP Upgrade ���,7/G1 , • � /v` ,t� x// f,•�, it - -. '' ,... ,,...r�.r�--�'•'`,.r.-w-.-wf"�,^^i�ti.',�"' .rte � .. , � ...--�-+--�,r^.-.....-.-.:.).r..�i1r.•5,,..r_'^•.'t+',...^.P.-.--�.,�-i....-.-..--•...E'-...-.., ,� COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES ,= BUILDING DIVISION 7 County Center Drivb Otoville,`Cblifornia 95965 el'elePhone (530) 538:-7541 P •KNIT N (Rev. 12/96) APPLICATION AND PERMIT f ASSESSORPARCEL N,?q/�''� ^may^ �(] %`j ZONING 14 �; 'BUILDING PERMIT 4 f. OWNER. if �S TELEPH-NE I 3J PHO SO. FT. . 1OCC. . r BUILDING VALUATION/A t .OWNERS UNO ADDRESS � n �D A et.�f t' 1"i C 4t Gc ( J 1, CONTRACTORS �NAMEn TELEPHONE CONTRACTORS MAW AD RESS �- -,a. CONSTRUCTION LENDER r LN Fireplace LENDER'S MAIUNG ADDRESS- a.. Total -Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS ` Plan Checking Fee $ BUILDING ADDRESS �] '� �,,�, Energy Plan Checking Fee $ $ fes . PERMIT FEE $ LOT NO. SUBONISIONS NAME # PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF 10+, Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat um 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: Jr IL r Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W Q20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service 200A OR LESS 23.00UE. &j LICENSED CONTRACYOR'S DECLARATION I' 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. r 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. 1, 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 I Main Service TO 46.00so CCUOOOA NEW CONST. OWEWNO OCCUP. SO W:o OR ADDNS. ( a ACC. S.3.5¢Fr; NOµpESlpT MULTI -OUTLET @7.50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occu OUTLET OR FIXTURES BAL o I: o FRED APPLNS. OR Ex. Occup. S.00 O. ETs RESID. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 Y'1 0 - 71 , �) 3AB 123�X. r PERMIT FEE $rtr ( f 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 "� ` ' 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.) le'lcertify 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' 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 . ose provisions. ° 1u1 Date q/,Li X � • ' 1 /,Li Signature of lAppl— nt - Owner ❑ Contractor ❑ Agent 1 - An OSHA permit is required for excavations over 5'0" deep and demolition or construction. of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation :, • �•; , ; r • + PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection -Fee ' T $ occ CONST. TYPE , +' TOTAL -FEE $ HAZ. D. FEES IMP FLOOD COF PARCEL PD HD VIE This permit is .hereby issued under the applicable provisions in the Butte County Code and/or beentp i to do work above for which fees have been aid. '- Q�� t�fr�' f/'al! By Date PERMIT EXPIRES ON __f____' i I . , . ate Receipt No.f1rs WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 14 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE - OWNER PERMIT NO. i A routine inspec ' indicates that the following violations of butte county Ordinances exist at the above addres and shout 'be corrected. Please notice this office when correction of work is completed f you hav any questions pertaining to this matter, or need additional explanation, please not this fice immediately. Date � : Inspecto —R Y �a REV 10192 , COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION %11 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541/'x) � P,���• (Rev. 12/96) APPLICATION AND PERMIT ( � ASSESSOR PARCEL NU�/'`!�-OO ``yyii ZONING BUILDINGPERMIT OWNE TELEPHONE " 518-4113 .OWNER'S NG.AD DRESS Cho 959 SO. FT. OCC. BUILDING VALUATION CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS "UNG ADDRESS Plan Checking Fee $ BUILDINGADDRESSr•-Uys St. XU !