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HomeMy WebLinkAbout005-434-010-- OX COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AI�D'PERMIT APPLICATION .�,J 1 PERMIT NO. I � ` ASSESSOR PARCEL NUMBER • �`'aY — ��/ ZONING 1 BUILDING PERMIT.,, OWNER . \) TwEfLEPHONEE SQ. FT. OCC. BUICDING VALUATION OWNE/R._SM/AIILING ADDRESS_. CO,NTRACTOR'5 NAME TELEPHONE. CONTRACTOR'S)) MAILING ADD'RE'SS/��• -r`� rIPePireplace CONSTRUCTION -LENDER. �1 UNKNOWN Total Valuation $ ' Filing Fee $ 10.00 NG ADDRESS LENDER'S MAILING Permit Fee $ ARCHITECT OR"�NEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT ENGINEER'S MAILING ADDRESS Penalty $, BUILDING ADDRESS Permit fee $ 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 SA Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home. S I G I IN 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation -0 `Other. ❑ Describe work: Permit Fee $ /raj r Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 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 BUsines$ and Professions Code and my license is in full force and effect. License No. 3� 7�r4, Classification iii ❑ 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.d) +/zQsgft OR ADONS. l ACC. BLDGS. NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea /POWER APPARATUS d1 (SINGLE OUTLET CIR. I 20 0 600 Ex. Occup(OUTLETS OR FIXTURES SAL@30 Ex. OCCUp. OUTLETS (RESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ® I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation perml4 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 f the granting of this permit. . _ /3 , 16A X - zr>� – Date 1 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. t Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ �/ �� OcCUP. CONST.TYPE ISCHOOLIFLOO131I.CELI PD ND ISSUE This permit is hereby issued under :ions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY 1l 1,Z°'"'v ' J PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. i� ' WHITE-O.P.W., YELLOW -ASSESSOR, 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 -ARCEL�{UMBER z 2 ZONING - BUILDING PERMIT OWN R_ T NE SQ. FT. OCC. BUILDING VALUATION OWN5FV,S MAILING ADDRESS c '•C TR A CT'O.R'S N ME TELEPHONE - CON RACTOR A LING ADD S C r fireplace C NS -RUC I LENER UNKNOWN Total Valuation Is Flling Feb $ 10 00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT ENGINE'.ER LICENSE NO. Plan Checking Fee $ Energy.Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS _ Permit fee $ PLUMBING PERMIT FiIingFee 10.00 G 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 S� Duplex❑ Mobitehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W O.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V 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 a d my license is in full force and effect. License No. �11 161 Classification (3 - �- ❑Ex. 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 OCCUP.ai) NEW CONST. ( DWELLING OR ADDNS. ACC. BLDGS. I yzQsgft NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS h (SINGLE OUTLET CIR. Ex. Occup(O OR FIXTURES 20@9 30 DAL030 IXEDTS Occup. OUTLETS P(RESID )RE A.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating ` Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot 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 sai ount n consequ .ce f the granting of this permit. ,- !3 _ t1? X - Datey Signature of Applicant — Owner ElContractor� Agent F1work An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures ove�r-3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ , OCCUP. CONST.TYPE SCHOOL vLOoo PARCEL PD HD S9UE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do indicated above for which fees have been paid. R 0 OF PUBLIC WORKS G/ BY Date �3 � PPIR S Date Receipt No.,& / WHITE-D.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. GOLD ENROD-APPLICAMT