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BUTTE COUNTY INTERDEPARTMENTAL CORRESPONDENCE
DELIVER TO LAST PERSON NAMED
DATE I NAME I DEPT. 11 DATE I NAME I DEPT.
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COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS,3�/�3 E _%--�_
7 County Center Drive - Oroville, California 95965
Telephone: 533-1230, Ext. 259
APPLICATION.AND PERMIT r
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BUILDING
Owner7� , ^-^ �� t
SQ. FT. OCC. BUILDING VALUATION
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Mailin Address Q �.
I -c" h
Fireplace
Contractor 7 �' a
Total Valuation
Mailing Address-
Permit Fee
Plan Checking Fee &/or Penalty
•
Permit Fee
Building Addre s=/C- w
'�f
PLUMBING No.1 @ FEE
PERMIT FILING FEE $2.00)vt✓
,
/1 �,/ ��, / a /�,, ,
Each Trap 1.�0
_ r `� �Y r t
l
Repair drainage or vent piping 1.50
Water piping 1.5�, .i
Each gas water heater or vent 1.50
A. P. No:,(�._ /
Zoni g -Z
Gas piping system 1 - 5 outlets 1.5Q, J
additional outlet , .50
Fire Zone
.001/Each
'
Fire Dept. �—-.Saad
a io r%
Planning
se e
Building r.Z` ,,
,,, 5,00' R r
Plans
�-
Fees
Wt,C.
-
R/W
—
Encroachment
Lawn sprinkler system 2.00
NEW ❑ ADDITION 1:17 OTHER ❑
Permit Fee
�� "•��
ELECTRICAL No. @ FEE
PERMIT FI4ING FEE $3. 0
Main service incl. 1 meter >
Additional meters, each 1._66
USE OF STRUCTURE Single Family,❑ Duplex ❑ Others ❑
Sub -panel (92 or less) (more than 12)
Range, dryer or water heater 1.00
Oven, Cook -top or space heater 1.00
Light fixtures bo I VU
Receps., switches & fix outlets 20 25
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:
Hood, Ex. Fan or F.A. Furn. Motor 1.00
Evap. cooler, gar, disp. or D.W. 1.00
Air conditioner or heat pump
Water pump `) W. SG
Misc. wiring) '6
License No. Classification
O I am exempt from the Contractors License Laws of the State of California.
v
Permit Fee
WORKMEN'S COMPENSATION INSURANCE
I 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.
El I certify that in the performance of the work for which this
i/ 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
-
Permit Fee
I certifythat I have read this application and state that the above
pp
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
ahnvc_,.,or,r�n., o.r ., �. f—
State Fee for srr�rg Motion $0.07/$1000 Evaluation
Instrumentation rogram
TOTAL PERMIT FEE 7
e•�
$_ l
This permit is hereby issued under the applicable provisions
of
-01
"Date
Signature of Permitee or Agent
i
Receipt No. / _� �_ _
White-D.P.W. — Pink-Inspec or _ Goldenrod -Assessor — Yellow -Applicant
the tsutte county code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
13 y�./�e�Yi Date�Z�7Z
v Building Permit Expires Date, �'�
OUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORK
7 County Center Drive — Orovi Ile, California 95965
Telephone: 533-1230, Ext. 259
APPLICATION AND PERMIT
Cqi**�am exempt from the Contractors License Laws of the State of Cali fomia.
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section 3700 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.
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.
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 prop for inspect' purposes.
Date
Signature Permi ee or Agent
Receipt No.
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
Permit Fee ,
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heatino
Cooling
Ventilation
Permit Fee $ $
$$tate Fee for StrD ng Motion 0:07/$1000 Evaluation
In siru men t ation Program $ $
TOTAL PERMIT FEE ,s
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 % �' 7
Building Permit Expires Date/ 7� _
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address ~
7" (O
Fireplace
Contractor
Total Valuation
Mai I i ng Address
Permit Fee
Plan Checking Fee &/or Penalty
Permit Fee $
$
Building Address
s49-11
0 0
PLUMBING No. @ FEE
PERMIT FILING FEE $2.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50 ,
Each gas water heater or vent 1.50
A. P. No.r- Zoning —�
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .50
Fire Zone
Fire Dept.PIa ng
ding sewer ' 5.00
Plans
Fees �
W. C.
R/W
Encroachment
Lawn sprinkler system 2.00
;
NEW ❑ ADDITION OTHER ❑
Permit Fee $
$ ,
c
ELECTRICAL No. @ FEE
PERMIT FILING FEE $100
Main service incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
USE OF STRUCTURE Single Family Duplex ❑ Others ❑
Range, dryer or water heater 1.00
Oven, Cook -top or space heater 1.00
Light fixtures
Fig
Receps., switches & fix outlets
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:
Hood, Ex. Fan or F.A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump ,
Misc. wiring ro
Licen a No. Classification
Cqi**�am exempt from the Contractors License Laws of the State of Cali fomia.
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section 3700 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.
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.
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 prop for inspect' purposes.
Date
Signature Permi ee or Agent
Receipt No.
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
Permit Fee ,
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heatino
Cooling
Ventilation
Permit Fee $ $
$$tate Fee for StrD ng Motion 0:07/$1000 Evaluation
In siru men t ation Program $ $
TOTAL PERMIT FEE ,s
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 % �' 7
Building Permit Expires Date/ 7� _