\�i 1-µV` ' Energy Plan Checking Fee $ $ I--, — PERMIT FEE $ LOT NO. SUBONISIONS NAME f PA CEL MAP PLUMBING PERMIT Fling 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 as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: _a Q/,{' (,Lvo —VTC, 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 Fling Fee 20.00 600V OR LESS Main Service OA 0.. S 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.POWER 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: ❑ [,as owner of the property, or my employees with wages as their sole compensation, mill do the work, and the structure is not intended or offered for sale. GV 1• 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 200A TO 1000A 46.00 NEW CONST. OW EWNG OCCUP. OR ADDNS. ( a ACC. S. SO 3.5¢FT. p6ID MULTI -OUTLET @7.50 APPARATUS 8 SINGLE Otm Er C.. Ex. Occup. OUTLET OR FIXTURES 20 @ 1'50 BAL o .so Ex. Occup. OME. ASID OERla 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 E2-AU PERMIT FEE $ WORKERS' COMPENSATION DECLARATION I 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 2 0. 00 Heating Cooling Hood 6.50 Ventilation PERMIT FEIE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation �°f one hundred dollars ($100) or less.) a 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 fo Tcvijh co pi lth provisions. X r Date(] Signature of Ap Icant - 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 $ (0(0,W HAZ. D. FEES IMP ROOD CDF PARCEL I PD I HD ISS 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. By4,4N�� Q ate PERMIT EXPIRES ON 1 7 (DJI,) Receipt No. 0a ' --� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT PRE -INSPECTION REPORT Y LOCATION: �'�g, • (� k CONTRACTOR: PRE-INSPETION FOR DATE:/—/ 5-Ov A.P. # 6(5 5. 3%-C )oq Mel ►il► N C DATE TO INSPECTOR Y-/5 t -V -AA • ft .e Building Description: Electric: Commercidusage: Residential/# of Units: Currently Occupied Abandoned/Vacant Yes No Condition of Electric PERMIT HISTORY:( ) NONE 64 AS FOLLOWS: t BUELDING INSPECTOR'S REPORT �t Electric currently Old j Off . It Gas: •� l Natural Propane None Currently On Off Obvious Problems: Sanitation: I� Plumbing Working Well Working Potable Water' Obvious SewageProblems , Comments: ACTION RECOMMENDED: ISSUE: HOLD FOR M K G Inspector. Date !-�l! o#4• �� -A^� , GcJarar.,,�-`Leat. Sketch buildings on reverse and indicate location on propert`' M-0 `�lt3.�3:1+�y'�`-('�':ciCr;'T jii!k"3'i'F��?�'�°y� �'t�R-'�i�..f�;� .'�a.+�i y` r,i,.:� `h. •� I •f _.;�y,�, �„� a y 't r<<i }� •• y i r * • i j • r r � F,i---- ,:�+Pt- Yr �.�;�, �.r.:..i5;3=9t'ti ":,pre�:�.,+KYr-v►'"�`R+"Y''kN' .d • C�r 5-396-04 4113-90P;E,M ` HALLGREN, Lynn • 788 Colorado St, Chico s, (elec serv, gas line, wall heater/sf) ck ... � + � - - • sem': P,;,,�2�� .. - •... • .�., . ��• x.30 , Cv r BOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. `.. 7 County Center Drive - Oroville, California 93965 - Telephone: 916/538-7541 =-- �. -- APPLICATION, AND PERMIT�� ASSESSOR PARCEL NUMBER a 5-396-004 ZONING AR BUILDING ISERMIT OWNER L nn Ha11 e TELEPHONE - SO. FT. OCC.1 BUILDING VALUATION 2 square s 9 6( OWNER'S MAILING ADD ESS P.O. Box 648 " CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is��f:- Filing Fee - i$ 10.00 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 Permit fee $ PLUMBING PERMITFiling Fee 10.00 Colorado788 rhirn 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 9 Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets1 5.00 Building sewer 5.00 Mobile Home JSFG W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities K] Installation[] Other ❑ Describe work: wall, 100 Amp Service, Gas Piping and Wall Heater Permit Fee $Iroo Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS 100 AMP OR LESS 1 10.00 10.007 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 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 IN GOCCUP h) OR ADDNST ( DWEACCLL 2'/20sgft NEW CONSTR ULTI-OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. OCCUP( OR FIXTURES 20950Q eALO 30 FIXED APLN Ex. Occup. OUTLETS P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 1 15.00 lg,OQ Permit Fee $35.00 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. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $16.00 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 consequen a of the granting of this pgrmit. _X_ fy � Date c Signature of Applicant — Owner;?fN Contractor ElAgent ❑ 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 TOTAL FEE $ 66.00 AZ CUA PARK SCHL FED PAR PD HD Iss This permit is hereby issued under the applicable p sions of the Butte County Code and/or resolutions to do work indicated above„for whicQh flies have been paid. DIRECT R OF PUBLIC WORKS F/ .� By �'� ' it��1�,C� Date m Abr ,,, PERMIT EXPIRES Date Receipt No. 8 WHITE-D.P.W.. YELLOW-ASSE330R, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE y 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 Q Q,cn 0 M y//3 - T 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 correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. J Date Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OroOle. California 95965 - Telephone: 916/538-7541 �. •,.., APPLICATION AND PERMIT PERMIT NO. V "qo VV I ASSESSOR PARCEL NUMBER r 5396-004 ZONING AR BUILDING PERMIT OWNER Ha AIL TELEPHONE - SQ. FT. OCC. BUILDING VALUATION 2suars@6 OWNER'S NG A DD ESS P.O. Box 6487 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Pian Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 788 CaInrgrin St-, Chirr) Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each gas water heater or vent 5.00 USE OF STRUCTURE SF[3 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 9 nn Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ® Installation[] Other ❑ Describe work: Npl.g 1� 00 AmpServic e , C;as Piping and Wall Heater Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR 100 AMP ORLESS1 10.00 10,00 Main service EA. ADD'L too 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 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 contrac ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.& OR ADDNS. L ACC. BLDGS. 2h¢sgft NEW CON5TR ULT' -OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occu p OUTLETS OR FIXTURES 20 @30 eAL FIXED APLNS. Ex. DCCUp. OUTLETS P(RESID )REA.) 1 2.00 Temporary service 1 10.00 Home Facilities Mobile Hot- X5.00 Misc. 9 15.00 15.00 Permit Fee $35.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department 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 FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue paainst id County in co s quen of the granting of this permit. Date �/� f of Applicant — Owner Contractor ❑ Agent 1:1 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 ALL TOTAL FEE $ 66,00 HAz CUA PARK Fro PAR Po Ho Issu This permit is hereby issued under the applicabvisions of the Butte County Code and/or resolutions to do work in ated above for which f s have been paid. DI T OF PU WORKS 5. B _Dat PERMIT EXPIRES Date / Receipt No. 84308 WHITE-D.P.W., YELLOW -ASSESSOR. PINK•INSPECTOR, GOLDENROD=APPLICANT .- COUNTY OF BUTTE - DEPARTME,NT�,OF PUBLIC WORKS= BUILDING DIVISION ��: -" 7 COUNTY CENTER DRIVE - OROVIL�LE�,. CALIFORNIA 95965- TELEPHONE: 916/538-7541 PERMIT APPL;ICA,TION DATA SHEET L Permit No. OV NER 6 !`/1//f/ r�/7' Z— A. P. o. l Proposed Building Use�:Z el" Building Inspector . Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: ti A ',/ DATE RECEIVED APPROVED ✓ 1. All items have been submitted. ..: .............................. 2. Plot plans in duplicate/triplicate, sighbd 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 -_ inst ............ 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 (seeNCity for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... j. 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) I Pre-Inspec. request to 20. Pre -Inspection for required ... 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 ......... " 5. Letter of signature authorizat. ............ ..................... . 2 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 Copy of plans sent Health Dept., Fire Dept., Other Date 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 —mal l—counter by date Plans checked by Date Plans approved by Sets of plans on hold in File cabinet AP folder Copy—DPW Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Califbrnia 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT ASSESSOR P RCEL NU$-� r =��`�/% ZON1 BUILDING PERMIT — OWNER ✓ V TE EPN/ON E SO. FT. ACC. BUILDING VALUATION OWNER' AI_ING ADORES,S CONTCT ;S N _NF --� TELEPHONE CONTRACTORS MATLING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ _ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT CR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT ZR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDI A RE Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 1 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 USE OF STRUCTURE SF/)< Dup'.ex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets5.00 Building sewer 5.00 Mobile Home S I G W 10.00e TYPE OF WORK New❑ Addition❑ Remodel❑ Utilitie� Installation Other[] Other[]Permit Describe work: /�� � %l /yl S �/� , CO%f Q%a/G A-yZJ Ofj-LL A/772-- Fee Contractor $ ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS a 10.00 V CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El an licensed under provisions of Chapt. 9, Div. 3 of the BuSlnesS 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- sat:on, 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 ar:t exempt under Sec. , Business and Professions Code for :his reason Main service EA. ADO'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.� OR ADONS. ( ACC. BLOCS. ) , �20sgIt NEW CoNSTR ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup( OR FIXTURES 20050¢ eALO 30 ED APLNS Ex. Occup. ou LETS (PRESTO IREA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g �' 15.00 ad Permit Fee Contractor $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The ?ermit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I s. -,all not employ any person in any manner so as to become subject to :.e 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. I MECHANICAL PERMIT Filing Fee 10.00 Heating t414L 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 c:nstruction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree .o 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. Signature of A;plicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA pernit 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 TOTAL FEE $ `? V HAz I CUA PARK I SCHL I FLo I PAR PTD ISSUE Th;s permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By OCOl/tT CVCIIOCC rl...,. the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. O ,• 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) 611,,91 �2. I (have/have not) signed an application 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. 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 Ole- Social Sec Num r — - 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. - 4 PRE -INSPECTION r WNER: N� �-- / %2�v(/ DATE .. LOCATION.' .. .. . CONTRACTOR:. GlJ.!/ �j�� ZONING_��% PRE -INSPECTION FOR: DATE TO INSPECTOR ------------------- PERMIT HISTORY: NONE AS FOLLOWS: t • a 1 TYPE OF OCCUPANCY FIELD - INFORMATION BUILDING USAGE: TENNANT : OCCUPIED ] HAS ELECTRIC HAS GAS M HAS SANITATION FACILITIES Q HEATED -COOLED �l PERSON CONTACTED11 OTHER COMMENTS: h z/, Le 2' /'l AP s owe- - Gr `i a 4 ACTION RECOMMENDED: ISSUE C] HOLD FOR OTHER: �a, /�� o a . � /7 r c u�.• e Q 0 r10, T r ;�SC/i•r'ig� LSiG�p�BNG—PS /i�/^" �!�/7frirJ�' �(0G. T 1 BY / i, ��y% ', DATE / �2 , /lC� •..,a-.....- -�,... <.., ....•..-'--v..r.:nrv..r�.vn...s �>xs!,.;., ,Y:f9'WS ?%fi 3Y4'114 �: �%. _ ;M�j•�'L.'. av ..'3e:s+ar•' . :,SN, t.r, • , � $• }:ba�p;bdS. RibtlN� ..« _ '�sy a4ij'�.;'t . l�3K�'�" w 005-39—"04, g s 00-2263 ' DAVENPORT, CECILIA 788 COLORADO STREET, CHICO r CONTR: OWNER •. WATER HEATER; GAS LINE' (1�%0.i—�UM^�-c;t � �.. Lel ,�A , i i � q r - -71 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530)'538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT C . ASSESSOR PARCEL NUMBER 109 ZONING BUILDING PERMIT OWNER I ` TE HONE , / ? 3 T SO. FT. OCC. BUILDIN/G� VALUATION < I S e-, W9 'o U - - OWNERS ILINO D S Cai CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 5� y 0. ARCHITECT OR ENGINEER LICENSE NO. Filing F $ 20.00 Permit Fee $ a- l ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESSf " n 8 C, n ( G- l Energy Plan Checking Fee $ .� C, f$ PERMIT FEE $ 4I LAT NO. SUBDN`jS.IO SNAME \_ Qti, PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 1 USEOFSTRUCTURE SFX Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 C TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other A. .�� 1C Describe Work: (,�_1n. ' 1 �k.( (t.ly �J 2 G' / V _ Gas piping system 1 - 5 outlets t 15.00 t; 1&6 - Building sewer 15.00 Mobile Home S G W @ 20.00 PERMIT FEE l I� 1 i ` lir./ ELECTRICAL PERMIT Fling Fee 20.00 0V OR LE Main Service 200.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 thet't 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 structuiie is not intended or offered for sale. 13100"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 200A TO 1000A 46.00 NEW CONST. DWELLING UP,, ORAD NS. ( t SO 3.5¢FT: MunoTcousLn�S. NO REBID. 97.50 POWER APPARATUS a SINGLE OUrLET CIR. Ex. OCCu OUTLET OR FIXTURES 200 .00 BAL O 150 FIXED APPLNS. OR Ex. Occu . DUTLEIS RAID• EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ 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. ❑ I 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 Policy Number (The above sections need not be completed if the permit is for work of a valuation hof one hundred dollars ($100) or less.) 9/1 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 'visions of section 3700 of the Labor Code, I shall fo with Com I it� th provisions: Wi X /_.�/ Date I0� Signature 'ofLAp6,r1cd'nt%6A5rOw,ner ❑ Contractor ❑ Agent I An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating t� J u Cooling Hood 6.50 Ventilation PERMIT FEI= $ ��j • } Mobile Home Installation Fee $ Energy Inspection Fee $ OCC �� CONST. TYPE TOTAL FEE $ ' `�� �1L) HA . D. FE IMP FLOOD �.. CDF ., PARCEL ... PD HD _ ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have / By,_ f PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date �' " -J Date Receipt No. �(} % f;/'�j'� �` Q. &J WHITE-D.D.S.-S.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION :7 Co4nty Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 ,y/,� PE MIT NO (Rev. 12/96) APPLICATION AND PERMIT C ASSESSOR PARCEL NUMBER no - 3n- Cao ZONING BUILDING PERMIT \ OWNER TELEPHONE 3 5 SQ. FT. OCC. BUILDING VALUATION 0 .OWNER'S (LING /VSD CONTRACTOR'S NAME R ' NE CONTRACTORS MAILING ADDRESS -O 0_0 .! CONSTRUCTION LENDER LENDER'S MAILING ADDRESS i" ��I li `� ,../ ' ARCHITECT OR ENGINEER {� p1 -' _ LICENSE NO. v - Fireplace Total Valuation $ Filing Fee $ 20.00 Permit Fee $ 2 - ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checkin Fee Plan $ BUILDING ADDRESS �$a Energy Plan Checking Fee $ $ PERMIT FEE $ .O() LAT NO. PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities he �,,❑,, Installation 13 Other Describe Work: L,L_)AA KkQl � Qaeo A/� — Gas piping system 1 - 5 outlets 15.00 5� 6 Buildingsewer 15.00 Mobile Home S G W @20.00 PERMIT FEE cay ELECTRICAL PERMIT Fling Fee 20.00 Main Service '..*A RR 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.POWER 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, mill do the work, and the structure is not intended or offered for sale. 31-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 TO 46.00SO CCU000A WEE200A NEW caN57. DWELLING occuP. OR ( ACC.BLDSr 3.5ttF°; cONS. M NO RESI.. cu @7.50 APPARATUs a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 200 1.00 BAL @ .so Ex. Occup. ouXn s PIP AID.°E 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 15-01> Cooling Hood 6.50 Ventilation PERMIT FEE S OD Policy Number (The above sections need not be completed if the permit is for work of a valuation �f one hundred dollars ($100) or less.) 91 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 f I should become subject to the workers' compensation 1Xovisions of section 3700 of the Labor Code, I shall fort ith com th provisions. X Date_� Do Signature of nt 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 $ cc corer. TYPE TOTAL FEE $ 9 -AT D. FE IMP FLOOD CDF PARCEL PO .--- HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate above for which fees have been paid. 11,9 By Date EllU PERMIT EXPIRES ON iF_1!!V Date Receipt No. Jm . (JJ WHITE-D.D.S.-B.O. CANA V -AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT